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THE CIRCULATORY SYSTEM
        Heart and Vessels




     Assoc. Prof Dr. Karim Al-Jashamy
             IMS/MSU 2010
 The Circulatory System:
 The circulatory system comprises both the blood and lymphatic
  vascular systems. The blood vascular system is composed of
  the following structures:
 The heart, an organ whose function is to pump the blood.
 The arteries, a series of efferent vessels that become smaller
  as they branch, and whose function is to carry the blood, with
  nutrients and oxygen, to the tissues.

 The capillaries, the smallest blood vessels, constituting a
  complex network of thin tubules that anastomose profusely and
  through whose walls the interchange between blood and
  tissues takes place.
 The veins, which result from the convergence of the capillaries
  into a system of channels. These channels become larger as
  they approach the heart, toward which they convey the blood
  to be pumped again.
 The   lymphatic vascular system begins in the lymphatic
  capillaries, closed-ended tubules that anastomose to form vessels
  of steadily increasing size; these vessels terminate in the blood
  vascular system emptying into the large veins near the heart.
 One of the functions of the lymphatic system is to return the fluid of
  the tissue spaces to the blood. The internal surface of all
  components of the blood and lymphatic systems is lined by a single
  layer of a squamous cells, called endothelium.

 It  is customary to divide the circulatory system into the
  macrovasculature, vessels that are more than 0.1 mm in diameter
  (large arterioles, muscular and elastic arteries, and muscular veins),
  and the microvasculature (arterioles, capillaries, and postcapillary
  venules), visible only with a microscope.
 The microvasculature is particularly important as the site of
  interchanges between the blood and surrounding tissues under
  normal conditions and in the event of inflammatory processes
Basic Structure of Circulatory System
 Tunica intima
   Endothelium supported by basement membrane and
   delicate collagenous tissue.
 Tunica media
   Muscle and CT
 Tunica adventitia
   CT
Tissue Components of the Vascular Wall

 The  vascular wall is composed of three basic
 structural constituents: the endothelium, the
 muscular tissue, and the connective tissue, which
 includes elastic elements.

 The amount and arrangement of these tissues within
 the blood circulatory system are influenced by
 mechanical factors, represented primarily by blood
 pressure, and metabolic factors, which reflect the
 local needs of the tissues. These tissues are all
 present in different proportions in the vascular wall,
 except for capillaries and postcapillary venules, in
 which the only structural elements represented are
 the endothelium, its basal lamina, and pericytes
 The endothelium is a special type of epithelium
  interposed as a semipermeable barrier between two
  compartments of the internal medium, the blood
  plasma and the interstitial fluid.
 Endothelium is highly differentiated to actively
  mediate and monitor the extensive bidirectional
  exchange of small molecules and to restrict the
  transport of some macromolecules.
 In addition to their role in interchanges between blood
  and surrounding tissues, endothelial cells perform
  several other functions:
 1. Conversion of angiotensin I to angiotensin II (Urinary
  System).
 2. Conversion of bradykinin, serotonin, prostaglandins,
  norepinephrine, thrombin, etc, to biologically inert compounds.

 3. Lipolysis of lipoproteins by enzymes located on the surface
  of endothelial cells, to yield triglycerides and cholesterol
  (substrates for steroid-hormone synthesis and membrane
  structure).
 4. Production of vasoactive factors that affect the vascular
  tone, such as endothelins, vasoconstrictive agents, and nitric
  oxide, a relaxing factor.
 Growth factors such as vascular endothelial growth factors
  (VEGFs) play pivotal roles in the formation of the vascular
  system during embryonic development, in the regulation of
  capillary growth under normal and pathological conditions in
  adults, and in the maintenance of the normal vasculature.
MEDICAL APPLICATION
 The    endothelium also has an antithrombogenic action,
  preventing blood coagulation. When endothelial cells are
  damaged by atherosclerotic lesions, for example, the
  uncovered subendothelial connective tissue induces the
  aggregation of blood platelets.
 This aggregation initiates a cascade of events that produces
  fibrin from blood fibrinogen. An intravascular coagulum, or
  thrombus (plural, thrombi), is formed that may grow until
  there is complete obstruction of the local blood flow.
 From this thrombus, solid masses called emboli (singular,
  embolus) may detach and be carried by the blood to obstruct
  distant blood vessels. In both cases, the vascular flow may
  stop, a potentially life-threatening condition. Thus, the integrity
  of the endothelial layer, which prevents contact between
  platelets and the subendothelial connective tissue, is an
  important antithrombogenic mechanism.
Vascular Smooth Muscle
 is present in all vessels except capillaries and pericytic
 venules. Smooth muscle cells are frequent and are arranged
 in helical layers in the tunica media of the blood vessels. Each
 muscle cell is enclosed by a basal lamina and by variable
 amounts of connective tissue.
 Vascular Connective Tissue
 Components of connective tissue are present in the walls of
  blood vessels in amounts and proportions that vary based on
  local functional requirements.

