Micro HSB HEART & BLOOD VESSELS Go, Aldriena Siarleen L.

HEART - thick, muscular, rhythmically contracting portion of Vascular System - lies in PERICARDIAL CAVITY within MEDIASTINUM - has 4 chambers: R & L Ventricles, R & L Atria Blood Flow: BODY Sup & Inf Vena Cava HEART R Atrium R Ventricle forced through lungs (aerated) L Atrium L Ventricle Aorta

*Orifices between Atria & Ventricles are close by TRICUSPID VALVE (right) & MITRAL VALVE (left) *Pulmonary Artery (PULMONARY SEMILUNAR VALVES) and Aorta from R & L Ventricles (AORTIC SEMILUNAR VALVES) WALLS OF THE HEART a. Endocardium b. Myocardium c. Epicardium *Endocardium & Myocardium are bound by SUBENDOCARDIUM ENDOCARDIUM - glistening layer that covers inner surface of atria and ventricles - lined by endothelium o simple squamous o continuous with blood vessels (BV s) entering & leaving heart - SUBENDOCARDIUM o thin layer of LCT o consisting of Collagenous & Elastic Fibers (C & E) o BV s, Nerves (N s) o branches of impulse conducting portion MYOCARDIUM - main mass of the heart, contains rich vascular network - cardiac muscles arranged in tracts or bundles - cardiac muscle cells o striated o involuntary o cylindrical/elongated with branching ends o mononucleated PURKINJE FIBERS: modified cardiac muscle cells located in the AV bundle and its branches o impulse generating conducting fibers o reduced number of myofibrils found in periphery o more sarcoplasm & abundant glycogen o more round nucleus in groups of 2 or more o large diameter o lacks transverse tubules of cardiac muscles o found in the SUBENDOCARDIUM

Micro HSB HEART & BLOOD VESSELS Go, Aldriena Siarleen L. EPICARDIUM - aka VISCERAL PERICARDIUM - lined by a single layer of flat cuboidal mesothelial cells SUBEPICARDIUM: thin layer of CT o Elastic Fibers, BV S, N s PERICARDIAL CAVITY o space between epicardium and parietal pericardium o Serous fluid: secreted by mesothelial cells (usually 100mL) o permits layers to glide freely during contraction and relaxation

CARDIAC SKELETON central supporting structure, made up of DCT, attachment of muscle fibers & valves 1. SEPTUM MEMBRANACEUM - upper fibrous part of Interventricular Septum, provides attachment for free ends of fibers 2. 3. TRIGONA FIBROSA between Arterial Foramina & AV Atrioventricular Canals provide support and maintain the integrity of all four orifices (holes) without these rings of support orifices will stretch and valves will be unable to function ANNULI FIBROSI Fibrous Ring principal attachment of muscular fibers of atria, ventricles and AV valves main portion of cardiac skeleton dense connective tissue that surround the openings of the four orifices AORTIC RING is the strongest

IMPULSE CONDUCTING SYSTEM - SA Node o Pacemaker of the heart o found in Sulcus Terminalis area - AV Node o located in posterior lower part of interatrial septum below posterior leaf or aortic valve - Bundle of HIS o located in DCT of Trigona Fibrosum Dextum and continuous into Septum Membranaceum where it divides in two: - RIGHT & LEFT Branches of Bundle of HIS - Subendocardial Network of Purkinje Fibers * PARASYMPATHETIC NS decreases heart rate (relax) * SYPATHETIC NS increase heart rate (contract)

Micro HSB HEART & BLOOD VESSELS Go, Aldriena Siarleen L. BLOOD VESSELS - tubular structures that convey blood away and towards the heart o ARTERIES away convey blood to organs & tissues o CAPILLARIES anastomosing channels of small caliber, thin walls, substance interchange (blood & tissue) o VEINS returns blood to heart 3 LAYERS OF BV s 1. TUNICA INTIMA o innermost o ENDOTHELIUM single layer of endothelial cells o SUBENDOTHELIUM LCT o INTERNAL ELASTIC MEMBRANE (IEM)  is a fenestrated elastic sheet (lamina)  forms boundary between Tunica Intima & Tunica Media 2. TUNICA MEDIA o middle o circumferentially arranged SM (with elastic, collagen, proetoglycans) o in larger BV s and EXTERNAL ELASTIC LAMINA is found separating Tunica Media & Tunica Adventitia 3. TUNICA ADVENTITIA o outermost o LCT (C & E Fibers, BV s, N s)   VASA VASORUM blood supply of blood vessels, vessel within a vessel, NERVI VASORUM nerve supply of blood vessels lumen, nutrient BV

ARTERIES - TM thickest coat 1. LARGE ARTERIES - aka CONDUCTING (carry blood) or ELASTIC (fenestrated elastic membrane) a. TI  tall, round or polygonal endothelial cells  plenty of C & E fibers  IEM not prominent b. TM  fenestrated elastic membrane (concentric arrangement), some SM  thickest coat c. TA  LCT, C & E, BV s, N s & VV  elastic (light staining), needed to accommodate large volume of blood

Micro HSB HEART & BLOOD VESSELS Go, Aldriena Siarleen L. 2. MEDIUM SIZED ARTERIES - aka MUSCULAR (thick TM) or DISTRIBUTING (distribute blood) a. TI    b. TM  c. TA  LCT, BV s, N s 25-40 layers of circumferentially arranged SM single layer squamous endothelial cells SUBENDOTHELIUM: C & E fibers IEM very prominent

