Respiratory

Anatomy-Histology Correlate

By: Michael Lu, Class of ‘07

 NOTE:
- Visceral pleura is in direct contact with
the lungs, while parietal pleura is
everything else.
- 4 sections of parietal pleura: cupola,
costal, diaphragmatic, and mediastinal.
- Surface projections of parietal pleura:
Landmark Inferior border of lung Pleural reflection
Midclavicular 6th rib 8th rib
Midaxillary 8th rib 10th rib
Scapular 10th rib 12th rib

- Potential spaces of the costomediastinal

and costodiaphragmatic recesses, where
there is no lung tissue.
- The right lung contains 3 lobes –
superior, middle, and inferior – separated
by horizontal and oblique fissures.
- The left lung only contains superior and
inferior lobes. In addition, the cardiac
notch is an indent in the superior lobe,
forming the lingula that wraps around the
apex of the heart.
- Review the locations of the great vessels –
aorta, pulmonary trunk, pulmonary arteries
and veins, superior and inferior vena cava,
azygos vein, thoracic duct, etc.
- With the lungs removed, we see a better
view of the mediastinum. Notice on both
sides the phrenic nerves passing anterior
to the root of the lungs, vagus nerves
passing posterior, and the sympathetic
trunk running along the vertebrae. In the
thorax, the sympathetic trunk gives off both
white and grey rami communicantes
posteriorly and the greater splanchnic
nerve anteriorly.
- Note the left vagus nerve giving off the
recurrent laryngeal nerve wrapping under
the aortic arch. The arch of the aorta is also
attached to the left pulmonary artery via the
ligamentum arteriosum.
- Note on the right side the azygos vein
running posteriorly and draining into the
vena cava.
- Note on the left side the thoracic duct
that drains all the lymph in the body below
the diaphragm and on the left side above
the diaphragm.
- Note the relative locations of the
pulmonary arteries and veins and bronchi,
and the differences between the right and
left sides. These will be looked more closely
in the next slide.
NOTE:
- The left lung contains 2 lobes – an upper
and a lower lobe – separated by an oblique
fissure. The right lung contains 3 lobes – an
upper, a middle, and a lower lobe –
separated by transverse and oblique
fissures. The corresponding segments are
detailed in the next slide.
- Both lungs have grooves for the
subclavian arteries, brachiocephalic veins,
1st rib, esophagus, and cardiac impression.
The left lung has a groove for the aorta,
while the right lung has one for the azygos
vein.
- Since the apex of the heart is situated left
of midline, the left lung also has a cardiac
notch and lingula that wraps around the
apex.
- The reflection of the parietal pleura
forming the pulmonary ligament.
- On both sides, the bronchus is
posterior and the pulmonary veins are
anterior and inferior.
- On the left side, the pulmonary arteries
are the most superior, even above the
bronchus.
- On the right side, the pulmonary
arteries lie anterior to the bronchus.
 Right lung Left lung

SUPERIOR LOBE

Apical, anterior, and posterior segments Apicoposterior, anterior, superior lingular,

and inferior lingular segments
MIDDLE LOBE

Medial and lateral segments N/A

INFERIOR LOBE

Superior, medial basal, lateral basal, Superior, medial basal, lateral basal,
anterior basal, and posterior basal segments anterior basal, and posterior basal segments
- The respiratory system is divided into the conducting portion and the respiratory portion. The conducting
portion includes the nasal cavities, pharynx, larynx, trachea, and bronchi; the respiratory system starts from the
first branches of the respiratory bronchioles, alveolar ducts, and alveoli. The conducting portion warms, humidifies,
and cleans the air as it passes down to the respiratory portion for actual gas exchange.
- As shown above, the conducting portion is characterized by pseudostratified columnar epithelium with cilia,
goblet cells, gland tissue, and hyaline cartilage. The respiratory portion begins with the first branches of the
respiratory bronchioles; essentially where hyaline cartilage ends and there is abundant smooth muscle, elastic
fibers, reticular fibers, and epithelium transition from cuboidal to simple squamous.
- We will start at the beginning of the respiratory tract
and work our way down.
- Pay attention to the superior, middle, and inferior
nasal conchae and meatuses. The following histology
slides will show the abundance of blood vessels near
the surface to warm the air, and ciliated cells along the
epithelium to clean it. In addition, the conchae and
meatuses create turbulence within the nasal cavity to
slow down the inspired air and to help warm and
humidify it.
- Note the various sinuses and their openings: frontal
sinus, sphenoidal sinus, maxillary sinus, ethmoidal
cells, ethmoidal bulla, semilunar hiatus, frontonasal
duct, and nasolacrimal duct.
- Nasal concha and its mucosa are shown
in the histological slides here.
- The top panel emphasizes the warming
function of the nasal mucosa. The large
number of dilated veins transfer heat from
the blood to the inspired air. This
appearance of thin-walled veins
immediately adjacent to the mucosa is
typical of the nasal walls and cavity.

- The lower panel is a close-up of the nasal

mucosa. Note the respiratory epithelium,
which is mainly composed of
pseudostratified, ciliated columnar
helium with goblet cellsepit. The other
structures include mixed muco-serous
glands, nerves, normal arteries and veins,
and thin-walled dilated veins.
- The goblet cells and glands provide mucus
to humidify the inspired air and trap dust,
particles, and bacteria.
- The ciliated cells beat and help to clear the
nasal cavity of these foreign particles and
mucus and clean the inspired air.
- The olfactory mucosa is located at the
superior part of the nasal cavity. Respiratory
epithelium lines the remainder of the walls
of the nasal cavity.

