‫)‪Histology II (19021‬‬ ‫‪Lecture 1‬‬

‫ﻋﻠم اﻷﻧﺳﺟﺔ ‪2‬‬

‫اﻟطب اﻟﺑﺷري‬ ‫‪Ch11: Cardio-‬‬
‫ﻛﻠﯾﺔ اﻟطب وﻋﻠوم اﻟﺻﺣﺔ‬ ‫‪vascular system‬‬
‫ﺟﺎﻣﻌﺔ ﺑوﻟﺗﻛﻧﯾك ﻓﻠﺳطﯾن‬
‫د‪ .‬ﺳﻼﻣﺔ اﻟﻮﺣﺶ‬

‫‪15.09.2022‬‬
 The cardiovascular system
• Subdivided into two functional parts:

1. Blood vascular system

2. Lymph vascular system

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 Blood vascular system
• distributes nutrients, gases, hormones to all
parts of the body
• collects wastes produced during cellular
metabolism
• consists of a continuum of blood vessels
* arteries
* arterioles
* capillaries
* venules
* veins
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* a muscular pump (heart)
 The blood vessel
• Vessel wall  three major layers (Tunics):
1. Tunica intima
* endothelium
* subendothelial layer
* internal elastic lamina (arteries and arterioles)
2. Tunica media
external elastic lamina (arteries)
3. Tunica adventitia (tunica externa)
• Lumen
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The vessel wall

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 The vessel wall
1. Tunica intima
– Inner lining comprising a single layer of squamous
epithelial cells (endothelium) supported by a basement
membrane and delicate collagenous tissue (sub-
endothelial layer) which may contain scattered smooth
muscle
– Forms a smooth surface to reduce friction
– In arteries, the intima often appears scalloped
(wrinkled) in sections due to contraction of the smooth
muscle cells present in the subendothelial layer

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The vessel wall

2. Tunica media
– Intermediate layer
– Predominantly circularly arranged layers of
smooth muscle fibers, with sheets of
collagen and elastin in between
– Vasodilation and vasoconstriction
– Thicker in arteries than in veins

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The vessel wall
3. Tunica adventitia
– Outer layer of connective tissue
– Contains many collagen and a few elastic fibers that
run longitudinally
– Strengthens the vessel wall and anchors it to
surrounding tissue
– Thicker in veins than in arteries
– May contain:
* vasa vasorum- meaning 'the vessels of the
vessels'
* nervi vascularis-
a small nerve filament that supplies the wall of
a blood vessel. 9
The vessel wall

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 Medical application: Atherosclerosis
• Atherosclerosis is a disease of elastic arteries and large
muscular arteries that may play a role in nearly half of all
deaths in developed parts of the world
• It is initiated by damaged or dysfunctional endothelial cells
oxidizing LDLs in the tunica intima, which induces adhesion
and intima entry of monocytes/macrophages to remove the
modified LDL
• Lipid-filled macrophages (foam cells) accumulate (+ free
LDL) produce a pathologic sign of early atherosclerosis
called fatty streaks
• During disease progression these develop into fibro-fatty
plaques, or atheromas, consisting of a gruel-like mix of
smooth muscle cells, collagen fibers, and lymphocytes with
necrotic regions of lipid, debris, and foam cells 11
• Predisposing factors include dyslipidemia (> 3:1 ratios of
LDL to HDL [high-density lipoprotein]), hyperglycemia of
diabetes, hypertension, and the presence of toxins
introduced by smoking
– In elastic arteries atheromas produce localized
destruction within the wall, weakening it and causing
arterial bulges or aneurysms which can rupture
– In muscular arteries such as the coronary arteries,
atheromas can occlude blood flow to downstream
vessels, leading to ischemic heart disease

An aneurysm is an abnormal bulge or

ballooning in the wall of a blood vessel.
"A proportion of these patients will go on to
have a rupture.
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Cross section of coronary artery

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Arteries
• On the basis of size and characteristics of
the tunica media  classified into:

– Large or Elastic arteries (Conducting Arteries)

– Medium or Muscular arteries
– Small arteries and Arterioles

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Elastic arteries
• Comprise the major conducting vessels

– Aorta
– Brachiocephalic trunk
– Common carotid arteries
– Subclavian arteries
– Most of the large Aorta
pulmonary arterial
vessels

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 Elastic arteries
• Largest diameter
• Contain more elastin in their
tunica media than any other
vessel
• Are distensible, serve to
elastic laminae
conduct blood from the
heart to smaller arteries and
adjust blood pressure and
flow
Simple squamous endothelial cells (arrows)
line the intima that also has subendothelial
connective tissue and in arteries is separated
from the media by an internal elastic lamina
(IEL), a structure absent in all but the largest
veins. 16
17
 Adventitia

