Anatomy and Histology of The Cardiovascular System

Irma Savitri/0806358022/Group A Trigger 1-Cardiovascular odule

Anatomy of The Hearti

The heart is located near the anterior chest wall, directly posterior to the sternum. The great veins and arteries are connected to the superior end of the heart at the attached base. The base sits posterior to the sternum at the level of the third costal cartilage, centered about 1.2 cm to the left side. The inferior, pointed tip of the heart is the apex. A typical adult heart measures approximately 12.5 cm from the base to the apex, which reaches the fifth intercostal space approximately 7.5 cm to the left of the midline. A midsagittal section through the trun does not divided the heart into two e!ual halves, because "1# the center of the base lies slightly to the left of the midline, "2# a line drawn between the center of the base and the apex points further to the left, "$# the entire heart is rotated to the left around this line, so that the right atrium and right ventricle dominate an anterior view of the heart. The heart, surrounded by the pericardial sac, sits in the anterior portion of the mediastinum. The mediastinum, the region between the two pleural cavities, also contains the great vessels "the large arteries and veins lin ed to the heart#, thymus, esophagus, and trachea. The lining of the pericardial cavity is called the pericardium. The pericardium is lined by a delicate serous membrane that can be subdivided into the visceral pericardium and the parietal pericardium. The visceral pericardium, or epicardium, covers and adheres closely to the outer surface of the heart% the parietal pericardium lines the inner surface of the pericardial sac, which surrounds the heart. The pericardial sac, or fibrous pericardium, which consists of a dense networ of collagen fibers, stabili&es the position of the heart and associated vessels within the mediastinum. The small space between the parietal and visceral surfaces is the pericardial cavity. 't normally contains 15(5)m* of pericardial fluids, secreted by the pericardial membranes. This fluid acts as a lubricant, reducing friction between the opposing surfaces as the heart beats.

Superficial Anatomy of The Heart

The four cardiac chambers can easily be identified in a superficial view of the heart. The two atria have relatively thin muscular walls and are highly expandable. +hen not filled with blood, the outer portion of each atrium deflates and become lumpy, wrin led flap. This expandable extension of an atrium is called an atrial appendage, or an auricle. The coronary sulcus, a deep groove, mar s the border between the atria and the ventricles. The anterior interventricular sulcus and the posterior interventricular sulcus, shallower depressions, mar the boundary between the left and right ventricles. The connective tissue of the epicardium at the coronary and interventricular sulci generally contains substantial amounts of fat. These sulci also contain the arteries and veins that carry blood to and from the cardiac muscle.

The Heart Wall

A section through the wall of the heart reveals three distinct layers, an outer epicardium, a middle myocardium, and an inner endocardium. The epicardium is the visceral pericardium that covers the outer surface of the heart. This serous membrane consists of an exposed mesothelium and an underlying layer of loose areolar connective tissue that is attached to the myocardium. The myocardium, or muscular wall of the heart, forms both atria and ventricles. This layer contains cardiac muscle tissue, blood vessels, and nerves. The myocardium consists of concentric layers of cardiac muscle tissue. The atrial myocardium contains muscle bundles that wrap around the atria and encircle the great vessels. -uperficial ventricular muscles wrap around both ventricles% deeper muscle layers spiral around and between the ventricles.

The inner surfaces of the heart, including those of the heart valves, are covered by the endocardium, a simple s!uamous epithelium that is continuous with the endothelium of the attached great vessels.

Internal Anatomy and Organization

The atria are separated by the interatrial septum and the ventricles are separated by the much thic er interventricular septum. .ach septum is a muscular partition. Atrioventricular "A/# valves, folds of fibrous tissue, extend into the openings between the atria and ventricles. These valves permit blood flow in one direction only% from the atria to the ventricles.

The Right Atrium

The right atrium receives blood from the systemic circuit through the two great veins% the superior vena cava and the inferior vena cava. The superior vena cava, which opens into the posterior and superior portion of the right atrium, delivers blood to the right atrium from the head, nec , upper limbs, and chest. The inferior vena cava, which opens into the posterior and inferior portion of the right atrium, carries blood to the right atrium from the rest of the trun , the viscera, and the lower limbs. The cardiac veins of the heart returns blood to the coronary sinus, a large, thin(walled vein that opens into the right atrium inferior to the connection with the superior vena cava. The opening of the coronary sinus lies near the posterior edge of the interatrial septum. 0rom the fifth wee of embryonic development until birth, the foramen ovale, an oval opening, penetrates the interatrial septum and connects the two atria of the fetal heart. 1efore birth, the foramen ovale permits blood flow from the right atrium to the left atrium while the lungs are developing. At birth, the foramen ovale closes, and the opening is permanently sealed off within three months of delivery. The fossa ovalis, a small, shallow depression, persists at this site in the adult heart. The posterior wall of the right atrium and the interatrial septum has smooth surfaces. 'n contrast, the anterior atrial wall and the inner surface of the auricle contain prominent muscular ridges called the pectinate muscles.

