Heart

and Blood Vessels

Grace Mendoza-Bardelosa, MD, FPDS

Department of Human Structural Biology
 Intended Learning Outcomes
• Discuss the layers of the wall of the heart.
• Differentiate between cardiac muscle cell and
Purkinje fibers.
• Discuss the supporting tissues of the heart.
• Differentiate the types of blood vessels.
• Discuss the layers of the blood vessel wall.
• Discuss common clinical conditions affecting the
heart and blood vessels.
 Circulatory System
• Mediates continuous movement of all body fluids
• Two functional components
– Cardiovascular system (CVS)
– Lymphatic vascular system
• Network of drainage vessels
• No central pump
• Returns excess extravascular fluid to CVS
• Called lymph and collects in thin-walled, irregularly shaped
lymphatic vessels
• Transports lymph to lymph nodes
• SMs & valves in lymph vessel walls
Functions of the Cardiovascular System
• Transports O2 and nutrients to tissues
• CO2 and metabolic waste products from tissues
• Temperature regulation
• Distribution of molecules and cells
– Ex: hormones, cells of the immune system
 Components of the
Cardiovascular System
• Heart
• Arteries
• Capillaries
• Veins
HEART
Heart
 Walls of the Heart

• Endocardium PM

• Myocardium

• Epicardium
 Endocardium
• Lining endothelium + supporting fibroelastic
connective tissue (CT)
• Scattered fibers of smooth muscles (SM) and CT
• Subendocardium, a deep layer of CT
– Modified cardiac muscles
– Impulse-conducting system of the heart
Endocardium
 Endothelium
• Single layer of squamous epithelium
– Polygonal and elongated
• Long axis in direction of blood flow
• Lines all internal components of blood and lymphatic
systems
• Selectively permeable barrier between two internal
compartments:
– Blood plasma
– Interstitial fluid
Endothelium
E