Large artery Large vein

More brownish color (smooth muscles) Collagen more
The thickness of adventitia is more
Larger lumen, collapse
Thin Tunica Adventitia: consists mainly of collagen fibers, some elastic fibers,
fibroblasts, macrophages may also be present
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These layers correspond roughly to the heart’s endocardium, myocardium, and epicardium
Muscular arteries
• Main distributing branches of the arterial
tree, e.g.
– Radial arteries
– Femoral arteries
– Coronary arteries
– Cerebral arteries

• Function to distribute blood to smaller arterial

vessels and to various organs.
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 Muscular arteries
• Thickest tunica media of all vessels
• Tunica media contains relatively more smooth
muscle and less elastic tissue than do elastic arteries
– Active in vasoconstriction and less distensible
– Internal and external elastic lamina on each side of the
tunica media
• Tunica intima is usually very thin and not visible at
low magnification
• Tunica adventitia is of variable thickness, composed
of collagen and a variable amount of elastic tissue;
may contain prominent vasa vasorum
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 Muscular arteries
IEL: internal elastic lamina
M: tunica media
EEL: external elastic lamina
A: tunica adventitia

The vasa vasorum is a network

of small blood vessels that supply
the walls of large blood vessels,
such as elastic arteries (e.g., the
aorta) and large veins (e.g., the
venae cavae)

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• With distance from the heart, arteries
gradually have relatively less elastin and
more smooth muscle in their walls. Most
arteries, large enough to have names, are
of the muscular type
• A transverse section through a muscular
(medium-caliber) artery shows a slightly
folded intima with only sparse connective
tissue between the endothelial cells (E)
and internal elastic lamina (IEL)
• Multiple layers of smooth muscle (SM) in
the media are thicker than the elastic
lamellae and fibers with which they
intersperse
• Vasa vasorum (V) are seen in the
adventitia. (X100; H&E)

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11.8 Vasa vasorum 11.9 Elastic artery

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 Arterioles
• Small muscular arteries  large arterioles  small arterioles
• Gradual transition involving the loss of internal
elastic lamina (IEL) and reduction in muscle layers
• Tunica media is mainly smooth muscle with a few
scattered elastic fibers
• Function to redistribute blood flow to capillaries and
to alter blood pressure by altering peripheral
resistance to blood flow
 referred to as peripheral resistance vessels

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Arterioles

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Capillaries
• Exchange of gases, fluids, nutrients and
metabolic waste products

• Low rate of blood flow

• Large surface area

• Exceedingly thin walls

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 Capillaries ■ The endothelium of continuous capillaries and
postcapillary venules is frequently surrounded by
thin cells called pericytes, whose contractions
facilitate blood flow and which can give rise to
• Their walls consist of just a smooth muscle and connective tissue during
microvascular remodeling or repair.
thin tunica intima ■

• Only a single layer of

flattened endothelial cells
(E) line the lumen
• These cells are supported
by pericytes (P), smooth
muscle-like cells that
stabilize the capillary wall
Pericytes from the walls of small blood vessels participate in the repair of
vascular smooth muscle
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 Capillaries
• Functions:
1. Permeability; capillaries are exchange vessels

- Intercellular junctions (small pores): water and

hydrophilic molecules
- Fenestrae (large pores): macromolecules: in
pinocytotic vesicles

2. Anti-thrombogenic function

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 Capillaries
• Functions:
3. Metabolic functions:
a. Activation: conversion of angiotensin I to
angiotensin II
b. Inactivation: conversion of bradykinin, serotonin,
prostaglandins, thrombin to biologically inert
compounds
c. production of vasoactive factors like endothelins
and nitric oxide (NO)
d. Lipolysis
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• Growth factors such as vascular endothelial growth factor
(VEGF)
• stimulate formation of the vascular system from embryonic
mesenchyme (vasculogenesis)
• help maintain the vasculature in adults
• promote capillary sprouting/developing and outgrowth from
small existing vessels (angiogenesis) during normal
growth, during
– tissue repair and regeneration
– in tumors and other pathological conditions
• In both processes other growth factors, called
angiopoietins, stimulate endothelial cells to recruit smooth
muscle cells and fibroblasts to form the other tissues of the
vascular wall.
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Capillaries
• Types:
1. Continuous capillaries
found in muscles, CT, exocrine glands, and nervous tissue