The Right Ventricle

1lood travels from the right atrium into the right ventricle through a broad opening bounded by three fibrous flaps. These flaps, called cusps or leaflets, are part of the right atrioventricular "A/# valve, also nown as the tricuspid valve. The free edge of each cusp is attached to connective tissue fibers called the chordae tendinae. The fibers originate at the papillary muscles, conical muscular pro2ections that arise from the inner surface of the right ventricle. The right A/ valve closes when the right ventricle contracts, preventing the bac flow of blood into the right atrium. +ithout the chordae tendinae to anchor their free edges, the cusps would be li e swinging doors that permitted blood flow in both directions. The internal surface of the ventricle also contains a series of muscular ridges, the trabeculae carnae. The moderator band is a muscular ridge that extends hori&ontally from the inferior portion of the interventricular septum and connects to the anterior papillary muscle. This ridge contains a portion of the conducting system, an internal networ that coordinates the contraction of cardiac muscle cells. The moderator band delivers the stimulus for contraction

to the papillary muscles, so that they begin tensing the chordate tendineae before the rest of the ventricle contracts. The superior end of the right ventricle tapers to the conus arteriosus, a conical pouch that ends at the pulmonary valve, or pulmonary semilunar valve. The pulmonary valve consists of three semilunar cusps of thic connective tissue. 1lood flowing from the right ventricle passes through this valve to enter the pulmonary trun , the start of the pulmonary circuit. The arrangement of cusps prevents bac flow as the right ventricle relaxes. 3nce in the pulmonary trun , blood flows into the left pulmonary arteries and the right pulmonary arteries. These vessels branch repeatedly within the lungs before supplying the capillaries, where gas exchange occurs.

The Left Atrium

0rom the respiratory capillaries, blood collects into small veins that ultimately unite to form the four pulmonary veins. The posterior wall of the left atrium receives blood from two left and two right pulmonary veins. *i e the right atrium, the left atrium has an auricle. A valve, the left atrioventricular "A/# valve, or bicuspid valve, guards the entrance to the left ventricle. As the name bicuspid implies, the left A/ valve contains a pair, not a trio, of cusps.

The Left Ventricle

The left ventricle has thic , muscular walls that enable it to develop pressure sufficient to push blood through the large systemic circuit. The internal organi&ation of the left ventricle generally resembles that of the right ventricle, except for the absence of a moderator band. The trabeculae carneae are prominent, and a pair of large papillary muscles tense the cordae tendineae that anchor the cusps of the A/ valve and prevent the bac flow of blood into the left atrium. 1lood leaves the left ventricle by passing through the aortic valve, or aortic semilunar valve, into the ascending aorta. The arrangement of cusps in the aortic valve is the same as that in the pulmonary valve. 3nce the blood has been pumped out of the heart and into the systemic circuit, the aortic valve prevents bac flow into the left ventricle. 0rom the ascending aorta, blood flows through the aortic arch and into the descending aorta. The pulmonary trun is attached to the aortic arch by the ligamentum arteriosum, a fibrous band that is a remnant of an important fetal blood vessel that once lin ed the pulmonary and systemic circuits.

The Heart Valves The Atrioventricular Valves

The atrioventricular "A/# valves prevent the bac flow of blood from the ventricles to the atria when the ventricles are contracting. The chordae tendineae and papillary muscles play important rules in the normal function of the A/ valves. +hen the ventricles are relaxed, the chordate tendineae are loose, and the A/ valves offer no resistance of the flow of blood from the atria into the ventricles. +hen the ventricles contract, blood moving bac toward the atria swings the cusps together, closing the valves. At the same time, the contraction of the papillary muscles tenses the chordate tendineae, stopping the cusps before they swing into the atria.

