The Circulatory System

Dr Mutemwa
 CIRCULATORY SYSTEM
•Pumps and directs blood to all body tissues .
•There are two major components of the circulatory system

1.The cardiovascular system/blood vascular system

• Heart
• Arteries
• Capillaries
• Veins
 Circulatory System
2. The lymph vascular system
• blind ended lymphatic capillaries that collect lymph fluid from tissues.

• larger lymphatic vessels that connect with one another and finally
empty collected lymph into large veins in the neck where the
lymphatic and cardiovascular systems merge.
 General cardiovascular circulation

Two major components

1. arterial system
2. venous system

Together these two systems form two major circulations

1. systemic circulation
2. pulmonary circulation
• All components of the circulatory system are lined by endothelium.
Endothelium
• Simple squamous epithelium
• Selectively permeable barrier
• Active tissue
• Exchange
• Vasoactive factors
• Growth factors
• Antithrombogenic action (Thrombomodulin and Prostacyclin)- also
help in fibrinolysis (Tissue plasminogen activator)
• Help in clotting of blood (von Willebrand factor)
• Conversion of angiotensin I to II
• Conversion of bradykinn, serotonin, prostaglandins, norepinephrine,
thrombin to biologically inert compounds
 Heart
OBJECTIVES
• Describe the location of the heart.
• Describe the structure of the pericardium and the heart wall.
• Discuss the external and internal anatomy of the chambers
of the heart.
• Relate the thickness of the chambers of the heart to their
functions.
 The Heart

• The human heart has four chambers

• Left and right ventricle

• Left and right atrium

• The left side of the heart pumps oxygenated blood to the body while
the right side of the heart pumps deoxygenated blood to the lungs
where oxygen can be absorbed by the hemoglobin carrying red blood
cells
 Histology of the HEART
Epicardium
• Mesothelium (visceral pericardium).
• Fibrocollagenous tissue with elastic fibers and variable amount of
adipose tissue that predominates and becomes thickest over the
ventricular surfaces.
• It gives a smooth, slippery texture to the outermost surface of the
heart.
• It contains blood vessels, lymphatics, and vessels that supply the
myocardium.
• It corresponds to the Tunica adventitia
Myocardium
• composed of cardiac muscle tissue.
• The muscle fibers (cells) are arranged as endomysium and
perimysium.
• The cardiac muscle bundles swirl diagonally around the heart and
generate the strong pumping actions
• It corresponds to Tunica media

Endocardium
• a thin layer of endothelium
• a thin layer of connective tissue with elastic fibers
• It corresponds to Tunica intima
 Heart
• Cardiac Skeleton
• Chorda tendineae
• Conducting system of the heart.
• Sinal atrial (SA) node
(Pacemaker)
• Atrioventricular (AV) node
• AV bundle (of His)
• Purkinje fibres
 Structure of vessels
• 3 layers
• Tunica intima
–Inner layer of epithelial tissue : endothelium
- Endothelium supported by basement membrane
and delicate collagenous tissue.
- Endothelium, subendothelial connective tissue and internal elastic lamina
• Tunica media
– Middle layer of muscle with connective tissue
-concentric layers of smooth muscle, elastic fibers, collagen fibers and external elastic lamina
• Tunica adventitia
-External layer of connective tissue
collagen fibers with elastic fibers
Tissue of the Vascular Wall
• Nonthrombogenic surface
• Endothelin 1 and Angiotensin Converting Enzyme (ACE).
• P-selectin and Weibel-Palade bodies
• Interleukins
• Growth factors i.e. for vasculogenesis (angiogenesis)
• Vasa vasorum.
 Vasculature
• Elastic artery
• Muscular artery
• Arterioles
• Capillary
• venules, small vein
• Vein
• Muscular vein
Arteries
Classifications
• Size
 Large
 Meduim
 Small

• Function
 Conducting
 Distributing
 resistance

• Structure content
 Elastic
 Muscular
 arterioles
Summary
• Large/elastic/conducting
• Medium/muscular/distributing
• Small/arterioles/resistance
 Elastic Arteries
• Examples include: Aorta, pulmonary artery, Carotids, vertebral and
subclavian arteries
• Are also called conducting arteries
• They have a thick tunica media in which elastic lamellae alternate with
smooth muscle layers.
Layers of Aorta
• Tunica intima- is well developed
– Endothelium
– Collagenous fibers, elastic fibers & elastin sheets
- separated from media by internal elastic lamina
• Tunica media
– Extremely elastic (sheets of elastin), smooth muscle
- much thicker
• Tunica adventitia
– Collagenous (type I), elastic fibers
- thinner than media
Elastic Arteries

