Blood Vessels & Heart

Page 1: Session materials

Session learning objectives (SLO):
1. Recognize, differentiate and classify the following types of blood vessels: capillaries,
sinusoids, arterioles, venues, muscular arteries, medium veins, elastic (large) arteries and
large veins
2. Describe the characteristics of the various types of blood vessels
3. Describe the structural organization of the walls of blood vessels
4. Identify the three layers in the walls of each type of blood vessel excluding capillaries
5. Recognize and identify the components of each layer
6. Distinguish between the different types of capillaries (somatic and fenestrated)
7. Identify, in electron micrographs, continuous (somatic) capillaries, fenestrated capillaries
and pericytes
8. Identify vasa vasorum and small nerve bundles in the tunica adventitia of large arteries
and large veins
9. Explain the function of blood vessels
10. Describe the organization of the heart
11. Identify the three layers of the heart (endocardium, myocardium, pericardium), nodal
tissue, Purkinje fibers, pulmonary valves and atrio-ventricular valves

Clinical & functional examples of applied histology:

a. Atherosclerosis, arteriosclerosis, hypertension
b. Ischemic heart disease, coronary artery thrombosis
c. Aneurysm, varicose veins, Marfan’s syndrome
d. Rheumatic heart valve disease

Learning resources:

Required “reading”:
Lecture recordings, pre-lab recordings, supplemental recordings
Junqueira's Basic Histology, 14e (Chapter 11: The Circulatory System)
Tulane medical histology website

Recommended reading: Histology: A Text and Atlas with Correlated Cell and Molecular
Biology, 7e (Chapter 13: Cardiovascular System)

Practice questions:
Junqueira's Basic Histology, 14e (Chapter 11: The Circulatory System)
Canvas, 01-Yr17-Histology, quizzes (non-graded)
Exam master: https://matas.tulane.edu/resources/guides (You need to register yourself)
The 3-Question principle: With every image, always ask yourself these 3 questions: 1. What is
it? (the identity of the cell, structure or tissue that I am looking at) 2. What does it do normally?
3. What would happen if it is removed, inactivated or dysfunctional?

Page 2: Concept map

Page 3: Study guide

CARDIAC What are you expected to learn from the study of cardiac muscle structure?
MUSCLE
Review the histology of skeletal muscle

WHAT IS CARDIAC MUSCLE? striated muscle that forms the myocardium in the heart.
Cardiac myocytes contain central nuclei with halo of clear/empty juxtanuclear region; striated,
fibers branch; associated with lots of capillaries; where are the capillaries that supply the cardiac
myocytes located?

o MYOFIBRILS AND MITOCHONDRIA: contain myofibrils made up of isoform specific

actin and myosin proteins; Cardiac myocytes located in the atria contain cytoplasmic
granules called Atrial Natriuretic Peptide (ANP) that promotes urinary excretion of
sodium (and water) by reducing reabsorption of sodium at renal tubules
o MITOCHONDRIA: contains high number of mitochondria within the myocyte
sarcoplasm that prevents/obstructs myofibrils from forming cylindrical bundles. If the
heart were to stop beating due to oxygen insufficiency, in what phase of activity would it
stop: systole or diastole?
o T-TUBULES: arranged as diads and associated with Z lines. Linked to calcium release
via sarcoplasmic reticulum.
o INTERCALATED DISCS: cellular junctions that provide mechanical and electrical
connections for cardiac myocytes. Contain desmosomes and fascia adherens junctions.
o HYPERTROPHIC GROWTH: cardiac muscle grows by hypertrophy rather than cell
division. Dead cardiac muscle cells become replaced by connective tissue scars. There
are no satellite cells in cardiac tissue (review skeletal muscle to recall what satellite cells
do).
o CONTRACTION: as with skeletal muscle, the sliding and interaction between actin and
myosin filaments provides the physical basis for contraction.
o ENERGY: for muscle contraction is derived from abundant mitochondria. Understanding
the intracellular relationship between mitochondria, sarcolemma, and sarcoplasmic
reticulum (SR) is important. SR • T-tubule • mitochondria • calcium • myosin •
contraction
o REPAIR: unlike skeletal muscle, cardiac muscle injury is followed by connective tissue
scar formation at the injury site

HEART What are you expected to learn from the study of the histology of the heart?

