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Cardiovascular

Objectives

  1. Identify types of vessels (small, medium/muscular, large/elastic, venules/arterioles, lymph channels).
  2. Describe structure and function of cell types in vessels.
  3. Identify the layers of the heart (endocardium, myocardium, epicardium).
  4. Describe structure and function of cell types in the heart.

Overview

The chief function of the cardiovascular system is to transport blood to and from the respiratory system and the rest of the body. It consists of a four-chambered pump, the heart, a system to distribute blood from the heart to capillary beds (arteries), and a system to return blood from capillaries to the heart (veins). There are two main divisions of the circulatory system, namely the pulmonary circulation and the systemic circulation. The pulmonary circulation conveys deoxygenated blood from the heart to the lungs, where it becomes oxygenated before returning to the heart. The systemic circulation conveys oxygenated blood from the heart to the body and returns deoxygenated blood to the heart, which pumps it through the pulmonary circuit for oxygenation. Capillaries are specialized for transfer of oxygen and carbon dioxide, nutrients, and hormones across their thin walls. Histologists describe three layers in the walls of structures in the cardiovascular system:

  • An inner, tunica intima (called endocardium in heart), which consists of an endothelium and a thin CT domain.
  • A middle, tunica media (called myocardium in heart), which consists of contractile elements, either smooth muscle or cardiac muscle, and CT.
  • An outer, tunica adventitia (called epicardium in heart), which consists of CT domains most often.

Vessels:

Modified Table 13.1 from Histology: A Text and Atlas: With Correlated Cell and Molecular Biology, 8e, 2020. Copyright © Wolters Kluwer. CT- Connective Tissue; SM- Smooth Muscle.

To review lymphatic vessels, see Immune System and Lymphatic Tissue page.

Heart:

The heart is made up of 4 chambers, a right and left atrium and a right and left ventricle. The right atrium receives deoxygenated blood from the body and heart which then flows to the right ventricle and then through the pulmonary trunk to the lungs where the blood receives oxygen. The oxygenated blood then flows to the left atrium then the left ventricle followed by the aorta and systemic circulation.

Heart Walls:

  • Endocardium (Inner layer)- endothelium with subendothelial CT and SM; a subendocardial layer of CT and the intrinsic conduction system can be found in some regions.
  • Myocardium (Middle layer)- cardiac muscle, review basic structure in Muscle page.
  • Epicardium (Outer layer)- CT and adipose tissue covered externally by mesothelial cells of the serous pericardium, cardiac vessels are visible in this layer.

Valves and Fibrous Skeleton:

  • Valves- composed of 3 layers of CT (fibrosa, spongiosa, ventricularis/atrialis) covered with overlying endocardium. The fibrosa layer is continuous with the chordae tendinea anchored to papillary muscles in the ventricles. Valve cusps are avascular.
  • Fibrous rings- dense CT that anchors valves.

Conduction System:

  • Sinoatrial (SA) node- known as the pacemaker of the heart located at the junction of the superior vena cava and right atrium made of specialized nodal cardiac muscle cells (smaller than surrounding cardiac muscle cells).
  • Atrioventricular (AV) node- located near the coronary sinus in the interatrial septum also composed of nodal cardiac muscle cells.
  • AV bundle, bundle branches, and Purkinje fibers- modified cardiac muscle cells that are slightly larger than typical cardiac muscle cells. Purkinje fiber cells have myofibrils located at the periphery of the cells with large, round nuclei. Intercalated discs are present but number varies and the cells stain pale with H&E due to glycogen storage.

*Remember to zoom out and view the entire image before zooming in. You can click on the regions of interest to go through emphasized structures.

Vessels

Using the slides in this section, you should practice identifying vessels and classifying them into small, medium/muscular, large/elastic, and venules/arterioles. Vessels are embedded in tissue throughout the body so each slide is taken from different structures in the body. At this time, focus on the vessels in the tissues, you will learn specifics of these structures in other lab lessons. There is a brief description of each slide under each picture. You can click on the image or the slide title to bring you to the digital slide.

Michigan 088. Aorta, H&E. There are 5 annotation boxes.