Arterial sensory structures

Carotid sinus (baroreceptors)

Innervated by CNIX

Aortic bodies (chemoreceptors)

innervated by CNX
Muscular Arteries
• Distribute blood to organs and
help regulate blood pressure.
• Tunica intima
– Endothelium
– Fine collagenous fibers, smooth
muscle in very thin subendothelial
layer.
– Clearly evident Internal elastic
lamina
• Tunica media
– Smooth muscle
– Collagenous, reticular, elastic fibers
– External elastic lamina clearly evident in large muscular arteries.
• Tunica adventitia
– Thick collagenous, elastic tissue
Lymphatic vessels, vasa vasorum and nerves are found in this layer
Arterioles
• Tunica intima
– Endothelium
– Some CT in very thin subendothelial layer
– Internal elastic lamina is absent
• Tunica media
– Muscle layer several layers thick
– External elastic lamina may be present
• Tunica adventitia
–Very thin and inconspicuous
- Collagenous, elastic CT.
These are the resistant vessels. The smooth
muscles act as sphincters closing arterioles and
producing periodic blood flow into capillaries.
Arterioles
• Anastomoses
• Microvasculature
• Smooth muscles act as sphincters
• Arteriovenus shunt
• Innervated by autonomic nervous system
• Portal system
• Hepatic portal vein
• Hypothalamic-hypophyseal portal system
Capillaries
• Permit and regulate metabolic
exchange between blood and
tissues
• Capillary bed
• Metarterials
• Thoroughfare
• Postcapillary venules
Capillaries

Types of Capillaries
Continuous
Found in muscles, CT, Lungs and
nerve tissue
Fenestrated
In Kidneys, intestine, choroid
plexus and endocrine glands.
Discontinuous (sinusoid)
Found in Liver, Spleen and Bone
marrow.
Venules
• Postcapillary venules converge
into collecting venules.
• Structure of postcapillary venules
is similar to that of capillaries,
with Pericytes.
• Collecting venules increase in size
and smooth muscle layers and
become Muscular venules.
• All venules have lumen with a
large diameter compared to the
wall.
Veins
• Carry blood back to the heart.
• Have valves prevent back flow of blood.
• Tunica intima
– Endothelium
– Scant CT (thin subendothelial layer)
• Tunica media
– Thin muscle layer
– Collagen, elastic fibers
• Tunica adventitia
– Bulk of vessel wall
• Most veins are small or medium veins (diameter of 10 mm or less).
• Large veins are paired with elastic arteries close to the heart.
• Have well developed T. Intima and relatively thin media, and a thicker
adventitia.
• Media and adventitia contain elastic fibers.
• Internal and external elastic laminae are absent.
Lymphatic System
• Very thin-walled channels that
collect interstitial fluid called
lymph.
• Lymphatic capillaries
• Lymph nodes
• Large lymphatic vessels
• Thoracic duct
• Right lymphatic duct
NB: There is NO lymphatic system
in CNS and bone marrow.
Applied Anatomy
• Ischaemic heart disease → Myocardial Infarction
• Stroke
• Atherosclerosis
• Hypertension
• Aneurysm
• Hyperglycaemia → Diabetic microangiopathy.
• Oedema.
 Heart
• It rests on the diaphragm

• It lies in the middle mediastinum -an anatomical region that extends

from the sternum to the vertebral column, from the first rib to the
diaphragm, and between the lungs

• About two-thirds of the mass of the heart lies to the left of the body’s
midline
Gross Anatomy of the heart
• Placed in the mediastinum, in the thoracic cavity.
• It has a base posteriorly and an apex projecting forward, downward,
and to the left
• It consists the following surfaces of:
1. a diaphragmatic (inferior) surface
2. an anterior (sternocostal) surface oriented anteriorly;
3. a right pulmonary surface; and
4. a left pulmonary surface.
The base of the heart consists of:
• the left atrium, a small portion of the right atrium and the proximal
parts of the great veins (superior and inferior venae cavae and the
pulmonary veins)
• It is opposite the bodies of vertebrae TV to TVIII (TVI to TIX when
standing).
• The esophagus lies immediately posterior to the base.
• The apex of the heart is formed by the inferolateral part of the left
ventricle and is positioned deep to the left fifth intercostal space, 8-9
cm from the midsternal line.

