VESSELS general overview
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Transcript of VESSELS general overview
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VESSELSVESSELSgeneral overviewgeneral overview
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• tunica intima
• subedothelial layer of connective tissue
• membrana elastica interna
• tunica media
• membrana elastica externa
• tunica adventitia = tunica externa
GENERAL STRUCTURE OF VASCULAR WALLGENERAL STRUCTURE OF VASCULAR WALL
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General structure of vascular wallGeneral structure of vascular wall
• tunica intima
• tunica media
• tunica adventitia
(externa)
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Tunica intimaTunica intima
• endothelial cells (endotheliocyti)– simple flat/squamous epithelium– on basal lamina
• subendothelial layer (stratum subendotheliale)– loose connective tissue– some smooth muscle cells
• lamina elastica interna – elastin
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Endothelial cells (Endothelial cells (EndotheliocytiEndotheliocyti))
• mesenchymal origin• zonulae occludentes, desmosomes, nexuses• intermediate filaments, microfilaments (contraction)• corpora multitubularia (Weibel-Palade‘s bodies)
• f. VIII – vWF, P-selectin• receptors: adrenergic, histaminic, ADH• synthesis of vasoactive substances: NO, PG
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Tunica mediaTunica media
• smooth muscle cells– spiral arrangement
• elastic a collagen fibers (type III)
• lamina elastica externa– only in thicker arteries
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Tunica adventitia (externa)Tunica adventitia (externa)
• fibroblasts
• collagen fibers (type I)
• elastic fibers
• vasa vasorum
• nervi vasorum
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Vessel typesVessel types• arteries (arteriae) - aer + térein
– muscular x elastic x mixed– microcirculation: small arteries – less than 1 mm– arterioles (arteriolae)
• less than 100 μm• several layers of smooth muscle cells• principal source of peripheral resistance !!!
– metarterioly• one smooth muscle cell layer, precapillary sphincter
• capillaries (vasa capillaria)– no nerve fibers– endotheliocyte + pericyte (Rouget‘ s cell)– caliber ± 7 μm
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Vessel typesVessel types
• veins (venae)– few muscle cells, more valvules– venules (venulae)
• capacity part of circulation (70% of blood)
• lymph vessels (vasa lymphatica)– lymph capillaries (vasa lymphocapillaria)
• originate as cul-de-sac
– lymphatic trunks and ducts (trunci et ductus lymphatici)
• collectors in limbs• valvules
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Elastic arteriesElastic arteriesaorta, truncus pulmonalis, a. subclavia, axillaris, iliaca, femoralis, thoracica int.
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Elastic arteryElastic artery((Arteria elastotypica)Arteria elastotypica)
• Tunica intima– lamina elastica interna – incoherent
• Tunica media– elastic membranes with fenestrations – elastin – smooth muscle cells– lamina elastica externa
• Tunica adventitia (externa)– frequent vasa vasorum
• supply outer 2/3 of wall
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Elastic artery (van Gieson + elastin)
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Elastic artery (elastin)
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Muscular artery (Muscular artery (arteria musculotypica)arteria musculotypica)
• Tunica intima– thin– lamina elastica interna – obvious
• Tunica media– circular smooth muscle cell layer (up to 40 layerss)
• each cell is covered with basal lamina – communication• synthesis of extracellular matrix
– lamina elastica externa – several elastic membranes
• Tunica externa– nerve bundles – contraction
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Muscular arteryMuscular artery (HE) (van Gieson + elastin)
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Arterioles = Arterioles = ArteriolaeArteriolae caliber < 0.5 mm
• Tunica intima– Weibel-Palade‘ s bodies within endothelail cells
(not in capillaries!)– lamina elastica int. – absent in smallest arterioles
• Tunica media– 1-3 layers of smooth muscle cells– lamina elastica ext. – absent
• Tunica adventitia (externa) – very thin
principal source of peripheral resistance
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ArteriolaArteriola (HE)
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ArteriolaArteriola (HE)
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SensorySensory structures in arteriesstructures in arteries
• Glomera supracardiaca (aortica) – sup., medium, inf. - baroreceptors
• Sinus caroticus - baroreceptor– thicker, richly innervated tunica adventitia– thinner tunica media
• Glomus caroticum - chemoreceptors– oval structures - 3-5 mm
• glomus cells – large nucleus, vesicles with catecholamines• shield cells – cover neural endings as glia
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Capillaries (Capillaries (Vasa capillariaVasa capillaria))
• microvascular part of circulation– vas capillare arteriale, intemredium, venosum– site of gas and nutrients exchange
• capillary– caliber 7-9 μm– length 1 mm (50 mm in renal glomerulus)– total length approximately 96 000 km– formed by endothelial cells on basal lamina
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Capillaries – Capillaries – wall structureswall structures
• Endothelial cell (Endothelicytus)
• Basal lamina (Lamina basalis)
• Pericyte (Pericytus; Rouget‘s cells)– mesenchymal cells with long processes– stem, supporting and transporting cell– proper lamina basalis– contractile proteins (replaces tunica media)
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Capillary bed(HE)
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Capillary typesCapillary types• somatic capillaries
– muscle, conncetive tissue, exocrinne glands (pinocytar vesicle in the wall), nervous tissue (no vesicles)
• fenestrated (visceral) capillaries with diaphragms– fenestrations 60-80 nm (quick metabolic exchange)– kidneys, gut, endocrinne glands
• fenestrated capillaries without diaphragms– glomeruli in kidney
• sinusoids– caliber 30-40 μm, often without lamina basalis– hematopoetic organs – liver, spleen, bone marrow, dental
pulp
• glomus, glomi n. (vessel glomerule) – ball of fingers, nailbeds, auricle, penis / clitoris, uterus
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Capillaries -Capillaries - functionfunction• permeability
– exchanger vessels (diffusion, pores, fenestration, vesicles)
• metabolic function– activation of angiotensin I angiotensin II
(lungs)– inactivation of bradykinin, serotonin,
prostaglandins– lipolysis
• antithrombotic function– inhibition of tissue thromboplastin
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Somatic capillarySomatic capillary (EG)
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Somatic capillary Somatic capillary (EG)
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Fenestrated capillary Fenestrated capillary (EG)
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Fenestrated capillary Fenestrated capillary (EG)
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Other structures of vascular wallOther structures of vascular wall
• vasa vasorum
• vasa nervorum
• nervi vasorum
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Other peculiar vascular structuresOther peculiar vascular structures
• vas anastomoticum (anastomosis)• vas collaterale (collateral)• rete mirabile = portal system
– 2 capillary beds series-connected
• anastomosis arteriovenosa (arteriolovenularis) – endothel bulges of intimal cushions with
myoepitheloid cells• simple (skin, lungs, kidneys)• composed (glomus coccygeum)
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Vessel network arrangementVessel network arrangement
• terminal (retina, spleen, kidney)
• functionally terminal (heart, brain)
• anastomotic
angiogenesis – hypoxia is the strongest factor !
