Test 3 - 2 Flashcards
Blood vessel tunics
- Intima
- media
- adventitia
tunica intima
- Endothelium and basal lamina
- Subendothelial layer
- Loose connective tissue
- Scattered fibroblasts and, in arteries, occasional smooth muscle cells
- Internal elastic lamina (membrane): Composed of elastin; Contains fenestrae for diffusion of substances
tunica media
- Concentric layers of smooth muscle cells
- Variable amounts of: Elastin, elastic fibers, fibronectin and fibrillin-1; Reticular fibers; Proteoglycans
- External elastic lamina (membrane) comprised of elastin
tunica adventitia
- Connective tissue layer
- Type I collagen fibers
- Elastic fibers
- Fibroblasts
components of the cardiovascular system
blood vessel system, lymphatic system
Vasa vasorum (vessels of the vessels)
Arteries - outer wall mostly vs. veins-gets right up to tunica intima (poorer oxygen conc and diffusion need to go deeper)
-Required for vessels greater than 1 mm in diameter
vessels that supply blood to blood vessels
syphilis and vasa vasorum:
Vasa vasorum of the ascending aorta become inflamed in syphilis. This results in endarteritis and periarteritis of the vasa vasorum, which then eventually become obliterated. This causes focal necrosis and scarring of the media and degeneration of the elastic lamellae. The focal scarring of the media results in depressions that can be observed on the surface of the intima. Consequently, a tree bark appearance is imprinted on the intimal surface.
atherosclerosis and vasa vasorum
-In atherosclerosis, vasa vasorum contribute to the angiogenesis and inflammation of the diseased vascular wall (this includes intimal thickening).
Innervation of BV
- network of autonomic nerve fibers known as the nervi vasorum or vascularis
- ARTERIES: nerve endings do not penetrate the media;
- VEINS: Nerve ending in adventitia and media; density is less than arteries
-mainly sympathetic fibers but some parasymp in vascular beds
Endothelial cells
- Flattened, polygonal cells; long axis is in direction of blood vessel
- Intercellular juntions between endothelial cells and to basal lamina. Also, myoendothelial junction. Shear stress exerted by blood flow increases endothelial [Ca2+] producing endothelial cell hyperpolarization. conducted to vascular smooth muscle via gap junctions=hyperpolarization=vasodilation.
- Contain Weibel – Palade bodies. Bodies contain: Von Willebrand factor (coagulating factor VIII); Tissue plasminogen activator; Interleukin 8; P-selectin attachment for leukocytes to move into ECM; Others: Promote/inhibit blood coagulation; Modulate smooth muscle activity (ex., endothelin and NO); Regulate inflammatory cell traffic; Transport – numerous pinocytotic vesicles; Regulate angiogenesis
- microvilli
Elastic (large) arteries
- Elastic lamellae increase with age
- Aging also causes mild to moderate intimal fibrosis and fragmentation of elastic lamellae in the media
- Marfan’s syndrome severe elastic medial fragmentation with GAG area - lose struts connecting adjacent lamelae.
- MEDIA IS THINK IN ARTERY
- INTERNAL AND EXTENAL ELASTIC MEMBRANES BETTER DEVELOPED
muscular (medium) arteries
- Aging also results in progressive intimal fibrosis (thickening) and alterations of elastic elements
- Aneurysm - circle of Willis
Arteroiles
smaller-ish that meduium?
-BLOOD PRESSURE CONTROL HERE
Metarterioles
- Vessels between arterioles and capillaries
- Media is composed of a discontinuous layer of smooth muscle
- Help to regulate blood flow into the capillary bed
- muscle sphincters determines blood distribution
Capillaries
1) Tunica intima: Endothelium & Basal lamina
2) Tunica media (true media is absent) - Pericytes relate to the position of this layer. Pericytes contribute to the formation of scar tissue in the CNS and perhaps in other organs.