Borders of the heart

• Upper/superior
• Right
• Left (Obtuse)
• Inferior (Acute)
• Surface landmarks of the heart:
• The heart has 4 chambers; two atria and two ventricles
• Externally, the coronary sulcus/groove circles the heart, separating
the atria from the ventricles and
• The anterior and posterior interventricular sulci separate the two
ventricles.
Pericardium
• The membrane that surrounds and protects the heart is the
pericardium
• It consists of two main parts: (1) the fibrous pericardium and (2) the
serous pericardium
• The superficial fibrous pericardium is composed of tough, inelastic,
dense irregular connective tissue. It resembles a bag that rests on and
attaches to the diaphragm;
• The fibrous pericardium prevents overstretching of the heart,
provides protection, and anchors the heart in the mediastinum..
• The deeper serous pericardium is a thinner, more delicate membrane
that forms a double layer around the heart
• The outer parietal layer of the serous pericardium is fused to the fibrous
pericardium.
• The inner visceral layer of the serous pericardium, also called the
epicardium, is one of the layers of the heart wall and adheres tightly to
the surface of the heart.
• Between the parietal and visceral layers of the serous pericardium is a
space known as the pericardial cavity and contains thin film of
lubricating serous fluid, pericardial fluid, reduces friction between the
layers of the serous pericardium as the heart moves.
Chambers of the heart
• The heart has four chambers; right and left atria, right and left
ventricles.
• The thin-walled atria receive blood coming into the heart, whereas
the thick-walled ventricles pump blood out of the heart.
• Interatrial, interventricular, and atrioventricular septa separate the
four chambers of the heart.
• The internal anatomy of each chamber is critical to its function.
Right atrium
Blood returning to the right atrium enters through;
• the superior vena cava and inferior vena cava, which together deliver
blood to the heart from the body; and
• the coronary sinus, which returns blood from the walls of the heart
itself.
• blood then passes into the right ventricle through the right
atrioventricular orifice guarded by the tricuspid valve.
• An anterior extension of the right atrium gives the right auricle.
• The right atrium is seperated from the left atrium by the interatrial
septum.
Right ventricle
• forms most of the anterior surface of the heart and a portion of the
diaphragmatic surface.
• The right atrium is to the right of the right ventricle and the right ventricle
is located in front of and to the left of the right atrioventricular orifice.
• Blood entering the right ventricle from the right atrium therefore moves
in a horizontal and forward direction.
• The cusps of the tricuspid valves are attached to the ventricular wall
through the Chordae tendinae
• The walls of the right ventricle roughened by numerous muscular,
irregular structures called trabeculae carneae.
• Blood leaves the ventricle and is pumped into the pulmonary artery
which is guarded by the pulmonary valves to the lungs.
Left atrium
• forms most of the base or posterior surface of the heart.
• Receives blood from the lungs through 4 pulmonary veins.
• It is separated from the left ventricle by the Mitral (bicuspid) valve.
Left Ventricle
• lies anterior to the left atrium.
• It contributes to the anterior, diaphragmatic, and left pulmonary
surfaces of the heart, and forms the apex
• Blood enters the ventricle through the left atrioventricular orifice and
flows in a forward direction to the apex
• It walls are thicker than that of the right ventrical, and are roughened
by trabeculae carnae.
• Blood leaves the ventricle through the aorta whose entrance is
guarded by the Aortic valve
Blood supply to the heart
• Coronary Arteries from the ascending aorta supply the heart.
Right Coronary Artery; gives off
• Sinuatrial nodal branch
• Right Marginal branch
• Posterior interventricular branch

• The right coronary artery supplies the right atrium and right ventricle,
the sinu-atrial and atrioventricular nodes, the interatrial septum, a
portion of the left atrium, the posteroinferior one-third of the
interventricular septum, and a portion of the posterior part of the left
ventricle.
• Left Coronary Artery
• divides into its two terminal branches, the anterior interventricular
and the circumflex.
• The left coronary artery supply most of the left atrium and left
ventricle, and most of the interventricular septum, including the
atrioventricular bundle and its branches.
Cardiac veins
• The coronary sinus receives four major tributaries:
• the great cardiac vein; It ascends in the anterior interventricular
sulcus, anterior interventricular vein. Reaching the coronary sulcus,
the great cardiac vein turns to the left and continues onto the
base/diaphragmatic surface of the heart, and gradually enlarges to
form the coronary sinus
• Middle cardiac vein; ascends in the posterior interventricular sulcus
toward the coronary sinus
• Small cardiac vein; begins in the lower anterior section of the
coronary sulcus between the right atrium and right ventricle
• Posterior cardiac vein; lies on the posterior surface of the left
ventricle just to the left of the middle cardiac vein