HISTOLOGY

LECTURE NOTES
(AN 1441)
BY
Dr. ISIS ZAKI
M.D., M.S., Ph.D.
TEXAS CHIROPRACTIC COLLEGE
BASIC SCIENCE DEPARTMENT

CYTOLOGY

The cell is the structural and functional unit of the body.

There are two different types of cells:
o The prokaryotic cells found only in bacteria, they have neither nuclear membrane nor
organoids.
o The eukaryotic cells, that have nuclear membranes and organoids
The cell is made up of two main components: the cytoplasm and the nucleus.

CYTOPLASM
- Is semi fluid in nature.
- Contains three main components:

Cytoplasmic organelles (organoids)

Cytoplasmic inclusions

Cytoplasmic matrix (cytosol)

CYTOPLASMIC ORGANELLES: have the following features
o
They are living structures
o
They are permanent structures inside cells
o
They perform specific functions

I. MEMBRANOUS ORGANELLES:
1. Cell Membrane (AKA: plasma membrane, plasmalemma)
Is formed of a lipid bilayer (formed of 2 layers) and protein
Each lipid layer is formed of molecules having two ends; a hydrophobic end (uncharged) that faces

inwards and a hydrophilic end (charged) that faces outwards

Under the electron microscope, the cell membrane appears as trilaminar structure, formed of two dark
layers (hydrophilic part of the molecule) separated by a middle lighter layer (the hydrophobic part of the
molecule): railroad pattern.
Lipids are mainly phospholipids with few cholesterol molecules
There are 2 types of proteins in the cell membrane: peripheral proteins & integral proteins that are
scattered between the lipid bilayer and are anchored to it. If they span the lipid bilayer from one surface
of the cell membrane to the other, they are known as transmembrane proteins (act as channels for
transport of substances across cell membrane): fluid mosaic model
Cell membrane is covered on its outer surface by a cell coat (glycocalyx) formed of glycoproteins and
glycolipids
Cell membranes may be attached to each other by different types of junctions to be discussed later with
epithelial tissue
Free border of cell membrane may be modified into microvilli, cilia and flagella
Under light microscope, the cell membrane appears as a thin pink line in HX & E stained sections

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Functions of cell membrane:

Isolation of the cellular contents from the surroundings cellular homeostasis

Selective permeability: controls the passage of different types of molecules

Transport of nutrients and oxygen and removal of waste products

Endocytosis: bring inside the cell macromolecules, this involves Pinocytosis (fluid); Cell
Drinking and phagocytosis (solid particles); Cell Eating

Exocytosis: getting rid of unwanted material

Cell membrane receptors: Transmission of hormones & neurotransmitters

Cell Coat functions in

cell recognition &
adhesion
Cell membranes of nerve and muscle cells are electrically excitable and carry the function of
conduction

2. Mitochondria

Double membranous organelle

Outer membrane is smooth
Inner membrane is thrown into cristae and shelves (tubular cristae)
Mitochondrial matrix fills the interior of mitochondria and contains DNA, RNA, ribosomes and
proteins.
Hence mitochondria are capable of dividing and multiplication
Mitochondria contain oxidative enzymes that produce the energy-rich compound ATP (Adenosine
Triphosphate)
They are considered as the power houses of the cell
Their number varies according to the function of cells, e.g. a Liver cell may contain up to 1000
mitochondria
Under light microscope they have a thread-like or rod-like appearance

3. Rough Endoplasmic Reticulum (RER)

o Intercommunicating membranous tubules, vesicles and cisternae
o They have ribosomes attached to their outer surface
o It is continuous with the outer layer of nuclear membrane

protein synthesis

o It is concerned with
: it receives proteins formed by
ribosomes, starts glycosylation and sulphation and then transfer them to Golgi apparatus
o It is abundant in cells involved in protein synthesis, e.g. plasma cells that form antibodies
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o Under light microscope they appear as areas of local basophilia (e.g. basal parts of pancreatic cells and
Nissl bodies in nerve cells)

4. Golgi Apparatus/Complex

3 parts of Golgi Apparatus:

a. Flattened Saccules
b. Transfer or Microvesicles (from RER)
c. Secretory vesicles (larger, towards the free border of the cell)

Function of Golgi Apparatus

a. Adding a sugar part to certain proteins

b. Packaging and concentration of secretory proteins
c. Formation of lysosomes
Under light microscope it appears as a pale area close to the nucleus compared to
intensely basophilic cytoplasm (negative Golgi image) in plasma cells

5. Lysosomes: Digestive Organelles

Tiny spherical (rounded) membranous vesicles that contain more than 40

hydrolytic enzymes (acid phosphatase, proteases, lipases, etc.)
Their number varies according to the function of the cell (numerous in
phagocytic cells as neutrophils and macrophages)
They are sites of intracellular digestion
During life they break phagocytosed material: primary lysosome +
phagosome secondary lysosome residual body
They also get rid of worn out organelles, e.g. old mitochondria
autophagocytosis
They are also considered as suicidal bags (their membranes protect the
cell from the hydrolytic effects of their enzymes)
They may release their enzymes outside the cell, as what happens in
osteoclasts
After death they are responsible for post-mortum autolytic changes
Clinically, in lysosomal storage diseases, there is a genetic lack of certain
enzymes that normally degrade cell products leading to accumulation of products leading to mental
impairment, loss of vision and muscular weakness (Tay-Sachs disease)

6. Smooth Endoplasmic Reticulum (SER):

Is made mainly of membranous interconnected tubules
Its surface is devoid (NO)

of ribosomes
protein synthesis)

(no cytoplasmic basophilia,

Is connected with RER

It is not easily identified by the light microscope
Its main functions are: a. Steroid hormone synthesis: Adrenal Cortex
b. Drug detoxification in the Liver
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c. Glycogen metabolism: Liver and Muscle

d. Calcium release and capture during Muscular Contraction

II NONMEMBRANOUS ORGANELLES
1. Ribosomes: are formed of RNA and
Are small electron dense particles
Concerned mainly with protein synthesis
A.

protein

Attached ribosomes are adherent to the outer surface of rough endoplasmic

reticulum form proteins that are secreted (pancreas) or stored in the cell (lysosomes) or integral
proteins of cell membrane

B. Free ribosomes form proteins that remain in the cell as cytoplasmic functional elements, e.g.
actin, myosin and hemoglobin
Are formed mainly of ribosomal ribonucleic acid (rRNA) and proteins, hence the deep basophilia
of cells rich in ribosomes (protein synthesizing cells and cancer cells)

2. Cytoskeleton: Microtubules, Intermediate filaments,

Microfilaments

A. Microtubules
Slender unbranched tubules made of protein tubulin
Present mainly in mitotic spindle, centrioles, cilia and flagella

o
o
o
o
o

A Centriole is formed of 27 microtubules arranged in 9 sets of triplets

Each cell contains one pair of centrioles located close to the nucleus
Centrioles play an important role in cell division and spindle formation during metaphase
and also in production of cilia and flagella

Cilia are hair-like motile processes that extend from the surface of cells
A cilium is formed of 9 peripheral doublets & 2 central singlets of microtubules

o
o

surrounded with the cell membrane (20 microtubules)

In the respiratory system, their beating spreads mucus- produced by goblet cells- along the
lining epithelium to trap inhaled particles
o
In the female reproductive system, they move the ova along lumina
o

Flagellum is longer than a cilium, it is present in the sperms tail whip-like

swimming movement

B. Intermediate filaments:
are not contractile and act as cytoskeleton (support and maintain cell shape), provide attachment between
epidermal cells of skin (tonofilaments/keratin filaments) in desmosomes and are used in tumor identification
(their proteins are a reliable indicator of the origin of tumor)

