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SYSTEMA CIRCULATORIUS

KLASIFIKASI: SISTEM KARDIOVASKULAR

PEMBULUH DARAH JANTUNG NODUS LYMPHATICUS PEMBULUH LIMFE

SISTEM LIMFATIK

HUBUNGAN STRUKTURAL/FUNGSIONAL: SISTEM KARDIOVASKULAR BERHUBUNGAN DENGAN

SISTEM LIMFATIK HISTOLOGI: SELURUH SISTEM DIBATASI OLEH ENDOTEL

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HUBUNGAN TIMBAL BALIK SISTEM LIMFATIK DAN SISTEM KARDIOVASKULER

SISTEM LIMFATIK

SISTEM KARDIO-VASKULER

DUCTUS THORACICUS ET DUCTUS LYMPHATICUS DEXTER

BERMUARA DALAM VENA BESAR SEBAGAI BAGIAN SISTEM PEMBULUH DARAH

SISTEM KARDIOVASKULER

SISTEM LIMFATIK

CAIRAN LIMFE DENGAN LIMFOSIT DALAM VENULA POST-CAPILER

DALAM SETIAP NODUS LYMPHATICUS SEBAGAI BAGIAN DARI SISTEM PEMBULUH DARAH, MASUK SISTEM LIMFATIK, YANG PADA AKHIRNYA DITAMPUNG DALAM KEDUA SALURAN LIMFE BESAR

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SYSTEMA CIRCULATORIUS

DUCTUS THORACICUS

JANTUNG ARTERIA BESAR ARTERIA SEDANG ARTERIA KECIL

S I S T E M K A R D I O V A S K U L A R

PEMBULUH KAPILER
SISTEM LIMFATIKA

VENA KECIL VENA SEDANG VENA BESAR

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SISTEM LIMFATIK

KAPILER LIMFE BUNTU

KAPILER LIMFE BUNTU

(vasa aferentia)

(vasa aferentia)

NODUS LYMPHATICUS

NODUS LYMPHATICUS Vasa eferentia

PEMBULUH LIMFE BESAR

DUCTUS THORACICUS ET DUCTUS LYMPHATICUS DEXTER

PEMBULUH DARAH VENA

JANTUNG

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ALIRAN CAIRAN LIMFE

CAIRAN LIMFE (CAIRAN JARINGAN) PLASMA LIMFOSIT PEMBULUH LIMFE DIMULAI DENGAN KAPILER LIMFE BUNTU MENAMPUNG DARI CAIRAN JARINGAN NODUS LYMPHATICUS MENAMPUNG KAPILER PADA PERMUKAAN CEMBUNG PEMBULUH LIMFE LEBIH BESAR MENAMPUNG DARI VASA EFERENTIA N. LYMPHATICUS PEMBULUH LIMFE BESAR MENUJU KE JANTUNG DIAMETER PEMBULUH LIMFE SEMAKIN BESAR DUCTUS THORACICUS V. SUBCLAVIA SINISTRA DUCTUS LYMPHATICUS DEXTER V. SUBCLAVIA DEXTRA
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ALIRAN CAIRAN LIMFE

ARTERI VENA

NODUS LYMPHATICUS

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SIRKULASI PLASMA DAN LIMFOSIT

SISTEM LIMFE

SISTEM KARDIO VASKULER

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DINDING VASA LYMPHATICA

VASA AFERENTIA

MENAMPUNG CAIRAN JARINGAN DIAMETER LEBIH BESAR SEDIKIT DARI KAPILER DARAH SELAPIS SEL ENDOTEL TIPIS TIDAK ADA PERISIT

MASUK KE DALAM SINUS LYMPHATICUS DALAN NODUS LYMPHATICUS KELUAR DARI HILUS SEBAGAI VASA EFERENTIA

STRUKTUR DINDING SAMA DENGAN VASA AFERENTIA MENGANGKUT CAIRAN LIMFE DENGAN LIMFOSIT
VASA LYMPHATICA

MENERIMA BEBERAPA VASA EFERENTIA, DIAMETER

BERTAMBAH BESAR DINDING BERTAMBAH TEBAL DI BAGIAN DALAM DILENGKAPI DENGAN VALVULA

DUCTUS THORACICUS DAN DUCTUS LYMPHATICUS DEXTER

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DINDING VASA LYMPHATICA

VALVULA

VENULA

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VASA LYMPHATICA BESAR

VASA LYMPHATICA BERDIAMETER >0,2 mm DILENGKAPI VALVULA DIBEDAKAN 3 LAPISAN DINDING:

TUNICA INTIMA TUNICA MEDIA

2 LAPISAN SEL-SEL OTOT POLOS BANYAK MENGANDUNG SERABUT KOLAGEN DAN ELASTIS

TUNICA ADVENTITIA

DUCTUS THORACICUS ET DUCTUS LYMPHATICUS DEXTER

(PEMBULUH LIMFE TERBESAR) DILENGKAPI DENGAN VALVULA 3 LAPISAN DINDING YANG KURANG JELAS

TUNICA INTIMA: ENDOTIL DAN SERABUT KOLAGEN & ELAS TUNICA MEDIA : SEL OTOT POLOS TUNICA ADVENTITIA: SEL-SEL OTOT POLOS MEMANJANG

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VASA LYMPHATICA BESAR

DUCTUS LYMPHATICUS DEXTER

VENA CAVA SUPERIOR

DUCTUS THORACICUS

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Arteries

Elastic arteries Muscular arteries Arterioles

Capillaries

Continuous Fenestrated Sinusoidal

Veins

Veins, venules

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Vessel Structure - General

All vessels same basic structure 3 wall layers (or tunics) Tunica adventitia (externa)
elastic and laminar fibers Tunica media

thickest layer elastic fibers and smooth muscle fibers endothelium non-stick layer basement membrane internal elastic lamina

Tunica interna (intima)

Lumen - opening

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Structure of Blood Vessels

Composed of three layers (tunics)

Tunica intima composed of simple squamous

epithelium Tunica media sheets of smooth muscle

Tunica externa composed of connective tissue

Lumen

Contraction vasoconstriction Relaxation vasodilation

Central blood-filled space of a vessel

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Copyright 2008 Pearson Education, Inc., publishing as Benjamin Cummings

Copyright 2008 Pearson Education, Inc., publishing as Benjamin Cummings

Structure of Arteries, Veins, and Capillaries

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Figure 19.1a

Types of Blood Vessels

Arteries carry blood away from the heart Capillaries smallest blood vessels

The site of exchange of molecules between blood

and tissue fluid

Veins carry blood toward the heart

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Copyright 2008 Pearson Education, Inc., publishing as Benjamin Cummings

Types of Arteries

Elastic arteries the largest arteries

Diameters range from 2.5 cm to 1 cm Includes the aorta and its major branches Sometimes called conducting arteries High elastin content dampens surge of blood pressure Aorta, brachiocephalic, common carotid, subclavian, vertebral, pulmonary, common iliac

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Vessel Structure Elastic Arteries

Elastic (conducting) arteries

Near heart Thick walls More elastic fiber, less

smooth muscle Lose elasticity with aging

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Vessel Structure - Elastic Arteries

Aorta and elastic arteries

Can vasoconstrict or vasodilate Large arteries expand, absorb pressure wave then release it with elastic recoil Windkessel effect Help to push blood along during diastole With aging have less expansion and recoil

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Types of Arteries
Muscular (distributing) arteries Lie distal to elastic arteries Capable of grater vasoconstriction and vaodilation to adjust the blood flow Diameters range from 1 cm to 0.3 mm Includes most named arteries Tunica media is thick, More smooth muscle Less elastic fibers Many of the arteries anastomose Unique features Internal and external elastic laminae Distribute blood to skeletal muscles & internal organs Ex: external carotid, brachial, mesenteric, femoral

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Figure 19.2b

Types of Arteries Arterioles Smallest arteries Diameters range from 0.3 mm to 10 m Larger arterioles possess all three tunics Diameter of arterioles controlled by

Local factors in the tissues (02 levels) Sympathetic nervous system hormonal stimulation

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Figure 19.2c

Arterioles

Arterioles are small arteries that deliver blood to capillaries. Also have the three layers as an artery. Tunica media 1-2 layers of smooth muscle fibers A change in diameter of arterioles can significantly affect blood pressure. Through constriction and dilation, arterioles assume a key role in regulating blood flow from arteries into capillaries and in altering arterial blood pressure.

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Vessel Structure - Capillaries

Allow exchange of nutrients and wastes between blood and

tissue Capillary structure - simple

Basal lamina - connective tissue Endothelial cells

Structure/function

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Arteriole: structure

1. Metarteriole Activity 3 2. Arteriole 3. Capillary

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Capillaries

Smallest blood vessels Diameter from 810 m Red blood cells pass through single file Site-specific functions of capillaries Lungs oxygen enters blood, carbon dioxide leaves Small intestines receive digested nutrients Endocrine glands pick up hormones Kidneys removal of nitrogenous wastes

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Capillaries

Tempat pertukaran material nutrien antara darah dan jaringan. Tempat terjadinya mikrosirkulasi:aliran darah dari arteriole menuju venule malaui kapiler. capiller tidak berpori (continuous Capillaries) dan berpori ( fenestrated). Precappilary sphincters mengatur aliran darah melalui capillaries. Pada liver berupa sinusoid

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Capillaries

Capillary walls are made of a single layer of endothelial cells and a basement membrane. They have no tunica media or tunica externa. Body tissues with high metabolic requirements, such as muscles, kidneys, liver and nervous system, have an extensive network of capillaries. Tissues with low metabolic requirements have fewer capillaries-tendons and ligaments. All covering and lining epithelia, cornea and lens of the eye-lack capillaries.

