CARDIOVASCULAR SYSTEM

A view from histological aspect

Fakultas Kedokteran Universitas Warmadewa

 Introduction Cardiovascular System Blood vessel Heart Lymphatic vascular System Lymphatic vessel

 Circulatory system Cardiovascular system

to carry the blood in both directions between heart and the tissue

Lymphatic vascular system

to collect the lymph

o

The excess extra cellular tissue fluid

To deliver it back to cardiovascular system

Circulation
Aorta Medium Arteries Small Arteries (arterioles) Heart Tissue Capillaries Large Veins Medium Veins Small Veins (Venues)

Blood Vessel
3 tunics or layers The tunica intima

The most internal layer

o

a single layer of flattened, squamous endothelial cells the subendotelial loose connective tisue the internal elastic tunic

Blood Vessel
3 tunics or layers

The tunica media

concentric smooth muscle layer, elastic fibers, type III collagen fibers and proteoglycan external elastic lamina
o

more delicate than the internal elastic lamina separates the tunica media from overlying tunica adventisia

Blood Vessel
3 tunics or layers

Tunica Adventisia

covers the outside surface of blood vessel type I collagen fibers vasa vasorum
o

the small arteries that enter the vessel walls to give the nutrient for the wall of blood vessel

Blood Vessel
Artery
efferent

vessels into 3 types

transport blood away from the heart to the capillary bed

classified

Large artery (elastic artery/ conducting arteries) Medium artery (muscular artery / distributing artery) Small artery (arterioles) and met arterioles

Blood Vessel
Large artery (elastic artery/ conducting

arteries)
o o o o o

aorta inominate artery carotic communis artery subclavian artery iliac artery

Blood Vessel
Large artery (elastic

artery/ conducting arteries)

The tunica intima

contains an endothelium supported by the narrow layer of underlying connective tissue

The internal elastic lamina

Thin laminae of elastic fiber consists of many fenestrated lamellae of elastin fibers a few amount of smooth muscle The external elastic laminae

The tunica media

Blood Vessel
Large artery (elastic

artery / conducting arteries)

Tunica adventisia

relatively thin, composed of loose fibroelastic connective tissue Vasa Vasorum

o

the small blood vessel located in the vessel wall of large or medium artery functions in supplying the nutrient and oxygen to that tissue

Blood Vessel
The function of

large artery

to drainage the blood to the medium artery to keep the systolic pressure in the constan condition to avoid the fluctuation of blood flow

Large Artery

Blood Vessel
Medium artery

brachialis artery ulnar artery femoral artery poplitea artery coronary artery umbilical artery arteries located in the brain

Blood Vessel
Medium artery

The tunica intima

thinner than in the elastic arteries

The internal elastic laminae

Prominent displays an undulating surface composed predominantly of smooth muscle cells

The tunica media

Blood Vessel
Medium artery

The external elastic lamina

identifiable in histological sections as several layers of thin elastic sheets elastic fibers collagen fibers a ground substance
o

The tunica adventisia

composed mostly of dermatan sulfate and heparan sulfate.

Blood Vessel
The function of

medium artery

is to distribute the blood to the target organ or tissue

Muscular Artery

The differences between Large and Medium Artery

Blood Vessel
Small Artery

Arteriole The endothelium of tunica intima

supported by a thin subendothelium layer

o

consisting of type III collagen and a few elastic fibers embedded in ground substance

Blood Vessel
Small Artery

An internal elastic lamina

present in small arteriole absent in terminal arterioles a single smooth muscle cell layer Scant represented by fibroelastic connective tissue

The tunica media

The tunica adventisia

Blood Vessel
Small Artery

one component of microvascular sistem

arteriole, metarteriole, capillary and venule

vasoconstriction of arteriole will increase the peripheral resistency

resulting in the increasing of systemic blood pressure

Blood Vessel
Met arteriole

An artery that supply blood to capillary beds The smooth muscle layer is not continuous but spaced apart

It is thought that this arrangement permits these smooth muscle cells to function as a sphincter upon contraction
o

controlling blood flow into the capillary bed

Blood Vessel
Nerve supply to vessel Sympathetic and parasympathetic

Sympathetic adrenalin vasoconstriction parasympathetic acetylcholine vasodilatation

Blood Vessel
Capillary The smallest blood vessels arising from the terminal ends of the arterioles capillary bed (network) between the arterioles and venules

Blood Vessel
Capillary 7-12 micrometer formed by a single layer of squamous endothelial cells

known as endothel

lined by basal membrane Pericytes

The cells located along the outside of the capillaries and small venules cells are flatenned in shape and contain tropomyosin isomyosin and protein kinase
o

all related to contraction that regulate the blood flow

Blood Vessel
Capillary There are 3 types of capillary

Continuous capillaries
o

have no interruptions (pore or fenestrated) in their wall present in the muscle, nervous and connective tissues have pore or fenestrae in their wall present in the pancreas, intestines, endocrine and kidney

Fenestrated capillaries
o

Blood Vessel
Capillary There are 3 type of capillary

Sinusoidal capilaries
o o

known as sinusoids have irregular shape which conform to the shape of the structure in which they are located found in the hemopoeitic tissue such as bone marrow and spleen, liver, cortex of adrenal and adenohipophysis

Blood Vessel
Veins 3 types

Medium veins
o

similar to medium artery but has no external elastic lamina many medium veins have valves composed of two leaflets a thin fold of the intima jutting out from the wall into the lumen function to prevent the back flow of blood The tunica intima of large vein is similar to medium vein except the large veins have a thick subendothelial connective tissue layer

Large veins
o

Blood Vessel
Arteriovenous anastomoses Terminal of most arteries end in capillary beds

which deliver their blood to venules for the return back to the venous side of the cardiovascular system

In many part of our body, however the artery simply joins with a venous channel forming an arteriovenous anastomoses (AVA)

useful in thermoregulation found abundant in the skin innervated with adrenergc and cholinergic nerves.