REVIEW gross structure of the heart (atria, ventricles, SA node, AV node, serous and visceral
pericardium).

o ENDOCARDIUM: layer of endothelial cells with an anti-thrombotic surface. The

subendothelial layer (subendocardium) contains connective tissue, collagen, elastic
tissue, smooth muscle cells, fibroblasts, blood vessels and nerves.
o ENDOTHELIAL CELLS: All capillaries have endothelial epithelium that rest on a basal
lamina; however, the basal lamina in sinusoidal capillaries is discontinuous. This explains
why the fenestrations in sinusoidal capillaries do not have diaphragms. Endothelial cells
contain desmin and vimentin intermediate filaments, and produce the glycoprotein von
Willebrand factor, and nitric oxide; can convert inactive angiotensin I to active
 angiotensin II; can breakdown lipoprotein to triglycerides and cholesterol. What
organelles would you expect to find in endothelial cells?
o MYOCARDIUM: cardiac muscle cells arranged as helices, along with numerous
capillaries.
o EPICARDIUM: layer of secretory mesothelial cells with connective tissue, collagen,
blood vessels and adipocytes.
o CARDIAC SKELETON: dense irregular connective tissue that provides attachment for
cardiac myocytes and heart valves.
o SA, AV NODES: contains small cardiac myocytes. Depolarization of these myocytes is
influenced by sympathetic and parasympathetic nerves
o PURKINJE FIBERS: large cardiac myocytes located in the subendocardium, containing
few myofibrils that are able to depolarize, but have no T-tubules (so depolarization does
not lead to contraction of Purkinje myocytes). i.e. Purkinje myocytes can transmit without
contracting. What is the relationship between Purkinje myocytes and the PQRST parts of
an EKG recording?
o WHAT CAN GO WRONG?: myocardial infarction from blocked coronary arterial blood
flow to the cardiac myocytes in the myocardium. Understanding the sequence of events
from atherosclerotic plaque formation to coronary artery blockage to cardiac myocyte
infarction is important. What is the physiological deficit in cardiac tissue in a patient with
AV node block? What clinical signs would you expect in a patient with pericarditis?
 BLOOD What are you expected to learn from the study of the histology of blood vessels?
VESSELS

WHAT IS A BLOOD VESSEL? how does an artery differ from a vein? All vessels are
constructed around the same principle: layered walls that contain up to 3 “tunics” – intima,
media and adventitia. Vessel types are differentiated by size and wall construction. Wall
architecture is determined by function of the vessel.

o TUNICA INTIMA: layer of endothelial cells that provide an antithrombotic property to

the tunica intima. Endothelium also produces nitric oxide, endothelin, and selectins: these
are important. Pericytes are cells associated with endothelium of capillaries and venules.
Which tunic is affected in atherosclerosis?
o TUNICA MEDIA: contains smooth muscle that reacts to sympathetic innervation and
chemical mediators, and can produce type 3 collagen and elastic fibers. What is the
consequence of Marfan’s syndrome for large arteries?
o TUNICA ADVENTITIA: contains connective tissue, fibroblasts, smooth muscle, and
type 1 collagen. Small blood vessels within the adventitia are vasa vasora.
o ARTERIAL SIZES: types of arteries – elastic (large), muscular (medium), arterioles,
capillaries (continuous, fenestrated, sinusoids). Can you track the sequential relationship
histologically between blockage of a coronary artery and the parts of an EKG recording?
o VENOUS SIZES: venules, medium, large
o WHAT CAN GO WRONG?: the difference between arteriosclerosis and atherosclerosis
is important. Also Marfan’s syndrome. What is the difference between aortic dissection
and aortic aneurysm? What is the pathogenetic relationship between tunica intima,
atherosclerosis and aortic dissection?

Page 4: Common Structure

The basic plan of all the blood vessels (except the capillaries) that make up the cardiovascular
system consists of these three layers.
◦ Tunica intima
◦ Tunica media
◦ Tunica adventitia

Tunica intima

This is the innermost layer which consists of an endothelial tube of longitudinally arranged,
simple, squamous epithelial cells termed endothelial cells.
o A sheet of elastic tissue, termed the internal elastic lamina, forms the boundary between
the intima and the second layer of the vessel, tunica media.
o The thin, squamous endothelial cells are separated from the internal elastic lamina by a
layer of loose connective tissue termed the subendothelial connective tissue. The
subendothelial connective tissue contains a few fibrocytes, occasional smooth muscle
cells, and thin collagen fibers.

Tunica media

This consists of multiple concentric layers of smooth muscle fibers and elastin. Some small
blood vessels lack muscle fibers and elastin.
o An external elastic lamina serves as the boundary between the media and the outermost
layer of the vessel, tunica adventitia.
o In larger vessels you may find small blood vessels, termed vasa vasorum, within the
media. The vasa vasorum serves to nourish the vessel.

Tunica adventitia

This is the outermost layer. It consists of fibrocytes, longitudinal bundles of collagen fibers, and
a loose network of thin elastic fibers.
o In larger vessels, vasa vasorum may also be found within the adventitia.

Page 5: Function

Functions of the cardiovascular system:

Figure 13.3 Diagram of the blood circulation. (Histology, A text and atlas) This diagram shows
the right and left side of the heart artificially separated.

The right side of the heart pumps blood through the low-pressure pulmonary circulation. The
right atrium receives deoxygenated blood returning from the body via the inferior and superior
venae cavae. The right ventricle receives blood from the right atrium and pumps it to the lungs
for oxygenation via the pulmonary arteries. The left side of the heart pumps blood through the
high-pressure systemic circulation. The left atrium receives the oxygenated blood returning from
the lungs via the four pulmonary veins. The left ventricle receives blood from the left atrium and
pumps it into the aorta for systemic distribution.