- Olfactory epithelium:
- thicker than respiratory epithelium
- Bowman’s glands, which are pure
serous glands, are found below the
epithelial surface
- abundant nerve fibers originating
from olfactory receptor cells
converge and give rise to the olfactory
tract, providing the special sense of
smell
- absence of goblet cells
- Respiratory epithelium:
- thinner than olfactory epithelium
- many mucus-secreting glands
- no nerve fibers
- abundance of goblet cells
- After the nose and nasal cavity, the air
travels down the pharynx, which is divided
into the nasopharynx, oropharynx, and
laryngopharynx.
- In the side panel, the pharyngeal mucosa
is detailed – note the non-keratinized
stratified squamous epithelium,
connective tissue, mucous glands, and
underlying elastic layer.
- Note the following: nasal septum, hard
and soft palate, hyoid bone, epiglottis,
thyroid cartilage, cricoid cartilage, vocal
fold, thyroid gland, pharyngeal and
lingual tonsils, pharyngeal constrictor
muscles, and retropharyngeal space.
- The pharynx connects the nasal and oral cavities
superiorly with the larynx and esophagus inferiorly. It
sorts food, water, and air to arrive at their destinations.
- In the pharynx, the paths of food and air cross. Food
travels from the mouth (anterior) to the esophagus
(posterior). Air travels from the choanae (posterior) to
the trachea (anterior).
- The pharynx contains 2 layers of muscles – outer
circular and inner longitudinal.
- The outer circular muscles include the superior,
middle, and inferior pharyngeal constrictor
muscles. One easy landmark to identify them is the tip
of the greater horn of the hyoid bone, to which the
middle pharyngeal constrictor attaches. The 3 muscles
contract serially to push a bolus down the esophagus.
- The inner longitudinal muscles include the
stylopharyngeus, salpingopharyngeus, and
palatopharyngeus muscles, which elevate and widen
the pharynx to accommodate a bolus when swallowing.
- The levator veli palatini and tensor veli palatini (not
shown here) muscles elevate the soft palate to seal off
the nasopharynx when swallowing. The epiglottis
closes off the larynx and trachea.
- The interior fascia is the pharyngobasilar fascia, an
area which does not have any muscle tissue.
- The pharyngeal mucosa is covered by non-
keratinized stratified squamous epithelium, with an
underlying dense layer of elastic tissue (blue brackets).
- The larynx connects the nasopharynx with the
trachea. It specializes in voice production. Note the
abundance of cartilages – 3 paired and 3 unpaired.
- The thyroid cartilage is the largest cartilage but does
not continue posteriorly. Anteriorly, it forms the
laryngeal prominence (Adam’s apple) with the
superior thyroid notch.
- The cricoid cartilage is the only complete ring of
cartilage in the larynx.
- The epiglottis protects the airway when swallowing.
- The 3 paired arytenoid, corniculate, and cuneiform
(not shown here) cartilages participate in voice
production.
- The intrinsic muscles of the larynx play a crucial
role in voice production.
- Cricothyroid muscles – tense the vocal folds to
control pitch.
- Posterior cricoarytenoid muscles – the ONLY
abductors of vocal folds.
- Lateral cricoaryteniod muscles – adduct vocal folds.
- Transverse arytenoid muscle – adducts vocal folds.
- Thyroarytenoid muscles – relaxes vocal folds.
- Vocalis muscles – contraction affects frequency of
vibrations and controls pitch.
- The vagus nerve is the major motor innervation, via
the superior and inferior laryngeal nerves and
recurrent laryngeal nerves.
-The panel on the left shows the relative positions of the true vocal
cords (vocal fold) and false vocal folds (ventricular or
vestibular folds). The panel below shows a magnified view, with
the true vocal cord closer to the cricoid cartilage and the false vocal
fold near the thyroid cartilage.
- The true vocal cords contain underlying skeletal muscle called the
vocalis muscles. Under the false vocal folds, the connective tissue
is filled with glands that secrete mostly mucus.
- The vocal cord is covered by stratified squamous non-
keratinized epithelium.
- The false vocal cord is covered by respiratory epithelium.
- As we continue down the respiratory tract, we enter
the trachea. Shown on the left panel is the trachea and
the major bronchi, which branch into segmental bronchi
and determine the bronchopulmonary segments.
- Histological slides of the trachea are shown below.
The bottom left panel exhibits the characteristic C-
shaped rings of hyaline cartilage (C). The rings are
joined posteriorly by bands of smooth muscle known as
trachealis muscle (T). Tracheal mucosa (M) and some
strands of longitudinal muscle (L) are also shown.
- The trachea is lined with respiratory epithelium
sitting on a thick basement membrane. The elastic layer
contains many longitudinally oriented elastic fibers. The
submucosa contains loose connective tissue and mixed
muco-serous glands.
-Continuing down the respiratory tract, the
trachea bifurcates into two main or primary
bronchi. Within the tracheal bifurcation is a
keel-shaped cartilage known as the carina.
- The right main bronchus is wider, shorter,
and runs more vertically than the left main
bronchus. The left main bronchus is longer
and passes inferior to the arch of the aorta
and anterior to the esophagus and thoracic
aorta.
- The main bronchi later divide into
segmental bronchi. A characteristic
component that allows us to identify bronchi
is the presence of cartilage that appear as
chips and not semi-circular as in the
trachea.
- Bronchi are lined with the pseudostratified
ciliated columnar epithelium (respiratory
epithelium) with glands within the
submucosa.
- Note the presence of bronchial arteries,
which are distinct from pulmonary arteries
and veins. This will be explained in a later
slide.
- The bronchi further separate into
bronchioles. The defining feature of a
bronchiole versus a bronchus is the
absence of cartilage.
- Notice the abundance of smooth muscle
within the bronchiole wall. The epithelium is
frequently folded due to contraction of the
smooth muscle.
- The epithelium goes through a transition
from the pseudostratified ciliated columnar
respiratory epithelium to cuboidal ciliated
epithelium, as shown magnified in the
lower panel.
- The lower panel also compares the
relative size of the bronchiole to a typical
pulmonary artery.
- There are progressively fewer goblet cells.
They are replaced by Clara cells. Within
the magnified inset of the lower panel, the
Clara cells are cuboidal but do not have
cilia. They secrete a more watery substance
than mucus and the fluid continues to
moisten, warm, and clean the air.
- Terminal bronchioles are the smallest and
last branches of the conducting portion and
ciliated respiratory epithelium is replaced by
non-ciliated and ciliated cuboidal cells.
- Terminal bronchioles continue as respiratory
bronchioles, which then open into alveolar ducts and
individual alveoli.
- This is the respiratory portion of the respiratory
system, where the actual gas exchange occurs.
- Note the walls are composed of squamous
epithelium, containing both type I and II pneumocytes.
Type I pneumocytes or alveolar cells are very thin and
provide support to the alveoli. The type II
pneumocytes synthesize and secrete surfactant –
reducing surface tension and allowing the alveoli to
remain open.
- The arrows in the lower right panel indicate
pulmonary macrophages in the alveoli, but not within
the walls.
-There are two different circulations within
the lung.
- The low pressure, high volume
circulation flows to the lungs from the right
heart in order to be oxygenated. The
pulmonary arteries and veins are both
thin-walled vessels in this circulation.
- The high pressure, small volume
circulation provides oxygenated blood
primarily from the left heart and aorta to the
conducting portion of the respiratory
system. It includes the bronchial arteries
that have thicker walls to carry the high
pressure blood flow.

