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CP03 - Histology of The Cardiovascular System - 112414 - Uncorrected
CP03 - Histology of The Cardiovascular System - 112414 - Uncorrected
CP03 - Histology of The Cardiovascular System - 112414 - Uncorrected
Welcome back everyone. It’s been awhile since we’ve spent some good, quality MNTS time together.
Now I know I’ve set some pretty high standards here with my notes. In fact someone told me they only
know me as the “the guy with nice hair who writes inspirational things in his MNTS” (thank you for
complimenting my hair). BUT, today were skipping the cheesy intro. If I spoil you you’ll get tired of it
and then it wont be special anymore, and we need to keep this set of notes so fresh, and really quite
clean. I work for the people and the people need to be kept satisfied long term. Can’t you see that this is
for our future? That I am doing this for the long-term health of our relationship? Sometimes sacrifices
need to be made my lovely class. So buckle up, get ready to have Djakiew come in like a wrecking ball,
and party in the USA. I will be back in all of my cheesy glory, so do not despair. And for the sake of
continuing my Miley references, I can’t wait to see you all again.
Dr. Djakiew gave us a pretty straightforward lecture as always. I will point out important points I
remember from last year, but the drill is the same for histology: memorize pictures the night before the
exam for ID, and use his comprehensive syllabus, because it has everything you need.
of course, and is where nutrient and gas exchange occurs. The venous flow of blood is from post-
capillary venules, to small/medium sized veins, to vena cava, and then to the right atrium.
Capillaries
As was previously stated this is where nutrient, gas, and waste exchange occurs. When you think of
capillaries and post-capillary venules think of exchange. Capillaries are the smallest of the blood
vessels, often only big enough to allow the passage of a single leukocyte or RBC. There are small rings
of smooth muscle called pre-capillary sphincters which regulate the flow of blood into capillaries on the
arterial side. There is also a standard structure of a capillary seen in the image below.
The 3 basic units of the capillary starting from the lumen and going
to the extracellular space are endothelial cells, basal lamina, and
pericytes. There is a single layer of endothelial cells lining the
capillary. The basal lamina surrounds this cell layer, and the
pericytes are a cell that has the ability to differentiate to an
endothelial cell if they were to die or become damaged. They
maintain the viability of the endothelial cell layer.
Types of Capillaries
There are continuous, fenestrated, and
sinusoid (discontinuous) capillaries
(pictured to the left from top to bottom). I
definitely remember the differences of these,
and their locations being on last years exam
so listen up!
one. Continuous endothelial cells have nuclei that bulge into the lumen, and the most identifiable
structure in them are numerous pinocytotic pits and vesicles that facilitate transport.
• Fenestrated – these capillaries have numerous pores in the lining endothelium, and the pores are
spanned by a thin diaphragm, except in the kidneys where there is no diaphragm, just a thick
basement membrane. They are found in the intestines and endocrine systems as well. This type is
represented in the middle picture above. Fenestrations faciliate more rapid exchange between
the lumen of fenestrated capillaries and the fluid outside.
o An additional special type of fenestration exists in the adrenal gland and
adenohypophysis: fenestrated sinusoids. They have wider fenestrations but still have a
diaphragm spanning them hence they are not true sinusoids.
• True Sinusoids – Sinusoidal capillaries are different than fenestrated sinusoids!! They allow for
an even high degree of exchange to take place. They are usually large, and have irregularly
shaped lumens. There may be prominent intercellular spaces between endothelial cells and
fenestrations in the endothelium . The basal lamina may be missing or discontinuous. If you
see large gaps between cells you know it’s a true sinusoid. Look how different the bottom picture
looks from the other two; there are large gaps present. These exist in the liver, spleen, bone
marrow, and also in the endocrine system.
• Transendothelial channels – This occurs when pinocytotic vesicles fuse together to make an
entire channel across the endothelial membrane. This facilitates more rapid transfer across the
membranes from lumen to connective tissue space.
This table is
your friend.
Know it. Love
it. Be one with
it. I remember
the different
layers of smooth
muscle being
particularly
important.
Arteries will have a thicker intima, with a prominent IEL. The IEL will not be very prominent in
veins. The tunica media will often be the thickest layer in arteries, but can be completely absent or
very small in veins. The adventitia will be the thickest layer in most veins. Additionally, there may be
muscle fibers in the adventitia of large veins running perpendicular to the circumferential muscle
fibers running in the media. Knowing where IELs, and EEL’s are present was a huge distinguishing
feature on the exam last year as well. Compare what I wrote above to these pictures below and see
where the differences lie. The artery is on the left and the vein is on the right in the picture on the left.