The Semilunar Valves

The pulmonary and aortic valves prevent the bac flow of blood from the pulmonary trun and aorta into the right and left ventricles, respectively. 4nli e the A/ valves, the semilunar valves do not re!uire muscular braces, because the arterial walls do not contract and the relative positions of the cusps are stable. +hen the semilunar valves close, the three symmetrical cusps support one another li e the legs of a tripod. -acli e dilations of the base of the ascending aorta are ad2acent to each cusp of the aortic valve. These sacs, called aortic sinuses, prevent the individual cusps from stic ing to the wall of the aorta when the valve opens. The right and left coronary arteries, which deliver blood to the myocardium, originate at the aortic sinuses.

onnective Tissues and the ardiac S!eleton

The connective tissues of the heart include large numbers of collagen and elastic fibers. .ach cardiac muscle cell is wrapped in a strong, but elastic, sheath and ad2acent cells are tied together by fibrous cross(lin s. These fibers, are, in turn, interwoven into sheets that separate the superficial and deep muscle layers. The connective tissue fibers provide physical support for the cardiac muscle fibers, blood vessels, and nerves of the myocardium% help distribute the forces of contraction% add strength and prevent overexpansion of the heart% and provide elasticity that helps return the heart to its original si&e and shape after a contraction. The cardiac s eleton "or fibrous s eleton# of the heart consists of four dense bands of tough elastic tissue that encircle the heart valves and the bases of the pulmonary trun and aorta. These bands stabili&e the positions of the heart valves and ventricular muscle cells and electrically insulate the ventricular cells from the atrial cells.

The "lood Supply to the Heart

The oronary Arteries

The left and right coronary arteries originate at the base of the ascending aorta, at the aortic sinuses. 1lood pressure here is the highest in the systemic circuit. .ach time the left ventricle contracts, it forces blood into the aorta. The arrival of additional blood at elevated pressure stretches the elastic walls of the aorta. +hen the left ventricle relaxes, blood no longer flows into the aorta, pressure declines, and the walls of the aorta recoil. The recoil, called elastic rebound, pushes blood both forward, into the systemic circuits, and bac ward, through the aortic sinuses and then into the coronary arteries. Thus, the combination of elevated blood pressure and elastic rebound ensures a continuous flow of blood to meet the demands of active cardiac muscle tissue. 5owever, myocardial blood flow is not steady, it pea s while the heart muscle is relaxed, and almost ceases when it contracts. The right coronary arteriy, which follows the coronary sulcus around the heart, supplies blood to the right atrium, portions of both ventricles, and portions of the conducting system of the heart, including the sinoatrial "-A# node and the atrioventricular "A/# node. The cells of these nodes are essential to establishing the normal heart rate. 'nferior to the right atrium, the right coronary artery generally gives rise to one or more marginal arteries, which extend across the surface of the right ventricle. The right coronary artery then continues across the posterior surface of the heart, supplying the posterior interventricular artery, or posterior descending artery, which runs towards the apex within the posterior interventricular sulcus. The posterior interventricular artery supplies blood to the interventricular septum and ad2acent portions of the ventricles. The left coronary artery supplies blood to the left ventricle, left atrium, and interventricular septum. As it reaches the anterior surface of the heart, it gives rise to a circumflex branch and an anterior interventricular branch. The circumflex artery curves to the left around the coronary sulcus, eventually meeting and fusing with small branches of the right coronary artery. The much larger anterior interventricular artery, or left anterior descending artery, swings around the pulmonary trun and runs along the surface within the anterior interventricular sulcus. The anterior interventricular artery supplies small tributaries continuous with those of posterior interventricular artery. -uch interconnections between arteries are called arterial anastomoses. 1ecause the arteries are interconnected in this way, the blood supply to the cardiac muscles remains relatively constant despite pressure fluctuations in the left and right coronary arteries as the heart beats.

The ardiac Veins

The great cardiac vein begins on the anterior surface of the ventricles. This vein drains blood from the region supplied by the anterior interventricular artery, a branch of the left coronary artery. The great cardiac vein reaches the level of the atria and then curves around the left side of the heart within the coronary sulcus. The vein empties into the coronary sinus, which lies in the posterior portion of the coronary sulcus. The coronary sinus opens into the right atrium near the base of the inferior vena cava. 3ther cardiac veins that empty into the great cardiac vein or the coronary sinus include "1# the posterior cardiac vein, draining the area served by the circumflex artery, "2# the middle cardiac vein, draining the area supplied by the posterior interventricular artery, "$# the small

cardiac vein which receives blood from the posterior surfaces of the right atrium and ventricle. The anterior cardiac veins which drain the anterior surface of the right ventricle, empty directly into the right atrium.