 Collagen fibers, ubiquitous element in the vascular system
 wall, are found between muscle cells, in adventitia, and in
 some subendothelial layers. Collagen types IV, III, and I are
 present in the basement membranes, tunica media, and
 adventitia, respectively.
 Elastic fibers guarantee the resilient shrinkage of the
  expanded vascular wall. These fibers predominate in
  large arteries where they are organized in parallel
  lamellae regularly distributed between the muscle cells
  throughout the entire media.
 Ground substance forms a heterogeneous gel in the
  extracellular spaces of the vessel wall. It contributes to the
  physical properties of the walls of the vessels and
  probably affects the diffusion and permeability across the
  wall.
 The concentration of glycosaminoglycans is higher in
  arterial than in venous tissue.
Types of Vessels
 Elastic artery
 Muscular artery
 Arteriole
 Capillary
 Muscular venule, small vein
 Vein
 Muscular vein
 Tunica Intima
 The intima consists of one layer of
  endothelial cells supported by a
  subendothelial     layer   of     loose
  connective      tissue      containing
  occasional smooth muscle cells.
 In arteries, the intima is separated
  from the media by an internal elastic
  lamina, the most external component
  of the intima.
 This lamina, composed of elastin, has
  gaps (fenestrae) that allow the
  diffusion of substances to nourish
  cells deep in the vessel wall. As a
  result of the absence of blood
  pressure and the contraction of the
  vessel at death, the tunica intima of
  the    arteries  generally    has    an
  undulating appearance in tissue
  sections
 Tunica Media
 The media consists primarily
  of    concentric    layers    of
  helically arranged smooth
  muscle cells .
 Interposed among these cells
  are variable amounts of
  elastic fibers and lamellae,
  reticular fibers (collagen type
  III),    proteoglycans,     and
  glycoproteins.
 Smooth muscle cells are the
  cellular    source     of   this
  extracellular matrix.
 In arteries, the media has a
  thinner external elastica
  lamina, which separates it
  from the tunica adventitia.
 Tunica Adventitia
 The adventitia consists
 principally of collagen and
 elastic fibers

 Collagen in the adventitia
 is type I. The adventitial
 layer gradually becomes
 continuous with the
 connective tissue of the
 organ through which the
 vessel runs.
Innervations
 Most blood vessels that contain smooth muscle in their walls are
  supplied with a profuse network of unmyelinated sympathetic nerve
  fibers (vasomotor nerves) whose neurotransmitter is norepinephrine.

 Discharge of norepinephrine from these nerves results in
  vasoconstriction.
 In veins, nerve endings are found in both the adventitia and the
  media, but the overall density of innervations is less than that
  encountered in arteries.
 Arteries in skeletal muscle also receive a cholinergic vasodilator
  nerve supply. Acetylcholine released by these vasodilator nerves
  acts on the endothelium to produce nitric oxide
 For didactic purposes, the arterial blood vessels are classified,
  based on their diameter, into arterioles, arteries of medium diameter
  (muscular arteries), and larger (elastic) arteries.
ELASTIC ARTERY: AORTA

Layers of Aorta
 Tunica intima
   Endothelium
   Collagenous fibers,
    elastic fibers & elastin
    sheets
 Tunica media
   Extremely elastic
    (sheets of elastin),
    smooth muscle
 Tunica adventitia
   Collagenous, elastic
    fibers
ELASTIC
ARTERY:
AORTA
Tunica Media: H&E stain
Muscular Artery
 Tunica intima
   Endothelium
   Fine collagenous fibers,
    smooth muscle
   Internal elastic lamina
    clearly evident
 Tunica media
   Smooth muscle
   Collagenous, reticular,
    elastic fibers
   External elastic lamina
    clearly evident
 Tunica adventitia
   Thick collagenous, elastic
    tissue
Muscular Artery (x4)
Muscular Artery x10
Muscular Artery   x10
Muscular Artery (L) vs Elastic Artery (R)
Arteriole
 The arterioles are generally less
  than 0.5 mm in diameter and have
  relatively narrow lumens .
 The subendothelial layer is very thin.