- There are 4 layers that exist between the

blood and inspired air in the blood-air
barrier:
- 1) capillary endothelium (continuous, no
fenestrations)
- 2) fused basal lamina
- 3) alveolar epithelium (type I pneumocyte)
- 4) surfactant
- Note the proximity of the red blood cell to
the inhaled air within the alveoli.
 The Nervous System
➢Structurally : divided into CNS + PNS
CNS: brain + spinal cord
PNS: 12 pairs of cranial nerves
31 pairs of spinal nerves
(8 cervical + 12 thoracic + 5 lumbar +
5 sacral + 1 coccygeal)
➢Functionally : * somatic NS (control
voluntary activities)
* autonomic NS (control
involuntary activities)
 Central
nervous Peripheral nervous
system (CNS) system (PNS)
Brain Cranial
Spinal cord nerves

Ganglia
outside
CNS
Spinal
nerves

Figure 48.19
1 coccygeal
 • The cerebral cortex controls voluntary
movement and cognitive functions
• Each side of the cerebral cortex has four
lobes
– Frontal, parietal, temporal, and occipital
Frontal lobe Parietal lobe

Somatosensory
Speech
Frontal association
association area
area Taste

Reading
Speech
Hearing
Visual
Smell association
Auditory area
association
area
Vision

Figure 48.27 Temporal lobe Occipital lobe

 The Central Nervous System
The central nervous system consists of:-
1- the cerebrum
2- cerebellum
3- spinal cord
* It has almost no connective tissue and is therefore a
relatively soft, gel-like organ.
• When sectioned, the cerebrum, cerebellum, and spinal
cord show regions that are white (white matter) and
that are gray (gray matter).
• The differential distribution of myelin in the central
nervous system is responsible for these differences:
• The main component of white matter is myelinated
axons and the myelin-producing oligodendrocytes.
White matter does not contain neuronal cell bodies.
 Gray matter
contains neuronal cell bodies, dendrites, and the
initial unmyelinated portions of axons and glial
cells.
• This is the region at which synapses occur.
• Gray matter is prevalent at the surface of the cerebrum and cerebellum.
• forming the cerebral and cerebellar cortex
• white matter
• is present in more central regions.
• Aggregates of neuronal cell bodies forming islands of gray matter
embedded in the white matter are called nuclei.
•
•
 Element of the Nervous
System
1- Nerve Cells ( neurons ) .
Oligodendrocytes , Astrocytes ,
Ependymal, cells , Microglia , special
glial
cells , -( CNS )
2- Glial Cells :
Schwann Cells , Satellite \ Capsule
Cells , Enteric ( gut ) glia – ( PNS )
3- Blood Vessels .
4- Connective tissue enclosing
Sheeths .
Type of Glial cells
1- protoplasmic Astrocytes
2- Fibrous Astrocytes
3- Oligodendrocytes
4- Microglia
5- Ependymal cells
Table 9–1. Origin and Principal Functions of Neuroglial Cells.

Glial Cell Type Origin Location Main

Functions
Oligodendroc Neural tube Central Myelin production,
nervoussystem electric insulation
yte
Schwann cell Neural tube Peripheral nerves Myelin production,
electric insulation