Lymphatic Vascular System

a series of vessels remove excess tissue fluid (lymph) from the interstitial tissue spaces return it to the cardiovascular system

Lympahtic vessel are found throughout the body

except in

the central nervous system and few other ares including cartilage, bone, bone marrow, thymus, teeth, internal ear and placenta.

Lymphatic Vascular System

an open system no pump and no circulation of fluid begins in the tissue of the

body

as blind ended lymphatic capillaries

The excess fluid in the

extracelluar space enters the lymphatic capillaries

Lymphatic Vascular System

The lymphatic capillaries empty their contents into

lymphatic vessels

which empty into successively larger vessels until one of the two lymphatic duct is reached

Right lymphatic duct

o

collects lymph from the upper right quadrant of body empties its contents into the venous system at the junction of right internal jugular and subclavian vein collect lymph from the remainder of the body empties its contents at the junction of the left internal jugular and subclavian veins

Thoracic duct
o o

Lymphatic Vascular System

Lymphatic Vascular

System

The lymphatic capillaries

composed of a single layer of endothelial cells with an incomplete basal lamina

The small and medium lymphatic vessels

characterized by closely space valves

Blood Vessel
Lymphatic Vascular System Large lymphatic vessels resemble small vein structurally, except

their lumen are larger and their wall thinner The smooth muscles in the tunica media are arranged in the irregular manner

HEART
the pump for the cardiovascular

system Its muscular wall (myocardium)

composed of cardiac muscle

The heart consists of four

chambers

two atria which receive the blood two ventricles which discharge blood from the heart

HEART
The wall of heart is

composed by 3 layers

endocardium that lining the heart lumen and direct contact to the blood myocardium, located in the middle part that contains the the cardiac muscle cells epicardium, also called as visceral layer of pericardium that covers the myocardium

HEART
Endocardium continuous with the tunica intima of the blood vessel entering and leaving the heart contains

An endothelium composed of simple squamous epithelium Subendothelium which contains the collagenous and elastic fibers

HEART
Endocardium Subendocardium

consists of loose connective tissue The subendocardium of ventricle and interventricular septum contain the Purkinje fibers
o

the modified myocardium that functions in nerve conducting system

absent in the papilaris muscle and corda tendinae.

HEART
Myocardium contains the cardiac muscle cells

separate cellular units uni\nucleate characterized by rhythmic, involuntary contractions controlled by autonomic innervation

HEART
Myocardium The cardiac muscle cells have 3 specialized properties

contraction endocrine secretion

o o

atrial wall and in the interventricular septum secreted peptides atriopeptin, atrial natriuretic polypeptide, cardiodilatin and cardionatrin released into the surrounding capillaries aid fluid maintenance and electrolyte balance and decreased blood pressure

impulse generation or impulse conduction

HEART
Myocardium The cardiac muscle cells have 3 specialized properties

impulse generation or impulse conduction

o

The heart rate is controlled by the sinoatrial node a pacemaker located at the junction of the superior vena cava and the right atrium These specialized nodal cardiac muscle cells can spontaneously create an impulse spreads over the atrial chamber wall by internodal pathways

HEART
impulse generation or impulse conduction
SA Node AV Node (septal wall) Atrioventricular bundle (bundle of His, interventricular septum) Purkinje fibers (Subendocardium of right and left ventricle) Cardiac muscle

HEART
EPICARDIUM visceral layer of the pericardium composed of a simple squamous epithelium The subepicardial layer of loose connective tissue

the coronary vessels, nerves and ganglia and an adipose tissue

HEART
EPICARDIUM

At the roots of the vessels entering and leaving the heart

the visceral pericardium becomes continuous with the serous layer of the parietal pericardium

The two layers of the pericardium enclose the pericardial cavity

a space containing a small amount of serous fluid for lubricating the serous layer of the pericardium and the visceral pericardium

HEART
Cardiac skeleton a structure that provide the structural framework for heart and attachment sites for cardiac muscle and cardiac valve composed of dense connective tissue three main components

septum membranaceum
o

constituting the upper portion of the interventricular septum, the atrioventricular foramina and atrial foramina.
constituting some of cuspal area of the aortic valve formed around the base of the aorta, pulmonary artery, and atrioventricular orifices.

trigonum fibrosum
o

annuli fibrosi
o

HEART
The cardiac valve a leaf like structure made by dense connective tissue that is attached to the annuli fibrosi 4 cardiac valves

Mitral or bicuspid valve

o o

2 leafs located between left atrium and left ventricle

Tricuspid valve
o o

3 leafs located between right atrium and right ventricle

HEART
The cardiac valve 4 cardiac valves

The semilunar aortic valve

o o

3 leafs located between aorta and left ventricle 3 leafs located between pulmonal and right ventricle

The semilunar pulmonal valve

o o

HEART
The cardiac valve The surface of cardiac valve is continuation of atrial and ventricle endocardium The edge of cardiac valve contains the corda tendinae

a fiber like structure composed by collagen fibers

The atrioventricular valve contains the small blood vessel, but the semilunar valves are avascular