2. Fenestrated capillaries
found in kidney, intestines, and endocrine glands

3. Discontinuous sinusoidal capillaries

found mainly in liver, bone marrow, and spleen
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Continuous capillaries
• Endothelial cells form a
continuous lining, with tight
junction between adjacent
cells

• The tight junctions leave

gaps to form intercellular
clefts which allow limited
passage of fluids and
solutes
This is the most common type of capillary and is found in muscle,
connective tissue, lungs, exocrine glands, and nervous tissue.
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Fenestrated capillaries
• Contain numerous pores (fenestrations,
perforation) that allow better passage of
molecules
• have a sieve-like structure that allows
more extensive molecular exchange
across the endothelium
• The basement membrane, however is
continuous and covers the
(80 nm in
fenestrations diameter)

• Fenestrated capillaries are found in

organs with rapid interchange of
substances between tissues and the
blood, such as the kidneys, intestine, 35
choroid plexus, and endocrine glands
 Sinusoidal (discontinuous) capillaries

• Fenestrated endothelial cells with

fewer tight junctions and larger
intercellular clefts
• Allow passage of large molecules or
even blood cells
• permit maximal exchange of
macromolecules as well as allow
easier movement of cells between
tissues and blood
• have highly discontinuous basement
Sinusoidal capillaries of this
membranes and much larger type are found in the liver,
diameters, often 30-40 μm, which spleen, some endocrine
slows blood flow organs, and bone marrow
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Sinusoid in spleen Sinusoid in liver

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MEDICAL APPLICATION
The hyperglycemia or excessive blood sugar that occurs with diabetes commonly
leads to diabetic microangiopathy, a diffuse thickening of capillary basal laminae
and concomitant decrease in metabolic exchange at these vessels in the kidneys,
retina, skeletal muscle, and skin 39
Metarterioles

1. metarterioles connect larger arterioles to capillaries

2. less than 40 µm in diameter

3. consist of endothelium surrounded by a few discontinuous smooth muscle fibers

4. Smooth muscle cells act as sphincters that control the flow of blood through
capillary beds

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Capillary beds

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Arterial Sensory Structures
• Carotid sinuses are slight dilations of the bilateral internal
carotid arteries where they branch from the (elastic)
common carotid arteries; they act as important
baroreceptors monitoring arterial blood pressure
• At these sinuses the tunica media is thinner, allowing
greater distension ‫ اﻧﺗﻔﺎخ‬when blood pressure rises, and the
adventitia contains many sensory nerve endings from
cranial nerve IX, the glossopharyngeal nerve
• The brain’s vasomotor centers process these afferent
impulses and adjust vasoconstriction, maintaining normal
blood pressure

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 Arterial Sensory Structures , …
• Functionally similar baroreceptors present in the aortic arch
transmit signals pertaining to blood pressure via cranial
nerve X, the vagus nerve
• Histologically more complex chemoreceptors which monitor
blood CO2 and O2 levels, as well as its pH, are found in the
carotid bodies and in the aortic bodies, located in the walls
of the carotid sinuses and aortic arch, respectively
• These structures are parts of the autonomic nervous system
called paraganglia with rich capillary networks
• The capillaries are closely surrounded by large, neural crest-
derived glomus cells filled with dense-core vesicles
containing dopamine, acetylcholine, and other
neurotransmitters, which are supported by smaller satellite
cells 43
Arteriovenous Anastomoses
• Direct communication between arterial and venous
circulation
• Glomus (plural: Glomera)
- Complex structures
- Arterioles and venules are continuous
- Arterioles acquire a thick concentric layer of
smooth muscle cells
- Found mainly in fingerpads, fingernail beds,
and ears
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 Glomus
• The glomera have an
important role in
regulating the blood
pressure and controlling
the circulation as in:
- menstruation
- erection
- thermoregulation

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• A glomus body is a component of the dermis layer of the skin,
involved in body temperature regulation. The glomus body consists
of an arteriovenous shunt surrounded by a capsule of connective
tissue. Glomus bodies are most numerous in the fingers and toes.
The role of the glomus body is to shunt blood away from the skin
surface when exposed to cold temperature, thus preventing heat
loss, and allowing maximum blood flow to the skin in warm weather
to allow heat to dissipate. The glomus body has high sympathetic
tone and potentiation leads to near complete vasoconstriction.
• Endothelial cells form a single, continuous layer that lines all
vascular segments. Junctional complexes keep the endothelial cells
together in arteries but are less numerous in veins. The organization
of the endothelial cell layer in capillaries varies greatly, depending
on the organ. The glomus bodies in the skin and elsewhere are
unusual in that their “endothelial cells” exist in multiple layers of cells
called myoepithelioid cells. These glomus bodies control small
arteriovenous shunts or anastomoses.[1]
• The arteriovenous shunt in the glomus body is a normal anatomic
shunt as opposed to an abnormal arteriovenous fistula.
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A metarteriole is another type.
 Venules
• Postcapillary venules consist
entirely of endothelium
around which a few
pericytes collect
• Extremely porous
• Larger venules have one or
two layers of smooth muscle
cells (a scanty tunica media)
and a thin adventitia