C. Microfilaments:

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Actin/thin filaments: either contractile (in muscle) or non-contractile (microvilli)

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Thick filaments: are present in muscles (myosin) and are contractile

CYTOPLASMIC INCLUSIONS: are temporary structures that result from cellular metabolic processes
Glycogen: in liver and muscle cells
Lipids: in fat cells (adipocytes)
Pigments: a. exogenous: carotene, carbon particles and pigments of tattooing
b. endogenous: hemosiderin, melanin and lipofuscin (age-related)
CYTOPLASMIC MATRIX (CYTOSOL)
o Lies in between the organelles and inclusions
o Contains many enzymes, proteins, ions, nutrients and cytoskeleton
THE NUCLEUS
Nuclei differ in shape, size, number and location inside cells. Some cells have no nuclei or more than one
nucleus. However each nucleus is made up of 4 basic components:
Nuclear membrane: double membrane with pores. The outer membrane is continuous with the rough
endoplasmic reticulum
Nuclear matrix: is composed mainly of proteins, metabolites and ions that fill the nucleus
Nucleolus: aggregates of RNA and protein. It functions in the synthesis of ribosomes and rRNA. There
are 3 types of RNA that participate in protein synthesis. What are those? What is the role of each in
protein synthesis?
Chromatin:
o Is the genetic material of the cell
o It is formed of double strands of DNA forming a double helix
o Heterochromatin is the coiled portion of chromatin threads (inactive)
o Euchromatin is the extended portion of chromatin threads (biologically active)
o Chromatin is transformed into chromosomes during cell division (coiling)
o There are 23 pairs of chromosomes in body cells (46 chromosomes: diploid number), 22 pairs
operate body functions (autosomes) and are formed of identical (homologous) chromosomes and
one pair operates sexual functions (sex chromosomes). In females, it is XX; in males it is XY
o There are 23 chromosomes (haploid number) in mature germ cells; ovum and sperm
o Karyotyping: Chromosome map detects genetic anomalies, for example in Kleinfelter
syndrome there is XXY, in Turner syndrome there is XO, and in Down syndrome there is
trisomy 21. It is also used for screening of genetic diseases and prenatal determination of
sex.
Cell Cycle: made up of two main stages:

The interphase: a non-dividing stage between cell divisions, divided into 3 phases
o G1: Gap of about 8-12 hours after mitosis: cell growth
o S: synthesis of DNA (duplication of nuclear material): 8 hours
o G2: Gap of about 4 hours before the following mitosis (duplication of centrioles 2 pairs)

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Mitosis: lasts about 1-1.5 hours

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- Cardiac muscle cells and nerve cells do not divide

CELL DIVISION: two types

I Mitosis: division in somatic body cells, mother cell has 46 chromosomes, daughter cells also have 46
chromosomes: 4 stages
1. Prophase: - each centriole pair moves toward opposite poles of the cell
- disappearance of nuclear membrane
- disappearance of nucleolus
- coiling of chromatin leading to appearance of chromosomes
2. Metaphase: - spindle formation where chromosomes are arranged at the equator and microtubules
connect them to centrioles
- each chromosome is formed of 2 chromatids attached together at the centromere
3. Anaphase: - separation of chromatids at the centromere
- migration of each set of chromatids to opposite poles of cell
- development of a circular furrow at the equator of the cell
4. Telophase: - splitting into 2 cells
- reformation of nuclear membrane
- reformation of nucleoli
- transformation of chromosomes into chromatin
II. Meiosis:
Reduction division in germ cells (ovum and sperm)
Each mother cell has 46 chromosome, each made up of 2 chromatids
Daughter cells have 23 chromosomes each
Requires 2 maturation divisions; meiosis I and meiosis II
In the first maturation division (meiosis I), homologous chromosomes separate and each goes to a
daughter cell. Accordingly, daughter cells will have 23 chromosomes, each made up of 2 chromatids
In the second maturation division (meiosis II), the chromatids separate and daughter cells each will have
23 chromatids, now called chromosomes

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EPITHELIAL TISSUE
- 4 Basic types of tissues in the body: Epithelial tissue
Connective tissue
Muscular tissue
Nervous tissue
Characteristics of Epithelial Tissues:
1. Covers and lines body surfaces
2. Cells are densely packed together with minimal amount of intercellular substance
3. Cells are firmly attached by intercellular junctions
4. Cells rest on a basement membrane partly derived from underlying connective tissue. Two functions of
basement membrane:
a. Anchors epithelium to underlying connective tissue
b. Acts as a selective barrier for diffusion
2. Avascular: derives its nutrition through diffusion of nutrients from underlying connective tissue
3. Richly supplied with nerve fibers
Epithelium develops from the three germ layers:
Ectoderm epidermis of skin
Endoderm epithelium of digestive tract
Mesoderm the serous lining of body cavities (mesothelium)
Classifications of Epithelial Tissue
1. Covering/ lining epithelium
2. Glandular epithelium (Endocrine & Exocrine)
3. Neuroepithelium (taste buds)
Covering/lining epithelial tissue is classified according to:
1. Number of layers of cells
a. Simple: one layer of cells
b. Stratified: two layers and more
2. Shape of surface cells
a. Squamous: Flat
b. Cuboidal: square
c. Columnar: tall
Covering/Lining Epithelial Tissues
Simple Epithelial Tissues: Formed of one layer of cells resting on a basement membrane
Function: Absorption, Diffusion, Secretion, Excretion
1. Simple Squamous Epithelium: Diffusion
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a. Bowmans Capsule in kidney

b. Lines blood vessels (Endothelium)
c. Lines body cavities (Mesothelium e.g., peritoneum)
d. Alveoli of lungs
2. Simple Cuboidal Epithelium: Absorption, Secretion
a. Convoluted tubules of kidney
b. Thyroid gland
c. Germinal epithelium of ovary
3. Simple Columnar Epithelium: Absorption, Secretion
Two subtypes:
Simple columnar ciliated: Lining of uterus and uterine tube
Simple columnar non ciliated: lining of
a. Stomach
b. Small intestine
c. Large intestine
d. Gallbladder
4. Pseudostratified Columnar Epithelium: Falsely layered, modification of simple epithelium. Still
one layer because all the cells reach the basement membrane, some cells dont reach the luminal
surface and the nuclei appear to be arranged in more than one layer. Two subtypes:
Pseudostratified columnar ciliated with goblet cells: Respiratory system
a. Nasal Cavity
b. Trachea
c. Bronchi
Pseudostratified columnar epithelium with stereocilia (non-motile microvilli): Male
reproductive system
Stratified Epithelial Tissues
- Multiple layers
- Main function is protection as they can withstand wear and tear
1. Stratified Squamous Epithelium (Dry & Wet)
a. Keratinized: Epidermis of Skin (dry)
b. Non-Keratinized: Oral cavity, Pharynx, Esophagus, Vagina (wet)
2. Stratified Cuboidal Epithelium: Rare
a. Small ducts of sweat glands of the skin
b. Ovarian follicles
3. Stratified Columnar Epithelium: Rare
a. Large ducts of salivary glands
b. Conjunctiva (mucus membrane that lines eyelids)
c. Penile urethra
4. Transitional Epithelium: Found in Urinary System (Calyces of Kidney, Ureter, Urinary bladder,
Prostatic urethra in males and female urethra)
a. Relaxed: Empty, 4-6 layers, surface cells are cuboidal, binucleate cells
b. Stretched: Distended (Full), appears to have only 2-3 layers, surface cells look cuboidal with
convex free border and rounded nuclei.