Blood is ejected under high pressure into systemic arteries, which branch and distribute blood
into tissues via thin walled capillaries. Blood flow through capillaries is regulated by arterioles
that can be opened and closed.

Blood from capillaries is collected by venules which lead into small, then larger veins. The
largest veins return blood to the heart.

The structure of the heart, and blood vessels has a common structural plan.

Impulse generating and conduction system:

Figure 13.5 Chambers of the heart and the impulse-conducting system. The heart has been cut
open in the coronal plane to expose its interior and the main parts of its impulse-conducting
system (indicated in yellow). (Histology, A text and atlas)

The conduction system of the heart is composed of modified cardiac muscle cells specialized
for the initiation and conduction of electrochemical impulses. The arrangement of this system
functions to coordinate contraction of the myocardium around the heart’s chambers.

1. Sinoatrial node (SA node) (pacemaker): located in the median wall of the right atrium
(subepicardium), near the opening of the superior vena cana. Cells of the SA node have
the fastest intrinsic rhythm of cardiac muscle cells. Impulses generated by the SA node
travel across the atria to the atrioventricular node by internodal fibers.

2. Atrioventricular node (AV node): located at the right side of the interatrial septum.
Impulses travel from the AV node directly into the atrioventricular bundle.

The SA and AV nodes are composed of modified cardiac muscle fibers which are
smaller than normal cardiac muscle cells.

3. Atrioventricular or AV bundle (Bundle of His): passes from the interatrial wall into
the interventricular septum. At its termination, it gives off the right and left bundle
branches to the ventricles.
 4. The right and left bundle branches give rise to the Purkinje plexus.

5. Purkinje fibers transmit impulses to the cardiac muscle cells to contract in a

synchronous, coordinated manner.

The AV bundle, right and left bundle branches and the Purkinje plexus are composed of
Purkinje fibers which are larger than other cardiac muscle cells. They contain sparse
myofilaments, abundant glycogen, and have 1 or 2 central nuclei.

Page 6: Lab Guide

Lab Specific Objectives
1. On slides, you should learn to identify and recognize different types of vessels, and
cardiac muscle fibers
2. Describe the structural organization and identify the components of the vessel wall, and
of the heart
3. Describe the relationship between vessel wall structure and function
4. Interpret vessel wall structure in relation to blood pressure
5. Recognize and interpret disorders of vessel wall structure in relation to vascular function

Important principles for Cardiovascular system:

1. Cardiac muscle is different from skeletal muscle. Cardiac muscle does not stop
contracting and relaxing until death. This level of activity has implications for the number
of mitochondria, and capillaries that are seen in cardiac tissue.
2. Conducting tissue in the heart is different from cardiac muscle. The fibers in conducting
tissue are different from the fibers in cardiac tissue.
 3. Blood pumped out of the heart goes directly into arteries and travels in veins. Understand
the structural and functional relationship between the heart and blood vessels. Changes in
arterial walls can affect cardiac tissue mass.
4. Understand vessel wall structure and its role to function. Many veins have valves to
regulate direction of blood flow. Damage to venous valves can affect venous walls.
5. Cardiac tissue can become damaged. Vascular walls can become damaged. Recognize
disorders of heart and vessel walls.
6. Cardiac muscle also produces and releases hormones.

Slides for this lab:

Slide Tissue

28, 29, TU023, TU099, TU100, arteries

TU102, TU103, DHA065
26, 27, 48A, 48B, 53, TU023, TU099, veins
TU100, TU101, DHA065
11, 26, 48A, 48B, 53, 64, TU006, capillaries
LHO139
13, 14, TU 027 cardiac muscle

Demonstration slides

D6 Tongue

D16 Aortic valve

D19 Ventricular wall of heart

Tasks in the lab:

1. Locate and identify the following:

A. cardiac muscle: striations, intercalated discs
B. capillary
C. arteriole
D. large artery, muscular artery, medium vein: elastic fibers, smooth muscle,
tunica layers
E. Purkinje fibers
2. At what magnification of objective lens of the light microscope does the internal elastic
lamina of the vessels in slides 26, 48A, and 48B become easily and readily
visible/apparent?
3. What is the difference between the muscle in TU 027 / slide 15 and the muscle in TU 102
/ Slide 28?
4. If arterial blood pressure were to increase, what would you expect to happen to the
histological appearance of (a) tunica intima (b) tunica media (c) tunica adventitia
5. If venous blood pressure were to increase, what would you expect to happen to the
histological appearance of (a) tunica intima (b) tunica media (c) tunica adventitia
Page 7: Heart
HEART

The heart is a muscular organ for pumping blood around the vascular system. There are 3 named
layers of the wall of the heart. You may find numerous red blood cells (erythrocytes) in the
chambers of the heart.
o endocardium (tunica intima)
o myocardium (tunica media)
o epicardium (tunica adventitia)

Endocardium

The endocardium lines the atria and ventricles and covers the heart valves.
If there are red blood cells in your slide of the heart, look at the first lining of the cardiac tissue in
the wall of the heart. This internal lining, adjacent to the erythrocytes, is called the endocardium
and consists of a layer of flattened nucleated cells (simple squamous epithelium or endothelium)
supported by a very thin layer of loose connective tissue.

