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CARDIOVASCULAR SYSTEM II
Post-capillary venules
Infection/inflammation
Capillaries
High
Loosest
ZO
Inflammation:
leukocyte exudation
Post-Capillary Venule
Lymph node
Note the endothelial cells (arrow heads). They are high cuboidal in nature,
therefore these vessels are called HEV (high endothelial vessels). These
vessels possess the loosest junctional complexes, facilitating the entry of
immune cells (arrow) from the lumen into the connective tissue, during
inflammation or as a normal phenomenon in locations such as lymph nodes.
lymphocyte
EC
HEVs play an important role in homing effect in lymphoid organs like lymph node.
This is the site where lymphocytes enter a lymph node from circulation.
Small Vein
Small vein
Small Artery
Medium-sized Veins
Muscular artery
Vein
The veins are characterized by the presence of valves, which are folds of
t. intima, supported by fibroelastic connective tissue.
These prevent the backflow of blood, as they drain the blood toward the heart
against gravity, assisted in most cases by skeletal muscles, through which
they travel.
t. intima
Tunica intima
Tunica adventitia:
Longitudinal smooth muscle
bundles
t.media
t. adv
Tunica media
Tunica media
Tunica adventitia
T. intima
T. media
T. adventitia
IVC
?
Example : Vena cava
LYMPHATIC
SYSTEM
Starts off as blind-ended lymphatic capillaries and empty into the circulation;
unidirectional valves
Lymphatic
capillary
venule
arteriole
Lymphatic
Lymphatic
Afferents
Efferent
Lecture Recap
T. intima
T. media T. adventitia -
T. intima
T.media
T.adventitia
Elastic artery
Muscular Artery
Arteriole
Continuous capillary
Fenestrated capillary
Continuous capillary
T. Adv
Sinusoidal capillary
Muscular vein
Clinical Considerations
Atherosclerosis
Marfans Syndrome
Aortic Aneurysm
Cerebral Aneurysm
Peripheral Vascular Disease
Varicose veins
Lymphedema
Cardiovascular Diseases
Cerebrovascular
Disease
Peripheral
Vascular
Disease
Angina
Stroke
Gangrene
Dementia
Intermittent
Claudication
ATHEROSCLEROSIS
Symptoms:
OOoohawwChest pains!!
Shortness of breath..
Back pain..
Pain radiating to the jaw..
Heart disease begins when cholesterol, fatty material, and calcium build up in
the arteries, a process known as atherosclerosis.
Risk factors:
Smoking
HTN
DM
Hypercholesterolemia
Lack of exercise
Unhealthy diet
Stress
Type A personality
Histopathogenesis
LDL in the blood contains
triglycerides and lipids. These are
insoluble in water medium of blood.
When there is excessive LDL, the
endothelial cells produce free
radicals which oxidize this LDL.
This oxidized product now initiates
migration of monocytes into the
tunica intima, which now become
macrophages.
Smooth muscle cells (SMC ) also
migrate from the t. media to the t.
intima (subendothelial CT).
Echocardiography
Stress tests
Progression of atherosclerosis
Normal myocardium
Marfans Syndrome
AORTIC ANEURYSM
Cerebral Aneurysm
Predisposing condition
S & S:
Pain and numbness
Claudication
Decreased wound healing
Tissue death-gangrene
Leading cause of amputations
Varicose veins
Intrinsic weakness of the t. media of veins
or defect in the valves that hamper flow of
blood to the heart.
Occurs anywhere but most common in the
legs (women), anorectally (hemorrhoids),
or in the spermatic cord (varicocele)
Esophageal Varices
Hemorrhoids
Varicocele
Causes:
Lymphedema
Penoscrotal lymphedema
Trauma
Post surgical
Post radiation
Inflammation
Parasitic obstruction
Obstruction due to
metastasis
filarial
Obstruction to lymphatics