Anatomy of the "lood Vesselsii

The Systemic irculation The Aorta and Its "ranches

The systemic circulation includes the arteries and arterioles that carry oxygenated blood from the left ventricle to systemic capillaries, plus the veins and venules that return deoxygenated blood to the right atrium. 1lood leaving the aorta and flowing through the systemic arteries is a bright red color. As blood flows through capillaries, it loses some of its oxygen and pic s up carbon dioxide, becoming a dar red color. All systemic arteries branch from the aorta. 6ompleting the circuit, all the veins of the systemic circulation drain into the superior vena cava, the inferior vena cava, or the coronary sinus, which in turn empty into the right atrium. The bronchial arteries, which carry nutrients to the lungs, also are part of the systemic circulation.

The aorta is the largest artery of the body, with a diameter of 2($ cm. 'ts four principal divisions are the ascending aorta, arch of the aorta, thoracic aorta, and abdominal aorta. The portion of the aorta that emerges from the left ventricle posterior to the pulmonary trun is the ascending aorta. The beginning of the aorta contains the aortic valve. The ascending aorta gives off two coronary artery branches that supply the myocardium of the heart. Then the ascending aorta arches to the left, forming the arch of aorta, which descends and ends at the level of the intervertebral discs between the fourth and fifth thoracic vertebrae. As the aorta continues to descend, it lies close to the vertebral bodies, passes through the aortic hiatus of the diaphragm, and divides at the level of the fourth lumbal vertebra into two common iliac arteries, which carry blood to the lower limbs. The section of the aorta between the arch of the aorta and the diaphragm is called the thoracic aorta, the section between the diaphragm and the common iliac arteries is the abdominal aorta. .ach division of the aorta gives off arteries that branch into distributing arteries that lead to various organs. +ithin the organs, the arteries divide into arterioles and then into capillaries that service the systemic tissues "all tissues except the alveoli of the lungs#.

Asce!di!g Aorta
The ascending aorta is about 5 cm in length and begins at the aortic valve. 't is directed superiorly, slightly anteriorly, and to the right. 't ends at the level of the sternal angle, where it becomes the arch of aorta. At its origin, the ascending aorta contains three dilations called aortic sinuses. Two of these, the right and left sinuses, give rise to the right and left coronary arteries, respectively. The right and left coronary arteries arise from the ascending aorta 2ust superior to the aortic valve. The posterior interventricular branch of the right coronary artery supplies both ventricles, and the marginal branch supplies the right ventricle. The anterior interventricular branch of the left coronary artery supplies both ventricles, and the circumflex branch supplies the left atrium and left ventricle.

T"e Arc" o# t"e Aorta

The arch of the aorta is 7(5 cm in length and is the continuation of the ascending aorta. 't emerges from the pericardium posterior to the sternum at the level of the sternal angle. The arch of the aorta is directed superiorly and posteriorly to the left and then inferiorly% it ends at the intervertebral discs between the fourth and fifth thoracic vertebrae, where it becomes the thoracic aorta. Three ma2or arteries branch from the superior aspect of the arch of the aorta% the brachiocephalic trun , the left common carotid, and the left subclavian. The first and largest branch from the arch of the aorta is the brachiocephalic trun . 't extends superiorly, bending slightly to the right, and divides at the right sternoclavicular 2oint to orm the right subclavian artery and right common carotid artery. The second branch from the arch of the aorta is the left common carotid artery. The third branch from the arch of aorta is the left subclavian artery, which distributes blood to the left vertebral artery and vessels of the left upper limb.

T"oracic Aorta
The thoracic aorta is about 2) cm in long and is a continuation of the arch of the aorta. 't begins at the level of the intervertebral disc between the fourth and fifth thoracic vertebrae, where it lies to the left of the vertebral column. As it descends, it moves closer to the midline

and extends through an opening in the diaphragm "aortic hiatus#, which is located anterior to the vertebral column at the level of the intervertebral disc between the twelfth thoracic and first lumbar vertebrae. Along its course, the thoracic aorta sends off numerous small arteries, visceral branches to viscera, and parietal branches to body wall structures.

