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Histology of the Cardiovascular System

Peter B. Baker, M.D.

Objectives for Part 1

Layers of the Heart Wall


Endocardium (EN) Myocardium (M) Epicardium (EP)

Visceral Pericardium

EN

EP

Components of Myocardium
Handout I.B.

Myocytes Collagen Blood Vessels Adipose Tissue Nerves

Right Ventricle

Histology of Cardiomyocytes
Handout I.B
1 or 2 central nuclei Cross striations End-to-end arrangement with branching

Myocardium

intercalated disc

Skeletal Muscle

Myocardium

Myocyte Ultrastructure Handout I.B.1-4


T-tubules Sarcoplasmic reticulum Mitochondria Glycogen Intermediate filaments Lipid Lipofuscin

Intercalated Disks Handout I.B.5


Specialized junctions between adjacent myocytes Transverse portion includes - Desmosomes - Fasciae adherentes

Longitudinal portion includes gap junctions

Atrial Myocyte Granules Handout I.B.6


Atrial Natriuretic Polypeptide (ANP) ANF released with atrial distension Diuresis (increased urine output)

Differences Between Cardiac and Skeletal Muscle, Handout I.B.7


Cardiac Nucleus T-tubule Central, single at Z discs Skeletal Peripheral, multiple at A-I junction

IC discs
T/SR jct

present
diad (1 SR)

not present
triad (2 SRs)

Granules
SR tubule Mitochon

Atria
fewer more cristae

none
more fewer cristae

Endocardium

Endocardium, Handout I.C

Handout 1.D, I.E

Mesothelial Cells

Collagen

Epicardium, with Abundant Adipose Tissue

Epicardium

Handout I.E

Epicardium with Nerves

Epicardium

Handout I.E

Objectives for Part 2

Aorta Superior vena cava Sinoatrial node Right atrial appendage

Sinoatrial node
Right ventricle

Sinoatrial Node

Atrioventricular Node

Atrioventricular Node
AVN

AVN

Atrial Myocardium Node

AV

Bundle of His
Bundle of His

IVS

Left Bundle Branch

Cardiac Conduction System


Handout I.H
Sinoatrial Node

Subepicardial at junction of RA and SVC SA nodal artery Nodal myocytes separated by collagen
Atrioventricular Node

Subendocardial above TV septal cusp AV nodal artery Bundle of His, left and right bundle branches

Cardiac (mitral) Valve

Objectives for Part 3

Histologic Layers in Blood Vessels Handout II


Intima Endothelium and subendothelial collagen Media Internal elastic layer (IEL) Smooth muscle cells / elastic fibers External elastic layer (EEL) Adventitia

Elastic Arteries Handout II.A.1


Absorb pulse wave Maintain diastolic pressure Structure Intima Media poorly formed internal elastic layer (IEL), concentric elastic lamellae, no external elastic layer (EEL) Adventitia Vasa vasorum

Aorta

IEL

Aorta

Vasa Vasorum

Muscular Arteries Handout II.A.2


Conduct blood Role in blood distribution Structure Intima Media prominent IEL, SMCs with few elastic fibers, EEL Adventitia

Muscular Artery Elastic Stain

EEL

IEL

Muscular Artery Elastic Stain

Arterioles Handout II.A.3


Regulate flow to capillary beds Precapillary sphincters Structure Intima Media one to few SMCs (discontinuous in metarterioles), thin IEL, no EEL, Adventitia - thin

Capillaries Handout II.B


Gas and nutrient exchange Structure Endothelium and basement membrane No smooth muscle cells Pericytes along the outside of the basement membrane Vessel connections in the capillary beds Thoroughfare channels True capillaries Through channels (arteriole to venule)

Capillaries in Lung

Capillaries in Glomerulus

Continuous Capillary
Pericyte

TJ
Caveolae

Fenestrated Capillary

Pore

Veins
Handout II.C
Post capillary venules diapedesis Larger veins distensibility allows pooling, congestion, stasis Valves maintain forward flow Structure Intima Media no IEL or EEL, irregular arrangement of smooth muscle Adventitia

Vein

Lumen M

Vein

Vein with Valve

Valve

Vein Artery Comparison

Vein Artery

Lymphatic Vessels Handout II.D


Collect tissue fluid Thin walls and valves Fluid passes through lymph nodes No lymphatics in some anatomic sites Flow occurs by Intrinsic smooth muscle contraction Skeletal muscle contraction Arterial pulsation Compression extrinsic to the body

Capillary Blood Vessel and Lymphatic

Capillary

Lymphatic

Portal Systems Handout II.E


Arterial Renal Glomerulus afferent arteriole glomerular capillaries efferent arteriole capillaries (vasa recta) Venous Hepatic Sinusoids portal vein liver sinusoidal capillaries hepatic veins inferior vena cava There is also a portal venous system in the anterior pituitary

Thank you for completing this module Questions? Peter.Baker@ChildLab.com