THE STATE UNIVERSITY OF MEDICINE AND PHARMACY

NICOLAE TESTEMITANU

CARDIOVASCULAR
SYSTEM

DEPARTAMENT OF HISTOLOGY, CYTOLOGY AND EMBRIOLOGY

GLOBA TATIANA
 Cardiovascular system includes
Heart pumps the blood
through the pulmonary and
systemic circulations.

Blood vessels provide

the route by which blood
circulates to & from all
parts of the body.

Lymphatic vessels carry

lymph (tissue-derived
fluid) back to the vascular
system.
 Blood vessels
Major types of vessels
Arteries

Veins

Microcirculatory or microvascular bed (arterioles,

capillaries, postcapillary venules)

Arteries carry blood AWAY from the heart
Veins carry blood TOWARD the heart
Capillaries contact tissue cells and directly serve
cellular needs, communicate between arteries and
veins.
Blood Vessels
 General structure of the wall of the entire vascular system
consists of 3 layers or tunics (beginning with luminal surface):

1. Tunica intima
2. Tunica media
3. Tunica adventitia
I. Tunica intima (Intima)
1. endothelium & BL (basement lamina)

2. subendothelium (very thin loose CT)

3. internal elastic membrane (not seen in veins)

Clinical note: The integrity of the intima is critical, since damage can lead to
atherosclerosis or clotting.
II. Tunica media (Media)
1. consists of circumferentially arranged smooth muscle and elastic
tissue in varying proportions
2. variable amount of connective tissue

3. external elastic membrane (not seen in veins)

The media of arteries is generally thicker than the media of veins of comparable
diameter.
III. Tunica adventitia (Adventitia)
1. loose connective tissue

2. vasa vasorum

3. nervi vascularis
Clinical note: The presence of adventitial connective tissue tightly adhering to vessels
facilitates the surgical isolation and repair of vessels.
 Arteries
are classified into 3 types on the basis of size and the
characteristics of the tunica media:
Large ELASTIC arteries (aorta, pulmonary trunk).

MIXED arteries are arteries that are located

between elastic and muscular arteries (subclavian,
common carotid, common iliac arteries).
Medium sized MUSCULAR arteries (ex. medium
& small arteries that carry blood to the organs &
extremities).
 Elastic Arteries
Tunica intima 10%
1. Endothelium (simple squamous epithelium)
2. Subendothelial layer
3. Smooth muscle cells that are arranged longitudinally (smooth muscle
cell is not only contractile, but also produces the extracellular ground substance
and fibers)
4. Plexus fibroelasticus is same as internal elastic membrane
Tunica media 80%
1. Concentric fenestrated lamellae of elastic fibers in adult there are
50-70 lamellae. The number & thickness of these lamellae are related
to the blood pressure & age.
2. Smooth muscle cells, collagen fibers, fibroblasts & ground substance
are arranged between elastic lamellae
Tunica adventitia 10 %
1. Loose connective tissue
2. Vasa vasorum
3. Nervi vascularis
Tunica INTIMA 10%

Tunica MEDIA 80%

Tunica
ADVENTITIA 10%
Aorta
AORTA

Elastic fenestrated
lamellae
 Muscular arteries
Have more smooth muscle & less elastic fibers in
the tunica media than do elastic arteries.
Prominent internal & external elastic membranes
help to distinguish them from elastic arteries.
Smooth muscle cells are arranged in a spiral fashion.
Their contraction assist in the maintaining of the
blood pressure.

Tunica intima ---- tunica media ---- tunica adventitia

5-10% 50% 40-45%
Muscular arteries
I. The tunica intima:
The endothelium
The subendothelium
The internal elastic lamina (thicker)

II. The tunica media is dominated by

numerous concentric layers of smooth
muscle cells. Fine elastic fibres and a few
collagen fibres are also present. Between
tunics media and adventitia is located an
external elastic lamina (thinner).
III. Tunica adventitia (consists of loose
connective tissue, which contains vasa
vasorum, and nervi vasorum).
Tunica INTIMA 5-10%

Internal elastic
membrane

Tunica MEDIA 50%

External elastic
membrane

Tunica ADVENTITIA
40-45%
 Mixed arteries
Tunica media is composed of 50% of
smooth muscle cells & 50% of elastic
fibers
Are placed between elastic & muscular
arteries
Capillary Bed arterioles, capillaries,
venules

Arteriole capillary venule

miraculous network:
Afferent arteriole capillary efferent arteriole --- kidney
Venule sinusoid capillary central vein --- liver
 Arterioles
<0.5 mm diameter
three tunics too, but tunica media is formed by only:
1-2-3 layers of smooth muscle cells
thin adventitia
Arterioles versus Venules
 Extremely narrow and thin
5mm-10mm in diameter