3) Tunica adventitia – ABSENT
Facilitate exchange bw blood and tissues
Three types of capillaries
- Continuous (location – CNS, muscle, and lungs)
- Fenestrated (location – kidney, intestines, endocrine glands)
- Sinusoidal (location – spleen, liver, and bone marrow)
Pericytes
- Mesenchymal cells
- contractile
- Can transform into smooth muscle cells and fibroblasts
thickest layer in vein
adventitia
continuous capillaries
- tight junctions bw endothelial cells - with marginal folds (help with defense cell movement)
- lack pores (or fenestrae)
- contain numerous pinocytotic vesicles
- well dev basal lamina
- in brain, muscle, CT, and exocrine glands, lungs
fenestrated capillaries
- fanestrae (pores) are present in endothelial walls-pores have thin diaphragm
- continuous basal lamina
- subclasses-witho r without diaphragm in pores
- in exchanging tissues: kidney (glomerlus without diaphragm), endocrine, intestines,
sinusoidal capillaries
- discontinuous endothelial lining - large openings
- discontinuous or absent basal lamina
- macrophages present
- incell exchange itssues: red bone marrow, liver, spleen, adrenal cortex
longitudinal bundle of smooth muscle is found in what and what layer?
adventitia of IVC, SVC, brachiocephalic, renal, iliac veins
age related change to muscular arteries
tunica intima gets thicker and media thins
arteriole distinguishing fact
if wall is about as thick as the lumen
venules
smallest - no smooth muscle but has pericytic - can be leaky during inflamation
-usually irght next to arterioles
venules join to form muscular venules
post capillary venules
can be leaky - help with cell migration-finds marginal folds to pass through intercellular junction
medium vein
thicker wall and better developed tunica media with smooth muscles (still weak)
tunica adventitia is thickest layer
no internal and external elastic membrane
large vein
like brachiocephalic, portal vein
thin tunica media
circumpherential muscle
start to see longitudinal smooth muscle in adventitia
vasculogenesis in adults occurs by three methods:
from endothelial precursor cells (EPCs)
from pre-existing vessels
from tumor angiogenesis (uses both mechnanisms)
vasculogenesis from endothelial precursor cells:
- EPCs are angioblast-like cells that reside in the red bone marrow of adults and non-bone marrow niches
- When necessary, EPCs mobilize from their niches and migrate to the site where blood vessel formation is to occur. The mechanism by which they home in on this site remains unclear.
EPC mech for vasculogensis uses:
- Replaces lost endothelial cells
- Re-endothelization of vascular implants
- Neovascularization of ischemic organs, wounds, and tumors
Pre-existing BV formation of BV steps
- Vasodilation (NO) and increased vascular permeability (VEGF) of pre-existing (parent) vessel
- Proteolytic degradation of the basal lamina of the parent vessel by metalloproteinases. Endothelial cells shed their cell-to-cell contacts (intercellular junctions). This loss of cell-to-cell contact is mediated by plasminogen activator.
- Migration and proliferation of endothelial cells which have disrupted their cell-to-cell contacts. The migration and proliferation is induced by proangiogenic factors (e.g., VEGF and angiopoietin). Fibroblast growth factor-2 can also mediate endothelial cell migration and proliferation.
- Endothelial cells mature into an endothelial capillary tube.
- Elaboration of basal lamina and recruitment of periendothelial cells. (pericytes for capillaries and pericytic venules and smooth muscle cells for larger vessels). Elaboration of basal lamina elements is mediated by TGF-β (tumor growth factor). Recruitment of periendothelial cells is mediated by the interaction of Ang 1 with the Tie2 receptor on endothelial cells. PDGR (platelet-derived growth factor) induces recruitment of smooth muscle cells. Angiopoietin (Ang) 2 is involved in the stabilization process. Ang2 bound to Tie2, in the absence of growth factors, makes the endothelial cell more responsive to antiangiogenic factors.