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Cell Junctions in Epithelial Tissue:

1. Tight or occluding junction tight seal that obstructs transmission between cells
2. Adherent junctions: are sites of strong adhesion between cells
3. Gap/communicating junctions: allow the transmission of ions and small molecules between cells
4. Desmosomes: are adherent junctions (subtype of # 2) that connect adjacent cells at certain spots only (they
dont encircle the whole cell as in adherent junctions). Intermediate filaments/tonofilaments are inserted into
electron-dense plaques of material on the cytoplasmic surfaces of the junctional membranes
5. Hemidesmosomes: connect epithelial cells to underlying connective tissue
Surface Specialization of Epithelial Tissues
1. Cilia: (Simple/Pseudostratified Columnar Ciliated Epithelium)
Attached to basal bodies that have the same structure as centrioles
Composed of microtubules covered with cell membrane
They beat to move things along a surface
Found in: Respiratory tract move mucus away from lungs
Fallopian tubes move ovum towards uterus
2. Microvilli= Brush Border
Very short
Formed of folds of cell membrane and a core of actin filaments
Increase surface area for absorption
Found in: 1. Small Intestine
2. Proximal Convoluted Tubules of Kidney (PCT)
3. Stereocilia: (Pseudostratified Columnar Epithelium with Stereocilia)
Long microvilli
Projection from the luminal pole of the cell
Composed of a core of actin filaments
Only found on columnar cells
Found in male genital passages as:
1. Epididymis
2. Vas Deferens
Other Specializations of Epithelial Tissue
1. Goblet Cells: Modified Columnar Cells (unicellular gland)
Synthesize and secrete mucus
Found in:
1. Gastrointestinal tract
2. Respiratory tract
2. Myoepithelial Cells
Contain contractile actin proteins
Surround and squeeze secretory units and ducts
Found in exocrine glands as:
Lacrimal, Salivary, Mammary & Sweat Glands
Glandular Epithelium
1. Organized collection of cells derived from covering epithelial cells
2. Function: They Synthesize & Secrete & Store the secretion
3. Vascular
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4. 2 Major classifications:
a. Exocrine Have ducts, maintains connection with surface cells
b. Endocrine Do not have ducts, secrete directly into the blood, loses connection with surface
cells
How are glands formed?
1. Proliferation of surface cells
2. Downward growth and invasion of the underlying connective tissue
3. Differentiation into
a. Exocrine
b. Endocrine
Exocrine Glands:
Are formed of secretory units formed of secretory epithelial cells that release secretion into a
lumen and a duct that conveys secretion to a surface
Classification is based on 4 main criteria:
1. Branching of the duct
a. Simple glands: Ducts do not branch
b. Compound glands: Branched duct system
2. Shape of secretory unit
i. Tubular Gland: Tube-like
ii. Acinar/alveolar: Bulbous-like
3. Type of secretion
a. Serous: Watery secretion containing enzymes
Example: Parotid (contains salivary amylase enzyme)
b. Mucous: thick mucus secretion
Example: Goblet cells
c. Mixed: has both serous and mucous acini
Example: Submandibular Gland
2. Method/mode of secretion
a. Eccrine/Merocrine: Secretion released without loss of cell
Sweat Glands
b. Apocrine: Apex of cell is lost with secretion
Mammary Glands
c. Holocrine: Cell is lost as part of the secretion
Sebaceous glands in Skin

Endocrine Glands Are Classified by Arrangements

1. Follicular arrangement: e.g.Thyroid Gland
a. Arranged in rings called follicles: store secretion inside follicles
b. Lined with simple cuboidal epithelium
c. Follicles are surrounded with blood capillaries to transport secretion
2. Anastomosing Cords Arrangement: e.g.Parathyroid gland
a. Granules are stored inside cells
b. Every cell must be in contact with a capillary for transport of secretion
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Functions of Epithelial Tissue:

1. Protection: Covers body surfaces: Epidermis of skin and cornea or lines hollow organs
(digestive tube, urinary and reproductive passages), blood vessels (Endothelium), body
cavities (Mesothelium)
2. Absorption: Intestines and kidney
3. Secretion: Glandular epithelium
4. Excretion: kidney
5. Sensation: Neuroepithelium (taste buds)
6. Contractility: Myoepithelial cells of glands
7. Reproduction: Germinal epithelium of ovary and testis
CONNECTIVE TISSUE
Connective tissue is one of the four basic tissues of the body in which the cells are widely separated by a large
amount of intercellular substance. It is derived from mesoderm
1. Embryonic CT: 2 types: a. Mesenchyme: loose connective tissue of the embryo, its cells are
called undifferentiated mesenchymal cells (UMC)
b. Mucoid CT: dense CT found in the umbilical cord (Whartons Jelly)
2. Adult CT
I Connective Tissue Proper
i. Loose Areolar
ii. Dense Irregular CT
iii. Dense Regular CT
iv. Elastic Tissue
v. Reticular Tissue
vi. Adipose Tissue
II Specialized Connective Tissue:
a. Cartilage
vii. Hyaline Cartilage
viii. Elastic Cartilage
ix. Fibrocartilage
b. Bone
i. Compact bone
ii. Spongy/Cancellous bone
c. Blood
Three Main Components of Connective Tissue
1. Cells
2. Fibers
3. Ground Substance
Fibers and ground substance constitute the extracellular matrix
Cells of Connective Tissue Proper
1. Fibroblasts
a. Main cells in CT Proper
b. Has abundant branched cytoplasm rich in RER & oval large nucleus
c. They synthesize the fibers & ground substance of CT proper
d. When resting, they are called fibrocytes
e. Unlike most other cells, fibrocytes can revert back to fibroblasts for repair and healing
wounds scar (myofibroblasts wound contraction
2. Macrophages:
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Are derived from Monocytes of the blood

They are large branched cells with darkly stained indented nucleus and plenty of lysosomes
Functions: a. Phagocytosis
b. Antigen presenting cells (APC)
Types:
a. Free Macrophages
i. Microglia: in CNS
iv. Kupffer cells in liver
ii. Dust Cells: in Lungs
v. Langerhans cells in skin
iii. Histiocytes: in CT Proper vi. Osteoclasts in bone
b. Fixed Macrophages: in spleen, lymph nodes, bone marrow

3. Mast Cells:
Oval to round cells with spherical nucleus and metachromatic granules (take a color
different from the original color of the stain)
Are numerous in CT of the skin and mucous membranes
Initiate inflammatory response, characterized by having secretory granules of 2 different
types
a. Histamine: vasodilator, increases permeability in the tissues swelling, involved in
inflammatory and allergic conditions
b. Heparin: anticoagulant
4. Plasma Cells: Clock-face eccentric nucleus, basophilic cytoplasm, negative Golgi image
a. Synthesize and secret antibodies into blood to attack antigens
b. Derived from activated B lymphocytes
5. Adipose Cells (fat cells= adipocytes)
a. Usually found in groups
b. Big empty clear rings with flat peripheral nuclei (signet-ring appearance)
c. Store lipids
d. Secrete leptin that reaches the brain, acts on the hypothalamus, decreasing food ingestion
and increasing energy consumption
6. Lymphocyte: is a type of white blood cells (WBCs)
a. Small number may be found in CT
b. Has a large nucleus and little cytoplasm
c. Immunity: B lymphocyte and T lymphocytes
d. Diapedesis: Process by which WBCs leave blood and enter CT.
7. Neutrophils: are phagocytic cells that migrate from blood vessels
Fibers of CT Proper: formed by fibroblasts
1. Collagen fibers: wavy, thick, unbranched fibers, tensile strength, stain pink
2. Elastic Fibers: straight, thin, stretchable and branch
3. Reticular Fibers: form supporting network for organs, stain black with silver
There are 5 major types of collagen fibers: collagen type I is the strongest, it is present in bone and
fibrocartilage (IVD), type II in cartilage, type III in blood vessels and skin, type IV in basement
membranes and type V in smooth muscles. Collagen is a protein formed from a precursor called procollagen
formed by fibroblasts
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Vitamion C is important for synthesis of normal strong collagen

