MEDICAL MICROSCOPIC

ANATOMY

CARDIOVASCULAR
SYSTEM
Prof. Daniel Djakiew
GEORGETOWN UNIVERSITY
MEDICAL CENTER
CARDIOVASCULAR SYSTEM
• Circulatory System
• Capillaries
• Structure of Larger Vessels
• Structure of Arteries
• Structure of Veins
• The Heart
• Lymphatics
CARDIOVASCULAR SYSTEM
• Circulatory System
• Capillaries
• Structure of Larger Vessels
• Structure of Arteries
• Structure of Veins
• The Heart
• Lymphatics
THE VASCULAR SYSTEMS

CIRCULATORY LYMPHOID
SYSTEM SYSTEM

CARDIOVASCULAR LYMPHATIC
SYSTEM SYSTEM

Blood Lymph
Heart pump No pump
Circulates Unidirectional
 HEART
A double-pump

ARTERY
Carries blood away
from the heart

VEIN
Returns blood
to the heart

CAPILLARY
Connects arterial
side to venous side,
with special
exceptions
CARDIOVASCULAR SYSTEM
• Circulatory System
• Capillaries
• Structure of Larger Vessels
• Structure of Arteries
• Structure of Veins
• The Heart
• Lymphatics
 CAPILLARIES

KEY POINT: Capillaries and postcapillary venules are the exchange

vessels for the tissues.
STRUCTURE OF CAPILLARIES

Endothelial cells
Basal lamina
Pericytes
 TYPES OF CAPILLARIES

Muscle Intestines Liver

Skin Endocrine Spleen
Lung Kidneys* Bone marrow
Brain Endocrine
CONTINUOUS
CAPILLARY

FENESTRATED
CAPILLARY

SINUSOIDAL
CAPILLARY
CAPILLARY EXCHANGE MECHANISMS
 Open pores/gaps

 Diffusion
 Filtration
 Vesicular transport
(“transcytosis”)
 Transendothelial
channels
 VESICULAR TRANSPORT

KEY POINT: System of pinocytotic pits and vesicles which move

large molecules across the endothelium.
TRANSENDOTHELIAL CHANNELS
SECRETORY & METABOLIC FUNCTIONS OF
ENDOTHELIAL CELLS

Adhesion
molecules
Produce
Vasoactive
compounds (NO,
endothelin)
Antithrombo-
genic factors
Metabolic
conversions
(angiotensin I to II)
CARDIOVASCULAR SYSTEM
• Circulatory System
• Capillaries
• Structure of Larger Vessels
• Structure of Arteries
• Structure of Veins
• The Heart
• Lymphatics
 HEART

ELASTIC
LARGE VEIN ARTERY

MEDIUM MUSCULAR
VEIN ARTERY

POSTCAPILLARY
VENULE ARTERIOLE

CAPILLARY
 STRUCTURE OF ARTERIES & VEINS

TUNICA INTIMA - endothelium & connective tissue

TUNICA MEDIA - smooth muscle
TUNICA ADVENTITIA - connective tissue + vv + nerves
DIFFERENCES BETWEEN ARTERIES & VEINS

ARTERY VEIN
DIFFERENCES BETWEEN ARTERIES & VEINS
CARDIOVASCULAR SYSTEM
• Circulatory System
• Capillaries
• Structure of Larger Vessels
• Structure of Arteries
• Structure of Veins
• The Heart
• Lymphatics
AORTA (elastin stain)
MUSCULAR ARTERIES
 MUSCULAR ARTERIES

H&E Elastin
 ARTERIOLE

H&E TEM
 Types of
Microcirculation
1. Arteriole-
capillary bed –
venule
2. Arteriovenous
anastomosis (skin)
3. Arteriole-capillary-
arteriole (kidney)
4. Venule-capillary-
venule (liver)
CARDIOVASCULAR SYSTEM
• Circulatory System
• Capillaries
• Structure of Larger Vessels
• Structure of Arteries
• Structure of Veins
• The Heart
• Lymphatics
POSTCAPILLARY/COLLECTING/MUSCULAR VENULES
MEDIUM SIZED VEIN
LARGE VEIN - Inferior Vena Cava
UNIDIRECTIONAL
BLOOD FLOW IN
VEINS
CARDIOVASCULAR SYSTEM
• Circulatory System
• Capillaries
• Structure of Larger Vessels
• Structure of Arteries
• Structure of Veins
• The Heart
• Lymphatics
STRUCTURE OF THE HEART

Endocardium - homologous to
tunica intima
Myocardium - homologous to
tunica media
Epicardium - homologous to
tunica adventitia
EPICARDIUM

ENDOCARDIUM
 SA node

Purkinje fibers
CARDIOVASCULAR SYSTEM
• Circulatory System
• Capillaries
• Structure of Larger Vessels
• Structure of Arteries
• Structure of Veins
• The Heart
• Lymphatics
THE VASCULAR SYSTEMS

CIRCULATORY LYMPHOID
SYSTEM SYSTEM

CARDIOVASCULAR LYMPHATIC
SYSTEM SYSTEM
LYMPHATIC VESSELS & LYMPH
NODES
FUNCTIONS:
Return excess 10%
of interstitial fluid to
blood
Transport lipids
absorbed from
intestines
Immunologic
support
 LYMPHATICS

KEY POINT: Lymphatic

capillaries have unique
permeability
characteristics
 LYMPHATICS
&
LYMPH NODES

KEY POINT: All lymph gets

filtered by at least one lymph
node before it re-enters the
blood.
 CLINICAL CONTEXT:
Myocardial Infarction (MI)

KEY POINT: Myocardial infarction alone is

responsible for 20-25% of all deaths in the US.
CLINICAL CONTEXT:
Berry Aneurysm

KEY POINT: Berry

aneurysms are related to
defects in the tunica
media of cerebral arteries.
CLINICAL CONTEXT:
Varicose Veins

KEY POINT: Varicose

veins are abnormally
dilated, tortuous veins
with valve insufficiency.
About 15-20% of the
general population will
develop varicose veins in
the lower legs.
THE END