Myocardium

Beneath the endocardium, you should find cardiac muscle: this is true in most locations. The
layer of cardiac muscle tissue is called the myocardium. Look for blood vessels (arterioles,
medium vessels and venules) that supply the myocardium. Look for the striations and
intercalated disks in the myocardium. Depending on the plane through which the cardiac muscle
has been cut (sectioned) and the type of stain used, intercalated disks should appear as dark
irregular lines that run across the striations in the cardiac muscle. This means that you can only
see intercalated discs in longitudinally cut cardiac muscle fibers.

What do intercalated discs represent?

In some locations immediately deep to the endocardium, some of the cardiac muscle cells appear
pale and swollen (larger), with few scattered myofibrils and larger nuclei. These are Purkinje
fibers (TU110).
Epicardium

The epicardium is the layer of muscle found covering the external surfaces of the heart. It
consists of mesothelial cells and underlying connective tissue and protectively encompasses the
heart. It is directly fused with the myocardium internally and is in contact with the serous layer
of the pericardium.
Pericardium is a folded fibrous connective tissue layer that encompasses the entire heart and the
roots of the great vessels. It has an inner and an outer layer which are continuous and create a
fascial space known as the pericardial sac. Within this sac is a viscous liquid known as the
pericardial fluid, which helps lubricate the outer beating surfaces of the heart and prevents
friction between the fibrous and serious layers of the pericardium.

Serous epicardium appears as a simple squamous epithelium or mesothelium, supported by

connective tissue. Look for flattened nuclei of the mesothelial cells (TU110). They are similar in
appearance to the squamous cells in the endocardium.

Endothelium + connective tissue = endocardium

Purkinje fibers + cardiac muscle fibers = myocardium
Mesothelium + connective tissue = epicardium

Page 8: Cardiac muscle

CARDIAC MUSCLE

This is striated muscle that contains cells/fibers whose intracellular contractile filaments
(myofibrils) can be seen with the light microscope; these filaments appear as striations. Cardiac
muscle cells are striated cells and are similar in appearance to skeletal muscle cells. There are
however differences between both types of muscles cells.

Cardiac muscle cells

Cardiac muscle cells/fibers are long and branching; they contain 1-2 centrally located nuclei. The
myofibrils are organized to create A and I banding in the muscle cell. Where two cardiac muscle
cells meet, an intercellular junction is defined by intercalated disks (Z disks, TU 027) which
represent a complex of gap and adherent junctions, and desmosomes. Depending on the plane of
section through the cardiac tissue and the stain used, Z disks appear as dark irregular lines
between two cardiac muscle cells.

How to identify cardiac muscle cells: in long profile, parallel cells with central nuclei, myofibril
banding, and Z disks; in transverse profile, round cells with round nuclei. Examples: TU027.
Slide TU110 shows very clear examples of the myofibrils in the sarcoplasm of the Purkinje
fibers.

Purkinje fibers characteristics:

o Usually occur in bundles
o Demonstrate a significantly increased muscle fiber diameter compared to other cardiac
muscle cells
o Have an increased intracellular glycogen content, resulting in lighter staining properties
o Have a reduced number of myofibrils, and therefore a reduction in the banding pattern
(when viewed in longitudinal section)
o The nuclei are more rounded and often found in groups of one or two within a single
Purkinje fiber.
Intercalated disc

Bands (striations)
 Purkinje fibers

Page 9: Arteries
There are three main types of arteries:
 o Elastic arteries
o Muscular arteries
o Arterioles

Elastic arteries:

Why do they need to be elastic?

The walls of elastic arteries are thin relative to their diameter.

When the heart contracts, and ejects blood into these arteries, the walls need to stretch to
accommodate the blood surge, storing energy. The arterial hydrostatic pressure that results from
ventricular contraction is the 'systolic blood pressure'.
Between heart contractions, the elastic walls recoil, to maintain blood pressure, continuing to
move blood even when ventricles are relaxed. The arterial hydrostatic pressure between
contractions is the 'diastolic blood pressure'. The walls of these arteries have lots of elastin.

Tunica intima is made up of an epithelium, which is a single layer of flattened epithelial cells,
together with a supporting layer of elastin rich collagen. The external border of the intima is
marked by an internal elastic lamina, which is not easily distinguished because of the large
amount of elastin within the media of the vessel.

Tunica media constitutes the bulk of the wall of an elastic artery and is composed of circularly
arranged smooth muscle and a large number of concentric fenestrated sheets of elastin.

Tunica adventitia of an elastic artery is usually quite thin. It consists of irregular connective
tissue with collagen and elastic fibers, some fibroblasts, and smooth muscle cells. It has small
'vasa vasorum' as the large arteries need their own blood supply.

