CMG

Cardiovascular System

TUNICA INTIMA

Simple squamous epithelium (endothelium) Loose CT Internal elastic lamina may be present

TUNICA MEDIA

Concentrically arranged smooth muscle cells Varying amounts of CT (elastin, collagen) secreted by and located b/w muscle cells

TUNICA ADVENTITIA

Longitudinally arranged connective tissue (mostly collagen) Large veins contain longitudinally arranged smooth muscle Large arteries contain nervi vascularis Large arteries & veins contain vasa vasorum Muscular arteries contain circumferential external elastic lamina

ELASTIC ARTERY
Function Diameter Tunica Intima Conduction of blood from heart >1cm Endothelial cells Subendothelial connective tissue with smooth muscle cells Elastica Interna NOT obvious Thickest layer; Smooth Muscle (synthesizes all extracellular matrix in T. Media); NO Fibroblasts Fenestrated Elastic Lamellae 40-70 layers of fenestrated circumferential elastin sheets allows systole distention and diastole recoil [subsidiary pump] Fenestrae facilitate the diffusion of nutrients across the T. Media Relatively Thin Vasa Vasorum (small BVs that supply O2 to outer half of vessel wall) Nervi Vascularis (autonomic nerves to control smooth muscle contraction) Collagen, Fibroblasts, Macrophages

Tunica Media

Tunica Adventitia

Examples

Aorta, Pulmonary Artery, Subclavian, Common Carotid, and Common Iliac

LARGE VEINS
Function Return blood to heart

Diameter
Tunica Intima Tunica Media Tunica Adventitia

>1cm
Endothelial cells, CT, and Smooth Muscle Poorly Developed Concentric Smooth Muscle (few) Thick Elastic & Collagen Fibers Longitudinal Smooth Muscle Vasa Vasorum & Lymphatics

Examples

Vena Cava, Subclavian, Portal Splenic, Superior Mesenteric, External Iliac, Renal, and Azygous

MUSCULAR ARTERIES
Function Distribution of blood to muscles, organs

Diameter
Tunica Intima Tunica Media Tunica Adventitia Examples

2-10mm
Endothelial cells Elastica Interna (prominent) Smooth Muscle (4-40 layers connected via gap junctions) Collagen fibers and elastic laminae NO Fibroblasts Elastica Externa Sympathetic, unmyelinated nerve fibers reach the elastica externa (contraction of smooth muscle in T. Media) Longitudinal orientation of CT (allows continual changes in vessel diameter)

Brachial, Femoral, Popliteal

MEDIUM VEINS
Function Return blood to heart; reduce backflow w/ valves

Diameter
Tunica Intima Tunica Media Tunica Adventitia

110mm
Endothelial cells, CT, and smooth muscle 2 or more layers of concentric smooth muscle Collagen and elastic fibers Thickest layer Longitudinally arranged collagen Fenestrated elastic lamellae (veins are capacitance vessels can store a lot of blood b/c of their great distensibility) Vasa Vasorum

Examples

Veins of Extremities Distal to the Popliteal and Brachial; Veins of the Viscera and Head

Longitudinal section of a vein showing valves

Derived from the T. Intima endothelial lining In the middle, thin plate of connective tissue Free margins are directed toward the heart Prevent retrograde flow

Valve leaflets

SMALL ARTERIES AND ARTERIOLES

Function
Diameter

Distribution of blood; Regulate blood pressure (peripheral resistance to flow); Arterioles control blood flow to capillary beds
S. Artery = 0.12mm Arteriole = 10100m

Tunica Intima
Tunica Media Tunica Adventitia

Endothelial cells Elastica Interna (thin)

S. Artery = 3-8 layers smooth muscle Arteriole = 1-2 layers smooth muscle Loose Connective Tissue (ill-defined) Arteriolar tone is controlled by endothelial factors (nitric oxide, prostacyclin) and autonomic NS (sympathetic norepinephrine)

VENULES AND SMALL VEINS

Function Diameter Tunica Intima Tunica Media Return blood to heart; Participate in exchange of blood-borne materials; Important in inflammation (site of fluid extravasation and emigration of WBCs) Small Vein = 0.11mm Venule = 10100m Endothelial cells Small Vein = Smooth Muscle (2-3 layers continuous with T. Intima) Venule = Smooth Muscle (1-2 layers) Postcapillary Venule = None CT w/ some Elastic Fibers Postcapillary Venule = None