 In the very small arterioles, the
  internal elastic lamina is absent, and
  the media is generally composed of
  one or two circularly arranged layers
  of smooth muscle cells; it shows no
  external elastic lamina.
 In both arterioles and small arteries,
  the tunica adventitia is very thin.
Arteriole
 Tunica intima
   Endothelium
   Some CT
   Internal elastic lamina
    may be present
 Tunica media
   Muscle layer several
    layers thick
   External elastic lamina
    may be present
 Tunica adventitia
   Collagenous, elastic CT
    as thick as tunica media
Capillaries
 Capillaries have structural variations
  to   permit     different  levels  of
  metabolic exchange between blood
  and surrounding tissues.
 They are composed of a single layer
  of endothelial cells rolled up in the
  form of a tube.

 The average diameter of capillaries
 varies from 7 to 9 µm, and their
 length is usually not more than 50µ
 m. The total length of capillaries in
 the human body has been estimated
 at 96,000 km (60,000 miles). When
 cut transversely, their walls are
 observed to consist of portions of
 one to three cells.
 In general, endothelial cells are
  polygonal and elongated in the
  direction of blood flow.
 The nucleus causes the cell to
  bulge into the capillary lumen.
 Its    cytoplasm     contains     few
  organelles, including a small Golgi
  complex,      mitochondria,       free
  ribosomes, and a few cisternae of
  rough     endoplasmic      reticulum.
  Junctions      of     the      zonula
  occludentes type are present
  between most endothelial cells
  and are of physiologic importance.

 Such    junctions offer variable
  permeability          to         the
  macromolecules that play a
  significant role in both normal and
  pathological conditions.
Veins
 Tunica intima
   Endothelium
   Scant CT
 Tunica media
   Thin muscle layer
   Collagen, elastic fibers
 Tunica adventitia
   Bulk of vessel wall
Artery, Vein
Artery, Vein
Lymphatic Vascular System
 The lymphatic capillaries originate in
  the various tissues as thin, closed-
  ended vessels that consist of a single
  layer    of  endothelium     and    an
  incomplete basal lamina.
 Lymphatic capillaries are held open by
  numerous microfibrils of the elastic
  fiber system, which also bind them
  firmly to the surrounding connective
  tissue
BLOOD VESSEL
HEART
 Epicardium
   (Tunica adventitia)
 Myocardium
   (Tunica media)
 Endocardium
   (Tunica intima)
 Surrounded by pericardium
Heart
 The heart is a muscular organ that contracts rhythmically,
  pumping the blood through the circulatory system.
 It is also responsible for producing a hormone called atrial
  natriuretic factor. Its walls consist of three tunics: the internal,
  or endocardium; the middle, or myocardium; and the external,
  or pericardium .

 The endocardium is homologous with the intima of blood
  vessels. It consists of a single layer of squamous endothelial
  cells resting on a thin subendothelial layer of loose connective
  tissue that contains elastic and collagen fibers as well as
  some smooth muscle cells.
 Connecting the myocardium to the subendothelial layer is a
  layer of connective tissue (often called the subendocardial
  layer) that contains veins, nerves, and branches of the
  impulse-conducting system of the heart (Purkinje cells).
 The   myocardium is the
  thickest of the tunics of
  the heart and consists of
  cardiac     muscle   cells
  arranged in layers that
  surround      the    heart
  chambers in a complex
  spiral.
 A large number of these
  layers insert themselves
  into the fibrous cardiac
  skeleton.             The
  arrangement of these
  muscle cells is extremely
  varied, cells are seen to
  be oriented in many
  directions.
 The heart is covered externally by simple squamous
 epithelium (mesothelium) supported by a thin layer of
 connective tissue that constitutes the epicardium.

 A subepicardial layer of loose connective tissue contains
 veins, nerves, and nerve ganglia.

 The adipose tissue that generally surrounds the heart
 accumulates in this layer.

 The epicardium corresponds to the visceral layer of the
 pericardium, the serous membrane in which the heart lies.
 Between the visceral layer
 (epicardium) and the parietal
 layer is a small amount of
 fluid that facilitates the
 heart's movements.