3. SMALL ARTERIES - 300 um, similar to medium sized artery, average diameter 300 um - IEM not prominent a. TI  single layer squamous endothelial cells  SUBENDOTHELIUM: C & E fibers  IEM not prom b. TM  SM present but thinner c. TA  thin & inconspicuous 4. ARTERIOLES - average diameter of 100 um a. TI  thin layer endothelial cells  no subendothelium  IEM not prominent b. TM  single layer of SM c. TA  LCT with few C & E fibers but inconspicuous 5. PRECAPILLARIES aka METAARTERIOLES transition from arteriole to capillary diameter is 50 um a. TI  thin layer endothelial cells  no subendothelium  no IEM b. TM  isolated SM c. TA  present but not obvious

Micro HSB HEART & BLOOD VESSELS Go, Aldriena Siarleen L. CAPILLARIES - thin walled tubes that branch extensively - diameter 5-10 um - length does not go beyond >50 um - single layer of endothelial cells with a basement membrane (+ thin adventitia manual) - 90% total BV is composed of capillaries (96,000 km) capillaries - slow velocity, suitable for nutrient exchange between organs - can only accommodate 1 RBC at a time 1. CONTINUOUS CAPILLARY endothelium uninterrupted, no holes lack pores in wall found in skeletal muscles, N s, CT

2. FENESTRATED CAPILLARY - fenestrated means with holes or pores a. FENESTRATED WITH DIAPHRAGM  ENDOTHELIUM: pores of 80-100 um closed by very thin porous diaphragm  pancreas, GIT, choroids plexus, ciliary body of eyes b. FENESTRATED WITHOUT DIAPHRAGM  pores not closed  found in organs that have very fast exchanges  renal glomeruli c. FENESTRATED SINUSOIDAL DIAPHRAGM  wider lumen  larger fenestrate  lack diaphragm  BM basement membrane is not prominent  some endocrine glands, carotid and aortic bodies 3. 4. SINUSOIDAL CAPILLARY ENDOTHELIUM: lined with relatively large caliber and irregular cross- sectional outline torturous path greatly enlarged in diameter discontinuous lining in walls with phagocytic cells absence of continuous basal lamina absence of continuous lining of endothelial cells liver, bone marrow, spleen, some endocrine glands CAPILLARY SINUSES elongated endothelial cells along longitudinal axis of BV exclusively found in SPLEEN (found in red pulp-full of RBC) scanty reticular fibers

Micro HSB HEART & BLOOD VESSELS Go, Aldriena Siarleen L. VEINS larger caliber compared to arteries thinner walls than artery TA has thickest coat present VV wider lumen that wall collapsed compared to more round arteries IEM is ABSENT

TI thin endothelium & subendothelium TM very thin, sparse circular SM, less rigid TA thickest coat, LCT, VV, NV 1. VENULE o TI single layer squamous endothelial cells o TM indistinct, incomplete/discontinuous layer SM o TA thickest coat, LCT, VV, NV 2. SMALL VEINS - thin outbranching, prevents backflow VALVES o TI single layer squamous endothelial cells, thin subendothelium (sometimes absent) o TM small bundles of SM o TA thick layer CT (i.e. trabecular layer of spleen) 3. MEDIUM SIZED VEINS - includes almost all veins in the body - found in veins of VISCERAL ORGANS o TI - single layer squamous endothelial cells, thin subendothelium o TM circulary arranged SM, C & E fibers o TA well developed, form bulk of wall, C & E fibers 4. LARGE VEINS o TI endothelial polygonal cells o TM poorly developed, thin layer SM, elastic fibers o TA more prominent, LCT, C & E fibers DIFFERENTIAL POINTS 1. LUMEN 2. WALL THICKNESS 3. COAT THICKNESS 4. RIGIDITY OF WALL 5. IEM 6. MUSCLE & ELASTIC tissue 7. VALVES 8. T. INTIMA 9. VASA VASORUM ARTERIES smaller thicker T. MEDIA more present abundant absent appears scalloped extends to T. MEDIA VEINS bigger thinner T. ADVENTITIA less absent present in LARGE VEINS only present in MED SIZED CALIBER never scallopes extends to T. INTIMA

Micro HSB HEART & BLOOD VESSELS Go, Aldriena Siarleen L. AUTONOMIC REGULATION OF HEART: 1. SYMPATHETIC FIBERS supply all parts of the heart chiefly SA & AV nodes NORADENERGIC SYMPATHETIC stimulation

heart rate & force contraction

2. PARASYMPATHETIC FIBERS - supply SA & AV nodes, Atria Musculature - CHOLINERGIC PARASYMPATHETIC stimulation CLINICAL CORRELATION:

heart rate & force atria myocardial contraction

ATHEROSCLEROSIS thickening of TI, continuous deposition of cholesterol ANEURISM- thinning of walls = bulges outward, ballooning of all layers HYPERTENSION thickening of walls of ventricles, BP

VARICOSE VEINS venous dilation causes incompetence of valves, retrograde BF, torturous dilation & lengthenin of BV s MYOCARDIAL INFARCTION o LEFT HEART FAILURE  damaged muscular wall of LEFT VENTRICLES  incomplete emptying in systole = pulmonary congestion o RIGHT HEART FAILURE  damaged muscular wall of RIGHT VENTRICLES  consequence of pulmonary congestion (LHF)  consequence of pulmonary disease  RHF leads to systemic congestion, venous pressure, dependent edema