Astrocyte tube Central nervous Structural support,

Neural System repair processes ,
Blood–brain barrier,
metabolic
exchanges

Ependymal Neural tube Central nervous Lining cavities of

system central nervous
cell system

Microglia Bone marrow Central nervous Macrophagic

system activity
 Blood–brain Barrier
The blood–brain barrier is a functional barrier
that prevents the passage of some substances,
such as antibiotics and chemical and bacterial
toxic matter, from the blood to nerve tissue.
between the endothelial cells of these capillaries,
represent the main structural component of the
barrier. The cytoplasm of these endothelial cells
does not have the fenestrations The expansions
of neuroglial cell processes that envelop the
capillaries are partly responsible for their low
permeability.
The cerebrum
 Gray matter
contains neuronal cell bodies, dendrites, and the
initial unmyelinated portions of axons and glial
cells.
• This is the region at which synapses occur.
• Gray matter is prevalent at the surface of the cerebrum and cerebellum.
• forming the cerebral and cerebellar cortex
• white matter
• is present in more central regions.
• Aggregates of neuronal cell bodies forming islands of gray matter
embedded in the white matter are called nuclei.
• In the cerebral cortex
• the gray matter has six layers of cells with different forms and sizes.
• Neurons of some regions of the cerebral cortex register afferent
(sensory) impulses; in other regions, efferent (motor) neurons generate
motor impulses that control voluntary movements.
• Cells of the cerebral cortex are related to the integration of sensory
information and the initiation of voluntary motor responses.
Silver-stained section of cerebral cortex showing many
pyramid-shaped neurons with their processes and a few
glial cells. Medium magnification.
Cerebral cortex :-
A- molecular layer
B- external granular layer
C- external pyramidal layer
D- internal granular layer
E- internal pyramidal layer
F- multiforme layer
cerebellum
 The cerebellar cortex
has three layers:-
A- outer molecular layer ( cell processes , but few cells )
B- a central layer of large Purkinje cells
C- an inner granule layer ( densely packed small neuron
).
• The Purkinje cells have a conspicuous cell body and
their dendrites are highly developed, These dendrites
occupy most of the molecular layer and are the reason
for the sparseness of nuclei.
• The granule layer is formed by very small neurons (the
smallest in the body), which are compactly disposed,
in contrast to the less cell-dense molecular layer
Photomicrograph of
the cerebellum. The
staining procedure
used (H&E) does not
reveal the unusually
large dendritic
arborization of the
Purkinje cell, which is
illustrated in Low
magnification.
Section of the cerebellum with distinct Purkinje
cells. One Purkinje cell shows part of its rich
dendritic arborization. H&E stain. Medium
magnification.
the spinal cord
 the spinal cord
In cross sections of the spinal cord,:-
* white matter is peripheral .
* gray matter is central
• assuming the shape of an H.
• In the horizontal bar of this H is an opening,
• the central canal, which is a remnant of the
lumen of the embryonic neural tube. It is lined
with ependymal cells.
• The gray matter of the legs of the H forms the
anterior horns. These contain motor neurons
whose axons make up the ventral roots of the
spinal nerves.
• Gray matter also forms the posterior horns (the
arms of the H), which receive sensory fibers
Cross section of the spinal cord in the transition between gray matter
(below) and white matter (above). The gray matter contains neuronal bodies
and abundant cell processes, whereas the white matter consists mainly of
nerve fibers whose myelin sheath was dissolved by the histological
procedure. PT stain. Medium magnification.
 Section of the gray matter of the spinal cord showing several motor
neurons with their basophilic bodies (Nissl bodies). Nucleoli are seen
in some nuclei. The neurons are surrounded by a mesh of neuronal
and glial processes. PT stain. Medium magnification.
Section of spinal cord gray matter. The meshwork of cell neuron
and glial processes appears distinctly. The small nuclei are from
glia cells. Note that these cells are more numerous than neurons.
H&E stain. Medium magnification
 HISTOLOGY OF THE CIRCULATORY
SYSTEM
The cardiovascular system is subdivided into two functional parts
1. Blood vascular system
a. The blood vascular system distributes nutrients, gases, hormones to all
parts of the
body; collects wastes produced during cellular metabolism.

b. The blood vascular system consists of blood vessels (arteries,

arterioles, capillaries, venules, veins) and a muscular pump (heart).

c. Blood is the fluid found within the blood vascular system.

2. Lymph vascular system

a. The lymph vascular system collects tissue fluid from tissues and returns it
to the
blood vascular system.

b. The lymph vascular system consists of blind-ended capillaries (lymphatic

capillaries)
connected to venous vessels (lymphatic vessels) and various lymphoid organs
(e.g.,
lymph nodes).
• 1. The heart wall can be viewed as a three-
layered structure.

• a. Inner layer = endocardium

• b. Middle Layer = myocardium
• c. Outer layer = epicardium (also called the
pericardium)

• 2. Except for the smallest vessels, blood and

lymphatic vessel walls can also be viewed as
three-layered structures.

• a. Inner layer = tunica intima

• b. Middle layer = tunica media
• c. Outer layer = tunica adventita
 Structure of the heart wall

• 1. The endocardium
is the inner layer of the heart wall and consists of the endothelial lining and
the underlying connective tissue layers.

a. The lumen of the heart is lined by an endothelium consisting of a typical

simple
squamous epithelium .

b. A connective tissue region consisting of three layers separates the

endothelium from

• the myocardium in humans consist of:-

(1) A thin layer of loose fibroelastic connective tissue FECT (containing
mainly fine collagen fibers) referred to as subendothelial layer which is next
to the endothelium.

(2) A thicker layer of moderately dense FECT (with many elastic fibers) and
some smooth muscle forms the center of the connective tissue region.

(3) A thin layer of loose FECT (often referred to as the subendocardial layer)
containing many blood vessels joins the endocardium to the myocardium

Purkinje fibers run in this layer in the interventricular septum.

LAYERS OF THE HEART HEART
Endocardium myocardium, epicardium
Endocardium (En) has the following
stratification:
❖ a continuous layer of simple
squamous epithelium (End) lying
on the BL,
❖ subendothelial layer (SL), a thin
layer of loose CT with a few
fibroblasts and delicate collagen
fibers (C),
❖ myoelastic layer (ML), consisting
of relatively dense CT with thick
CF & EF (El) and scattered
predominantly vertically oriented
SMC,
❖ subendocardial layer (SeL), a loose
CT continuous with the
endomysium of the myocardium
(My). In subencardial layer of the
ventricles and their common
septum Purkinje fibers are
scattered.
 2. The myocardium
• is the middle layer of the heart wall and contains the
cardiac muscle throughout most of the heart.