Slide TU102 is stained for elastic tissue and shows the elastic fibers in the aorta very clearly.
The tunica media is a very thick layer and contains a large amount of elastic fibers arranged as
membranes. The tunica media also contains smooth muscle. Look for the internal elastic lamina
which marks the boundary between the tunica intima and the tunica media. In Slide TU102, look
for the boundary between tunica media and tunica adventitia: where the elastic tissue layers in
the tunica media end. The tunica adventitia is not as thick as the tunica media and contains
fibroblasts and smooth muscle. Look for vessels in the tunica adventitia (vasa vasorum).
Examples of elastic arteries: TU102, TU103
 Wall of aorta

Muscular arteries:

These arteries distribute blood to various parts of the body. These include arteries such as the
femoral and coronary arteries. The walls of these arteries have lots of smooth muscle, which
means that they are able to contract or relax to change the amount of blood delivered, as needed.

Note the conspicuous intima in the muscular artery. The external limit of the intima is marked
by an internal elastic lamina (IEL), which is convoluted because of the contraction of the
elastic membrane during the fixation process.

The media of a muscular artery is composed of many circumferentially arranged smooth muscle
cells. Less well defined is the external elastic lamina (EEL).
The tunica adventitia contains circumferentially arranged fibrocytes and collagen fibers
arranged both circumferentially and longitudinally along the length of the vessel.

The internal elastic lamina is prominent and should be easy to identify. The dividing line
between the layers of transverse flattened nuclei of the smooth muscle cells in the tunica media
and the thinner tunica adventitia is sometimes difficult to determine but slide TU099 is a good
example to examine. Examples of muscular arteries: Slides TU023, TU099, TU100.

Arterioles:

Arterioles are small arteries that deliver blood to capillaries. Arterioles control blood flow
through capillary beds by contracting or dilating the size of the lumen, and therefore the tunica
media layer contains concentric rings of smooth muscle to do this. This compartment is
important in determining your blood pressure as the narrow diameter of these blood vessels
resists blood flow, and the back pressure helps to stretch the walls of the arteries during heart
contractions.

In an arteriole, the endothelial cells lining the tunica intima appear rounded and there are one or
two layers of smooth muscle cell nuclei in the tunica media. The internal and external elastic
laminae are not identifiable in H&E microscopy (probably because they are too small to be
visible), and the tunica adventitia is usually too thin to be a useful marker of identification.
Slide TU110.

Because of the difficulty and ambiguity in distinguishing between small and large arterioles, in
this class an arteriole will be defined as a vessel that:
o Has the wall thickness-to-lumen ratio that qualifies it as being a part of the arterial
system
o Possesses one or two layers of smooth muscle
o Lacks an internal elastic membrane
Page 10: Veins
To return blood to the heart, there is a series of venules, veins, and muscular veins. The venous
return from the legs is aided by contraction of skeletal muscle, which compresses the veins inside
them, and the veins of medium size also have valves in them, to overcome the problem of
reverse flow.

Vessels of the venous system possess the same three-layered organization as the arterial system.
However, there are several histological characteristics of the venous system that easily
distinguish its vessels from those of the arterial side of the cardiovascular system:
o The ratio of wall thickness to lumen diameter is considerably smaller for vessels of the
venous system.
o The media is relatively thin and poorly developed in vessels of the venous system.
o Internal and external elastic membranes are more difficult to distinguish in vessels of the
venous system.

Large vein

Large veins are large diameter vessels with poorly defined boundaries for the tunica media.
There is no internal elastic lamina because these vessels do not need to be pulsatile. Without
elastic tissue and good muscle support, the lumen in these vessels tend to collapse (slide
TU101).

Given this tendency for large veins to collapse, how would you prepare a vein into which
you wish to introduce a needle in order to draw blood (venepuncture)?

The tunica adventitia is more easily identified as a thick layer of connective tissue containing
smooth muscle, collagen fibers and elastic fibers. Compare the thickness of the tunica media
with the thickness of the tunica adventitia. Look for vessels and nerves in the tunica adventitia
(vasa vasorum and vasa nervosum). Examples in the body are vena cava, portal vein and external
iliac vein. TU101

Medium vein

A medium vein is similar in structure to a muscular artery but smaller than a large vein. In
general, the walls of veins are thinner than the walls in similarly sized arteries. In addition, veins
may contain valves. The endothelial cell nuclei appear rounded and the thin tunica media has
very few layers of smooth muscle cell nuclei. The tunica adventitia appears thicker than the
tunica intima or tunica media. Examples include the saphenous and renal veins. TU023, TU099,
TU100
 Medium vein

Page 11: Capillaries

Capillaries are small, normally around 4-10 µm. Note that the lumen diameter ranges in size
from slightly smaller than a single red blood cell (RBC) to one and one-half times the diameter
of an RBC.