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Types of Capillaries

True capillaries:emerge from arterioles and metarterioles. Continuous capillaries-found in skeletal and smooth muscle, connective tissues and the lungs. Fenestrated capillaries-kidneys, villi os the SI, choroid plexuses in brain, ciliary process, endocrine glands. Sinusoids:are wider and more winding than other capillaries. Present in liver, red bone marrow, pleen, ant.pit. Gland, and parathyroid glands.

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RBCs in a Capillary

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Figure 19.3

Capillary Beds

Network of capillaries running through tissues Precapillary sphincters

Regulate the flow of blood to tissues

Tendons and ligaments poorly vascularized Epithelia and cartilage avascular

Receive nutrients from nearby CT

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Capillary Beds

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Figure 19.4a

Capillary Beds

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Figure 19.4b

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Local control of blood vessels

Sphincters contract or relax based on demand for:

nutrients (AA, glucose, fatty acids) Dissolved gases (O2, CO2 load, lactic acid)

Additional capillaries grow in to area to satisfy increased energy demands

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Capillary Permeabillity

Endothelial cells held together by tight junctions and desmosomes Intercellular clefts gaps of unjoined membrane

Small molecules can enter and exit

Two types of capillary

Continuous most common Fenestrated have pores

Sinusoid

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Types of Capillaries

3 types of capillaries

1.

Continuous capillaries

continuous endothelial

cells except for cleft between cells tight junctions between endothelial cells prevent most things from leaving caps most capillaries in body

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Structure of Capillaries Cross Section

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Figure 19.5a

Types of Capillaries

2.

Fenestrated capillaries

fenestrations (slits) allow for

filtration of small substances glomerular capillaries in kidney

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Structure of Capillaries Cross Section

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Figure 19.5b

Routes of Capillary Permeability

Four routes into and out of capillaries

Direct diffusion Through intercellular clefts Through cytoplasmic vesicles Through fenestrations

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Low Permeability Capillaries

Blood-brain barrier

Capillaries have complete tight junctions No intercellular clefts are present Vital molecules pass through
Highly selective transport mechanisms

Not a barrier against

Oxygen, carbon dioxide, and some anesthetics

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Types of Capillaries

3.

Sinusoid capillaries

wider gaps between

endothelial cells allowing RBCs to exit the caps found in liver

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Sinusoids

Wide, leaky capillaries found in some organs

Usually fenestrated Intercellular clefts are wide open

Occur in bone marrow and spleen

Sinusoids have a large diameter and twisted course

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Sinusoids

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Figure 19.5c

Veins

Conduct blood from capillaries toward the heart Blood pressure is much lower than in arteries Smallest veins called venules

Diameters from 8 100 m Smallest venules called postcapillary venules

Venules join to form veins Tunica externa is the thickest tunic in veins

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Vessel Structure Veins

Veins

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Interna thicker than arteries Media thinner, less muscle Externa thick Valves Pressure low High compliance change volume easily with small change in pressure Varicose veins

 CIRI MENGANGKUT DARAH KE JANTUNG JUMLAH LEBIH BESAR DARIPADA ARTERIA MENDEKATI JANTUNG DIAMETER MAKIN BESAR BIASANYA BERADA DI DEKAT ARTERINYA KETEBALAN DINDING LEBIH TIPIS DENGAN VALVULA BIASANYA PADA SEDIAAN DALAM KONDISI KOLAPS KLASIFIKASI: VENA BESAR VENA SEDANG VENA KECIL = VENULA DINDING TUNICA INTIMA TUNICA MEDIA TUNICA ADVENTITIA
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VENA

VENA BESAR

MIKROSKOPIS

TUNICA INTIMA ( 45 m - 68 m)

ENDOTEL JARINGAN PENGIKAT SANGAT TIPIS

TUNICA MEDIA

TIDAK BERKEMBANG DENGAN BAIK SERINGKALI TIDAK ADA

TUNICA ADVENTITIA

MERUPAKAN BAGIAN UTAMA DARI DINDING JARINGAN PENGIKAT: SERABUT ELASTIS DAN
SERABUT KOLAGEN YANG MEMANJANG TERUTAMA MENGANDUNG SERABUT OTOT POLOS MEMANJANG CONTOH: VENA CAVA, VENA PORTAE, V. LIENALIS.