 The cardiac valves consist of
                                   The pericardium is a membrane
  a central core of dense          like a sac that surrounds the heart
  fibrous connective tissue        and its major blood vessels.
  (containing both collagen        Normally there is a small amount
  and elastic fibers), lined on    of fluid between the pericardium
  both sides by endothelial        and the heart that helps cushion
                                   the heart and reduces friction
  layers.                          between the heart and the
 The bases of the valves are      pericardium when the heart beats.
  attached to the annuli fibrosi
  of the fibrous skeleton.
HEART
Myocardium and Endocardium

                                        Endo




      Myo



Endocardium consists of endothelium which is supported by a
delicate layer of collagenous tissue beneath which lies a
fibro-elastic layer.
Epicardium




   Mesolthelium (single layer of epithelium) surrounds think layer of
   fibro-elastic tissue. Adipose tissue connects epicardium to
   Myocardium.
CIRCULATORY SYSTEM
CIRCULATORY SYSTEM

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CIRCULATORY SYSTEM

  • 1. THE CIRCULATORY SYSTEM Heart and Vessels Assoc. Prof Dr. Karim Al-Jashamy IMS/MSU 2010
  • 2.
  • 3.  The Circulatory System:  The circulatory system comprises both the blood and lymphatic vascular systems. The blood vascular system is composed of the following structures:  The heart, an organ whose function is to pump the blood.  The arteries, a series of efferent vessels that become smaller as they branch, and whose function is to carry the blood, with nutrients and oxygen, to the tissues.  The capillaries, the smallest blood vessels, constituting a complex network of thin tubules that anastomose profusely and through whose walls the interchange between blood and tissues takes place.  The veins, which result from the convergence of the capillaries into a system of channels. These channels become larger as they approach the heart, toward which they convey the blood to be pumped again.
  • 4.  The lymphatic vascular system begins in the lymphatic capillaries, closed-ended tubules that anastomose to form vessels of steadily increasing size; these vessels terminate in the blood vascular system emptying into the large veins near the heart.  One of the functions of the lymphatic system is to return the fluid of the tissue spaces to the blood. The internal surface of all components of the blood and lymphatic systems is lined by a single layer of a squamous cells, called endothelium.  It is customary to divide the circulatory system into the macrovasculature, vessels that are more than 0.1 mm in diameter (large arterioles, muscular and elastic arteries, and muscular veins), and the microvasculature (arterioles, capillaries, and postcapillary venules), visible only with a microscope.  The microvasculature is particularly important as the site of interchanges between the blood and surrounding tissues under normal conditions and in the event of inflammatory processes
  • 5. Basic Structure of Circulatory System  Tunica intima  Endothelium supported by basement membrane and delicate collagenous tissue.  Tunica media  Muscle and CT  Tunica adventitia  CT
  • 6. Tissue Components of the Vascular Wall  The vascular wall is composed of three basic structural constituents: the endothelium, the muscular tissue, and the connective tissue, which includes elastic elements.  The amount and arrangement of these tissues within the blood circulatory system are influenced by mechanical factors, represented primarily by blood pressure, and metabolic factors, which reflect the local needs of the tissues. These tissues are all present in different proportions in the vascular wall, except for capillaries and postcapillary venules, in which the only structural elements represented are the endothelium, its basal lamina, and pericytes
  • 7.  The endothelium is a special type of epithelium interposed as a semipermeable barrier between two compartments of the internal medium, the blood plasma and the interstitial fluid.  Endothelium is highly differentiated to actively mediate and monitor the extensive bidirectional exchange of small molecules and to restrict the transport of some macromolecules.  In addition to their role in interchanges between blood and surrounding tissues, endothelial cells perform several other functions:
  • 8.  1. Conversion of angiotensin I to angiotensin II (Urinary System).  2. Conversion of bradykinin, serotonin, prostaglandins, norepinephrine, thrombin, etc, to biologically inert compounds.  3. Lipolysis of lipoproteins by enzymes located on the surface of endothelial cells, to yield triglycerides and cholesterol (substrates for steroid-hormone synthesis and membrane structure).  4. Production of vasoactive factors that affect the vascular tone, such as endothelins, vasoconstrictive agents, and nitric oxide, a relaxing factor.  Growth factors such as vascular endothelial growth factors (VEGFs) play pivotal roles in the formation of the vascular system during embryonic development, in the regulation of capillary growth under normal and pathological conditions in adults, and in the maintenance of the normal vasculature.
