Cardiovascular System

Dr. Marwan Qubaja

Al-Quds University
Faculty of Medicine
Pathology Department 1
 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
* a muscular pump (heart)
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 The blood vessel
• Vessel wall  three major layers (Tunics):
1. Tunica intima
* endothelium
* subendothelial layer
* internal elastic lamina (arteries & 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 BM and delicate collagenous
tissue (subendothelial layer) which may
contain scattered smooth muscle

– Forms a smooth surface to reduce friction

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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
* nervi vascularis 8
The vessel wall

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The vessel wall

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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 distribution 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 elastic laminae
• Are distensible, serve
to conduct blood from
the heart to smaller
arteries and adjust
blood pressure and
flow

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 Elastic arteries

1: Tunica intima
2: Tunica media
3: Tunica adventitia

Thin Tunica Adventitia : consists mainly of collagen fibers, some elastic fibers,
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fibroblasts, macrophages may also be present
 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

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vessels and to various organs.
 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 16
 Muscular arteries

IEL: internal elastic lamina

M: tunica media
EEL: external elastic lamina
A: tunica adventitia

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Muscular arteries

Tunica intema

IEL M

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 Arterioles
• Small muscular arteries  large arterioles 
small arterioles
• Gradual transition involving the loss of 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
• Their walls consist of just
a 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
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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. Antithrombogenic 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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 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
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 Fenestrated capillaries
• Contain numerous
pores (fenestrations)
that allow better
passage of molecules

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 Sinusoidal (discontinuous)
capillaries
• Fenestrated
endothelial cells with
fewer tight junctions
and larger
intercellular clefts

• Allow passage of
large molecules or
even blood cells
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Capillary beds

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 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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 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 32
 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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 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
with underlying subendothelial layer
• The myocardium
- the thickest layer and consists of cardiac muscle
with connective tissue in between, blood vessels
and nerves.
• The subendocardial layer
- connective tissue between the endocardium and
myocardium
- contains nerves and the impulse-conducting system
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(Purkinje fibers)
 endothelium

subendocardial layer

Cardiac muscle

ICD: Intercalitaed disc PF: purkinje fiber, CM: cardiac muscle

MF: myofibril
ICD

nucleus

ICD
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The Heart

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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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 Lymph vascular system
• Collects fluid from tissues and returns it to
the blood vascular system.

• Consists of
- blind-ended capillaries (lymphatic
capillaries) connected to venous vessels
- lymphatic vessels
- lymphatic ducts
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Small lymphatic vessel & venule

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Medium sized lymphatic vessel

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