Elastic fibers are made up of protein called elastin. Reticular fibers are a form of collagen
Clinical correlations:
1. Ehlers-Danlos syndrome: abnormal collagen synthesis
2. Osteogenesis imperfecta
3. Scurvy: vitamin C deficiency defective collagen formation bleeding gums (weak vessel
wall)
4. Keloid: abnormal amounts of collagen that forms in the scar tissue of skin
5. Marfans syndrome decrease elastic tissue aortic rupture
Ground Substance: amorphous; contains water, electrolytes and
1. Proteoglycans: contain proteins and glycosaminoglycans (GAGs): interact with collagen fibers to
help hold the tissues together and hydrate them
2. Adhesive Glycoproteins: found in the basement membranes, anchors epithelial cells to CT.
What is the difference between proteoglycans and glycoproteins?
Six Types of adult Connective Tissue Proper
1. Loose Areolar CT
a. Has all elements of CT
b. Very vascular
c. Supports epithelium, blood vessels, surrounds axons & muscle fibers and found also under the
skin (subcutaneous tissues= superficial fascia)
2. Dense Irregular CT: more fibers, fibers are not in order
a. Bundles of collagen fibers
b. Stronger and less vascular than loose areolar CT
c. locations: Dermis of skin, organ capsules, perichondrium, periosteum, submucosa
3. Dense Regular CT: Very strong tensile strength
a. Organized: parallel bundles of collagen fibers
b. Sparse ground substance
c. Fibroblasts line up in rows between collagen fibers
d. Locations: tendons & ligaments and aponeurosis
4. Elastic Tissue
a. Parallel elastic fibers that form sheets or laminae
b. Locations: Aorta, ligamentum nuchae and ligamentum flavum
5. Reticular Tissue
a. Stains black to dark brown
b. Formed of a network of reticular fibers and reticular cells
c. Locations: Stroma of liver & Lymphoid organs
6.

Adipose Tissue
- Appears clear: fat dissolves during preparation of sections
a. Yellow/white adipose tissue: more widely distributed
i. Unilocular: one lipid droplet per cell
ii. Gives shape, good insulator and protector
iii. Yellow color is due to carotene; a lipid soluble pigment

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b. Brown adipose tissue: found mainly in newborns and hibernating animals

i. Multilocular: more than one lipid droplet
ii. Higher energy source and provide body heat
iii. Brown color is due to the vascularity and cytochrome pigment in mitochondria
Functions of Connective Tissue Proper
1. Support
2. Maintains shape of organs: supporting stroma of organs (capsule and septa)
3. Tensile strength: tendons & ligaments
4. Inflammatory and allergic responses: mast cells
5. Immune response: plasma cells and lymphocytes
6. Repair and healing of wounds: fibroblasts
7. Phagocytosis: macrophages (histiocytes)
8. Preserves body temperature, stores fat & provides shock absorption: adipose CT
9. Acts as a medium for transport of blood vessels, nerves and lymphatics to organs: loose areolar CT

CARTILAGE

A specialized type of connective tissue that belongs to the skeletal system

Characterized by being avascular (like epithelium) and firm in consistency
It obtains its nutrition by long-range diffusion from the surrounding vessels
Strong yet flexible (can bend), supporting tissue, semirigid, shock absorbing and provides tensile
strength.
Characteristics of a good supporting tissue: Tensile strength, Resilience (shock absorption) and Weight
Bearing
Cartilage is formed of the three main components of CT: cells, fibers and ground substance
Cartilage has only two types of cells
o Chondroblasts: lay down the matrix (fibers and ground substance)
o Chondrocytes: They are adult chondroblasts trapped in their own matrix, located in lacunae
(compartments). They help maintain cartilage matrix.
Cartilage has only two types of fibers
o Collagen fibers: add to the tensile strength
o Elastic fibers: impart elasticity to cartilage
Ground substance:
o Slightly basophilic, amorphous (no morphological features)
o Formed mainly of proteoglycans, glycoproteins and proteins
o Proteoglycans: very large molecules composed of a core of protein to which glycosaminoglycan
molecules are bound.
o Glycosaminoglycans (GAGs) are long-chain polysaccharides composed of repeating
disaccharide units. They are named for glucosamine, a sugar that is present in each disaccharide.
o Glycosaminoglycans include: chondroitin sulfate, keratin sulfate, hyaluronic acid, etc
o GAGs are negatively charged
o The negative charges attracts water, forming a hydrated gel
o The gel-like composition of the ground substance serves 2 functions:
a. Permits rapid diffusion of water soluble molecules and nutrients
b. Provides a shock-absorbing mechanism
The Perichondrium: is a fibrous membrane that surrounds cartilage. It is formed of 2 layers:
1. Outer fibrous layer (dense irregular CT) that contains blood vessels

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2. Inner chodrogenic layer that contains chondroblasts and has the potential for new cartilage
formation.
Perichondrium, however, does not surround articular cartilage of synovial joints( as this would
cause friction) nor fibrocartilage. The synovial fluid in these joints provides O2 and nutrients for
articular cartilage.
Functions of perichondrium:
1. Nutrition: since cartilage is avascular
2. Growth of cartilage 3. Regeneration of cartilage
Methods of Growth of Cartilage
1. Appositional growth: adding new cartilage under perichondrium through the activity of chodrogenic
layer of the perichondrium. Most common type of growth
2. Interstitial Growth: Growth from inside out. Chondrocytes in lacunae undergo mitosis forming cell
nests/isogenous groups (embryos & early in life)
3 Different Types of Cartilage
1. Hyaline Cartilage: most common type in body (Bluish white), frosted glass appearance
a. Locations:
i. Located in embryonic skeleton (template for bone)
ii. Epiphyseal disc/growth plate
iii. Nasal septum
iv. Respiratory system (Larynx, Trachea, Bronchi)
v. Costal cartilages: attach ribs to sternum
vi. Articular cartilages (synovial joints; no perichondrium)
b. Characteristics of Hyaline Cartilage
i. Have perichondrium (except articular cartilages)
ii. 40% of matrix type II Collagen fibers, are not apparent in matrix for two reasons:
a. Submicroscopic dimensions
b. Same refractive index as that of ground substance
iii. 60% of matrix ground substance
iv. Basophilic matrix: Chondroitin sulphuric acid
v. Isogenous group = cell nests: result from mitotic division of chodrocytes and
partitions of matrix form between daughter cells
2. Elastic Cartilage:
a. Locations
i. Ear: Auricle, External auditory meatus, Eustachian tube
ii. Epiglottis
b. Characteristics of Elastic Cartilage
i. Perichondrium is present
ii. Chondrocytes in lacunae are larger and closer together
iii. Less ground substance
iv. Two types of fibers in matrix: Elastic (more) and type II Collagen
3. Fibrocartilage: Combination of hyaline cartilage & collagen fibers
a. Provides tensile strength and weight-bearing features
b. Locations
i. Intervertebral disc (IVD)
ii. Menisci of knee joint
iii. Pubic symphysis
iv. Temporomandibular and sternoclavicular joints (intra-articular disc)
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c. Characteristics of Fibrocartilage
i. No Perichondrium
ii. Parallel bundles of Collagen type I fibers: tensile strength
iii. Very little ground substance
iv. Chondrocytes line up in rows
v. Chondrocytes are larger than fibroblasts and are inside lacunae and this is the main
difference between dense regular connective tissue (tendon) and fibrocartilage
The structure of the intervertebral disc is of special interest because of its involvement in many cases of
back pain. This will be covered in detail in the Spinal Anatomy course
Cartilage has limited ability for repair due to:
a. Avascularity
b. Limited ability of chondrocytes to divide
Damaged Cartilage heals by new bone formation
Hyaline cartilage in the adult calcifies with time and is replaced with bone as a part of aging
process. When cartilage matrix becomes heavily calcified, diffusion is interfered with and
chondrocytes swell and finally die