  • 9. MEDICAL APPLICATION  The endothelium also has an antithrombogenic action, preventing blood coagulation. When endothelial cells are damaged by atherosclerotic lesions, for example, the uncovered subendothelial connective tissue induces the aggregation of blood platelets.  This aggregation initiates a cascade of events that produces fibrin from blood fibrinogen. An intravascular coagulum, or thrombus (plural, thrombi), is formed that may grow until there is complete obstruction of the local blood flow.  From this thrombus, solid masses called emboli (singular, embolus) may detach and be carried by the blood to obstruct distant blood vessels. In both cases, the vascular flow may stop, a potentially life-threatening condition. Thus, the integrity of the endothelial layer, which prevents contact between platelets and the subendothelial connective tissue, is an important antithrombogenic mechanism.
  • 10. Vascular Smooth Muscle  is present in all vessels except capillaries and pericytic venules. Smooth muscle cells are frequent and are arranged in helical layers in the tunica media of the blood vessels. Each muscle cell is enclosed by a basal lamina and by variable amounts of connective tissue.  Vascular Connective Tissue  Components of connective tissue are present in the walls of blood vessels in amounts and proportions that vary based on local functional requirements.  Collagen fibers, ubiquitous element in the vascular system wall, are found between muscle cells, in adventitia, and in some subendothelial layers. Collagen types IV, III, and I are present in the basement membranes, tunica media, and adventitia, respectively.
  • 11.  Elastic fibers guarantee the resilient shrinkage of the expanded vascular wall. These fibers predominate in large arteries where they are organized in parallel lamellae regularly distributed between the muscle cells throughout the entire media.  Ground substance forms a heterogeneous gel in the extracellular spaces of the vessel wall. It contributes to the physical properties of the walls of the vessels and probably affects the diffusion and permeability across the wall.  The concentration of glycosaminoglycans is higher in arterial than in venous tissue.
  • 12. Types of Vessels  Elastic artery  Muscular artery  Arteriole  Capillary  Muscular venule, small vein  Vein  Muscular vein
  • 13.  Tunica Intima  The intima consists of one layer of endothelial cells supported by a subendothelial layer of loose connective tissue containing occasional smooth muscle cells.  In arteries, the intima is separated from the media by an internal elastic lamina, the most external component of the intima.  This lamina, composed of elastin, has gaps (fenestrae) that allow the diffusion of substances to nourish cells deep in the vessel wall. As a result of the absence of blood pressure and the contraction of the vessel at death, the tunica intima of the arteries generally has an undulating appearance in tissue sections
  • 14.  Tunica Media  The media consists primarily of concentric layers of helically arranged smooth muscle cells .  Interposed among these cells are variable amounts of elastic fibers and lamellae, reticular fibers (collagen type III), proteoglycans, and glycoproteins.  Smooth muscle cells are the cellular source of this extracellular matrix.  In arteries, the media has a thinner external elastica lamina, which separates it from the tunica adventitia.
  • 15.  Tunica Adventitia  The adventitia consists principally of collagen and elastic fibers  Collagen in the adventitia is type I. The adventitial layer gradually becomes continuous with the connective tissue of the organ through which the vessel runs.
  • 16. Innervations  Most blood vessels that contain smooth muscle in their walls are supplied with a profuse network of unmyelinated sympathetic nerve fibers (vasomotor nerves) whose neurotransmitter is norepinephrine.  Discharge of norepinephrine from these nerves results in vasoconstriction.  In veins, nerve endings are found in both the adventitia and the media, but the overall density of innervations is less than that encountered in arteries.  Arteries in skeletal muscle also receive a cholinergic vasodilator nerve supply. Acetylcholine released by these vasodilator nerves acts on the endothelium to produce nitric oxide  For didactic purposes, the arterial blood vessels are classified, based on their diameter, into arterioles, arteries of medium diameter (muscular arteries), and larger (elastic) arteries.
  • 17. ELASTIC ARTERY: AORTA Layers of Aorta  Tunica intima  Endothelium  Collagenous fibers, elastic fibers & elastin sheets  Tunica media  Extremely elastic (sheets of elastin), smooth muscle  Tunica adventitia  Collagenous, elastic fibers
  • 20. Muscular Artery  Tunica intima  Endothelium  Fine collagenous fibers, smooth muscle  Internal elastic lamina clearly evident  Tunica media  Smooth muscle  Collagenous, reticular, elastic fibers  External elastic lamina clearly evident  Tunica adventitia  Thick collagenous, elastic tissue