Tunica Adventitia

CAPILLARIES
Function
Diameter Tunica Intima

Exchange of nutrients, metabolites, oxygen and carbon dioxide between the blood and the tissues
79m Endothelium (single layer w/ occluding [tight] junctions) Pericytes (enclosed in basal lamina; partially surround the capillaries) Contain contractile proteins surrounded by basal lamina Important in blood-brain barrier stability as well as angiogenesis None None

Tunica Media Tunica Adventitia

Continuous Capillaries

Function: exchange via pinocytotic vesicles Morphology: endothelium forms a thin, uninterrupted layer around the entire circumference of the capillary Locations: Muscle, Lung, Exocrine Glands, Nervous Tissue (blood-brain and blood-nerve barriers) and Connective Tissue

Fenestrated Capillaries

Function: rapid exchange of fluids and metabolites Morphology: endothelium varies in thickness, with some areas exhibiting pores (fenestrae) 80 - 100 nm in diameter covered by a thin diaphragm (glycoproteins) Locations: Endocrine glands, Gallbladder, Intestine, Kidney, Pancreas, Choroid plexus
In renal glomerulus, pores are NOT covered by diaphragms

Sinusoids (a.k.a. Discontinuous Capillaries)

Function: rapid exchange of large molecules and cells Morphology: larger diameter (30 - 40m), irregular cross-sectional outlines, a discontinuous endothelial lining with large fenestrations of varying size and shape (no diaphragms), and a discontinuous basal lamina Locations: Bone Marrow, Liver, Spleen

Metarterioles

Arise from arterioles The proximal segments of thoroughfare channels Walls contain smooth muscle fibers in declining numbers from proximal to distal

Thoroughfare Channels

Allow some blood to pass more directly from arterioles to venules (bypassing the capillary bed)

Precapillary Sphincters

Smooth muscle cells that encircle capillaries as they arise from a metarteriole Regulate the entrance of blood into the capillary bed If they are constricted, blood flows mostly through the thoroughfare channel (not the capillary bed)

Arteriovenous Anastomoses (AVAs; AV shunts)

Direct routes from arteries to veins that divert blood from capillaries Are coiled arterioles that have a thick, richly innervated smooth muscle layer Constriction of the smooth muscle sends blood to the capillary bed Relaxation reduces blood flow to the capillaries Mostly present in the dermis of fingertips, lips, nose (thermoregulation), and in erectile tissue

1. Venous walls are thinner relative to their diameter than arterial walls 2. Lumens of veins are often collapsed, with irregular shapes 3. Indistinct layers in veins; adventitia is thickest layer 4. Veins may have valves

Endothelium damaged due to serum LDL, BP, smoking, etc.

Platelets stick to CT and smooth muscle of T. Intima

Atherosclerosis Thickening & hardening of Tunica Intima in medium & large arteries by an atheroma (lipid/cell/CT plaque) Possible causes of endothelium damage:
Free-radical reactions oxidized serum cholesterol, triglycerides, fibrinogen, homocysteine, insulin BP Obesity, chronic inflammation, lifestyle factors (physical inactivity and tobacco

Platelets and damaged endothelium release cytokines

Cytokines encourage proliferation of smooth muscle in T. Intima

T. Intima smooth muscle produces ECM

Endothelium releases free radicals which oxidize LDL et al

smoking) Diabetes

Oxidized LDL et al (lipids) deposit on endothelium

Intimal macrophages endocytose lipids which become foam cells

The most important complication is thrombosis

Can lead to myocardial infarction if in coronary arteries, stroke if in cerebral arteries.