BONE
Bone is a living tissue with rich blood and nerve supply
It is a specialized type of CT with a mineralized matrix that produces an extremely hard tissue capable of
support and protection
The mineral is calcium phosphate in the form of hydroxyapatite crystals
Bone matrix contains collagen fibers (type I)

Similarities Between Cartilage & Bone

Both have cells in lacunae that occupy spaces in the matrix
Matrix is reinforced with collagen fibers
Both have an outer membrane: perichondrium/periosteum
Both are derived from CT and form part of the skeleton

The main difference is that bone matrix is calcified and therefore does not depend on diffusion for
supply of nutrients (it depends on canalicular system)
Functions of Bone
1. Protection of internal organs
2. Support
3. Muscle attachment: mobility
4. Hematopoiesis: formation of blood cells
5. Mineral storage: calcium & phosphate
Classification of bone according to shape:
1. Long bones: Consist of a shaft (diaphysis) and 2 ends (epiphysis), metaphysis is the area between epiphysis
and diaphysis, e.g., femur and metacarpals
2. Short bones: Are nearly equal in length and diameter, e.g., carpal bones of the hand
3. Flat bones: Thin, plate-like, e.g., bones of skull cap, ribs and sternum. Formed of 2 layers of compact bone
with a middle layer of spongy bone called diploe
4. Irregular bones: e.g.,vertebrae, ethmoid bone of the skull
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Bone Cells
1. Osteoprogenitor cells (osteogenic cell): stem cells, develop from UMCs
a. Found on the surface of bone
b. If they have a rich vascular blood supply they make osteoblasts
c. If they have a limited blood supply, they make chondroblasts
2. Osteoblasts: originate from osteoprogenitor cells
a. Synthesize organic components of bone matrix: Osteoid tissue (Collagen fibers type I and
ground substance)
b. Secrete alkaline phosphatase enzyme that leads to deposition of calcium salts
c. Found on the surface of bone tissue as bone grows appositionally only
d. Bone matrix is laid around osteoblasts and around their cytoplasmic processes.
e. Once matrix is calcified, the osteoblasts become imprisoned in lacunae and their cytoplasmic
processes become surrounded with canaliculi (osteocytes)
f. Active osteoblasts are cuboidal cells, inactive cells are flat
3. Osteocytes:
a. They are mature bone cells.
b. They are found inside bone (not on the surface)
c. They communicate with each other through their cytoplasmic processes (gap junctions).
d. They function to maintain bone matrix
4. Osteoclasts: Phagocytic cells of bones
a. Bone- resorbing cells; very important cells in bone remodeling
b. Found on bone surfaces that break down
c. Large, Multinucleate cells, may contain from 5-50 nucleus/ cell
d. Derived from blood monocytes
e. They have a border with long microvilli called ruffled border
f. Removes excess or inferior quality bone tissue by the ruffle border:
i. Secrete carbonic anhydrase enzyme that leads to production of carbonic acid that lead
to decalcification of bone matrix
ii. Secrete collagenase enzyme (from lysosomes) that breaks down collagen fibers
iii. Create a depressions at active sites called Howships Lacunae
f. Regulates calcium levels in the blood:
- If blood calcium level drops
- Parathyroid glands release parathyroid hormone that stimulates
osteoclasts to resorbe bone and release calcium into blood
Bone Remodeling: is the process that leads to change in shape of a growing bone as a result of
formation (osteoblasts) at certain sites and resorption (osteoclasts) at other sites
Bone surfaces
1. Periosteal surface (outside)
2. Endosteal surface (inside, lining bone marrow cavities, Haversian and Volkmanns canals) and covering
bone trabeculae

Bone Matrix
1. 50% Organic part (osteoid tissue): Strength
a. 95% collagen fibers type I
b. 5% ground substance
2. 50% Inorganic part: Hardness & Rigidity (rock-hard)
a. Crystalline calcium in the form of hydroxyapatite crystals:
CA10 (PO4)6 (OH)2
b. Non crystalline calcium in the form of: calcium phosphate salts
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c. Calcium carbonate salts

d. Other salts
If you decalcify a bone, you remove mineral salts, it is still strong, but flexible
If you remove the fibers from a bone, it is still rigid, but breakable and fragile

Membranes that surround bone

1. Periosteum: a membrane on outer surface of bone, formed of 2 layers:
a. Outer fibrous layer (Dense Irregular C T) contains blood vessels
b. Inner osteogenic layer (Loose areolar CT) contains osteogenic cells
*Sharpeys fibers: Collagen fibers that connect periosteum to outer circumferential lamellae of
compact bone
2. Endosteum: a membrane that lines all bone cavities and made up of osteogenic cells
Two types of bone tissue: determined by arrangement of collagen fibers

Dr. Isis zaki

Woven Bone
Immature temporary bone
Primary bone
Lots of ground substance
Coarse fibers
Rapid Sloppy formation
Less Mineral Salts
More osteocytes
Mechanically Weak Tissue
Randomly arranged collagen
fibers

Lamellar Bone
Permanent, adult bone
Secondary bone
Very little ground substance
Fine collagen fibers
Slow layering of Bone
More mineral salts
Less osteocytes
Mechanically Strong tissue
Lamellar disposition of collagen
fibers

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Two Types of Lamellar Bone

1. Compact Bone: Outer, rigid shell, resists deformation
Structural unit is osteon or Haversian system
2. Spongy Bone: trabecular meshwork provides strength by acting as a
complex system of internal struts.
Structural unit is a trabeculum
Compact Bone: located mainly in long bones
1. Concentric ring-like structure of 4-20 lamellae of bone around the Haversian
canal
2. Haversian canal is parallel to the long axis of the diaphysis
3. Haversian canal contains blood vessels, nerves and loose CT
4. Haversian canals communicate with the blood vessels in the endosteum,
periosteum and with each other through transverse canals called Volkmanns
canals. These form as the matrix is laid down and keep bone alive.
5. Between lamellae of bone are the osteocytes in lacunae, which are connected to
each other and to the Haversian canal via canaliculi.
6. Interstitial lamellae do not contain Haversian canals. They lie between osteons
and are remnants of old osteons.
7. Canaliculi transmit interstitial fluid and nutrients
8. Inner and outer circumferential lamellae
9. Periosteum covers bone surface and endosteum lines bone marrow cavity (yellow
inactive bone marrow)
10. Two methods to prepare histological slides of bone:
a. Grinding method: bone is left to dry and then is finely ground into thin slices
b. Decalcification method: removal of calcium salts, bone sections are prepared
by routine histological methods and stained with Hematoxylin & Eosin
Spongy/cancellous bone: located mainly in flat and irregular bone
1. Irregular latticework of thin plates of bone = trabeculae
2. Trabeculae are made up of bone lamellae and osteocytes in lacunae
3. Trabeculae are covered by a thin endosteum with osteoblasts
4. Trabeculae are orientated along lines of stress within a bone
5. Osteocytes are connected by canaliculi, exchange metabolites with blood vessels
6. Spaces between trabeculae are filled with red (active) bone marrow
7. No Havershian Systems since bone marrow supplies blood to trabeculae
Bone development: 2 methods
I Intramembranous Ossification: bone growth within a vascularized embryonic
connective tissue (mesenchyme) e.g., Flat bones of the skull
Stages:
1. Sheets of vascularized mesenchyme containing UMCs and blood vessels
2. Primary center of ossification: osteoprogenitor cells give rise to
osteoblasts that lay down organic bone matrix, calcification follows, this
leads to encapsulation of osteoblasts osteocytes

