By Dr. Zafar

Qureshi

Based on Aantomical & physiological relation Based on Aantomical & physiological relation amount of elastic & muscular tissue in tunica amount of elastic & muscular tissue in tunica Media & Diameter of blood vessels.Media & Diameter of blood vessels.

1.1. Long sized Arteries (Elastic.A) conducting vessels Long sized Arteries (Elastic.A) conducting vessels Diameter >7000 um e.g. Aorta branches of arch Diameter >7000 um e.g. Aorta branches of arch of aorta.of aorta.

2.2. Medium size Muscular Arteries (Distribution Medium size Muscular Arteries (Distribution vessels) Muscular tissue is equal to Elastic, vessels) Muscular tissue is equal to Elastic, Diameter 1000-3000 um. Desending aorta, abd Diameter 1000-3000 um. Desending aorta, abd

Aorta, femoral etc.Aorta, femoral etc.3.3. Small size Muscular arteries:- Muscular Small size Muscular arteries:- Muscular

tissue>Elasric tissue tissue>Elasric tissue Diameter 50-100 umDiameter 50-100 um

4.4. MUSCULAR ARTERIES (Resistance vessels) MUSCULAR ARTERIES (Resistance vessels) Only muscular tissue is present, diameter Only muscular tissue is present, diameter

range from 50-100 micrometer. Provide range from 50-100 micrometer. Provide resistance to blood flow and mediating resistance to blood flow and mediating blood pressure.blood pressure.

5.5. TERMINAL ARTERIOLES (Resistance TERMINAL ARTERIOLES (Resistance vessels) Diameter more than 50 micrometer vessels) Diameter more than 50 micrometer & provide resistance to blood flow.& provide resistance to blood flow.

6.6. METARTERIOLES:- (Resistance vessels) METARTERIOLES:- (Resistance vessels)Diameter 10-15 Micrometer ; slide swelling Diameter 10-15 Micrometer ; slide swelling

due to localized accumulation of myosytes, due to localized accumulation of myosytes, known as precapillary sphincters, known as precapillary sphincters, terminates into capillaries. terminates into capillaries.

7.7. CAPILLARIES/ SINUSOIDS (Exchange CAPILLARIES/ SINUSOIDS (Exchange vessels ) lumen is 5 Micrometer, exchange vessels ) lumen is 5 Micrometer, exchange between tissue fluids and blood.between tissue fluids and blood.

8.8. VENULES (Exchange vessels) VENULES (Exchange vessels) Lumen 20-30 Micrometer Lumen 20-30 Micrometer 9.9. POST-CAPILLARIES VENULES (Exchange POST-CAPILLARIES VENULES (Exchange

vessels)vessels) Lumen 20-30 MicrometerLumen 20-30 Micrometer10.10. SMALL SIZE MUSCULAR VEINS SMALL SIZE MUSCULAR VEINS

(CAPACITANCE RESERVOIR VESSLES)(CAPACITANCE RESERVOIR VESSLES) Can accommodate large amount of blood. Can accommodate large amount of blood.

Thickness of wall is 1/10 of the lumen of Thickness of wall is 1/10 of the lumen of vein.vein.

11.11. MEDIUM SIZE MUSCULAR VEINS. MEDIUM SIZE MUSCULAR VEINS.

(Reservior)(Reservior)

12.12. LARGE SIZE MUSCULAR VEINS. LARGE SIZE MUSCULAR VEINS. (Reservios) sup & inf vena eara.(Reservios) sup & inf vena eara.

(i)(i) Conducting of Propulsue effect of Conducting of Propulsue effect of heart.heart.

(ii)(ii) Distribution of blood. Distribution of blood.

(iii)(iii) Muscular arteries provides resistance Muscular arteries provides resistance to the blood flow & them mediating the to the blood flow & them mediating the blood pressure.blood pressure.

(iv)(iv) Meta-arterioles provides resistance to Meta-arterioles provides resistance to flow of blood & maintain blood flow of blood & maintain blood pressure. pressure.

CAPILLARIES:CAPILLARIES:

Exchange b/w tissue fluids & blood Exchange b/w tissue fluids & blood across capillaries cuall e.g, across capillaries cuall e.g, electro lytes, protiem, mutrents, electro lytes, protiem, mutrents, O2, CO2, etc.O2, CO2, etc.

VEINS: VEINS:

(i) Exchange b/w tissue fluid & (i) Exchange b/w tissue fluid & blood across vessels wall & blood across vessels wall & Post Capillaries Venules.Post Capillaries Venules.

(i) Small , Medium & large size (i) Small , Medium & large size veins act as reservoir & veins act as reservoir & conney blood back to heart conney blood back to heart ( Rt artiuem) ( Rt artiuem)

ANASTOMOSIS:ANASTOMOSIS:(a) ARTERIO ARTERIAL ANASTOMOSIS(a) ARTERIO ARTERIAL ANASTOMOSIS

HETEROCLADIC:HETEROCLADIC:Anastomosis present b/w 2 Anastomosis present b/w 2

different arteries e.g: Sup different arteries e.g: Sup & inf. Mesentesic arteries& inf. Mesentesic arteries

HOMOCLADICHOMOCLADIC::

Anastomosis b/w Anastomosis b/w branches of same branches of same artery e.g Sup. artery e.g Sup. Masentic artery.Masentic artery.