Capillaries connect arterioles to venules. They allow the exchange of nutrients and wastes
between the blood and the tissue cells. This exchange occurs by 1) passive diffusion (such as O2
can pass freely across endothelial cells; 2) Solute-specific membrane transport carriers (such as
HCO3- across both surfaces of endothelial cells); 3) Transcytosis (move large molecules by the
rapid shuttling of endocytic and exocytic vesicles); 4) Leaks (between tight junctions).

Capillaries have a single layer of flattened endothelial cells. There are no muscular or adventitial
layers. The thinness of the capillaries helps efficient exchange between the lumen of the capillary
and the surrounding tissue.

There are three types of capillary:

o continuous
o fenestrated
o discontinuous

Continuous capillary

Continuous capillaries are the most common types of capillaries and found in brain, muscle, and
connective tissue. They often have pericytes associated with them. They lie just underneath the
endothelium of blood capillaries, and are a source of new fibroblasts.
Figure 13.21 Electron micrograph and diagram of a continuous capillary. (Histology, A text and
atlas)

The endothelial cells that make up the wall of a continuous capillary contain numerous
pinocytotic vesicles. The cell junctions are frequently marked by cytoplasmic (marginal) folds
that protrude into the lumen. The endothelial cell nuclei are not included within the plane of
section in the micrograph. Similarly, the electron micrograph shows only a small amount of
pericyte cytoplasm. Note that the pericyte cytoplasm is enclosed by basal lamina.

Fenestrated capillaries

These are found in some tissues where there is extensive molecular exchange with the blood
such as the kidney, choroid plexus, endocrine organs and the gut. The 'fenestrations' are pores
that will allow larger molecules through.

These capillaries are more permeable than continuous capillaries.

The cytoplasm of the endothelial cells contains numerous fenestrations (small arrows). In some
of the thicker regions of the endothelial cells where the fenestrations are absent, pinocytotic
vesicles are present. Part of a pericyte is seen on the bottom of the electron micrograph, including
its nucleus in the lower left corner of the micrograph.

Discontinuous Capillaries

These are only found in the liver. They are formed between the endothelial cells of the sinusoids
and hepatocyte cells. There are large clefts or spaces between the two layers of cells, that allows
proteins, or even blood cells to pass through.

Sinusoids are a special type of capillary that have a wide diameter. These are found in the liver,
spleen, lymph nodes, bone marrow and some endocrine glands. They can be continuous,
fenestrated, or discontinuous.
TU006. Given the relationship between diameter of a capillary and that of a red blood cell, what
do you think the speed of blood flow in a capillary is?

LHO139. Examine the endothelial cells that line a sinusoidal capillary in the liver, and compare
the appearance to that in a regular capillary in for example the myocardium.

Page 12: Comparison of all structures

Heart:
Tunica Adventitia (epicardium) contains fibroelastic connective tissue, blood vessels,
lymphatics and adipose tissue.
Tunica Media (myocardium) is the largest of the three layers, and contains cardiac muscle
fibers, and loose endomysial connective tissue that contains lots of capillaries.
Tunica Intima (endocardium) of the heart: stratified squamous epithelium.

Elastic Artery:
Tunica Adventitia has small “vasa vasorum”, as the large arteries need their own blood supply.
Tunica Media: broad, elastic, concentric fenestrated sheets of elastin, and collagen, few muscle
fibers.
Tunica Intima: single layer of flattened epithelial cells, supporting layer of elastin rich collagen.
Has “myointimal cells” that accumulate lipid with ageing, first sign of atherosclerosis.

Muscular Artery:
Tunica Adventitia: very broad, mostly collagen and elastin.
Tunica Media: muscle layer (with some elastin and collagen), sandwiched by an Internal Elastic
Layer (IEL) and an External Elastic Layer (EEL).
Notice how the tunica media layer is relatively smaller than that for the elastic artery
Tunica Intima: flattened endothelial cells.

Arteriole:
Tunica Adventitia: much reduced, merges in with surrounding tissue.
Tunica Media: few or single layer of smooth muscle cells.
Tunica Intima: single layer of squamous epithelium.

Capillary/Venules:

This shows a vasa vasorum. The large lumen suggests that it is a venule. It consists of a single
layer of flattened endothelial cells. There is no tunica media or tunica adventitia layer.

Large Vein:
Tunica adventitia layer is the most prominent layer, and has collagen fibers.

Medium Vein:
Tunica media is the most prominent layer.
There is no inner or outer elastic layer, as in the muscular artery.
 1. How do the structures of muscular arteries and veins differ?
2. Muscular arteries and veins both regulate their diameters by contraction of the muscle
layers in the tunica media, yet this layer appears very different in the two types of vessel.
How do you explain this?
3. How does the structure of the tunica adventitia differ from that of the muscular artery?
4. The lumen of the artery is very regular but that of the vein is very irregular. How is this
difference related to the structure of their walls?