Lipid is held in T. Intima by impermeable IEL

Plaque forms in T. Intima

Plaque grows protrudes into lumen & breaks through IEL

Plaque becomes fibrotic and eventually calcifies

Varicose Veins
Malfunctioning valves or weakness in the wall Pooling of blood in vessels enlarged, swollen veins Saphenous veins of the legs Veins of the ano-rectal region: Hemorrhoids Veins of the lower esophagus: Esophageal varices

Veins of the spermatic cord: Varicocele

Lymphatic vessels collect fluid (lymph) from the tissue spaces and return it to the blood

Lymph circulates only in one direction, toward the heart Movement of lymph is slow and driven mostly by compression of adjacent skeletal muscle Similar in structure to veins except they have thinner walls in relation to their diameter Layers of the wall are indistinct Interposed along lymphatic vessels Filter the lymph as it percolates toward the blood vascular system Originate in the tissues as blind-ended vessels which consist of a single layer of epithelium (an endothelium) with an incomplete basal lamina, making them more permeable than capillaries Anchoring filaments connect them (via the basal lamina) to surrounding collagen fibers and keep them patent (open) during increased tissue pressure, i.e. edema Better at removing protein- or lipid-rich fluid from tissue spaces than the blood capillaries (important in small intestine) Lymphatic capillaries converge on increasingly larger lymphatic vessels that ultimately unite to form the thoracic duct and right lymphatic trunk, which dump the lymph into the venous system in the neck Media contains both longitudinally and circularly arranged smooth muscle Relatively undeveloped adventitia Valves are present

Lymph nodes

Lymphatic capillaries

Larger lymphatic vessels

Cardiovascular System: Blood Vessels

Tunica intima (ti)

Endothelium Thickest part of this vessel Consists of multiple layers of fenestrated elastic laminae (dark pink, refractile bands) layered with lighter pink areas consisting of smooth muscle fibers and many collagen fibers
Concentrically arranged tubes of elastic fibers with large holes (fenestrations) in the wall of the tubes In cross section, the laminae appear discontinuous due to the holes When the left ventricle contracts, the wall of the aorta bulges out, storing some of the energy of systole (ventricular contraction) by dilating the fenestrated elastic laminae When systole ceases, the fenestrated elastic laminae spring back to their original shape

Tunica media (tm)

Elasticity helps propel blood along the aorta away from the heart

Tunica adventitia (ta)

Nerve fibers Vasa vasorum CT fibers Adipocytes

Patients with Marfan syndrome, a congenital defect in fibrillin structure, frequently die from sudden aortic aneurysms at a young age. Why? A: In Marfan syndrome, fibrillin microfibrils are absent and thus elastic fibers are abnormal. Elastic lamellae of the aorta are therefore not well attached to smooth muscle cells by fibrillin and undergo degeneration, which can eventually result in aortic aneurism with subsequent dissection.

Fenestrated Elastic Laminae

Tunica Media
Smooth Muscle and Collagen Fibers

Tunica Intima

Endothelium

Vasa vasorum
(supply oxygenated blood to Tunica Media)

Tunica Adventitia

Tunica Media

Fenestrated Elastic Laminae

Tunica Adventitia

Tunica Media

Tunica Intima

Fenestrated Elastic Laminae

Top of the left ventricle (lv) Part of the wall of the aorta (a) One of the three cusps of the aortic valve (av)
Fibrous CT in the valve merges into

the CT (part of the cardiac skeleton) between the ventricle and the aorta Avascular Covered by an endothelium More elastin on the ventricular side

Endocardium
(from L ventricle)

Tunic Intima
(from Aorta)

Tunic Intima
(from Aorta)

Endocardium
(from L ventricle)

This is a transverse section through a large vein in the abdomen -- Start at the lumen (L) and work your way outward into the wall of the vessel Tunica intima
Thin with endothelial cells

Tunica media (TM)

Pinkish, smaller, tightly packed

smooth muscle cells

Arranged circumferentially with respect to the lumen

Tunica adventitia (TA)

Lighter, larger bundles of smooth

muscle

Surrounded with pink borders of collagen fibers Arranged longitudinally

Tunica Adventitia

Tunica Media

Tunica Intima

This is a cross section of an artery (A), vein (V) and nerve (N)
Large muscular artery ~1/5: wall thickness/diameter ratio Smooth outline Large vein ~1/15: wall thickness/diameter ratio Irregular outline More blood in the lumen Study the walls of both large vessels and identify the three tunics See if you can find arterioles, venules, and capillaries