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3. The islands of developing bone are first known as bone spicules

(small) that later enlarge to trabeculae.
4. Spongy bone forms first (diploe), compact bone forms on its outer and
inner aspects (outer and inner tables)
5. The intervening mesenchymal cells develop blood vessels and bone
marrow cells red bone marrow
6. Original CT becomes the periosteum and endosteum
7. No Cartilagenous stage
II. Endochondral Ossification: bone growth within hyaline cartilage model e.g., long
bones
1. The cartilaginous model is covered with a perichondrium.
2. The perichondrium surrounding the diaphysis assumes an osteogenic activity,
formation of subperiosteal bone collar (spongy) by intramembranous
ossification. This part of the perichondrium becomes known as the periosteum
3. Chondrocytes in the middle of the diaphysis hypertrophy and secrete alkaline
phosphatase enzyme causing the cartilage matrix to calcify.
4. This leads to death of chondrocytes (no diffusion through calcified matrix)
leaving behind their lacunae that become confluent producing a large cavity
5. Periosteal Buds, carrying blood capillaries and osteoblasts, enter from the
periosteum to establish a primary center of ossification
6. Bone collar lengthened, marrow cavity widened.
7. Secondary ossification centers appear in the epiphyses.
8. All what remains of original cartilage model is the epiphyseal plate of
cartilage (growth plate) and articular cartilage.
9. The first bone formed in the epiphysis and diaphysis is spongy. That of the
epiphysis remains cancellous and its cavities become lined with endosteum
and filled with red bone marrow.
10. The spongy bone of the diaphysis is transformed into compact bone via the
activity of osteoclasts that remove this bone and widen the marrow cavity and
the activity of osteoblasts that lay down concentric lamellae of bone creating
Haversian systems.
11. Hyaline cartilage remains permanently as articular cartilage and temporarily
as epiphyseal plate
How bone grows in length?
Through the activity of hyaline cartilage of epiphyseal plate/disc
From the epiphysis to the diaphysis the following zones are recognized:
o Resting zone: looks like typical hyaline cartilage with chondrocytes
and cell nests scattered in the matrix
o Proliferating zone: chondrocytes increase in number and line up in
longitudinal columns
o Mature zone: Chondrocytes enlarge and secrete alkaline phosphatase
enzyme that leads to calcification of cartilage matrix
o Calcifying zone: cartilage cells die and their lacunae fuse together
creating longitudinal tunnels
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o Ossification zone: the tunnels become invaded by vascular osteogenic

tissue from the marrow cavity. Osteoblasts start laying down bone
from the inside around calcified matrix-and osteoclasts remove bone
from the outside
Round the age of 20, most of long bones stop growing in length under
the effect of sex hormones, no more proliferation of cartilage cells, no
more epiphyseal plate of cartilage this is known as closure of the
epiphysis
Fracture repair:

1. Damaged blood vessels ischemia death of bone cells

2. Damaged areas are removed by osteoclasts and macrophages
3. Proliferation of osteoprogenitor cells in periosteum and endosteum
Chondroblasts Hyaline cartilage (less vascular
environment; internal callus)
Osteoblasts spongy bone (external callus)
These two form the Callus
4. Replacement of callus with compact bone (remodeling)
The repaired bone is much stronger than the original bone,
so it is not likely to break a bone in the same place.

Abnormalities of bone architecture may result from:

1. Abnormal shape of bone due to fracture
2. Decreased amount of bone due to osteoporosis
3. Destruction of bone due to cancer
4. Maldevelopment of bone
Effect of Estrogen on the skeleton
1. Causes decreased osteoclastic activity and increased osteoblastic activity
accounting for the rapid growth rate in females following puberty
2. Causes closure between diaphysis and epiphysis.
3. After menopause, estrogen production stops leading to:
a. Decreased osteoblastic activity in bones leading to:

Decreased osteoid tissue formation (organic part)

Decreased deposition of calcium & phosphate in bone (inorganic part)
b. Normal osteoclastic activity more destruction than formation
Other hormonal effects on bone:
Male sex hormone testosterone have the same effects on bone development as
estrogen
Parathyroid hormone mobilizes Ca++ from bone through stimulating bone
resorption by osteoclasts and blood Ca++ level
Thyrocalcitonin hormone (from thyroid gland) inhibits bone resorption and
blood Ca++ level. Calcium is essential for muscle contraction, blood
coagulation, cell membrane permeability and transmission of nerve impulses
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Growth hormone of pituitary: Excess gigantism (before closure of

epiphysis) or acromegaly (after closure of epiphysis). Decrease in this
hormone before puberty dwarfism

Nutritional effects on bone:

Vitamin D deficiency: leads to defective absorption of Ca++ from the
intestine and leads to rickets in children (may lead to permanent
skeletal deformity) and osteomalacia in adults: in both cases the
bones are soft but strong
Vitamin C deficiency: leads to defective collagen formation and a disease
known as Scurvy: bones are rigid, but weak
Mechanical effects on bone:
Exercises are the best stimulus for bone formation and remodeling
Osteoporosis: decrease in total bone mass
1. Present in most people over 50 (less physical activity, vitamin & protein
deficiency)
2. Due to imbalance between bone formation and bone resorption
3. Usually more severe in post-menopausal women, probably due to decreased
levels of estrogen hormone.
4. Can affect all bones, most commonly in weight bearing bones such as:
a. Vertebral bodies
i. Change in shape
ii. Decrease in height (decrease overall height of people & Kyphosis)
iii. Compression fractures
b. Neck of the femur: the most commonly- reported fracture in old people
2. Compact and trabecular bone become thinner, more fragile and more prone to
fracture
Prevention of Osteoporosis:
2. Balanced diet
3. Weight bearing Exercises
4. Avoid smoking and drinking
5. Bone density tests (bone scan)
6. Estrogens replacement therapy following menopause
7. Fosamax: a new drug that is taken by osteoclasts leading to their inactivation and
lysis due to interference with their enzymes
8. Leptin: a hormone secreted by fat cells. It has two effects;
a. Affects the brain cells leading to decreased appetite
b. Stimulates brain cells to release a substance that increases osteoblastic
activity

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BLOOD

Blood is considered as a special type of CT because it develops from mesoderm

Main functions of blood include:
o Transport of nutrients and oxygen to the cells
o Transport of wastes and CO2 away from cells
o Delivery of hormones and regulatory substances to and from cells
o Maintenance of homeostasis (stable internal environment)
o Transport of immune cells and antibodies
Blood is formed of a fluid part called plasma (55% of blood volume) and blood
elements (45% of blood volume: 44% RBCs and 1% leucocytes)
Blood volume is 5-6 liters in the normal adult (7-8% of total body weight)
Plasma is formed of:
o Water (90%)
o Proteins: 7-8% (albumin colloid osmotic pressure, globulin
antibodies, fibrinogen blood coagulation)
o Other solutes: - 1-2%, electrolytes (Na+, K+, Ca2+, etc.)
- Nonprotein nitrogen (urea and uric acid)
- Nutrients (glucose, lipids, amino acids)
- Blood gases (oxygen, carbon dioxide, nitrogen)
- Hormones and enzymes
Blood elements include:
Erythrocytes or Red Blood Cells (Corpuscles) or RBCs
o Are not true cells (no nuclei)
o 44 % of blood volume
o Appear as circular biconcave discs (to increase surface area)
o Rouleaux formation: RBCs stick together temporarily and
resemble stacks of coins (during passage in a narrow capillary)
o 7.5 in diameter
o Normal count is 5 million/ cubic mm of blood in males (4.5
million/cubic mm of blood in females; due to menstruation)
o Life span is about 120 days (4 months); old RBCs are destroyed by
phagocytic cells in the spleen, bone marrow and liver
o Filled with the red pigment hemoglobin (heme iron-containing
part and protein globin). It transports oxygen to the tissues and
carries carbon dioxide away. Oxyhemoglobin is red, when it
releases its oxygen it transforms to slightly blue, darker color.
o RBCs contain also carbonic anhydrase enzyme (for uptake of
CO2)
o Decrease in number of RBCs or hemoblobin leve in blood
anemia (e.g., iron deficiency anemia)
o Increase number of RBCs polycythemia (high altitudes)
o Decrease size of RBCs microcytic anemia