  • 24. Muscular Artery (L) vs Elastic Artery (R)
  • 25. Arteriole  The arterioles are generally less than 0.5 mm in diameter and have relatively narrow lumens .  The subendothelial layer is very thin.  In the very small arterioles, the internal elastic lamina is absent, and the media is generally composed of one or two circularly arranged layers of smooth muscle cells; it shows no external elastic lamina.  In both arterioles and small arteries, the tunica adventitia is very thin.
  • 26. Arteriole  Tunica intima  Endothelium  Some CT  Internal elastic lamina may be present  Tunica media  Muscle layer several layers thick  External elastic lamina may be present  Tunica adventitia  Collagenous, elastic CT as thick as tunica media
  • 27. Capillaries  Capillaries have structural variations to permit different levels of metabolic exchange between blood and surrounding tissues.  They are composed of a single layer of endothelial cells rolled up in the form of a tube.  The average diameter of capillaries varies from 7 to 9 µm, and their length is usually not more than 50µ m. The total length of capillaries in the human body has been estimated at 96,000 km (60,000 miles). When cut transversely, their walls are observed to consist of portions of one to three cells.
  • 28.  In general, endothelial cells are polygonal and elongated in the direction of blood flow.  The nucleus causes the cell to bulge into the capillary lumen.  Its cytoplasm contains few organelles, including a small Golgi complex, mitochondria, free ribosomes, and a few cisternae of rough endoplasmic reticulum. Junctions of the zonula occludentes type are present between most endothelial cells and are of physiologic importance.  Such junctions offer variable permeability to the macromolecules that play a significant role in both normal and pathological conditions.
  • 29.
  • 30. Veins  Tunica intima  Endothelium  Scant CT  Tunica media  Thin muscle layer  Collagen, elastic fibers  Tunica adventitia  Bulk of vessel wall
  • 33. Lymphatic Vascular System  The lymphatic capillaries originate in the various tissues as thin, closed- ended vessels that consist of a single layer of endothelium and an incomplete basal lamina.  Lymphatic capillaries are held open by numerous microfibrils of the elastic fiber system, which also bind them firmly to the surrounding connective tissue
  • 35.
  • 36. HEART  Epicardium  (Tunica adventitia)  Myocardium  (Tunica media)  Endocardium  (Tunica intima)  Surrounded by pericardium
  • 37. Heart  The heart is a muscular organ that contracts rhythmically, pumping the blood through the circulatory system.  It is also responsible for producing a hormone called atrial natriuretic factor. Its walls consist of three tunics: the internal, or endocardium; the middle, or myocardium; and the external, or pericardium .  The endocardium is homologous with the intima of blood vessels. It consists of a single layer of squamous endothelial cells resting on a thin subendothelial layer of loose connective tissue that contains elastic and collagen fibers as well as some smooth muscle cells.  Connecting the myocardium to the subendothelial layer is a layer of connective tissue (often called the subendocardial layer) that contains veins, nerves, and branches of the impulse-conducting system of the heart (Purkinje cells).
  • 38.  The myocardium is the thickest of the tunics of the heart and consists of cardiac muscle cells arranged in layers that surround the heart chambers in a complex spiral.  A large number of these layers insert themselves into the fibrous cardiac skeleton. The arrangement of these muscle cells is extremely varied, cells are seen to be oriented in many directions.
  • 39.  The heart is covered externally by simple squamous epithelium (mesothelium) supported by a thin layer of connective tissue that constitutes the epicardium.  A subepicardial layer of loose connective tissue contains veins, nerves, and nerve ganglia.  The adipose tissue that generally surrounds the heart accumulates in this layer.  The epicardium corresponds to the visceral layer of the pericardium, the serous membrane in which the heart lies.
  • 40.  Between the visceral layer (epicardium) and the parietal layer is a small amount of fluid that facilitates the heart's movements.  The cardiac valves consist of The pericardium is a membrane a central core of dense like a sac that surrounds the heart fibrous connective tissue and its major blood vessels. (containing both collagen Normally there is a small amount and elastic fibers), lined on of fluid between the pericardium both sides by endothelial and the heart that helps cushion the heart and reduces friction layers. between the heart and the  The bases of the valves are pericardium when the heart beats. attached to the annuli fibrosi of the fibrous skeleton.
  • 41. HEART
  • 42.
  • 43. Myocardium and Endocardium Endo Myo Endocardium consists of endothelium which is supported by a delicate layer of collagenous tissue beneath which lies a fibro-elastic layer.
  • 44. Epicardium Mesolthelium (single layer of epithelium) surrounds think layer of fibro-elastic tissue. Adipose tissue connects epicardium to Myocardium.