((b) ARTERIO VENOUS ANASTOMOSIS (Shunts)b) ARTERIO VENOUS ANASTOMOSIS (Shunts)Blood of arterial tree by-pass the capillaries Blood of arterial tree by-pass the capillaries

beds & Sinusoids, into Venous system.beds & Sinusoids, into Venous system.

Preferential Thorough-Preferential Thorough-fare Channelsfare Channels

(i)Open on demands (i)Open on demands

(ii)Opened (ii)Opened permonently & act permonently & act as by pass usually as by pass usually present at present at precapillary precapillary Sphineters.Sphineters.

SIMPLE ARTERIO SIMPLE ARTERIO VENOUS VENOUS

e.g present at e.g present at muscular arteries & muscular arteries & veins e.g:- suin veins e.g:- suin ofnose ext. Ear, ofnose ext. Ear, muscosa, gut ere muscosa, gut ere tissue. tissue.

(iii)(iii) Arterio Venous anastomosis- Arterio Venous anastomosis- present at digital pads & nail beds.present at digital pads & nail beds.

FUNCTION:FUNCTION:

(i)(i) Regulate blood flow Regulate blood flow

(ii)(ii) Regulate body temperature. Regulate body temperature.

(iii)(iii) Cooling effect tongue of dog. Cooling effect tongue of dog.

(iv)(iv) Absorption of metriart from gut. Absorption of metriart from gut.

ANASTOMOSIS:ANASTOMOSIS:

VASCULAR (SHUNTS) VASCULAR (SHUNTS) ORGAN ORGAN

(URETERO (URETERO

VEGINAL)VEGINAL)

NERVES:- NERVES:- JACO BONES JACO BONES ANASTOMOANASTOMOSIS IN SIS IN TYMPENTIC TYMPENTIC PLAXES- PLAXES- INFO INFO LARGEAL LARGEAL NERVESNERVES

VASCULAR PATTERN:VASCULAR PATTERN:

Venae conitantes veins acompries arteries & Venae conitantes veins acompries arteries & veins in neurovasalar bundles or along the veins in neurovasalar bundles or along the arteries e.g along redial artery in lumber arteries e.g along redial artery in lumber venous placus pampini form venus plexus.venous placus pampini form venus plexus.

(i) END ARTERIES:(i) END ARTERIES:

No anastomosis at arterial or capillaries No anastomosis at arterial or capillaries lenes.lenes.

Incase of blockage organ loads to necerosis Incase of blockage organ loads to necerosis e.g central retinal artery.e.g central retinal artery.

(i) Anastomosis in end (i) Anastomosis in end arteries anastomosis arteries anastomosis present at present at capillaries level e.g capillaries level e.g central branches of central branches of cereback arteries.cereback arteries.

(ii) Segmental arteries (ii) Segmental arteries of spleen, kidney, of spleen, kidney, hug, metephyseal hug, metephyseal arteries of long arteries of long bone.bone.

In sufficient In sufficient anastomosis in anastomosis in end arteries e.g end arteries e.g coronary artery coronary artery present c’ poor present c’ poor capillaries capillaries anastomosisanastomosis

ARTEROSCLEROSIS, ARTEROSCLEROSIS, ATHEROSCLEROSIS & VERICOSE ATHEROSCLEROSIS & VERICOSE VEIN.VEIN.

ARTEROSCLEROSIS:ARTEROSCLEROSIS:Hardening of arterial wall due to fibrosis & calcification Hardening of arterial wall due to fibrosis & calcification

of arterial wall leads to narrowinp of lumen & of arterial wall leads to narrowinp of lumen & elasticity.elasticity.

ATHEROSCLEROSIS:ATHEROSCLEROSIS:Reposition of fat (plaque) (Atheroma) on inner most Reposition of fat (plaque) (Atheroma) on inner most

layer of artery (tunica intima) ultimately leads to layer of artery (tunica intima) ultimately leads to thrombosis & occlusion of muscular arteries e.g 1HD, thrombosis & occlusion of muscular arteries e.g 1HD, M 1, stroke ( brain infaction death tissue ) gangloen M 1, stroke ( brain infaction death tissue ) gangloen limbs muolned.limbs muolned.

Veins becomes dilated lengthened & Veins becomes dilated lengthened & tortuous due to lose of elasticity & tortuous due to lose of elasticity & weekening of wall e.g great Sephanus weekening of wall e.g great Sephanus vein become vericosed due vein become vericosed due incompetence of velues mainly incompetence of velues mainly Sepheno femoral or aduetor or Sepheno femoral or aduetor or perfectors velues or due to over load perfectors velues or due to over load of great Sephenus in result of DVT or of great Sephenus in result of DVT or ocelusim due tumour in peluis or in ocelusim due tumour in peluis or in pregency or congenitaly wall or velue pregency or congenitaly wall or velue weekness.weekness.