tumor endothelial marker for tumor vessels
tumor endothelial marker 8
Proangiogenesis for clinical benefit
Myocardial ischemia Peripheral ischemia Cerebral ischemia Wound healing and fracture repair Reconstructive surgery Transplantation of islets of Langerhans
Antiangiogenesis for clinical benefit
Tumor growth and metastases Ocular neovascularization Hemangiomas Rheumatoid arthritis Atherosclerotic plaque neovascularization Birth control
vascular remodeling is driven by:
changes in stress drive trasnformational changes in the wall of the blood vessel to normalize wall stress
angiogenic steps from preexisting vessels again:
1) vasodialate (NO)]] and increase permeability (VEGF)
2) Degrade basal lamina with MMP and disrupt intercellular junctions with plasmalogen activator
3) ANG-2 destabilized vessel
4) Migration and proliferation of endothelial cells with (to) VEGF and FGF
5) Formation of endothelial capillary tube
6) Reform basal lamina with TGF-Beta and recruit periendothelial cells (pericytes or SMCs) with ANG-1-TIE-2 and PDGF
high flow on vascular remodeling=
increase in outside diameter and in increase in luminal diameter - vessel wall thickness the SAME
low flow on vascular remodeling=
decrease in outside diameter and a decrease in luminal diameter - vessel wall thickness decreases
increased pressure on vascular remodeling of large arteries=
outward hypertrophy - vessels become larger in diameter as wall becmoes thicker (smooth muscle externally - hence outward) - diameter of lumen unchanged
increased pressure on vascular remodeling of small arteries=
inward hypertrophy - outside diameter remains the same as wall becomes thicker (adding to INSIDE)- diameter of lumen decreases
increased pressure on vascular remodeling of arterioles=
- inward hypertrophy
- Inward (eutrophic) remodeling – wall thickness and wall diameter decrease. Prolonged stimulation by NE + ANG II induces activation of ROS-dependent activation of MMPs.
- Rarefaction (vessels disappear)
heart layers
1) Endocardium - inner layer (tunica intima) a. Endothelium (simple squamous epithelium) and basal lamina b. Subendothelial layer c. Myoelastic layer: smooth muscle and elastic and collagen fibers d)Subendocardium; Loose connective tissue; Small blood vessels; Nerve fibers; Purkinje cells or fibers (ventricles only)
2) Myocardium contains three types of cardiocytes (tunica media): a) Contractile b) Myoendocrine-Atrial natriuretic factor; B-type natriuretic factor (ventricles); Diuresis and vasodilation; B-type is elevated in congestive heart failure c) Specialized conductive
3) Epicardium (tunica adventitia)-Mesothelium (simple squamous epithelium) and basal lamina; Subepicardium
Cardiac skeleton is made up of
Dense connective tissue where cardiac muscle and valves are anchored
three layers of AV valves
1) Atrialis – layer of elastic and collagen tissue subjacent to endothelium of the atrial surface. Helps to contract valve
2) Spongiosa – middle layer of loose CT that serves as a shock absorber
3) Fibrosa – core of denser irregular collagenous tissue for mechanical integrity. Is subjacent to endothelium of ventricular surface
three layers of semilunar valves
1) Fibrosa – core of denser irregular collagenous tissue for mechanical integrity. Is subjacent to endothelium of aortic or pulmonic surface
2) Spongiosa – middle layer
3) Ventricularis – layer of elastic and collagen tissue subjacent to endothelium of ventricular surface
Myxomatous degeneration of AV valve basically means
floppy valves bc of dermatan sulface deposition
Conduction tissue of heart
1) SA node- cells smaller than atrial muscle cells; fewer myofibrils; SA node degenerates with age
2) AV node-similar to SA node
3) AV bundle of his- purkunje cells (fibers); travel into subendocardium; gap junctions; few myofibrils
glycogens; 1-2 nuclei
CSCs and ECCs differentiate into
cardiomyocytes, SMCs and endothelial cells
hCSCs are able to
replace the myocyte compartment 11 to 15 times.
