By Dr. Zafar Qureshi

Based on Aantomical & physiological relation amount of Based on Aantomical & physiological relation amount of elastic & muscular tissue in tunica Media & Diameter of elastic & muscular tissue in tunica Media & Diameter of blood vessels.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 of Diameter >7000 um e.g. Aorta branches of arch of aorta.aorta.

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

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

tissue tissue Diameter 50-100 umDiameter 50-100 um

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

from 50-100 micrometer. Provide resistance to from 50-100 micrometer. Provide resistance to blood flow and mediating blood pressure.blood flow and mediating 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 due to Diameter 10-15 Micrometer ; slide swelling due to

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

7.7. CAPILLARIES/ SINUSOIDS (Exchange vessels CAPILLARIES/ SINUSOIDS (Exchange vessels ) lumen is 5 Micrometer, exchange between ) lumen is 5 Micrometer, exchange between tissue fluids and blood.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 vein.Thickness of wall is 1/10 of the lumen of 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 heart. Conducting of Propulsue effect of heart.( i i)( i i) Distribution of blood. Distribution of blood.(i i i)( i i i) Muscular arteries provides resistance to Muscular arteries provides resistance to

the blood flow & them mediating the 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 pressure. flow of blood & maintain blood pressure.

CAPILLARIES:CAPILLARIES:

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

VEINS: VEINS:

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

(i) Small , Medium & large size veins (i) Small , Medium & large size veins act as reservoir & conney blood act as reservoir & conney blood back to heart ( Rt artiuem) back to heart ( 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 & inf. different arteries e.g: Sup & inf. Mesentesic arteriesMesentesic 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 beds & Blood of arterial tree by-pass the capillaries beds &

Sinusoids, into Venous system.Sinusoids, into Venous system.

Preferential Thorough-Preferential Thorough-fare Channelsfare Channels

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

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

SIMPLE ARTERIO SIMPLE ARTERIO VENOUS VENOUS

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

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

FUNCTION:FUNCTION:(i)(i) Regulate blood flow Regulate blood flow (i i)( i i) Regulate body temperature. Regulate body temperature.(i i i)( i i i) 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) ORGAN VASCULAR (SHUNTS) ORGAN

(URETERO (URETERO

VEGINAL)VEGINAL)

NERVES:- JACO NERVES:- JACO BONES BONES ANASTOMOSANASTOMOSIS IN IS IN TYMPENTIC TYMPENTIC PLAXES- INFO PLAXES- 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 lenes.No anastomosis at arterial or capillaries 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 arteries anastomosis present anastomosis present at capillaries level at capillaries level e.g central branches e.g central branches of cereback arteries.of cereback arteries.

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

In sufficient In sufficient anastomosis in end anastomosis in end arteries e.g 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 of Hardening of arterial wall due to fibrosis & calcification of

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

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

of artery (tunica intima) ultimately leads to thrombosis of artery (tunica intima) ultimately leads to thrombosis & occlusion of muscular arteries e.g 1HD, M 1, stroke & occlusion of muscular arteries e.g 1HD, M 1, stroke ( brain infaction death tissue ) gangloen limbs muolned.( brain infaction death tissue ) gangloen 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 vein weekening of wall e.g great Sephanus vein become vericosed due incompetence of become vericosed due incompetence of velues mainly Sepheno femoral or aduetor velues mainly Sepheno femoral or aduetor or perfectors velues or due to over load of or perfectors velues or due to over load of great Sephenus in result of DVT or 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 Lymph Part of circulatory system deals c’ circulation of Lymph (tissue fluid) rich in proteins of cells (Lymphoeytes & (tissue fluid) rich in proteins of cells (Lymphoeytes & organism & cell delesis).organism & cell delesis).

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

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

Lymph vessels of thywid, oesopfhagus cornary & triangle Lymph vessels of thywid, oesopfhagus cornary & triangle ligaments of liver are exceptionals these do’t traverse ligaments of liver are exceptionals these do’t traverse lymphnodes & pass directly to venous system through lymphnodes & pass directly to venous system through thoracic duct.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 in cornea, cartilages, CNS & bone mrrous very few in endomysium of skeletal muscles.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 adjacent have much wider calliber than those of adjacent capillaries.capillaries.

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

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

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

lacteals.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 lymph superficial fascia drains to superficial lymph nodes.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 small Absorption & transport of fat from small

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

body.body.

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

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

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

lymphadenopathy.) Painfully enlarge.lymphadenopathy.) Painfully 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 bornDIRECT LYMPHOGENONS Blood born

Directly into Ca Breast & most (Henatogenous)Directly into Ca Breast & most (Henatogenous) Contigous of Ca E.g Sarcomas.Contigous of Ca E.g Sarcomas. Structures of Structures of Body.Body.