• a. Cardiac muscle cells in the myocardium are arranged in

strands whose ends attach to the dense connective tissue
which surrounds the valves.

• b. Loose FECT holds bundles of cardiac muscle

cells/fibers together and contains numerous blood vessels.

• c. Dense FECT (heavily collagenous) replaces the cardiac

muscle in region around each of the major heart valves
This connective tissue frame around each valve is called
the cardiac skeleton
 PURKINJE FIBERS, periodic acid-
Schiff and hematoxylin stains, 162 x.

muscle fibers
Myocardium is the thickest of the tunics of the heart and consists of :
❖ contractile fascicles of cardiac muscle fibers arranged in sheets
in a complex, spiral manner;
❖ noncontractile modified muscle fibers called Purkinje fibers.
Note subendocardial location of the Purkinje fibers.
CARDIAC MUSCLE: Purkinje fibers, cross section,
H. & E., 162 x.
Heart Wall
(Atrium),
H&E
HEART, Ventricular wall, Rhesus monkey, H. & E., 5 x.
CARDIAC MUSCLE, Human, Mallory's stain, 612 x.
 CARDIAC MUSCLE

Longitudinal section,
Human,
phosphotungstic
acid - hematoxylin
stain, 162 x.
 Scheme of
Cardiomyocyte

Intercalated disks
 Junctional Specialization of the Intercalated Disc
of the Cardiac Muscle
 The epicardium
• is the outer layer of the heart and consists of a
connective tissue region covered by a mesothelium on
its outer surface.
• a. The connective tissue region consists :

• (1) The inner two regions are referred to collectively as

the subepicardial layer and contain large blood vessels
(coronary vessels), nerves, and varying amounts of
adipose tissue.

• (2) A thin layer of loose FECT with many elastic fibers

connects the connective tissue layers of the epicardium
to the mesothelial covering.
Epicardium is composed of HEART
❖ mesothelium (Mes), a single layer
of squamous epithelial cells lying
on the basal lamina (BL);
❖ subepicardial layer (SpL),
consisting of a loose CT, rich in EF
fibers, blood and lymphatic
vessels, and nerve fibers and with
a variable number of adipose cells
(Ad), predominantly along the
coronary vessels.
The heart is enveloped by a
fibroserous sac – the pericardium (P)
built up of the following layers:
❖ mesothelium (Mes), with its BL,
both on the inner aspect of the
pericardium facing the epicardium
fibrous layer (FL), consisting of
dense CT with blood and
lymphatic vessels and nerve
fibers.
Epicardium
• Adipose Tissue
• Coronary vessels and
cardiac nerves
• Mesothelium
A mesothelium (simple squamous epithelium) covers the outer surface of
the heart (except where the arteries leave and the great veins enter the
heart). This covering epithelium closely resembles the mesothelial
covering of the other thoracic and abdominal organs.

• The thickness of the heart wall and the thickness of the layers within the
heart wall varies with location.

• 1. The myocardium is thickest in the ventricular region, especially the left

ventricle, and contains more cardiac muscle in the ventricles than in the
atrium. The myocardium around the valves contains only dense
collagenous CT which forms the cardiac skeleton.

• 2. The endocardium and epicardium are thinner in the ventricles than in

the atria
 Special features of the heart

A heart valve normally allows blood to flow in only one direction

through the heart. The four valves commonly represented in a
mammalian heart determine the pathway of blood flow through the
heart. A heart valve opens or closes incumbent on differential blood
pressure on each side
The four main valves in the heart are:
The two atrioventricular (AV) valves, the mitral valve (bicuspid valve),
and the tricuspid valve, which are between the upper chambers
(atria) and the lower chambers (ventricles).
The two semilunar (SL) valves, the aortic valve and the pulmonary
valve, which are in the arteries leaving the heart.
The mitral valve and the aortic valve are in the left heart; the tricuspid
valve and the pulmonary valve are in the right heart.
• "Pacemakers"
• in the heart are modified cardiac muscle cells.
a. Cardiac muscle cells in the myocardium of the sinoatrial (SA) node
are modified to serve as the pacemaker region. The plasma
membrane of the cells has a high leakage rate, giving them the
fastest intrinsic contraction rate among the populations

b. Cardiac muscle cells in the atrioventricular (AV) node have a

similar histological appearance, but have a lower intrinsic rate of
contraction, so these cells do not normally act as a pacemaker
region. These cells receive the wave of excitation from the cardiac
muscle of the atria and pass the excitation on to the bundle of His.
 The impulse-conducting system
• which connects the atria with the ventricles serves
several functions.
• a. The impulse conducting system is made up of a series
of Purkinje fibers which are specialized cardiac muscle
cells.

• (1) Purkinje fibers are organized into a branched bundle

(Bundle of His) which extends from the atrio-ventricular
(AV) node, through the interventricular septum down to
the apex of the ventricles.

