Cutaneous (Skin)

circulation

Dr. Chhaya Saraf

Learning Issues

Characteristic features
Triple response
Role in temperature regulation
Factors regulating cutaneous
circulation
General responses changing the
color of skin

Cutaneous (Skin)
circulation

Characteristics
Well innervated anastomotic
connections between arterioles &
venules specially hands & fingers
Vary with thermoregulation
Heat stress mainly increases blood
flow through A -V anastomoses of
hands & feet
Low metabolism

Characteristics.
Subdermal capillaries & venous
plexuses are special reservoirs
Alterations in blood flow can be
observed visually
Thick muscular layer
Rich nerve supply
Mainly under SNS control

Heat Exchange in the

Skin

Nervous control
Noradrenergic nerves, circulating epinephrine &
nor epinephrine VC
VD is due to
Reduction in VC activity
Local bradykinin in sweat glands
Local VD metabolites

VC activity is modified by
Hypothalamic response to temperature
variation
Stimulation by temperature receptors through
lateral spinothalamic tract

General responses & Color

changes in skin
Fiery red color in reactive hyperemia
Re establishment of circulation
after a period of occlusion
Hypoxia dilates arterioles
Pale /cold skin Arterioles are
constricted in shock
Warm, red skin Both are dilated
Rudy complexion in cold VD
Emotional factors via
corticohypothalamic (SNS) fibers
produces
Blanching of skin e.g. pale with fear
Blushing by anger / embarrassment

Triple response
Skin is stroked with blunt object
White reaction Constriction of precapillary sphincter
Skin stroked more firmly with pointed object
Red reaction redness at the site appears in
about 10 second due to capillary dilation.
Wheal local edema due to increased
permeability of capillaries.
Flare redness spread out from injury due to arteriolar dilation

Triple response mechanism

Red reaction
Dilatation of precapillary sphincter due to direct response of
capillaries to pressure
No role of nerves so no effect of anesthesia

Wheal
Increased capillary permeability by histamine / sub.P
Increased capillary pressure due to dilatation of precapillary
sphincter

Flare
Dilatation of arteriole, precapillary sphincters by axon reflex
Increased local blood flow increases local temperature
Abolished by local anesthesia

Axon
reflex
Flare is
due to
antidromic
conduction
in
sensory
nerve
branches

Study material
Guyton Chapter 73
Ganong 21st edition chap. 32

Thanks