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VENA BESAR

OTOT POLOS

OTOT POLOS

TUNICA MEDIA CUKUP TEBAL

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VENA SEDANG (2 - 9 mm)

MIKROSKOPIS

TUNICA INTIMA (TIPIS)

SEL ENDOTEL JARINGAN PENGIKAT TIPIS SEDIKIT SERABUT ELASTIS

TUNICA MEDIA (LEBIH TIPIS DARIPADA ARTERI SEDANG)

TERUTAMA SEL OTOT POLOS SIRKULER OTOT POLOS DIPISAHKAN SER. KOLAGEN MEMANJANG SEDIKIT FIBROBLAS

TUNICA ADVENTITIA (LEBIH TEBAL DARIPADA TUNICA MEDIA)

JARINGAN PENGIKAT LONGGAR DENGAN BERKAS TEBAL

SERABUT KOLAGEN MEMANJANG DAN ANYAMAN SERABUT ELASTIS BAGIAN DALAM SERING ADA BERKAS SEL-SEL OTOT POLOS MEMANJANG

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VENA SEDANG (2 - 9 mm)

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PERBANDINGAN STRUKTUR DINDING ARTERIA SEDANG DAN VENA SEDANG

VENA SEDANG

ARTERIA SEDANG

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VENULA (15 m - 200 m)

MENERIMA DARAH DARI KAPILER DINDING: TUNICA INTIMA

ENDOTEL JARINGAN PENGIKAT, BEBERAPA SEL OTOT POLOS, MAKIN BESAR DIAMETER: SEL-SEL MAKIN RAPAT
1 ATAU BEBERAPA LAPIS SEL-SEL OTOT POLOS FIBROBLAS DAN SERABUT TIPIS ELASTIS DAN KOLAGEN MEMANJANG

TUNICA MEDIA TUNICA ADVENTITIA SIFAT: PERMEABILITAS CUKUP TINGGI

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VENULA DENGAN KATUP (15 m - 200 m)

KATUP

KATUP

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ARTERIOLA DAN VENULA

MEMBRANA ELASTICA INTERNA

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Mechanisms to Counteract Low Venous Pressure

Valves in some veins

Particularly in limbs
Muscles press against
thin-walled veins force blood back to heart valves prevent back flow

Skeletal muscle pump

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Figure 19.6

Vascular Anastomoses

Vessels interconnect to form vascular anastomoses

Organs receive blood from more than one arterial

source

Neighboring arteries form arterial anastomoses

Provide collateral channels

Veins anastomose more frequently than arteries

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Vasa Vasorum

Tunica externa of large vessels have

Tiny arteries, capillaries, and veins

Vasa vasorum vessels of vessels

Nourish outer region of large vessels

Inner half of large vessels receive nutrients from luminal blood

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Arteries

Sympathetic fibers of the ANS innervate vascular smooth muscle. An inc. in sympathetic stimulation typically stimulates the smooth muscle to contract-vasoconstriction. When sympathetic stimulation decreases, or in presence of certain chemicals-NO, K+, H+ and lactic acid, they relax-vasodilation.

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Vessel Structure - Function

Capillary Function

Site of exchange between blood and tissues Delivery of nutrients and removal of wastes Slow flow allows time for exchange

Mechanisms of nutrient exchange

Diffusion - O2, CO2, glucose, AA's, hormones

diffuse down [ ] gradients If lipid soluble, can travel through cell If water soluble, between cells

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Capillary Fluid Exchange

Fluid movement

Fluid filtered and reabsorbed across capillary wall Starlings law of the capillaries

Forces driving the movement of fluid

Hydrostatic pressure capillary (HPc) Hydrostatic pressure interstitial fluid (HPif) Osmotic pressure capillary(OPc) Osmotic pressure interstitial fluid (OPif)
Net filtration pressure (NFP) is a sum of all

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Capillary Fluid Exchange

On average 85% of fluid filtered at arteriole end is reabsorbed at venular end

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Normal Coronary Artery Cross Section

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60% Narrowing of Coronary Artery

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90% Blockage of Coronary Artery

remaining lumen

calcified area

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Atherosclerotic Plaque Histology

cholesterol crystal (cleft) foam cells

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Thrombus Causing MI

Thrombus ocluding artery

Likely site of plaque rupture

Needle-Like white spots are cholesterol crystals

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Myocardial Infarction Histology

necrosed muscle cells red blood cells

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Myocardial Infarction Histology

normal muscle cells remaining macrophages and the beginnings of scar tissue

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