• (2) Purkinje fibers are attached (by intercalated disks) to

cardiac muscle cells in the myocardium at the apex of
the ventricles and along outer walls of both ventricles
• b. The impulse conducting system improves heart
function in two ways
 IMPULSE-CONDUCTING SYSTEM

Aorta
Superior
vena cava
Left bundle branch
Anterior fascicle
Sinoatrial
node

Atrioventri-
cular node
Bundle of His
Right bundle Posterior fascicle
branch
Purkinje system
This is a system of specially modified cardiac muscle cells with function of
generating and conducting impulses of heart contraction to various parts of
myocardium, as well as to assure proper succession of beat of atria and
ventricles. It is composed of:
1) sinoatrial node or node of Keith and Flack,
2) atrioventricular node or node of Ascoff and Tawara,
3) atrioventricular bunch or bundle of His with its left and right branches,
4) Purkinje fibers. Impulse-conducting system is isolated from surrounding
myocardium by a CT sheet and consists of the three types of cells.
Purkinje
Fibers,
H&E
 Purkinje Fibers

Muscle

Conduction System =
AV Bundle of His + Purkinje Fibers
Purkinje Cells,
Large
Magnification,
H&E

These cells conduct action potentials rapidly (3-4 ms compared to

0.5 ms for cardiac muscle) to all regions of both ventricles, causing
ventricular depolarization and then contraction.
 Ultrastructure of the Pace-Maker Cell of the
Impulse-Conducting System
Purkinje Cell

Pace-maker Cell Transitional Cell

 Feature Pace-Maker Cells Transitional Purkinje Cells
Sino-atrial and
Constitute sino-atrial and atrioventricular nodes Subendocardial layer
Location a atrioventricular nodes + sites of connection from AV-bundle of His
between Purkinje cells to the apex of the heart
and cardiomyocytes
Size 10x25 mc Elongated, longer 50x100 mc
than pace-makers
Nucleus Round Elongated Elongated, often 2
Lower density (compar-
Cytoplasm Very clear Higher density ed to the transitional
cells)
Mitochondria Several large Numerous small Numerous small
Golgi Complex + + ++
Cisternae of RER + ++ +
Myofibrils + +++ ++
Vesicles ++ + +
Glycogen particles ++ + +++
+
Basal Lamina + + around the whole fiber
Cell junctions Zonulae adherentes Zonulae adherentes Desmosomes, nexuses,
fasciae adherentes
Generate contraction impul-
se, conduct it to the cardiac Conduct impulse to Conduct impulse to the
Function the cardiac myocytes transitional cells
myocytes and transitional
cells
 Microanatomy of Blood Vessels
• Most larger blood vessel walls contain three major layers with sublayering.
• 1. The tunica intima is the luminal layer.

• a. The lumen is lined by an endothelium of simple squamous epithelium.

• b. A subendothelial layer of loose FECT is present in most medium to large vessels
and may contain scattered smooth muscle in larger vessels.

• 2. An internal elastic lamina (elastica interna) marks the boundary between the tunica
intima and the tunica media.

• 3. The tunica media contains layers of either elastic laminae/lamellae (fenestrated

sheets) or FECT alternating with layers of smooth muscle.

• 4. If present, the external elastic lamina (elastica externa) marks the boundary between
the tunica media and the tunica adventita.

• 5. The tunica adventita contains loose to moderately dense FECT, +/- scattered smooth
muscle cells. Small and medium arteries and veins are present in the tunica adventitia
of large arteries and veins
 THE MAIN FEATURES OF THE ARTERIES

1. Arteries are blood vessels conveying blood away from

the heart.
2. With the exception of the pulmonary artery and umbilical
artery all of them carry oxygenated blood.
3. Arteries decrease in size and increase in number as they
proceed distally from the heart.
4. Arteries are classified according to the size or
predominant tissue component into:
❖ large elastic (or conducting) arteries (aorta, the
common carotid and sublavian arteries, the common
iliac arteries and the pulmonary trunk).
❖ medium-sized muscular (distributing) arteries
(brachial, ulnar, renal etc),
❖ small arteries (arterioles have already been covered
by us). Some authors distinguish also hybrid and
mixed types.
 Large arteries (also called elastic arteries or conducting arteries)
• include the aorta and its largest main branches.
• (a. Tunica intima - thin (relative to other layers in this type of vessel)
• (1) Endothelium
• (2) Subendothelial layer contains some smooth muscle, elastic fibers,
collagen fibers
• b. Internal elastic lamina - not as distinct as in other arteries
• c. Tunica media - thick
• (1) 40 - 60 distinct, concentrically arranged elastic laminae
• (2) Between elastic laminae - fibroblasts, elastic fibers, collagen fibers,
spiral (to circular) smooth muscle

• d. Tunica adventita - thin; consists mainly of collagen fibers, blood

vessels, nerves; some elastic fibers, fibroblasts, macrophages may also
be present

• 2. Function = to conduct blood from the heart to smaller arteries and to

even out blood pressure and flow. The presence of elastic laminae gives
these vessels elastic properties. They expand as the heart contracts (to
modulate blood pressure and store energy) and recoil during ventricular
relaxation (to maintain more even pressure in large arteries).
Aorta,
Human,
Weigert's elastic
tissue stain and
phloxine, 162 x.
Elastic Artery
 Elastic Artery, Orcein, Low Magnification

Intima
Elastica
intema

Media

Adventitia

Adventitia

The wall is relatively thin as compared to their wide lumen (1/10 of the
vessel diameter). The intima of aorta is rather thick (150 mc), it is composed
of the endothelium with the basal lamina and subendothelial layer rich in
collagen and elastic fibrils and longitudinally arranged bundles of smooth
muscle cells.
Tunica media is the thickest layer (2 mm thick) and consists largely of
elastic tissue that forms 50 to 70 concentric sheets or elastic membranes.
The adventitia is relatively thin and contains bundles of CF, a few EF, nerve
fibers, lymphatics and blood vessels (so-called vasa vasorum - a small
system of vessels to nourish the heavy arterial wall.
 AORTA