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o Increased size of RBCs is found in some cases of anemia

pernicious anemia (due to in Vitamin B12)
o Variation in shape of RBCs is present in other types of anemias,
e.g., sickle cell anemia
o Destruction of RBCs with liberation of hemoglobin is called
hemolysis, e.g., malaria
White Blood Cells or Leukocytes:
o Are true cell (nucleated)
o I % of blood volume
o They function mainly in immunity
o The normal count is 5,000-11,000/c.m.m. of blood
o Increase in number is called leukocytosis as what occurs in some
infections
o Reduction in the number is called leukopenia which occurs due to
inhibition of bone marrow by drugs (antibiotics)
o Leukemia is a malignant condition of the bone marrow where immature
leukocytes are released into the blood and the leukocytic count shows an
excessive increase
o Leukocytes are motile cells that pass between capillary endothelium
(diapedesis) into connective tissue
o There are two main types of leukocytes:
Granular leukocytes
Specific granules in cytoplasm
Lobed nuclei
3 types: Neutrophils, Eosinophils and Basophils

Nongranular leukocytes
No granules
Rounded or indented nucleus
2 types: lymphocytes and monocytes
GRANULAR LEUCOCYTES:
Neutrophils (polymorphs)
Most common leukocyte: 60-70 % of total leukocytic count
10-12 in diameter
Multilobed nucleus (2-5 lobes connected by fine chromatin threads)
Cytoplasm contains 2 types of granules: a. specific granules (mauve)
b. azurophilic granules (lysosomes)
Their main function is phagocytosis
They circulate for 6-10 hours, enter the tissues (motile), continue their phagocytic
anti-inflammatory function for 2-3 days and then die pus
Pathological increase is called neutrophilia, it occurs in acute bacterial
infections

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Eosinophils
2-4 % of total leukocytic count
12-14 in diameter
Bilobed nucleus
Cytoplasm contains large acidophilic coarse specific granules (histaminase)
They phagocytose antigen-antibody complexes that form during allergic
reactions
They secrete histaminase enzyme
Pathological increase is called eosinophilia e.g., allergic conditions and
parasitic infections
Basophils
0.5-1 % of total WBCs
10-12 in diameter
Nucleus (s-shaped) and hard to see (masked by the granules)
Cytoplasm contains specific coarse basophilic granules (histamine and heparin)
They secrete histamine and are involved in systemic allergic reactions (fatal
anaphylactic shock) as well as local allergic reactions (contact dermatitis)
They also secrete heparin
Pathological increase is called basophilia and occurs in chicken pox
Lymphocytes
Nongranular leukocytes
20-30 % of total leucocytes
Circulate in the blood, enter the tissues and are also present in lymph and lymphoid
tissue
Lymphocytes are the only type of leukocytes that return to circulation from tissues
The majority are small lymphocytes: 6-9 in diameter, with a rounded nucleus that
almost fills the whole cell, leaving a thin rim of cytoplasm at the periphery
A small number of large lymphocytes (10-12 ) is present in the circulating blood
There are 3 functional types of lymphocytes:
1. T-lymphocytes (60-75% of circulating blood lymphocytes), they function in cellmediated immunity
2. B-lymphocytes (20-30%) and they transform into plasma cells that produce
antibodies upon exposure to antigens (humoral immunity)
3. Natural killer (NK) cells (5-10%), they can attack virus-infected cells and cancer
cells without previous stimulation
Pathological increase is called lymphocytosis and occurs in chronic infections
Monocytes
Non-granular leucocytes
2-6 % of total WBCs
Are the largest leukocyte, their diameter is about 14-20 in diameter

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Kidney-shaped (indented nucleus)

They are phagocytic cells; after circulating in the blood for 1-3 days, they enter the
tissues.
They are the precursors of macrophages, Langerhans giant cells and osteoclasts
Pathological increase is called monocytosis, e.g., malaria

Blood platelets (thrombocytes)

150,000-350,000/c.m.m. of blood.
Are not cells (no nuclei)
2-4 microns in diameter
They are produced by megakaryocytes; giant blood cells of the bone marrow
They have a central dark zone called chromomere and a peripheral lighter zone, the
hyalomere
It functions in the production of important factors for blood clotting
Pathological decrease in platelets number leads to a condition called
thrombocytopenia (bleeding tendencies)
BLOOD DEVELOPMENT= HEMOPOIESIS= HEMATOPOIESIS
o Occurs in the hemopoietic tissue where elimination of old blood elements also takes
place.
o Hemopoietic tissue includes 2 tissues:
1. Myeloid tissue = red bone marrow: formation of most blood elements
2. Lymphoid tissue: maturation of T lymphocytes in thymus
Myeloid tissue

Red bone marrow is located in medullary cavity of flat and irregular

bones (sternum, ribs, iliac bone, flat skull bones, vertebrae, etc)

Yellow bone marrow is confined to the medullary cavity of long bones, it

stores fat instead of producing blood elements
Myeloid tissue is formed of:
a. Reticular tissue:
1. Reticular fibers: a network of supporting fibers
2. Reticular cells: primitive reticular cells (supportive) and phagocytic reticular
cells
3. Fibroblasts
b. Blood sinusoids: are wide venous channels lined with fenestrated endothelial cells
and phagocytic cells. They are supported with discontinuous basement membrane
to allow forming blood elements to pass through them to the blood
c. Developing blood elements
d. Fat cells
Blood elements develop from Pluripotential Hematopoietic Stem Cell (PHSC) that
is found in the bone marrow. Bone marrow transplants succeed if the recipients
marrow becomes repopulated by PHSC; also known as PPSC

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DEVELOPMENT OF RBCS
Erythropoiesis in adults, is stimulated by erythropoietin hormone secreted by the
kidney in response to low oxygen tension in the blood
This stimulates PHSC to differentiate into proerythroblast. Three main changes
occur in this cell during development to produce a mature RBC:
a. Reduction in size
b. Formation of hemoglobin
c. Elimination of the nucleus
This occurs over a number of stages, as follow:
1. Proerythroblast: a large cell with rounded central nucleus and basophilic
cytoplasm, undergoes mitosis to give:
2. Basophil erythroblast: basophilic cytoplasm caused by RNA in preparation of
hemoglobin synthesis, undergoes mitosis to give:
3. Polychromatophil erythroblast: acidophilic cytoplasm due to hemoglobin
synthesis, this is the last stage to divide
4. Orthochromatophil erythroblast/ Normoblast/Acidophil erythroblast: has a
small dark pyknotic nucleus (which is finally extruded from the cell) and an
acidophilic cytoplasm with some basophilia
5. Reticulocytes: are the last stages in the development of RBCs. They contain a
basophilic network of RNA
Reticulocytes occur normally in the peripheral blood, forming about 1% of RBCs,
they may increase during increased erythropoiesis in compensation for blood loss
DEVELOPMENT OF GRANULAR LEUKOCYTES: GRANULOPOIESIS
o PHSC differentiates to the mother cell of all granulocytes known as myeloblast
o Myeloblast is a large cell, with a rounded nucleus and basophilic cytoplasm
o Three changes occur in this cell in order to develop to the mature stage:
a. Reduction in size
b. Development of specific cytoplasmic granules
c. Lobulation of the nucleus
This occurs in a number of stages which are:
o Promyelocyte: Contains non specific azurophilic granules
o Myelocyte: a smaller cell with some specific granules that start the differentiation
of neutrophils, eosinophils and basophils.
o
Metamyelocyte: a smaller cell with more specific granules, and
kidney-shaped nucleus
o Band form: further reduction in size and the nucleus assumes a horse-shoe shape
o Segmented granulocytes: with characteristic shape of nuclei &specific granules
DEVELOPMENT OF BLOOD PLATELETS (THROMBOPOIESIS)
PHSC Megakaryoblasts which are the mother cells of platelets