The aorta is classified as a large/elastic artery. It is the largest artery of the body and consists of 3 layers: tunica intima, tunica media, and tunica adventitia. The tunica intima is the thinnest layer, lined with endothelial cells along the lumen. Within the tunica media, you will find layers of fenestrated elastic laminae (dark pink wavy bands) among smooth muscle and collagen. The elastic laminae in the media have large fenestrations. In reality, they are concentrically arranged tubes of elastic fibers with large holes (fenestrations) in the wall of the tubes. Thus, in cross section, the laminae appear discontinuous due to the holes. When the left ventricle contracts, the wall of the aorta bulges out, storing some of the energy of systole (ventricular contraction) by dilating the fenestrated elastic laminae. When systole ceases, the fenestrated elastic laminae spring back to their original shape. This elasticity helps propel blood along the aorta away from the heart. The tunica adventitia is fairly thick in the large artery. You will find smaller blood vessels called the vasa vasorum surrounded by loose connective tissue. To see the aorta in a different stain that highlights the elastic fibers, see the “More Practice Vessels” section below.

Slide 17, Artery/Vein/Nerve, H&E. There are 10 annotated boxes in this slide.

Use this slide to identify the cross section of an artery, vein and nerve. Then determine the size you would assign to the artery and vein (small, medium, or large?). The most obvious difference between the two vessels is the ratio of thickness of media to vessel diameter. There are many different size vessels in this slide, you should be able to identify medium, small, venules, arterioles, and capillaries. Note also that the outline of the artery is relatively smooth whereas the outline of the vein is irregular. Identify the three tunics/layers of the largest vessels you see in the image.

Michigan 030 Mesentery, H&E. There are 10 annotation boxes.

Mesentery is found in the abdomen attached to the small and large intestines. It carries blood vessels, lymphatic vessels, nerves and lymph nodes. You can easily see several lymph nodes with germinal centers. The surrounding tissue is loose connective tissue filled with adipocytes. Use this slide to practice identifying different size vessels. You can also examine the different cell types and tissue types found withing vessels including endothelial cells, smooth muscle cells, fibroblasts of connective tissue, adipocytes, and nerves in larger vessels.

Slide 47, Epiglottis, Elastin Stain. There are 4 annotated boxes in this slide.

This is an excellent slide for studying smaller vessels like small arteries/veins, arterioles, venules, and capillaries, located in the connective tissue surrounding the elastic cartilage in the middle of the epiglottis. The elastic stain stains the elastic fibers in this specimen a dark purple/black color. A counter stain conveniently stains RBCs yellow so look for these inside blood vessels.  You can find numerous smaller muscular arteries (with a prominent wrinkled internal elastic lamina, 5-10 layers of smooth muscle in the media, and a sparse external elastic lamina. Arterioles have about 2 layers of smooth muscle in the media and little or no internal elastic lamina. The distinction between the smallest muscular arteries and the largest arterioles is slight and of no great significance. The arteries may be accompanied by veins and the arterioles may be accompanied by venules. Capillaries are also present.

Slide 34, Efferent Ductules (Male Repro System), H&E, Plastic Section. There are 3 annotated boxes in this slide.

Efferent ductules (lumen with pseudostratified columnar epithelium) in the male reproductive system are surrounded by a large amount of CT (pink stroma). Use this section to identify small arteries and veins, arterioles and venules, and capillaries. Review the differences between small vessels, arterioles/venules, and capillaries.

Slide 60, Liver, H&E Stain, Plastic Section. There are 5 annotated boxes in this slide.

This is a thin plastic section of the liver. It consists of cords and plates of hepatic parenchymal cells surrounded by hepatic sinusoids. In any given organ, the parenchymal cells are the organ-specific cells. Be aware that many organs have both parenchymal and nonparenchymal cells, e.g., CT, blood vessels, nerves, lymphatics. A sinusoid is a generic term for a capillary. It implies that there is sluggish, meandering blood flow through a network of capillaries with large lumina. Sinusoids are also found in bone marrow, the spleen, endocrine organs, etc. Sinusoids are just capillaries. The hepatic sinusoids carry nutrient-laden blood from the GI tract and as they pass by the hepatic parenchymal cells, the nutrients leave the blood and enter the liver, for processing. Hepatic sinusoids are unusual capillaries. They are intermingled stretches of discontinuous capillaries and fenestrated continuous capillaries, although these details are not visible in this slide. Furthermore, there are two distinct types of marginal cells. One is a flattened, typical endothelial cells and the other is a fatter, phagocytic Kupffer cell. The capillaries here have one additional peculiarity—they have a thin, discontinuous basement membrane.  In this preparation, one can see numerous flattened endothelial cell nuclei but the Kupffer cell nuclei are harder to locate and difficult to differentiate from hepatic parenchymal cells.