A$domi!al Aorta
The abdominal aorta is the continuation of the thoracic aorta. 't begins at the aortic hiatus in the diaphragm and ends at about the level of the fourth lumbal vertebra, where it divides into the right and left common iliac arteries. The abdominal aorta lies anterior to the vertebral column. As with the thoracic aorta, the abdominal aorta gives off visceral and parietal branches. The unpaired visceral branches arise from the anterior surface of the aorta and include the celiac trun and the superior mesenteric and inferior mesenteric arteries. The paired visceral brances arise from the lateral surfaces of the aorta and include the suprarenal, renal, and gonadal arteries. The unpaired parietal branch is the median sacral artery. The paired parietal branches arise from the posterior surfaces of the aorta and include the inferior phrenic and lumbar arteries.

Arteries of the #elvis and Lo$er Lim%s

The abdominal aorta ends by dividing into the right and left common iliac arteries. These, in turn, divide into the internal and external iliac arteries. 'n se!uence, the external illiacs become the femoral arteries in the thighs, the popliteal arteries posterior to the nee, and the anterior and posterior tibial arteries in the legs.

Veins of the Systemic irculation

Although only one systemic artery, the aorta, ta es oxygenated blood away from the heart "left ventricle#, three systemic veins, the coronary sinus, superior vena cava, and inferior vena cava, return deoxygenated blood to the heart "right atrium#. The coronary sinus receives blood from the cardiac veins% the superior vena cava receives blood from other veins superior to the diaphragm, except the air sacs "alveoli# of the lungs% the inferior vena cava receives blood from the veins inferior to the diaphragm.

Veins of the Head and &ec!

8ost blood draining from the head passes into three pairs of veins% the internal 2ugular, external 2ugular, and vertebral veins. +ithin the brain, all veins drain into dural venous sinuses and then into the internal 2ugular veins. 9ural venous sinuses are endothelial(lined venous channels between layers of the cranial dura mater.

Veins of the 'pper Lim%s

1oth superficial and deep veins return blood from the upper limbs to the heart. -uperficial veins are located 2ust deep to the s in and often visible. They anastomose extensively with one another and with deep veins% and they do not accompany arteries. -uperficial veins are larger than deep veins and return most of the blood from the upper limbs. 9eep veins are

located deep in the body. They usually accompany arteries and have the same names as the corresponding arteries. 1oth superficial and deep veins have valves, but valves are more numerous in the deep veins.

Veins of the Thora(

Although the brachiocephalic veins drain some portion of the thorax, most thoracic structures are drained by a networ of veins, valled the a&ygos system, that runs on either side of the vertebral column. The system consists of three veins : the a&ygos, hemia&ygos, and accessory hemia&ygos veins, that show considerable variation in origin, course, tributaries, anastomoses, and termination. 4ltimately they empty into the superior vena cava.

Veins of the A%domen and #elvis

1lood from the abdominal and pelvic viscera and abdominal wall returns to the heart via the inferior vena cava. 8any small veins enter the inferior vena cava. 8ost carry return flow from parietal branches of the abdominal aorta, and their names correspond to the names of the arteries. The inferior vena cava does not receive veins directly from the gastrointestinal trac , spleen, pancreas, and gallbladder. These organs pass their blood into a common vein, the hepatic portal vein, which delivers the blood to the liver. The superior mesenteric and splenic veins unite to form the hepatic portal vein. After passing through the liver for processing, blood drains into the hepatic veins, which empty to the inferior vena cava.

Veins of the Lo$er Lim%s

As with the upper limbs, blood from the lower limbs is drained by both superficial and deep veins. The superficial veins often anastomose with one another and with deep veins along their length. 9eep veins, for the most part, have the same names as corresponding arteries. All veins of the lower limbs have valves, which are more numerous in the veins of the upper limbs.

Histology of the ardiac )uscleiii

6ardiac muscle "heart muscle# is found only in the heart and in pulmonary veins where they 2oin the heart. 6ardiac muscle is derived from a strictly defined mass of splanchinic mesenchyme, the myoepicardial mantle, whose cells give rise to the epicardium and myocardium. The adult myocardium consists of an anastomosing networ of branching cardiac muscle cells arranged in layers "laminae#. *aminae are separated from one another by slender connective tissue sheets that convey blood vessels, nerves, and the conducting system of the heart. 6apillaries, derived from these branches, invade the intercellular connective tissue, forming a rich, dense networ of capillary beds surrounding every cardiac muscle cells. Almost half the volume of the cardiac muscle cell is occupied by mitochondria, attesting to its great energy consumption. ;lycogen, to a certain extent, but mostly triglycerides form the energy supply of the heart. 1ecause the oxygen re!uirement of cardiac muscle cells is high, they contain an abundant supply of myoglobin.