Lymphatic vascular system made up of:
1) lymph capillaries: thin blinded end vessels - single layer endothelial cells - incomplete or absent basal lamina-microfibrils for anchoring - no pericytes - no smooth muscle
2) Lymph vessels: like veins but thinner walls - VALVES
3) lymph ducts (thoracic and R lymphatic): like veins, vasa vasorum, smooth muscle present
when does tunica intima thickening occur?
occurs in injury and as a normal consequence of aging
- Recruitment of smooth muscle cells
- Smooth muscle phenotype is proliferative/synthetic hence ECM elements are elaborated
modifiable risk factors for atherosclerosis
- Hyperlipidemia and cholesterol guidelines: < 200 mg/dL total; < 130 mg/dL LDL; > 45 mg/dL HDL; Triglycerides < 150 mg/dl
- Hypertension
- Smoking – one or more packs per day increases risk 200%
- Diabetes mellitus
- Incidence of MI is twice as high in diabetics as in nondiabetics, when other factors are equal
- 100-fold increased risk for gangrene of lower limb
- Other factors: Elevated C-reactive protein, a marker of inflammation; Elevated homocysteine (controversy exists)
nonmodifiable risk factors for atherosclerosis
- Age. Incidence of MI increases 5-fold between 40 and 60 years of age
- Sex. Men are at greater risk than premenopausal women. After menopause, the incidence in women increase until the risk is equal by the 7th to 8th decade of life.
- Family history
- Genetics. Familial hypercholesterolemia may lead to cholesterol levels of 300 to 500 mg/dL; in rare cases, over 800 mg/dL.
key events of atherosclerosis
1) Injury to epithelial cells=dysfunction:More permeable and cannot synthesize adhesion molecules
2) accumulation of lipoproteins (LDL)
* 3) oxydation of LDLby smooth muscle, endothelial cells and macrophages*
4) Adhesion of blood monocytes and otherleukocytes to endothelium - Macrophages with LDL=foam cells
5) platlet adhesion=less NO =>increases adhesion of platelets and leukocytes
6) Growth factors are released by platelets, endothelial cells, and macroph=more smooth muscle cells into endothelial compartment of tunia intima-smooth muscle is from precursors in blood or from media layer migration
7) smooth muscle cells tarnsition from contractile to proliferative synthetic=ECM deposited in subendothelial compartment=thickening of tunica intima
8) accumulation of lipids
consequences of atherosclerosis:
- ischemic heart disease=coronary artery narrowing and thrombosis - most=ant IV artery
- cerebral infarts=microscopic changes eosinophilia of neurons (red neurons)- neutrophil infiltration occurs at sites where bv are intact; macroph and reactivegliosis
wavefront phenomena of cell death
death occurs in the inner wall of the myocardium (subendomyocardium) and proceeds outward toward the subpericardium
myocardial infarct consequences:
- Arrythmias
- Acute rupture of the cardiac wall or IV septum
- Rupture of papillary muscles
- Ventricular aneurysm
predominant cell type in atherosclerosis
foam cells - macrophages
atherosclerosis is (basic)
chronic inflamatory state due to endothelial injury
primary lymphatics tissues
bone marrow-make immunocompetent cells
thymus
secondary lymphatic tissues
- lymph nodes - FILTER LYMPH
- mucosa associated lymphatic tissue(SURVEILLANCE-MALT): GUT, BRONCHUS, GU, TONSILS
- spleen-BLOOD FILTER
Diffuse Lymphatic tissue (MALT)
- simple organization: part of lamina propria wall of GI tract (GALT), respiratory tract (BALT), GU tract.
- reticular fibers=support framework
- cells: lymphocytes, monocytes, macrophages, and plasma cells
lymphatic nodules (follicles)
- non-encapsulated, spherical, dense aggregations of lymphoctes
- primary nodule: homogeneous and small lymphocytes
- secondary nodule: -corona (mantle) zone:outer, dark staining=mature (small) lymphocytes; geerminal center: inner, light staining zone=mature (med&large) lympocytes.
- encounter with antigen=germinal center swells
solitary lmphatic nodules are
temporary and can appear or disappear at a particular site