CARDIOVASCULAR SYSTEM

A view from histological aspect

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Ahmad Aulia Jusuf, MD, PhD

Depart of Histology
Faculty Medicine University of Indonesia
2009
Agenda
 Introduction
 Cardiovascular System
 Blood vessel
 Heart

 Lymphatic vascular System

 Lymphatic vessel

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Introduction
 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

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 Circulation
Aorta  Medium Arteries  Small Arteries (arterioles)
 
Heart Tissue Capillaries
 
Large Veins  Medium Veins  Small Veins (Venues)

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Blood Vessel
3 tunics or layers
 The 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

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 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

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Blood Vessel
3 tunics or layers
 Tunica Adventisia
 covers the outside surface of
blood vessel
 composed of 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

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Blood Vessel
Artery
 efferent 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

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Blood Vessel
Large artery (elastic artery/ conducting
arteries)
o aorta
o inominate artery
o carotic communis artery
o subclavian artery
o iliac artery

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 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

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 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

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 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

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Large Artery

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Blood Vessel
 Medium artery
 brachialis artery
 ulnar artery
 femoral artery
 poplitea artery
 coronary artery
 umbilical artery
 arteries located in the brain
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 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

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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.

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 Blood Vessel
 The function of medium
artery
 is to distribute the blood
to the target organ or
tissue

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Muscular
Artery

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The differences between Large and Medium Artery

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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

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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

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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

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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

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Blood Vessel
 Nerve supply to vessel
 Sympathetic and parasympathetic
 Sympathetic adrenalin vasoconstriction
 parasympathetic acetylcholine vasodilatation

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

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 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
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 Blood Vessel
 Capillary
 There are 3 types of
capillary
 Continuous capillaries
o have no interruptions (pore
or fenestrated) in their wall
o present in the muscle,
nervous and connective
tissues
 Fenestrated capillaries
o have pore or fenestrae in
their wall
o present in the pancreas,
intestines, endocrine and
kidney

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 Blood Vessel
 Capillary
 There are 3 type of capillary
 Sinusoidal capilaries
o known as sinusoids
o 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

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 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

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Blood Vessel
 Veins
 3 types
 Medium veins
o similar to medium artery
 but has no external elastic lamina

o 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

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 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.

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 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.

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 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

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 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
o 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 body
o empties its contents at the junction of the left internal jugular and subclavian
veins

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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

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 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

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 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

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 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

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 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

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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.

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 HEART
 Myocardium
 contains the cardiac muscle
cells
 separate cellular units
 uni\nucleate
 characterized by rhythmic,
involuntary contractions
controlled by autonomic
innervation

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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

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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

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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

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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

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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

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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.
 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.

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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 leafs
o located between left atrium and left
ventricle
 Tricuspid valve
o 3 leafs
o located between right atrium and
right ventricle

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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

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 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

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