OBJECTIVES AS PER CBME AN 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 5.

8
At the end the student should be able to:
Ø Describe the Structure and functions of arteries, veins and capillaries
Ø Explain the relationship between different types of blood vessels
Ø Outline the differences between the arteries and vein, capillaries and sinusoids
Ø Discuss arteriovenous anastomosis and its functional significance
Ø Outline the various types of blood circulation: Pulmonary, Systemic and Portal
circulation
Ø Foetal circulation vs Adult circulation
Ø Definitions – Thrombosis, Aneurysm and Infarction
CARDIOVASCULAR SYSTEM:
Functions:
1. Transports nutrients
2. Removes waste products of metabolism
3. Responsible for gaseous exchange
4. Carries hormones and other regulatory molecules
5. Helps to protect the body from infection
COMPONENTS OF CVS:
1. Heart
2. Blood
3. Blood vessels
1.Arteries
2.Capillaries
3.Veins
Arteries:
Characteristic features:
1. Thick walled
2. Often accompanied with vein/veins and nerve/nerves – neurovascular
bundle
3. Lumen is smaller
4. No valves
5. Divide repeatedly
Functions of arteries:
Carrying oxygen-rich blood away
from the heart to the body.
Microscopic structure:
Ø TUNICA INTIMA
üEndothelium
üBasal lamina
üSub-endothelial connective tissue
üInternal elastic lamina

Ø TUNICA MEDIA.
üElastic tissue
üSmooth muscle
üExternal elastic lamina

Ø TUNICA ADVENTITIA.
üConnective tissue layer
Functions of Endothelium:
1. Smooth surface.
2. Selective permeability barrier.
3. Release of von Willebrand factor (plasminogen activator inhibitor).
4. Release of nitric oxide and prostacyclin- Vasodilator agents.
5. Release of endothelin, angiotensin-converting enzyme (ACE) –
Vasoconstrictor agents.
6. Hormone synthesis – Growth factors
7. Release of endothelial-derived relaxing factor (EDRF).
8. Synthesis of type IV collagen fibers.
Functionally arteries are classified into three types:
1. Elastic arteries (Conducting arteries)
2. Muscular arteries (Medium sized or Distributing arteries)
3. Arterioles (Resistance vessels)
1. Elastic arteries: (Diameter >10 mm)
TUNICA INTIMA:
ü Endothelial Lining – Simple squamous epithelium.
ü Sub-endothelial connective tissue – Collagen and elastic fibers and
smooth muscle fibers
ü Internal elastic lamina. External elastic
lamina

Sub-endothelial connective tissue

TUNICA MEDIA
ü Thickest layer
ü Elastic fibers are in the form of concentric fenestrated sheets
intervening with smooth muscle cells and collagen fibers and ground
substance
External elastic
lamina

Sub-endothelial connective tissue

TUNICA ADVENTITIA
ü Connective tissue layer
ü Thickness is less and consists of collagen fibers, elastic fibers, fibroblasts
and macrophages
ü External elastic lamina
External elastic
lamina
E.g.: Aorta, Pulmonary trunk,
Brachiocephalic trunk, Common
carotid artery, Subclavian artery,
Common liac artery, Pulmonary
artery Sub-endothelial connective tissue
I: Tunica intima
M: Tunica media
A: Tunica adventitia

V: Vasa vasorum
IEL: Internal elastic lamina
2. Muscular arteries: (Diameter 2-10 mm)
TUNICA INTIMA:
ü Endothelial Lining – Simple
squamous epithelium. External
elastic lamina

ü Sub-endothelial connective tissue –

Sparse
ü Internal elastic lamina is well
Sub-endothelial connective tissue
defined with double layer
TUNICA MEDIA:
ü Large number of smooth muscle cells and collagen fibers arranged in
spiral fashion
ü Less number of elastic fibres.

External elastic
lamina

Sub-endothelial connective tissue

TUNICA ADVENTITIA:
ü Thick as tunica media
ü Made up of abundant collagen fibers
ü Collagen fibers are arranged longitudinal
ü Prominent external elastic lamina
External elastic
lamina
E.g.: Brachial artery, Femoral
artery and other arteries of
limbs

Sub-endothelial connective tissue

 Endothelium
Tunica intima
Subendothelial connective tissue

Internal elastic lamina

Tunica media
Smooth muscle

External elastic lamina

Tunica adventitia
L: Lumen
IEM: Internal elastic lamina
EEM: External elastic lamina

TI: Tunica intima

TM: Tunica media
TA: Tunica adventitia
3. Arterioles:
• Smallest division of muscular arteries
• 10-100 μm diameter
• Narrow lumen
• Abundant smooth muscle tissue
§Larger arterioles
- Three tunics are present
§Terminal arterioles
- < 50 μm diameter
- Devoid of internal elastic lamina
- 2 layers of muscle coat
§Meta-arterioles
- Non contractile cells called
pericytes or Rouget cells
- Terminate into capillaries
Through fare channels
Blood supply of the arteries:

• Tunica adventitia and outer two third of tunica media - Vasa

vasorum
• Tunica intima and inner one third of tunica media – diffusion
• Minute veins – drain the blood from arterial wall