Page 13: Common diseases

Common diseases of the myocardium:

The myocardial cells have a high energy demand and therefore a high and constant oxygen
requirement. When deprived of oxygen, individual cardiac muscle cells die and cannot be
replaced. When the reduction in oxygenation (due to progressively inadequate arterial supply) is
slow and gradual, a few muscle cells die at a time and the patient develops the symptom complex
called angina of effort (a characteristic crushing central chest pain on exertion, disappearing on
rest). With increasingly severe ischemia of the myocardium, the angina symptoms appear with
minimal or no exertion. Histologically, the dead muscle fibers are replaced by collagenous
fibrous tissue and remaining muscle fibers enlarge and increase their work rate (hypertrophy) to
compensate. The reduction in flow of arterial blood to the heart is due to the arterial
disease, atherosclerosis, reducing the lumen of the coronary arteries.
When a coronary artery suddenly becomes completely occluded (e.g. by thrombosis), a
substantial mass of the heart muscle cells dies, for example, the muscle comprising the entire
anterior wall of the left ventricle and the anterior part of the interventricular septum dies if the
anterior descending branch of the left coronary artery is blocked. This is called myocardial
infarction, commonly referred to as a ‘heart attack’. This sudden loss of contractile mass greatly
reduces the force of contraction of the left ventricle, leading to low-output left heart failure.
Death of some component of the conducting bundles of Purkinje fibers can also lead to
potentially fatal abnormalities of cardiac rhythm (arrhythmia). Histologically, all the muscle
fibers in the affected area die and are eventually replaced by collagenous fibrous tissue, which is
strong but not contractile, so the patient may have persistent left heart failure.

Common diseases of heart valves:

The aortic valve normally has three cusps, but occasionally there are only two (bicuspid) due to a
developmental anomaly. Bicuspid aortic valves are particularly prone to develop fibrous
thickening, within which calcium salts are deposited to make fibrocalcific nodules. These
severely distort the cusps, which also tend to fuse. This disease, called calcific aortic valve
disease, interferes with valve function, reducing flow of blood through the valve during systole
(aortic stenosis) and allowing blood to leak back from the aorta into the left ventricle during
diastole (aortic regurgitation). Thrombosis may occur on the free margins of heart valves and, if
there is subsequent bacteraemia, they may become infected (valvitis or endocarditis).
Depending on the bacterium involved, the infected thrombus may erode the valve, leading to
severe valve failure, or fragments of the thrombus may break off and pass in the circulation to
distant sites where they may block arteries (embolism).

Common diseases of arteries:

Elastic and muscular arteries develop the common disease called atherosclerosis in which lipid
material infiltrates the tunica intima and accumulates in macrophages. This stimulates the
proliferation of intimal fibroblasts and myointimal cells, with collagen deposition to produce
a plaque which thickens the intima. If severe and in a small-diameter artery, this intimal
thickening can severely reduce the artery lumen and limit the blood flow. These plaques
commonly rupture, further occluding the vessel lumen. The intimal surface is also roughened,
predisposing to the aggregation of platelets and fibrin to form a thrombus which may increase
the size of the plaque and further compromise the vessel lumen.

A further consequence of severe atheroma in elastic arteries is that the muscle cells in the tunica
media are replaced by non-contractile and non-elastic collagen, leading to a weakness in the
artery wall, which may bulge and rupture (aneurysm).
Page 14: Old style lab guide
BLOOD VESSEL

Blood vessels are classified as capillaries, arteries and veins. Blood vessels have three layers
(tunics) to their walls: tunica intima, tunica media and tunica adventitia. In general the tunica
intima consists of a single layer of endothelial cells which line the lumen and subendothelial
connective tissue. The major component of the tunica media is concentrically arranged smooth
muscle fibers. The tunica adventitia is composed mainly of fibroelastic connective tissue.
Capillaries and sinusoids will not display all of these three tunics.

CAPILLARIES

1. TU 006 (Esophagus) / Slide 11 (Skeletal muscle): Find capillaries cut in transverse

sections. The diameter of the lumen (4-10 um) should accommodate only one red blood
cell. Locate endothelial nuclei.

SINUSOIDAL CAPILLARIES

Sinusoidal capillaries have an enlarged diameter lined by endothelial cells. The endothelial wall
may be discontinuous with gaps between the endothelial cells in which case the basal lamina is
incomplete.

2. LHO 139 / Slide 64 (Liver): Study the sinusoidal capillaries between the cords of liver
cells. Attempt to identify the endothelial cells. Lining cells have gaps between them.

Arteries and veins are classified based upon their size and structure of the wall. Arteries
are usually distributed with their companion veins: 1) arterioles and venules; 2) muscular
arteries and medium veins and 3) large elastic arteries and large veins. The walls of arteries
are thicker with smaller lumens than their companion veins. The major component of the
wall of arteries is the tunica media, while the major component of the wall of veins tends to
be the tunica adventitia.

To identify blood vessels, look for the following: endothelium, internal elastic lamina, external
elastic lamina. Identification and recognition of arteries and veins is dependent on a combination
of vessel diameter (“size”), and composition and structure of the vessel wall.

