CARDIOVASCULAR SYSTEM A view from histological aspect All images in this document is removed due to copyright restriction Ahmad Aulia Jusuf, MD, PhD Depart

CARDIOVASCULAR SYSTEMA view from histological aspect

All images in this document is removed due to copyright restriction

Ahmad Aulia Jusuf, MD, PhD

Depart of Histology

Faculty Medicine University of Indonesia

2009

Tuesday, February 03, 2009

AAJ/Histological Aspect of Cardiovascular System 2

Agenda

IntroductionCardiovascular System

Blood vessel Heart

Lymphatic vascular System Lymphatic vessel



Introduction Circulatory system

Cardiovascular system to carry the blood in both

directions between heart and the tissue

Lymphatic vascular system

to collect the lympho 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 layersThe tunica intima

The most internal layer

o a single layer of flattened, squamous endothelial cells

o the subendotelial loose connective tisue

o 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

The external elastic lamina

o more delicate than the internal elastic lamina

o separates the tunica media from overlying tunica adventisia



Blood Vessel

3 tunics or layers Tunica Adventisia

covers the outside surface of blood vessel

composed of type I collagen fibers

vasa vasorumo the small arteries that enter

the vessel walls to give the nutrient for

the wall of blood vessel



Blood Vessel

Arteryefferent vessels

transport blood away from the heart to the capillary bed

can be classify into 3 types Large artery (elastic artery/ conducting arteries) Medium artery (muscular artery / distributing

artery) Small artery (arterioles) Met arterioles



Blood Vessel

Large artery (elastic artery/ conducting arteries)

o aortao inominate arteryo carotic communis arteryo subclavian arteryo 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 The tunica media

consists of many fenestrated lamellae of elastin fibers

a few amount of smooth muscle The external elastic laminae



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 The tunica media

composed predominantly of smooth muscle cells



Blood Vessel

Medium artery The external elastic

lamina identifiable in

histological sections as several layers of thin elastic sheets

The tunica adventisia elastic fibers collagen fibers a ground substance

o 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 The tunica media

a single smooth muscle cell layer

The tunica adventisia Scant represented by fibroelastic

connective tissue



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




There are 3 types of capillary

Continuous capillarieso have no interruptions

(pore or fenestrated) in their wall

o present in the muscle, nervous and connective tissues

Fenestrated capillarieso have pore or fenestrae in

their wallo present in the pancreas,

intestines, endocrine and kidney




There are 3 type of capillary Sinusoidal capilaries

o known as sinusoidso have irregular shape which

conform to the shape of the structure in which they are located

o found in the hemopoeitic tissue such as bone marrow and spleen, liver, cortex of adrenal and adenohipophysis



Blood Vessel Veins

afferent vessel collect and transport the blood

back to the heart

3 types Small vein

o The shape of small venule is irregular

o Tunica intima of venule is lined by a single flattened cells known as endothelial cells



Blood Vessel

Veins 3 types

Medium veinso similar to medium artery

but has no external elastic laminao 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 Large veins

o The tunica intima of large vein is similar to medium vein except the large veins have a thick subendothelial connective tissue layer



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 bodyo empties its contents into the venous system at the junction of right

internal jugular and subclavian vein Thoracic duct

o collect lymph from the remainder of the bodyo empties its contents at the junction of the left internal jugular and

subclavian veins



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 fiberso 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 atrial wall and in the interventricular septum o 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

o a pacemaker located at the junction of the superior vena cava and the right atrium

o 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 membranaceumo constituting the upper portion of the interventricular septum, the

atrioventricular foramina and atrial foramina. trigonum fibrosum

o constituting some of cuspal area of the aortic valve annuli fibrosi

o formed around the base of the aorta, pulmonary artery, and atrioventricular orifices.



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 2 leafso located between left atrium and

left ventricle Tricuspid valve

o 3 leafs o located between right atrium and

right ventricle



HEART

The cardiac valve 4 cardiac valves

The semilunar aortic valve o 3 leafs o located between aorta and left

ventricle The semilunar pulmonal valve

o 3 leafs o located between pulmonal and

right ventricle



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



Documents

CARDIOVASCULAR SYSTEM A view from histological aspect All images in this document is removed due to copyright restriction Ahmad Aulia Jusuf, MD, PhD Depart