0.5mm wall thickness

Composed of endothelial cells surrounded by basal lamina, pericytes &

adventitial cells

Pericytes
sometimes found between endothelium and basal lamina

undifferentiated cells that resemble smooth muscle cells

provide support

assist in contraction

potential for regeneration

Capillary
 Capillaries
3 types
Conitnuous : uninterrupted
lining of enothelium; most
common type

Fenestrated : enothelium
occasionally interrupted by
spaces

Discontinuous/Sinusoids :
incomplete endothelium
and basal lamina
 Continuous Capillary - somatic
Is formed by continuous endothelial cells & complete
basal lamina
found in brain, skin, muscle, connective tissue, thymus,
lungs, exocrine glands, nervous tissue
Continuous Capillary
Marginal Fold

Pericyte cells (P) support the endothelial cells of capillaries

Fibroblast (F) produce supporting connective tissue and collagen (C)
Can see basement membrane of capillary and pericyte (BM, BMp)
 Fenestrated Capillary
Endothelial cell body forms small openings called fenestrations.
Fenestrations may represent or arise from pinocytotic vesicles
which open onto both the luminal and basal surfaces of the cell.
Has continuous basal lamina
found in kidney, intestine and
endocrine glands
sealed by a diaphragm
Fenestrations in Endothelial
Fenestrations in Endothelium
 Discontinuous or Sinusoid Capillary
Is formed by incomplete endothelial layer & incomplete basement
membrane
has enlarged diameter & irregular shape
slows circulation

found in liver, bone marrow,

and spleen
 Discontinuous Capillary and Venous
Sinusoid

Wider than
capillaries
Spleen Sinusoid
Sinusoid
 Venules

media: 1-few smooth muscle cells thick

prominent adventitia
 Classification of veins

Unmuscular veins of pia & dura mater, retina,

bones, spleen, placenta, etc.
Muscular:
Weakly developed veins of the upper part of the body
(head, neck, v.cava superior)
Moderately v. brahialis
Most evident veins of the lower part of the body, lower
extremities.
 Features of vein morphology
The wall is thinner than in artery
Internal & external elastic membranes are absent
The layering in the wall is not very distinct
Present valves
Tunica adventitia is more developed than tunica
media
Vaso vasorum are more in the tunica adventitia
The wall has the tendense to collapse
 Veins
usually irregularly shaped
lumen, blood
So Which is Which???
Vein
Heart
 Tissue Layers
Endocardium
Myocardium Heart histology
Pericardium
Visceral Pericardium
Parietal Pericardium
Pericardial Fluid
Heart Wall

ENDOCARDIUM the innermost layer of the heart

consists of:
Endothelium (simple squamous epithelium) that rest

on the second layer.

Subendothelial layer (loose connective tissue).

Fibromuscular plexus elastic, collagen fibers and

smooth muscle cells.
Subendocardial layer (outer fibrous layer) which
contains small blood vessels, collagenous and elastic
fibers, but not smooth muscle.
Heart Wall
The MYOCARDIUM is the thickest of the tunics of the
heart and is formed by cardiac striated muscle tissue.
There are 3 types of cardiac muscle cells:
Contractile cardiocytes which contract to pump
blood through the circulation.
Secretory cardiocytes which produce biological
active substances.
Conductive cardiocytes present under the
endocardium of interatrial and interventricular septa.
There are 3 types of conductive cardioctes:
Type I located in the sinoatrial node.

Type II located in the atrioventricular node.

Type III located in the left and right bundles of Purkinje fibers.
Organ Membrane

Pericardium - Double Sac (2)

Visceral - inner, serous layer (epicardium)
Parietal - (outer) attached to pleura & diaphragm
Electrical Activity of the Heart
Contraction of heart depends on electrical
stimulation of myocardium
Impulse is initiated on right atrium and spreads
throughout the heart
Conduction pathway:
SA node.
AV node.
Bundle of His.
Purkinje fibers.
Stimulation of Purkinje fibers cause both
ventricles to contract simultaneously.
May be recorded on an ECG
 Lymphatic System
Lymphatic capillaries:
Closed-end tubules that
form vast networks in
intercellular spaces.
Lymph:
Fluid that enters the
lymphatic capillaries.
Lymph carried from
lymph capillaries, to
lymph ducts, and then to
lymph nodes.
Lymph nodes filter the
lymph before returning
it to the veins.
Lymphatic Capillaries
Lymphatic Vessels
No fenestrations
No basal lamina
Anchoring filaments (microfibrils) in endothelia
hold vessel open and prevent collapse of lumen
Large lymphatics have numerous valves
Lymphatic vessels
have very thin walls
with less smooth
muscle than veins and
indistinct layers.
Valves are numerous.
Lymphatics will not
normally have any
blood cells.
Lymphostasis
 Alex
General medicine
1st year

Histology
Histology