ARTERIOLES AND VENULES

Arterioles are the branches of the arterial system which give origin to capillaries and regulate the
flow of blood into the capillary beds. The tunica media contains one to two layers of smooth
muscle. Large arterioles usually have an internal elastic lamina. The tunica adventitia is scant in
arterioles.

Postcapillary venules are similar to capillaries in structure except they have a larger diameter (10
to 50 um). The endothelial cells are supported by reticular fibers and have pericytes associated
with them. Larger venules will contain one or two poorly organized layers of smooth muscle,
which may be incomplete in areas.

3. DHA 065 (This slide contains three sections of gut. Move to the submucosa of the larger,
topmost section) / Slide 53 (Jejunum): Study arterioles in transverse sections. Compare
them to the small muscular arteries. Note variations in the sizes of arterioles. Identify the
3 tunics. Look for an internal elastic lamina in the larger arterioles.

Compare arterioles to their accompanying venules as to diameter of the vessels; relative

thickness of walls; relative thickness of corresponding tunics; and composition of tunics. Note
that the tunica intima of venules consists of little more than an endothelial lining, and the media
and adventitia are not sharply demarcated.

MUSCULAR/MEDIUM ARTERIES AND MEDIUM-SIZED VEINS (Refer to characteristics

page)

Most of the named arteries except the aorta, its largest branches and the pulmonary arteries, are
termed “medium-sized” or muscular arteries. Those ranging in size between arterioles and
medium-sized arteries are termed “small arteries”. Since the structure of small and medium
arteries is the same, we will classify both as “muscular arteries”.
Medium and small sized veins are basically the same in structure and for the purposes of this
course no distinction will be made between the two. All veins within the size range will be
identified as medium sized veins. Medium veins have valves which prevent the back flow of
blood.

4. TU 100 / Slides 26 (Neurovascular bundle) and TU 099 / 48A&48B (Medium sized

arteries and veins): Identify the three layers of the muscular arteries in these slides:
tunica intima, tunica media, tunica adventitia. Compare the relative thicknesses of the
three tunics and the thickness of the wall as a whole with the diameter of the lumen.
Study the intima. Note the subendothelial connective tissue. The internal elastic lamina is
 commonly considered a part of the tunica intima. The external elastic lamina, a
component of the tunica media may or may not be present. In slide 48A also identify
arterioles, venules and nerve bundles.

Locate and study transverse sections of medium-sized veins. The tunica intima is thin; the
subendothelial connective tissue is an inconspicuous layer containing only a few elastic and
collagenous fibers. A poorly defined internal elastic lamina is present in some medium veins.
Compare with the muscular artery, as to the thickness and makeup of the tunica media and tunica
adventitia. Note the differences in the arrangement of the smooth muscle fibers in the tunica
media of muscular arteries and medium veins.

LARGE ARTERIES AND VEINS

5. TU 103 / TU 102 / Slide 29 (Aorta) / Slide 28 (Aorta): The slides contain two sections.
One is stained with H&E, the other with orcein which specifically stains elastic fibers.
Note the distribution of the elastic fibers. Compare the relative thickness and composition
of the three tunics of the aorta with those of the muscular artery. Be able to identify the
three tunics. Compare the relative amounts of elastic tissue and muscle in the aorta to that
in the muscular arteries. Note the distribution of elastic laminae and elastic fibers.
Internal and external elastic laminae are present but are not obvious due to the abundance
of elastic fibers. Locate vasa vasorum and vasa nervosum.

6. TU 101 / Slide 27 (Vena cava-transverse section): Compare the structure of the vena
cava with the medium-sized vein and with the aorta. Identify the three tunics. There is no
internal elastic lamina. Note the irregular distribution of smooth muscle bundles in the
wall. The tunica media is poorly defined. The thick tunica adventitia has longitudinally
arranged bundles of smooth muscle, which is characteristic of this type of vessel as well
as some of the medium veins. Locate vasa vasorum and vasa nervosum.

HEART

CARDIAC MUSCLE

7. TU 110 / TU 027 / Slides 13 and 14 (Cardiac muscle): Cardiac muscle fibers can be
found cut in longitudinal, transverse, and tangenital planes. In longitudinally oriented
muscle fibers locate intercalated discs. Note the branching of the cardiac muscle fibers,
the centrally located nuclei, and the A and I bands. In cross sections of cardiac muscle
fibers note the centrally located nuclei.

Compare TU 025 / slide 11 (skeletal muscle) with TU 110 / TU 027 / slides 13 and 14,
note the following differential features:
1. Branching of cardiac muscle fibers; no branching of skeletal muscle fibers
2. Presence of intercalated discs in cardiac muscle
3. Centrally located nuclei in cardiac muscle; peripherally located nuclei in skeletal muscle
8. TU 110 (Heart, section through the ventricular wall): Look for muscle fibers adjacent
to the subendothelial connective tissue. They appear to be atypical, swollen and contain
scattered myofibrils. These are Purkinje fibers. Note that these fibers are not rich in
myofibrils, and in most preparations contain large empty spaces due to extracted or
unstained glycogen.