Part of circulatory system deals c’ circulation of Part of circulatory system deals c’ circulation of Lymph (tissue fluid) rich in proteins of cells Lymph (tissue fluid) rich in proteins of cells (Lymphoeytes & organism & cell delesis).(Lymphoeytes & organism & cell delesis).

Lymphatic system consists of lymphatics, lymphoid Lymphatic system consists of lymphatics, lymphoid tissue (lymphnod, thymus, spleen) also thorasic tissue (lymphnod, thymus, spleen) also thorasic duct, cisternachlldi.duct, cisternachlldi.

Tissue fluids is forward at arteries end of Tissue fluids is forward at arteries end of capillaries & most of it returrned to circulation capillaries & most of it returrned to circulation via venous ends of capillaries. But 10-20% of via venous ends of capillaries. But 10-20% of tissue fluids passes into blind ending lymphatics tissue fluids passes into blind ending lymphatics known as lymph and traverses one of more known as lymph and traverses one of more lymph nodes before return to venous system lymph nodes before return to venous system (hemal eirculation)(hemal eirculation)

Lymph vessels of thywid, oesopfhagus cornary & Lymph vessels of thywid, oesopfhagus cornary & triangle ligaments of liver are exceptionals these triangle ligaments of liver are exceptionals these do’t traverse lymphnodes & pass directly to do’t traverse lymphnodes & pass directly to venous system through thoracic duct.venous system through thoracic duct.

LYMPH CAPILLARIES:LYMPH CAPILLARIES:Lymph capillaries are absent in epidermis, hair, nail, Lymph capillaries are absent in epidermis, hair, nail,

cornea, cartilages, CNS & bone mrrous very few cornea, cartilages, CNS & bone mrrous very few in endomysium of skeletal muscles.in endomysium of skeletal muscles.

LYPPHATIC CAPILLARIES:LYPPHATIC CAPILLARIES:Lymphatic capillaries are blind ended more irregular Lymphatic capillaries are blind ended more irregular

& have much wider calliber than those of & have much wider calliber than those of adjacent capillaries.adjacent capillaries.

CHYLE:CHYLE:Lymph from small intestine is milky due to Lymph from small intestine is milky due to

absorption of fat globules (chylomicrons) absorption of fat globules (chylomicrons) and is called CHYLE.and is called CHYLE.

LACTEALS:LACTEALS:Lymph capillaries in small intestion are Lymph capillaries in small intestion are

known as lacteals.known as lacteals.

SUPERFICIAL LYMPH VESSELS:SUPERFICIAL LYMPH VESSELS:Superficial lymph vessels are located in skin, Superficial lymph vessels are located in skin,

superficial fascia drains to superficial superficial fascia drains to superficial lymph nodes.lymph nodes.

DEEP LYMPH VESSELS:DEEP LYMPH VESSELS:Deep lymph vessels located deep to deep Deep lymph vessels located deep to deep

fascia & viscera usually acompany the fascia & viscera usually acompany the arteries drains to deep lymphnodes.arteries drains to deep lymphnodes.

FUNCTIONS OF LYMPHATICS:FUNCTIONS OF LYMPHATICS:(i)(i) Drainage of tissue fluid. Drainage of tissue fluid.(ii)(ii) Absorption & transport of fat from Absorption & transport of fat from

small intestine.small intestine. Defense imumune mechomism of the Defense imumune mechomism of the

body.body.

LYMPHOGRAPHY:LYMPHOGRAPHY:Radiological study of lymph vessels & lymph nodes Radiological study of lymph vessels & lymph nodes

is possible after the cannulation of an appropriate is possible after the cannulation of an appropriate peripheal lymph vessels by ingecting radiopaque peripheal lymph vessels by ingecting radiopaque contrast material e.g Indian ink, prussian blue, contrast material e.g Indian ink, prussian blue, Neoprence laterim cadaners while methylene Neoprence laterim cadaners while methylene blue & lipoidal used for radiology of living.blue & lipoidal used for radiology of living.

LYMPHADENITS:LYMPHADENITS:2ndly inflammation of lymph nodes. (enlaged lymph 2ndly inflammation of lymph nodes. (enlaged lymph

nod, lymphadenopathy.) Pamfully enlarge.nod, lymphadenopathy.) Pamfully enlarge.

CLINICAL CLINICAL IMPORTANCEIMPORTANCE::FNAC or Ex. Biopy of elanged lymph nod give FNAC or Ex. Biopy of elanged lymph nod give

diagnosis about diseases.diagnosis about diseases.

DIRECT LYMPHOGENONS Blood DIRECT LYMPHOGENONS Blood bornborn

Directly into Ca Breast & most Directly into Ca Breast & most (Henatogenous)(Henatogenous)

Contigous of Ca. E.g Contigous of Ca. E.g Sarcomas.Sarcomas.

Struetures of Struetures of

Body.Body.