Course CP
Lecturer Dr. Djakiew
Date 11/24/2014
Lecture 3
Page 6 of 11
Structure of Arteries
This is the aorta. Notice the I, M, and A letters
designating the intima, media, and adventitia. Notice
that the media is the largest layer. This is an elastin
stain, highlighting the elastic nature of the aorta and its
need to handle high pressures coming from the heart.
There can be 40-60 layers of smooth muscle present
in elastic arteries.
Types of Microcirculation
Different types of microcirculation or capillary relationships exist.
• Arteriole – capillary bed – venule
o this is the most common and what you typically think of when you think of capillaries
• arteriovenous anastomosis – this connection bypasses capillaries completely
o this is present in the skin and is an important component in thermoregulation—blood
flows away from the skin when we are cold (skin that is cold is white), and blood flows
to the skin when you are hot to drive off heat (you become flushed when you exercise)
• Arteriole – capillary – arteriole – this happens in the kidney where filtration occurs under high
pressures. A vein on the other side of the capillary would burst, so we use a stronger arteriole
instead
• Venule – capillary – venule – This is present in the liver
Structure of Veins
We have already been over this a little bit, but just to drive the point home because it is so important:
The media is thin or absent in veins, the adventitia is thicker, you usually do not see an EEL, and
only sometimes see an IEL. It is possible to have perpendicular muscle fibers in the adventitia.
These are different than the circumferential muscle fibers in the tunica media. Veins will have an
irregularly shaped lumen that is often large compared to the size of the vessel wall.
These are post-capillary venules. Notice that they have larger lumens
than capillaries, with an irregular shape to them. I remember this
picture being pretty important last year because it shows a PCV,
collecting venule, a collecting venule, a capillary, and an arteriole.
Notice how the capillaries and arterioles have more distinctly shaped
lumens while the venules all tend to be a little wild. The tunica media
of the venules are also not prominent.
Course CP
Lecturer Dr. Djakiew
Date 11/24/2014
Lecture 3
Page 8 of 11
This is a medium sized vein. Notice that there are only 3-4 layers of
smooth muscle in the media. The lumen is also extremely large
compared to the size of the vessel wall. There is a large adventitia
present as well. This is also no prominent IEL, like in arteries.
o contains glands and adipose tissue, and if you are not careful could be confused with the
endocardium/purkinje fibers.
o It is also continuous with the pericardial sac covering the entire heart
Lymphatic System
Home stretch. I am so tired of looking at these slides. The lymphatic system represents a drainage
system whereby fluid and plasma protein which has collected in the interstitium is returned to the
blood. The function of lymphatic vessels are to:
• Return excess 10% of interstitial fluid to the blood
• Transport absorbed lipids from the intestines to the body
• Provide immunological support
Lymphatic vessels are designed to allow unique permeability characteristics. They have a single layer
of endothelium, a discontinuous or missing basal lamina, no pericytes, and fibers of connective
tissue that anchor the endothelium to the surrounding tissue. And remember that all lymph vessels
pass through at least one lymph node before returning to the heart. The way to differentiate lymph
vessels and veins in a histological slide is to look for the presence of nucleated cells!! Veins will
contain RBC’s which do not have a nucleus. So if you see a picture with a valve, do not automatically
assume that it is a vein. It could be a lymph vessel. This was definitely tested last year.
Clinical Correlates
• Myocardial infarctions are heart attacks due to occlusion of coronary arteries, and are
responsible for 20-25% of all deaths in the US.
• Berry Aneurysm are due to defects in the tunica media of cerebral arteries. If the media is not
functioning properly then high pressures could cause a rupture of the vessels
• Varicose veins are abnormally dilated, and tortuous veins with a valve insufficiency present.
This causes pooling of blood in the veins of extremities due to retrograde blood flow.
Course CP
Lecturer Dr. Djakiew
Date 11/24/2014
Lecture 3
Page 11 of 11
That’s all she wrote folks. Just to let you know that as of the writing of this MNTS on the 24th of
November its going to be my birthday tomorrow. The Big 2-6. I’m getting old and time flies. My mom
always called me her little turkey because I was the cause of her missing her only Thanksgiving dinner
ever. Thanks Mom!! Look how wonderful I turned out.
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