Nerve

Large Vein

Muscular Artery

Large Vein

Muscular Artery

Large Vein

Small muscular arteries and arterioles, located in the connective tissue surrounding the elastic cartilage (EC) in the middle of the epiglottis

The elastic stain stains the elastic fibers in this specimen a dark purple/black color A counter stain conveniently stains RBCs yellow so look for these inside blood vessels

Small muscular arteries

Prominent wrinkled internal elastic lamina 5-10 layers of smooth muscle in the media Sparse external elastic lamina ~2 layers of smooth muscle in the media Little or no internal elastic lamina

Arterioles

The distinction between the smallest muscular arteries and the largest arterioles is slight and of no great significance The arteries may be accompanied by veins and the arterioles may be accompanied by venules Capillaries are also present

This thin plastic section from the male reproductive system

Has a lot of CT (pink)

between efferent ductules (purple lumina) Small muscular arteries Companion veins Arterioles Venules Many capillaries

Venule

Arteriole

This is a thin plastic section of the liver -- consists of cords and plates of hepatic parenchymal cells surrounded by hepatic sinusoids
In any given organ, the parenchymal cells are the organ-specific cells
Many organs have both parenchymal and nonparenchymal cells, e.g., CT, blood vessels, nerves, lymphatics

A sinusoid is a generic term for a capillary

Implies that there is sluggish, meandering blood flow through a network of capillaries with large lumina Sinusoids are also found in bone marrow, the spleen, endocrine organs, etc

The hepatic sinusoids carry nutrient-laden blood from the GI tract and as they pass by the hepatic parenchymal cells, the nutrients leave the blood and enter the liver, for processing
Hepatic sinusoids are unusual capillaries -- they are intermingled stretches of discontinuous capillaries

and fenestrated continuous capillaries, although these details are not visible in this slide

Two distinct types of marginal cells

Flattened, typical endothelial cells
The capillaries here have one additional peculiaritythey have a thin, discontinuous basement membrane

Fatter, phagocytic Kupffer cell

The Kupffer cell nuclei are harder to locate and difficult to differentiate from hepatic parenchymal cells

Slide 90, Pituitary Gland, H&E Continuous Fenestrated Capillaries

The pituitary gland is the master endocrine organ of the body -- It has two main components, a neurohypophysis (N) (an extension of the CNS, directly connected to the brains hypothalamus) and an adenohypophysis (A) Adenohypophysis -- contains a plethora of capillaries (sinusoids) engorged with RBCs
Secretes hormones, synthesized in plates, cords,

and follicles of epithelial cells, into the blood in the capillaries that surround the epithelial cells These capillaries are continuous fenestrated capillaries At high mag., you can see the flattened nuclei of capillary endothelial cells The fenestrations are not visible in the light microscope

Continuous Fenestrated Capillaries

Cardiovascular System: Blood Vessels

The three basic types of capillaries, differentiated by the continuity between the endothelial cell and the basal lamina A. B. C.
Continuous capillary

Continuous capillary X120,000 Fenestrated capillary X70,000 Discontinuous capillary X30,000 (sinusoid)

Fenestrated capillary

Discontinuous capillary

Pinocytotic vesicles

Continuous Capillary

TEM, transverse section of a muscle capillary, continuous type. Note nucleus and junction between neighboring cells (N). Pinocytotic vesicles are abundant in the cytoplasm (arrows).

Capillaries Venule

Arteriole

Light micrograph of a cast of the blood supply to skeletal muscle. The tissue has been digested away, but the capillaries (Ca) follow a course parallel to the muscle fibers. They are supplied by arterioles (Ar) and drained by venules (Ve). X350.

Arteriole

Subadjacent Smooth Muscle Cell

Lining Endothelial Cells

Connective Tissue Cell

TEM of an arteriole showing the lining endothelial cells (star) and a subadjacent smooth muscle cell (dot). A connective tissue cell lies at the periphery.

TEM, muscular artery -- detail of the inner part of the vascular wall. Through a fenestra of the internal elastic lamina, processes of the endothelial cell establish a myoendothelial junction (Mej) with the adjacent smooth muscle cell belonging to the media. In the latter, the prevalent muscular tissue is interspersed with the less frequent and discontinuous elastic lamellae X6000