P
 Functions of Endothelium
• Metabolite exchanges between blood and tissues
• Nonthrombogenic surface
– Blood will not clot
– Secretes agents to control local clot formation
• Inflammation and local immune responses
• Secretes interleukins
– Affect local activity of WBCs during inflammation
• Secretes growth factors and proteins
Endothelium
 Purkinje fiber
• Modified cardiac muscle cells located in the AV
bundle and its branches
– Reduced number of myofibrils
– More sarcoplasm
– Abundant glycogen granules and mitochondria
– More rounded nucleus in groups of 2 or more
– Larger diameter
– Lack transverse tubules of cardiac muscles
– connect with each other by desmosomes and gap
junctions
Purkinje Fibers
Purkinje Fibers
Purkinje Fibers
 Myocardium
• Thickest layer
• Spirally arranged cardiac muscles
• Thicker in walls of ventricles
• Strands of connective tissues and vascular network in
between cells.
 Myocardium
• Cardiac muscle cells
• Striated
• Involuntary
• Cylindrical with branching
• Mononucleated or binucleated
• Centrally-located nucleus
• Intercalated discs
Cardiac Muscle
Cardiac Muscle
 Epicardium
• Visceral layer of the pericardium
• Lined by a single layer of squamous mesothelial cells
• Subepicardium: thin layer of CT
• During heart movements
– Adipose tissues
– Lubricant fluid
 Epicardium
• Pericardial cavity
– Space between epicardium and parietal pericardium
– Serous fluid: secreted by mesothelial cells
– Layers glide freely
Epicardium
 Cardiac Skeleton
• Septum membranaceum
• Trigona fibrosa
• Annuli fibrosi
 Cardiac Skeleton
• Dense irregular CT in endocardium
• Functions
– Anchor and support heart valves
– Provide firm points of insertion for cardiac muscle
– Help coordinate heartbeat by acting as electrical insulation
between atria and ventricles
 Septum Membranaceum
• Upper fibrous part of the interventricular septum
• Attachment for free ends of fibers of cardiac muscles
Septum Membranaceum
 Trigona fibrosa
• Between arterial foramina & AV canals
• Provides support
• Maintains the integrity of all four orifices
• Without these rings of support the orifices would
stretch and the valves would be unable to function
properly.
Trigona Fibrosa
 Annuli Fibrosi
• Fibrous ring
• Principal attachment of muscular fibers of atria,
ventricles, and AV valves
• Main portion of the cardiac skeleton
• Surround the openings of the four orifices
• Aortic ring is the strongest
Annuli Fibrosi
BLOOD VESSELS
 Tissues of the Vascular Wall
• Endothelium
• Smooth muscles
• Connective tissue
 Walls of Blood Vessels
• Tunica intima
– Endothelium, LCT
– Internal elastic lamina (IEL)
• Tunica media
– Concentric layers of helically arranged SM cells
– Elastic fibers, external elastic lamina (EEL)
• Tunica adventitia
– Tunica externa
– Collagen type I & elastic fibers
 Vasa Vasorum
• Vessel of the vessel
• Arterioles, capillaries, venules
• In adventitia and outer part of media
• Large veins have more vasa than arteries
Vasa vasorum
Vasa vasorum
 Nervi Vasorum
• Nerve supply of blood vessels
• Unmyelinated autonomic nerve fibers
Nervi vasorum
 Elastic Arteries
• Aorta, pulmonary artery, & their largest branches
• Conducting arteries
– Conduct blood from heart to organs
– Elastic recoil move blood forward under steady pressure
• Intima: well developed, smooth muscles (SM) cells in
subendothelial CT
– IEL is not prominent
• Media: thick; alternate elastic lamillae + SM fibers
• Adventitia: much thinner than media
Elastic artery
 Muscular Arteries
• Distributing arteries
– Distribute blood to all organs
– Maintain steady BP and flow with vasodilation and
constriction
• Intima
– Thin subendothelium; prominent IEL
• Media
– 40 layers of SM cells; much less elastic material
• Adventitia
– CT, LV, nerves; vasa vasorum may be present
Muscular artery
Muscular artery
 Small Arteries
• Intima: endothelium; CT, < SMs
• Media: 3-10 layers of SMs
• Adventitia: CT; (-) Vasa vasorum
• Distribute blood to arterioles
• Dilation & constriction adjust flow
Small Arteries
 Arterioles
• Indicate the beginning of an organ’s microvasculature
– Where molecular exchange takes place between blood and
interstitial fluid
• Intima: endothelium
• Media: 1-3 layers of SMs
• Adventitia: very thin CT
• Resist & control blood flow to capillaries
• Major determinants of systemic blood pressure
Arterioles
Microvasculature
 Capillaries
• Branch extensively
• Single layer of endothelial cells on a basement
membrane rolled in a tube
• Pericytes
– Perivascular contractile cells
– Facilitate blood flow
– Give rise to SMs and CT during microvascular repair
• Average diameter: 4 to 10 μm
• Individual length: not > 50 μm
 Capillaries
• Most capillaries are essentially empty at any given
time
• Thin walls
• Extensive surface area
• Slow, pulsatile blood flow
Capillary with Pericytes
 Continuous Capillaries
• Tight, well-developed occluding junctions
• Between slightly overlapping endothelial cells
• Examples:
– Muscle
– Connective tissue
– Lungs
– Exocrine glands
– Nervous tissue
Continuous capillary
Continuous capillary
 Fenestrated Capillaries
• Sieve-like structure
• Allows more extensive molecular exchange across
the endothelium
• Endothelial cells penetrated by fenestrations
• Some are covered with diaphragm of proteoglycans.
• Basal lamina is continuous and covers fenestrations.
 Fenestrated Capillaries
• Fenestrated with diaphragm
– Endothelium: pores of 80-100 um closed by very thin
porous diaphragm
– Ex: Pancreas, GIT, choroid plexus, ciliary body
• Fenestrated without diaphragm
– Pores are not closed
– Ex: Renal glomeruli
Fenestrated capillary
Fenestrated capillary
 Discontinuous Capillaries
• Endothelium: lined of relatively large caliber
and irregular cross-sectional outline
• Commonly called sinusoids
• Greatly enlarged diameter
• Discontinuous lining in walls
• With phagocytic cells
• Discontinuous basal lamina
• Ex: liver, spleen, bone marrow, some endocrine
glands
Sinusoidal capillary
Sinusoidal capillary
 Venules
• Postcapillary, collecting, muscular
– Tunica intima
• Single layer of flattened endothelial cells
• No valves
– Tunica media
• Very indistinct
• Incomplete layer of smooth muscle
– Tunica adventitia
• CT
• Primary site WBC’s adhere to endothelium and leave
circulation; infection, tissue damage
Venules
 Small veins
• Tunica intima
– Endothelium; CT, scattered SMs
• Tunica media
– Small bundles of SM
• Tunica adventitia
– Thick layer of LCT
Small vein
 Medium veins
• Tunica intima
– Endothelium; CT with valves
• Tunica media
– 3-5 layers circularly arranged smooth muscles
• Tunica adventitia
– Well-developed
– Forms the bulk
– C & E
Medium vein
Medium Vein
 Large Veins
• Tunica intima
– Endothelium
– CT, SMs
– Prominent valves
• Tunica media
– 5 layers of SMs
– Much collagen
• Tunica adventitia
– Greater part
– Bundled longitudinal SM
– LCT, C & E
Large vein
CLINICAL CORRELATES
 Hypertension
• Elevated blood pressure
• Depends on cardiac output and total peripheral
resistance to blood flow
• Renal or endocrine
• More commonly essential
 Atherosclerosis
• Aka arteriosclerotic vascular disease (ASVD)
• An artery wall thickens
• Initiated by damaged or dysfunctional endothelial
cells
• Invasion and accumulation of WBC’s, cholesterol and
triglycerides, other crystallized materials
• Plaque-formation
• Hardening of an artery specifically due to an
atheromatous plaque
 Ischemia
• Lack of oxygen when coronary arteries are occluded
by heart disease
• Tissue damage and injury to cardiac muscles
 Aneurysms
• Atheromas produce localized destruction within
elastic arterial wall
• Weakening causing arterial bulges
• Can rupture
 Thrombus
• An intravascular clot (thrombi)
• With a fibrin framework
• Forms to stop blood loss from damaged vessels
 Embolus
• Solid masses from large thrombi
• May detach and carried by blood
• May obstruct distant vessels

• Myocardial infarction
• Stroke
• Pulmonary embolism
THANK YOU