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Clinical relevanceClinical relevance
• aneurysma
• atherosclerosis (athere + skleros)
• necrosis, infarctus
• air embolism in large cervical veins
• varices
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Blood distribution in organsBlood distribution in organs
• heart (coronary arteries) 5%
• brain 15%
• muscles 15%
• viscera 35%
• kidneys 20%
• skin, skeleton 10%
according to Stingl
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Development of arterial systemDevelopment of arterial system
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Developmental arteriesDevelopmental arteries• Saccus aorticus (aortal sac)• Aa. arcuum pharyngeorum (pharyngeal arch
arteries; „aortal arches“)– 5 pairs develop and change successively
• Aorta dorsalis (original 2 merge into 1)– a.a segmentales ventrales ( a. omphalomesenterica,
unpaired branches from AA)– truncus umbilicalis ( a. iliaca communis + int.)– a. umbilicalis– aa. segmentales laterales ( paired branches from AA)– aa. intersegmentales dorsolaterales ( branches from a.
subclavia)– a. sacralis mediana
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Day 20-22
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Pharyngeal arch arteries derivatesPharyngeal arch arteries derivates• 1st pair – arteria maxillaris + carotis externa• 2nd pair – arteria stapedia • 3rd pair – central – arteria carotis communis
– peripheral – arteria carotis interna
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Pharyngeal arch arteries derivatesPharyngeal arch arteries derivates• 4th pair
– left – part of the arcus aortae– right – a. subclavia dx.
• peripheral part of a. subclavia dx. is derived from aorta dorsalis dextra
– a. subclavia sin. is NOT derived from the 4th aortic arch but from 7th intersegmental artery
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Pharyngeal arch arteries derivatesPharyngeal arch arteries derivates• 5th – Ø• 6th pair
– left central left pulmonary artery
peripheral ductus arteriosus (Botali)– right central right pulmonary artery
peripheral Ø
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Arteriae omphalomesentericaeArteriae omphalomesentericae(vitellinae)(vitellinae)
• number of paired arteries• supply yolk sac• develop in vascular supply of gut → truncus
coeliacus, arteria mesenterica superior et inferior
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Arteriae umbilicalesArteriae umbilicales• paired branches
– central: truncus umbilicalis from aorta dorsalis– peripheral: within mass of diverticulum allantoicum
• to placenta (originally to allantois) in embryonic (connective) stalk or later in umbilical cord
• persist as arteriae iliacae internae and vesicales superiores – central: pars patens)– peripheral: ligamentum umbilicale mediale = pars
occlusa
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Malformation of arteriesMalformation of arteries
• Ductus arteriosus patens
• Coarctatio aortae
• Arcus aortae duplex
• Arcus aortae dexter
• Arteria lusoria– abnormal origin of the right subclavian artery –
obliteration of right aortic arch – origin of 7th segmental artery
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Malformation of arteriesMalformation of arteries
• course changes
• clinically relevant:– a. radialis
• a. brachioradialis (14%)
– a. ulnaris• a. brachioulnaris superficialis (3%)
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Development of venous systemDevelopment of venous system
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Developmental veinsDevelopmental veinsvv. somaticae• v. cardinalis communis = ductus Cuvieri• v. precardinalis ( v. jugularis int.+ ext.)• v. postcardinalis ( v. azygos + hemiazygos)• anastomosis subcardinalis
– vv. subcardinales
• vv. intersegmentales – v. marginalis membri + v. axialis m.s./m.i.( vv. subclaviae + superficial and deep limb veins)
vv. viscerales• vv. omphalomesentericae (vitellinae)• v. umbilicalis (originally 2, right one disappears)• v. pulmonalis communis
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Vena cava inferiorVena cava inferior
• v. omphalomesenterica intraembryonica pars hepatica VCI
• anastomosis subcardinalis + v. subcardinalis dx. pars subcardinalis VCI
• developmental anomalies 1-2%– infrarenal duplication
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Vena portaeVena portae
• vv. omphalomesentericae intraembryonicae
• vv. afferentes hepatis
• ductus venosus lig. venosum)
• vv. efferentes hepatis vv. hepaticae
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Vena portae Vena portae preduodenalispreduodenalis
rare