Surgical Anatomy.—An artery has three coats: an internal coat—the tunica intima—made up of a single layer of endothelial cells lining the lumen; outside of this a layer of delicate connective tissue; and still farther out a dense tissue composed of longitudinally arranged elastic fibres—the internal elastic lamina. The tunica intima is easily ruptured. The middle coat, or tunica media, consists of non-striped muscular fibres, arranged for the most part concentrically round the vessel. In this coat also there is a considerable proportion of elastic tissue, especially in the larger vessels. The thickness of the vessel wall depends chiefly on the development of the muscular coat. The external coat, or tunica externa, is composed of fibrous tissue, containing, especially in vessels of medium calibre, some yellow elastic fibres in its deeper layers.
In most parts of the body the arteries lie in a sheath of connective tissue, from which fine fibrous processes pass to the tunica externa. The connection, however, is not a close one, and the artery when divided transversely is capable of retracting for a considerable distance within its sheath. In some of the larger arteries the sheath assumes the form of a definite membrane.
The arteries are nourished by small vessels—the vasa vasorum—which ramify chiefly in the outer coat. They are also well supplied with nerves, which regulate the size of the lumen by inducing contraction or relaxation of the muscular coat.
The veins are constructed on the same general plan as the arteries, the individual coats, however, being thinner. The inner coat is less easily ruptured, and the middle coat contains a smaller proportion of muscular tissue. In one important point veins differ structurally from arteries—namely, in being provided with valves which prevent reflux of the blood. These valves are composed of semilunar folds of the tunica intima strengthened by an addition of connective tissue. Each valve usually consists of two semilunar flaps attached to opposite sides of the vessel wall, each flap having a small sinus on its cardiac side. The distension of these sinuses with blood closes the valve and prevents regurgitation. Valves are absent from the superior and inferior venæ cavæ, the portal vein and its tributaries, the hepatic, renal, uterine, and spermatic veins, and from the veins in the lower part of the rectum. They are ill-developed or absent also in the iliac and common femoral veins—a fact which has an important bearing on the production of varix in the veins of the lower extremity.
The wall of capillaries consists of a single layer of endothelial cells.