The elastic
membranes of the
tunica media are
called fenestrated as
they have holes (O) in
them to facilitate
diffusion of nutrients
and waste materials.
Successive lamina are
connected by elastic
fibers (EF).
The abundant elastic
tissue in the wall of
the aorta helps to
make the wall easily
distensible and helps
maintain a constant
blood flow.
 Axillary Artery, Gomori Trichrome

Additional Types of the Large Arteries:

- Mixed arteries: carotid external, axillary (they have both elastic
and smooth muscle components mixed in the media).
- Hybrid arteries: visceral branches of the abdominal aorta (smooth
muscle dominates in the internal part of media while elastic – in the
external part of it.)
 Medium to small arteries (also called muscular arteries)

• a-Tunica intima - thin

• (1) Endothelium
• (2) Thin subendothelial layer consisting of scattered fine collagen
and elastic fibers and a few fibroblasts
• b. Internal elastic lamina - very distinct, usually folded
• c. Tunica media - thick
• (1) Circular smooth muscle, 5 - 40 layers
• (2) Small amount of CT with collagen fibers and elastic fibers
(longitudinal orientation) between muscle
• (3) Thickness decreases as diameter of vessel decreases
• d. External elastic lamina (May be indistinct in smaller muscular
arteries)
• e. Tunica adventita - thick; loose FECT
Function - to distribute blood to smaller arterial vessels. The
muscular wall resists damage due to relatively high blood pressure
in these vessels
 MUSCULAR ARTERY
Muscular arteries include most of
the named arteries such as
femoral, renal, brachial, ulnar and
radial. They may be as large as
the femoral or branchial arteris or
as small as unnamed arteries just
visible to the unaided eye. While
the main function of the elastic
arteries is to conduct blood the
main function of the muscle
arteries is to distribute blood to
specific organs.
Upon demand they have the
capacity to increase greatly in
size. For example, an occlusion
of the principal arteries to a
region the smaller collateral,
muscular arteries enlarge
sufficiently to effectively carry
the needed blood to the ishemic
area.
 The tunica intima consists of a layer of The Muscular Artery,
endothelium and a flattened subendothelial H & E, x 132.
layer of collagenous and elastic fibers (the
latter may be absent in the smaller divisions of
muscular arteries). To these two layers is
added a fenestrated internal elastic lamina
which delimits the tunica intima from tunica
media. The tunica media ™ is very thick and
mainly muscular, consisting of 5-30 helical
layers of smooth muscle that are
concentrically arranged. Among the smooth
muscle cells may be fine reticular, CF & EF, as
well as some amorphous intercellular
substance. An external elastic lamina is
located between the medial and adventitial
layers and consists of several elastic fibers.
The adventitia is rather thick and is about ½ of
the width of the media. It consists of collagen
and elastic fibers, a few fibroblasts and
adipose cells. Lymphatics, vasa vasorum and
nerves are also found in the adventitia, and
these structures may penetrate to the outer
part of media. There are interrupted elastic
lamellae (E) in the tunica media.
MUSCULAR ARTERY, x 132
Muscular Artery,
High Magnification,
H&E
Muscular Artery,
Orcein
 Comparison of Elastic Artery and Muscular Artery
Elastic Artery
Tunica intima: width~one-fifth of
total wall; less elastin than in media
Tunica media comprises bulk of wall
Mainly elastic fibers in media; some
smooth muscle cells
Tunica adventitia relatively thin;
both collagenic and elastic fibers
Muscular Artery
Tunica intima thinner in muscular
artery (in many areas, endothelium
lies directly on internal elastic
lamina)
Occasionally a split internal elastic
lamina
Chiefly smooth muscle in media;
relatively few collagenic, reticular,
and elastic fibers
Adventitia thick;
approximately one-third to two-
thirds of thickness of media; both
collagenic and elastic fibers
 Arterioles

• 1. Structure
• a. Tunica intima - very thin consisting only of endothelium
• b. Internal elastic lamina - usually present except in smaller
arterioles
• c. Tunica media - 1 to 5 layers of smooth muscle, some
elastic fibers
• d. Tunica adventita - thin, consisting of longitudinally
arranged collagen and elastic
• fibers
Function - to redistribute blood flow to capillaries and to alter
blood pressure by altering peripheral resistance to blood flow.
Arterioles can change diameter very drastically therefore
affecting blood pressure and flow patterns. Arterioles are
referred to as peripheral resistance vessels.
 Capillaries
• 1. Structure - consist only of endothelium.
• Three types of capillaries may be distinguished

• a. Continuous (type I) capillaries have relatively thick cytoplasm

and the capillary wall is continuous
• b. Fenestrated (type II) capillaries have extremely thin cytoplasm
• c. Sinusoidal capillaries are larger in diameter than the other.
• 2. Functions
• a. Capillaries are the site of normal exchange of materials between
blood and tissue
• fluid.
• b. Capillaries may be a site of exit of WBCs from blood into tissue
under some conditions, although this is probably more frequent in
venules.
 Only endothelium
Capillaries Variably permeable

 ~ 8 µm

Characterized by circular fenestrae or

pores that penetrate the endothelium -
permit exchange of larger molecules.
somewhat
permeable

Intestinal mucosa Choroid plexus,

Most body regions
endocrine glands, kidneys
 Sinusoids
• Resemble fenestrated capillaries, yet
1. irregular shapes
2. have longer pores
3. thinner (or no) basement membranes

• Blood movement very slow

• Found in the liver, heart, etc.

sometimes called sinusoidal capillary.
 VEINS

1. Veins carry blood from the capillary bed to the heart.

2. With the exception of the umbilical and pulmonary

veins they carry deoxygenated blood.