Heart

Using the slides in this section, you should be able to identify the different layers of the heart and describe function of different cell types.

Slide 10, Heart, H&E Stain, Plastic Section. This slide has 3 questions.

This specimen contains the thin endocardium at the bottom of the slide. The majority of the specimen consists of the myocardium. You should be able to identify the typical structure of myocytes and Purkinje fibers. There are also some vessels throughout the specimen.

How would you describe the difference between a Purkinje fiber and a typical myocyte? Think about what the stored glycogen would do to the cytoplasm.

Slide MCO 93W3533, Heart. This slide has 4 questions.

This specimen of the heart has some excellent examples of Purkinje fibers, located on the endocardial surface of the heart in a small, oval, lightly stained areas. The pericardial surface, with some adipose tissue and a large blood vessel is in the top of the slide. Compare and contrast standard cardiac myocytes with Purkinje fibers using this slide. Notice that the  Purkinje fibers are more lightly stained, have a larger diameter, have a few peripheral myofibrils, a centrally placed nucleus, and a large perinuclear clear area that is packed full of glycogen granules when compared with nearby cardiac myocytes.

Slide 29, Aortic Valve and Aorta, H&E. This slide has 4 questions.

This is section through the top of the left ventricle (LV). It also includes a part of the wall of the aorta (A) and one of the three cusps of the aortic valve (AV). There is fibrous CT in the valve that merges into the CT (part of the cardiac skeleton) between the ventricle and the aorta. Note that the valve is avascular and covered by an endothelium. The dark ridges found throughout the aorta is artifact from wrinkles in the tissue.

More Practice Vessels

Iowa Neurovascular Bundle, H&E. There are 5 annotation boxes.

Study the vasculature in this bundle of vessels and nerves.

Michigan 36. Aorta, Aldehyde Fuchsin (elastic fibers are black/dark purple). There are 4 annotation boxes.

This specialized stain highlights the elastic fibers in a black/dark purple color. Nuclei appear in a brown color and collagen fibers appear bluish-green.

More Practice Vessels Answers

Slide Iowa Neurovascular Bundle

  1. A) Artery; B) internal elastic membrane; C) Medium- prominent internal elastic membrane
  2. A) black- tunica intima; B) blue- tunica media; C) green- tunica adventitia
  3. A) vein; B) medium- arteries and veins of the same size often travel together.
  4. Nerves- as a reminder, peripheral nerves are encapsulated by Schwann cells, areas of lipid are washed out
  5. A) black- arteriole (3 layers of SM); B) blue- nerve; C) green- venule (arteries and veins of same size travel together, 1 layer of SM visible)

Slide Michigan 88 Aorta

  1. A) green- tunica intima; C) white- tunica media; D) red- tunica adventitia
  2. Endothelial cells
  3. A) white- elastic fibers; B) green- smooth muscle cells
  4. A) red- collagen; B) yellow- nerve; C) blue- arteriole or venule, vasa vasorum
More Practice Heart
Michigan 098 AV Heart, H&E. There are 7 annotation boxes.

This image contains an atrium and ventricle including an atrioventricular valve leaflet. Identify these gross anatomical structures by zooming in and examining the tissue. You will also see how the valve leaflet is connected by chordae tendineae to a papillary muscle in the ventricle. You can also see the pectinate muscles of the atrium projecting into the lumen.

More Practice Heart Answers

Slide Michigan 098 AV Heart

  1. A) black- ventricle (thicker wall); B) blue- valve; C) green- atrium (thinner wall)
  2. yellow- papillary muscle
  3. pectinate muscle
  4. A) epicardium; B) black- coronary artery; C) blue- coronary vein
  5. Area of interest, no questions
  6. intercalated discs
  7. heart valves are avascular