Although the resting lengths of individual cardiac muscle cells vary, on average they are 15 micrometer in diameter and <) micrometer in length. .ach cell possesses a single, large, oval, centrally placed nucleus, although two nuclei are occasionally present. 8uscle cells of the atria are somewhat smaller than those of the ventricles. These cells also house granules "especially in the right atrium# contining atrial natriuretic peptide, a substance that functions to lower blood pressure. This peptide acts by decreasing the capabilities of renal tubules to resorb "conserve# sodium and water.

Intercalated *is!s
6ardiac muscle cells form highly speciali&ed end(to(end 2unctions, referred to as intercalated dis s. The cell membranes involved in these 2unctions approximate each other, so that in most areas they are separated by a space of less that 15 to 2) nm. 'ntercalated dis s have transverse portions, where fasciae adherents and desmosomes abound, as well as lateral portions rich in gap 2unctions. 3n the cytoplasmic aspect of the sarcolemma of intercalated dis s, thin myofilaments attach to the fasciae adherens, which are thus analogous to = dis s. ;ap 2unctions, which function in permitting rapid flow of information from one cell to the next, also form in regions where cells lying side by side come in close contact with each other.

Organelles
The bandings of cardiac muscle fibers are identical with those of s eletal muscles, including alternating ' and A bands. .ach sarcomere possesses the same substructure as its s eletal muscle counterpart% therefore, the mode and mechanism of contraction are virtually identical in the two striated muscles. -everal ma2or differences should be noted, however% they are found in the sarcoplasmic reticulum, the arrangement of T tubules, the calcium ion supply of cardiac muscle, the ion channels of the plasmalemma, and the duration of the action potential. The sarcoplasmic reticulum of cardiac muscle does not form terminal cisternae and is not nearly as extensive as in s eletal muscle% instead, small terminals of sarcoplasmic reticulum approximate the T tubules. These structures do not normally form a triad, as in s eletal muscle% rather, the association is usually limited to two partners, resulting in a dyad. 4nli e in s eletal muscle, dyads in cardiac muscle cells are located in the vicinity of the = line. The T tubules of cardiac muscle cells are almost two and one(half times the diameter of those in s eletal muscle and are lined by an external lamina. 1ecause the sarcoplasmic reticulum is relatively sparse, it cannot store enough calcium to accomplish a forceful contraction% therefore, additional sources of calcium are available. 1ecause the T tubules open into the extracellular space and have a relatively large bore, extracellular calcium flows through the T tubules and enters the cardiac muscle cells at the time of depolari&ation. 8oreover, the negatively charged external lamina coating of the T tubule stores calcium for instanteous release. - eletal muscle cell action potential is achieved by an abundance of fast sodium channels, which open and close within a few ten(thousandths of a second, leading to the generation of very rapid action potentials. 'n addition to fast sodium channels, cardiac muscle cell membranes possess calcium(sodium channels "slow sodium channels#. Although these channels are slow to open initially, they remain open for a considerable time "several tenths

of a second#. 9uring this time, a tremendous number of sodium and calcium ions enter the cardiac muscle cell cytoplasm, thus increasing the calcium ion concentration supplied by the T tubule and the sarcoplasmic reticulum. An additional difference between the movement of ions in s eletal and cardiac muscle cells is that potassium ions can leave the s eletal muscle cells extremely !uic ly, thus reestablishing the resting membrane potential% in cardiac muscle cells, the egress of potassium ions is retarded thus contributed to the protracted action potential.

Histology of The "lood Vesselsiv

The whole circulatory system has a common basic structure. 't has tunica intima, which is an inner lining comprising a single layer of endothelium supported by a basement membrane and delicate collagenous tissue% tunica media, which is an intermediate predominantly muscular layer% and tunica adventitia% which is an outer principally supporting tissue layer. The tissue of the thic walls of large vessels "e.g.# aorta cannot be sustained by diffusion of oxygen and nutrients from their lumina, and are supplied by small arteries "vasa vasorum# which run in the tunica adventitia and sends arterioles and capillaries into the tunica media. The muscular content exhibits the greatest variation from one part of the system to another. 0or example, it is totally absent in capillaries but comprises almost the whole mass of the heart. 1lood flow is predominantly influenced by variation in activity of the muscular tissue.

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