Nerve supply:
• Nervi vasorum/nervi vascularis – nonmyelinated sympathetic
fibres
Capillaries:
Ø Capillaries form a network of vessels in tissue
Ø Average diameter of 8 μm
Ø Human body has 40 billion capillaries
Type of capillaries:
According to the nature of endothelial lining, the capillaries
can be classified into:
1. Continuous capillaries
E.g.: Connective tissue, Skin, lungs,
muscle and CNS

2. Fenestrated capillaries
E.g.: Renal glomeruli, Pancreas, gall bladder
endocrine glands, Intestinal villi,
choroid plexus, ciliary process of eye
Sinusoids: E.g.: Liver, spleen, bone marrow, endocrine glands
(adrenal cortex, hypophysis cerebri, parathyroid glands) and carotid bodies
Veins:
Characteristic features:
Ø Thin walled
Ø Larger veins are formed by union of smaller veins
Ø Larger lumen
Ø Provided with valves
Ø Dead space

Functions:
Carries deoxygenated blood to
the heart
Veins are classified into four groups based on their size:
1. Venules
2. Small veins
3. Medium sized veins
4. Large size veins
1) Venules: Two types
a) Postcapillary venules
(diameter 10-50 µm)
b) Muscular venules
(diameter 50-100 µm)

2) Small veins:
(diameter 0.1 - 1 mm)
Postcapillary venule Muscular venule
3. Medium sized veins (diameter 1-10 mm)
E.g.: Tibial vein, radial vein, popliteal vein etc..
4. Large size veins (diameter >10 mm)
E.g.: Superior vena cava and inferior vena cava
Blood supply to veins:

• Vasa vasorum

Nerve supply:

• Nervi vasorum/nervi vascularis – nonmyelinated sympathetic

fibres
Pattern of distribution of Arteries and veins:

1. Larger veins are usually single

2. Medium sized veins are usually double
3.In many regions venous pattern is entirely different from
arterial pattern
Venous valves:
Inner lining of most of the medium and small sized veins
Veins which do not have valves in their lumen:
1.SVC, IVC, Hepatic veins, Renal, Uterine, Ovarian veins
2.Facial, Pulmonary, Umbilical, Emissary, Portal veins
3.Veins less than 2 mm in diameter

Veins which do not have muscular tissue in their

wall:
1.Dural venous sinuses, pia, retinal veins
2.Veins of erectile tissue of penis
3.Veins of spongy bone
Anastomosis is the communication between neighbouring vessels
through a collateral channel.
Types of Anastomoses: Three types of anastomoses
a) Arterial
b) Venous
c) Arteriovenous
Arterial anastomosis: Communication between two arteries
Two types:
1. Actual anastomosis: Two types
a) End to end anastomosis:
E.g.: Palmar arches, plantar arch, circle of Willis, labial
branches of facial arteries
b) Convergent anastomosis:
E.g.: two vertebral arteries unite to form a larger basilar artery

Basilar artery

Vertebral arteries
2. Potential anastomosis: It is a communication established by
union of terminal arterioles.
E.g.: Coronary arteries, Cortical arteries of cerebral hemispheres.
End arteries:
Arteries whose branches does not anastomose with branches of
other adjacent arteries
E.g.: a) Central artery of retina
b) Arteries of spleen, liver, kidneys,
metaphyses of long bones
c) Central branches of cerebral arteries
d) Vasa recta of mesenteric arteries
Functional end arteries:
Coronary arteries and central branches of cerebral arteries
are functional end arteries
Venous anastomosis:
It is the communication between adjacent veins
E.g.: Dorsal venous arches of hand and foot
Arteriovenous anastomosis:
Direct connection between the arteries and veins without
intervention of capillaries are termed as arteriovenous anastomoses
or shunts
Sites:
1. Skin of nose, lips and external ear
2. Mucous membrane of alimentary canal and nose
3. Erectile tissue of sex organs
4. Thyroid gland
5. Tongue
Functions:
• Regulation of temperature
• Regulation of regional blood flow
• Regulation of blood pressure
Types of circulation:
Four types:
1. Systemic circulation
2. Pulmonary circulation
3. Portal circulation
4. Foetal circulation (During embryonic life)
3. Portal circulation:
Seen in:
1. Liver (hepatic portal circulation)
2. Hypophysis cerebri (hypothalamo-hypophyseal portal circulation)
3. Kidney (renal portal circulation)
Foetal circulation:
Clinical correlation:
Thrombosis:
The formation or presence of a
blood clot in a blood vessel (an
artery or vein) in your body or
sometimes inside of your heart.
Causes of Thrombosis:
Ø Endothelial damage
Ø Stasis or blood flow disturbance
Ø Hypercoagulability
Ø Vessel wall injury in atherosclerosis
Aneurysm: It is a sac like dilatation of arterial wall (tunica
media) because of its weakness
Arteriosclerosis:
Ø Hardening of the arteries
Ø Occurs after middle age

Intermittent claudification
Atherosclerosis:
Infarction:
Is tissue death (necrosis) due to inadequate blood supply to
the affected area. It may be caused by artery blockages,
rupture, mechanical compression, or vasoconstriction
- Myocardial infarction
Causes of infarction:
Ø Atherosclerosis
Ø Thrombosis
Ø Embolism
Ø Vasospasm
Ø Inflammation
Ø Trauma