3. They may be referred to as capacitance vessels

because more than 70% of the total blood volume is
in this portion of the CVS at any one time.
 Venules

• Size varies from 10 microns (post-capillary venules) to 1

mm (muscular venules)

• 2. Post-capillary venules
• a. Structure - larger diameter than capillaries; consist of
endothelium surrounded by pericytes

• b. Functions
• (1) Collect blood from capillaries
• (2) Respond to vasoactive agents (e.g., histamine,
serotonin) by altering permeability

• (3) Also a site of exchange of materials between tissue

fluid and blood
• (4) Site of exit of WBCs from blood into tissue
 Larger muscular venules

• a. Structure
• (1) Tunica intima - thin; endothelium surrounded by outer
sheath of collagen fibers

• (2) Tunica media - thin; 1 - 3 layers of smooth muscle

(circular) with collagen and elastic fibers between muscles

• (3) Tunica adventita - thick; loose FECT containing

longitudinal collagen fibers and scattered elastic fibers and
fibroblasts

• b. Function - to collect blood from post-capillary venules

 Small to medium veins
• 1. Structure
• a. Tunica intima - thin
• (1) Endothelium
• (2) Thin subendothelial layer
• (3) May be folded to form valves

• b. Tunica media - thin; circular smooth muscle, collagen fibers,

some elastic fibers

• c. Tunica adventita - well developed; loose FECT with

longitudinally arranged collagen and elastic fibers, bundles of
longitudinal smooth muscle

• 2. Function - to collect blood from smaller venous vessels

 Medium-Sized Vein

Valves occur first in the

post-capillary venules and are
particularly numerous in the
veins of the legs which conduct
blood against gravity.
Cerebral veins, veins
within organs and bone marrow,
jugular veins, vena cava superior
and inferior have no valves.
 Large veins - vena cavae and larger branches
• 1. Structure
• a. Tunica intima - thicker
• (1) Endothelium
• (2) Thin subendothelial layer

• b. Internal elastic lamina - usually distinguishable

• c. Tunica media - thin, poorly developed; mostly FECT; little smooth
muscle

• d. Tunica adventita - very thick; moderately dense FECT with spirally

arranged collagen fibers, elastic laminae, longitudinal smooth muscle

• 2. Function - to collect blood from medium sized veins and return it to

heart
Muscular Artery and
Companion Vein

vein artery
Muscular
Artery
and Vein.
 Muscular Artery and
Companion Vein

vein artery
SCHEME OF THE MUSCULAR ARTERY AND VEIN

Arteries do not contain valves!

1. The lumen of an artery is smaller than in its companion vein.

2. The wall of the artery is thicker and more rigid than its companion vein.
3. Arteries are generally better supplied with elastic fibers and smooth
muscle cells than veins while collagen fibers are more widely used in
veins.
4. The tunica media of the artery is the thickest coat, while the tunica
adventitia of veins is the thickest coat.
5. Veins tend to be more loosely constructed than arteries.
6. The internal elastic lamina is better developed in arteries than in veins.
The Medium-
Sized Vein,
H & E.
 Large Vein - Vena Cava Inferior

Large veins have a diameter

greater than 10 mm.
Adventitia is very prominent
and makes up most of the wall.
At the junction with heart the
adventitia of the pulmonary veins and
venae cavae (VCS, VCI) are provided
with a coat of cardiac muscle.
A system of vasa vasorum is
best developed in large veins, they may
even extend into the media and even
intima.
Vena Cava Inferior, H & E.

The innermost layer of the

adventitia (1) displays thick collagen
bundles (arrows) arrayed in a spiral
configuration, which permits it to become
elongated or shortened with respiratory
excursion of the diaphragm. The middle
layer presents smooth (or cardiac)
muscle cells, longitudinally disposed.
The outer layer (3) is
characterized by thick bundles of CF
interspersed with elastic fibers. The
region contains vasa vasorum which
supply nourishment to the wall of the
vena cava.
VENA CAVA Human,
Weigert's* stain and
phloxine, 162 x.
 Characteristics of Veins

TYPE TUNICA INTIMA TUNICA MEDIA TUNICA ADVENTITIA

Large veins Endothelium; CT; smooth Smooth muscle

basal lamina, muscle cells cells oriented in
valves in some; longitudinal
subendothelial bundles; cardiac
CT muscle cells near
their entry Into the
heart; collagen
layers with Fbl.
Medium and Endothelium; Reticular and Collagen layers
small veins basal lamina, elastic fibers, with fibroblasts
valves in some; some smooth
subendo-thelial muscle cells
CT
Venules Endothelium; Sparse CT and a Some collagen
basal lamina few smooth and a few
(pericytes,post- muscle cells fibroblasts
capillary venules)
 Microanatomy of Lymphatic Vessels

• A. Lymph capillaries
• 1. Structure - blind-ended tubules; consist only of
endothelium (which lacks cell junctions); similar to
post capillary venules of blood vascular system

• 2. Function - to collect excess tissue fluid

Actual slides:
1 Artery
2 Vein
3 Nerve fascicles
4 Skeletal Muscle Tissue
5 Lumen of the vein (with RBC’s)
6 Vein Tunica Media- smooth muscle
layer
7 Vein Tunica Externa- connective tissue
layer
8 Lumen of the Artery (with RBC’s)
9Artery Tunica Externa- connective tissue
layer
10 Artery Tunica Media- smooth muscle
layer
11 Artery Tunica Interna- endothelial cells
(simple squamous)
12 Artery Tunica Interna- Internal elastic
lamina
13 Capillary Tunica Interna- endothelial
cells
14 Vein Tunica Interna- endothelial cells
 3

4
2
3

1
16

12

10
8

15
2
9
Thank you!