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 Veins
• Relatively thin walls and
large lumen
• Poorly developed tunica
media, with less prominent
muscular and elastic
features
• Adventitia is the thickest
layer and contains smooth
muscle
• Capacitance vessels
(blood reservoir)

 Contain 65 – 70% of the total blood volume

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 Venous valves

• Develop from
projections of the tunica
intima

• Similar in structure and

function to the cardiac
semilunar valves

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Venule & Arteriole

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Small Vein & Muscular Artery

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 Precapillary Vascular shunt

Medical application sphincters

Metarteriole

• Junctions between
endothelial cells of
postcapillary venules are
the loosest of the
microvasculature Postcapillary
venules
• This facilitates
transendothelial migration of
leukocytes at these locations
during inflammation, as well
as a characteristic loss of
fluid here during the
inflammatory response,
leading to tissue edema.

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The Heart
• The heart wall can be viewed as a three-layered structure:

a. Inner layer = endocardium

b. Middle Layer = myocardium
c. Outer layer = epicardium

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The Heart

• The endocardium
- thin layer consists of
– Endothelium on the surface
– The subendocardial layer
- connective tissue between the endocardium and myocardium
- contains nerves and the impulse-conducting system (Purkinje fibers)

• The myocardium
- the thickest layer and consists of cardiac muscle with
connective tissue in between, blood vessels and nerves

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The Heart

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Purkinje fibers, located in the
subendocardial layer of both
ventricles, are distinguished from
contractile fibers by their greater
diameter, abundant glycogen, and
more sparse bundles of myofibrils.
■
■ Masses of dense irregular
connective tissue make up the cardiac
skeleton, which surrounds the bases
of all heart valves, separates the atria
from the ventricles, and provides
insertions for cardiac muscle.

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 Endocardium

Tunica Adventitia (Epicardium)

This layer contains fibroelastic connective
tissue, blood vessels, lymphatics and
adipose tissue.
The simple squamous epithelium of the
tunica adventitia layer is called
the mesothelium (that lines the cavities)
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 This is picture of the myocardium at a higher
magnification.
Now you can see the individual muscle fibres,
their striated appearance, and the intercalated
discs at the end of each muscle cell.

Mesothelial
This diagram shows that the simple squamous epithelium of the tunica adventitia layer of the heart
(mesothelium) is also the visceral layer of the serous pericardium.
The pericardium is a two-layered connective tissue sac that encloses the heart. The fibrous pericardium
is the outer layer, and the serous pericardium is the inner layer.
The space between the two layers is the pericardial cavity, that contains serous fluid. This facilitates the
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pumping action of the h
The purkinje fibres are found in the sub-
endocardium.
They are larger than cardiac muscle cells,
but have fewer myofibrils, lots of glycogen
and mitochondria, and no T-tubules. These
cells are connected together by
desmosomes and gap junctions, but
not by intercalated discs.
They are specialised conducting fibres,
which extend from the interventricular
septum, to the papillary muscles, and up
the lateral walls of the ventricles

Electron microscope for purkinje fibers

Take a look at this EM of a purkinje cell. How does
it differ from that of a cardiac or muscle cell?
(Hint - how many myofibrils can you see?)

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The Heart
• The epicardium
- outer layer consists of connective tissue
- contain large blood vessels (coronary
vessels) and nerves
- large amount of adipose tissue
- covered on its outer edge by a
mesothelium which lines the pericardial
cavity
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The epicardium

mesothelium

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• The epicardium is a simple squamous mesothelium
supported by a layer of loose connective tissue containing
blood vessels and nerves
• The epicardium corresponds to the visceral layer of the
pericardium, the membrane surrounding the heart
• Where the large vessels enter and leave the heart, the
epicardium is reflected back as the parietal layer lining the
pericardium
• During heart movements, underlying structures are
cushioned by deposits of adipose tissue in the epicardium
and friction within the pericardium is prevented by lubricant
fluid produced by both layers of serous mesothelial cells.
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