They are large cells with basophilic cytoplasm

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Megakaryocytes are the next stage, they have a large

multilobulated nucleus (the largest cells of the bone marrow, 50 microns in
diameter),
Megakaryocytes develop cytoplasmic processes that fragment and form blood
platelets
The organelles accumulate in the center forming the chromomere, while the clear
cytoplasmic area around forms the hyalomere

DEVELOPMENT OF LYMPHOCYTES
o
The stem cell (PHSC) is in the bone marrow
o Cells that are destined to be T lymphocytes, leave the bone marrow and travel to
the thymus gland and develop and mature there
o Cells that are destined to become B lymphocytes, mature in the bone marrow
o PHSC lymphoblast medium-sized lymphocyte small (mature)
lymphocyte
DEVELOPMENT OF MONOCYTES
PHSC (bone marrow) monoblast monocyte circulate enter tissues
differentiate macrophages
MUSCULAR TISSUE
Muscles are formed of elongated cells called muscle fibers. They have two prominent
physiological properties:
1. Excitability: ability to produce action potentials
2. Contractility: ability to shorten in response to action potentials
Muscles are classified into 3 main types according to two main criteria:
- Voluntary/involuntary control of contraction
- Striated/non-striated (cross striations)
Types of muscles in the body:
Skeletal: striated and voluntary
Cardiac: striated and involuntary
Smooth: non-striated (smooth) and involuntary
Skeletal Muscles:
- Most widely spread, moves parts of the body, attached to skeleton
- Formed of muscle fibers and connective tissue
Connective Tissue of Muscle:
- Epimysium: Dense irregular CT that covers the entire muscle (CT cells, collagen
fibers, blood vessels, nerves and lymphatics)

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- Perimysium: Partitions that divide the muscle into bundles (Dense irregular CT,
contains blood vessels, nerves and lymphatics).
- Endomysium: loose CT between the individual muscle cells
Functions of CT:
1. Transmits the power of contraction of the muscle to the attachment site (Bone,
tendon, aponeuroses, periosteum)
2. Carry the blood vessels, nerves, and lymphatics to the skeletal muscles fibers
SKELETAL MUSCLES
- Muscle fibers/cells are cylindrical in shape
- Nuclei: flat, multiple and peripherally located
- Surrounded by a cell membrane called sarcolemma (Latin: sarcos= flesh)
- On the outside of the cell membrane, there is an external lamina
- Sarcoplasma is the cytoplasm of the muscle cell. It contains organoids and inclusions:
a. Mitochondria are energy-producing organoids. Present in rows between myofibrils.
Muscle contraction requires energy that is provided by ATP of mitochondria.
b. Sarcoplasmic reticulum: smooth endoplasmic reticulum that stores calcium ions
c. Glycogen is the main cytoplasmic inclusion
d. Myoglobin is the muscle pigment (oxygen-binding pigment)
e. Myofibrils are the contractile organoids (contractile elements of skeletal muscle);
longitudinally arranged, parallel to each other.
- Under the light microscope, myofibrils appear to have alternating dark and light bands.
Dark and light areas are arranged on the same level leading to cross striations
appearance. Dark bands (A): anisotropic and Light bands (I): isotropic. Each I band
is bisected by a dark line called the Z line. The area between two successive Z lines is
called a sarcomere (contractile unit of striated muscle). The A band is bisected by a
light area called H band that shows a dark line in the center called the M line.
Fine structure of myofibrils (Electron Microscopic Structure):
- Myofibrils contain 2 types of myofilaments within each sarcomere:
1. Thin filament (Actin-containing filament) located in I band and part of the A
band, and is attached to the Z line. It is formed of 3 types of molecules:
a. Actin two chains
b. Tropomyosin straight fiber that wraps around the actin chains
c. Troponin contains three subunits
i. TnC captures calcium
ii. TnT attaches to the tropomyosin molecule
iii. TnI - inhibits myosin and actin union
2. Thick filament (Myosin): fills the area of the A band and is attached to the M
line within the A band. (Does not extend into I band at all). It is formed of
myosin molecules that end by myosin heads (cross bridges) that initiate muscle
contraction

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T- tubules (transverse tubules) run transversely across the muscle: connect the
sarcolemma to the sarcoplasmic reticulum and transmit the nerve impulse
Sarcoplasmic Reticulum Primary function is to regulate calcium ion concentration
within myofibrils. Stores calcium when muscle fiber is relaxed
Triad of tubules: 1 T-tubule in center with 2 terminal cisternae (from endoplasmic
reticulum); one on each side. The triad is located at junction between the A and I bands.
The nerve impulse reaches the muscle at the motor end plate causing the release of
acetyl choline leading to a wave of depolarization transmitted through the T-tubule
to terminal cisternae. When the impulse reaches the smooth endoplasmic reticulum,
the calcium is released and picked up by the TnC subunit and the contraction will
take place.
(Calcium exposes area on TnC subunit of thin filament for thick filament to hold.)
ATP then attaches to myosin head and causes it to release the thin filament.
Mechanism of Muscle Contraction includes Five Stages:
1. Attachment phase: Myosin head binds with the actin
2. Release : ATP is attached to myosin head causing it to release the actin
3. Bending: the head bends to be attached to a new binding site on the actin
molecule
4. Force generation: the head then connects with the actin again and energy is
released to pulls the actin filament power stroke
5. Reattachment: myosin heads bind to a new actin molecule of the thin filament
This is known as sliding theory mechanism for muscle contraction
As a result of muscular contraction:
1. Sarcomere shortens
2. I bands shorten
3. H zone disappears
After death, there is no ATP, thus actin and myosin remain tightly attached rigor
mortis
Sources of energy for muscle contraction:
Glucose is the primary source of energy for muscle contraction. It is derived from
blood as well as from breakdown of glycogen
Myoglobin an oxygen-binding pigment present in muscle cells, supplies oxygen
needed for oxidative phosphorylation
ATP- from mitochondria: the energy stored in these high-energy phosphate bonds
comes from the metabolism of glucose and fatty acids
Afferent Innervation of Skeletal Muscle:
Muscle spindle: is a proprioceptor.
- A proprioceptor is a receptor within the muscle that is sensitive to changes in
position of the muscle e.g., stretching
- It is located within the muscle close to the musculotendinous junction
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It is a spindle- shaped structure that contains 8-10 intrafusal muscle fibers,

located within a capsule between the skeletal muscle fibers (extrafusal muscle
fibers)
There are 2 types of intrafusal muscle fibers: nuclear bag and nuclear chain
types
There are 2 types of sensory nerve fibers that terminate on the intrafusal muscles:
1. Annulospiral ending primary termination of nerve ending (fibers wrap
around the muscle fiber)
2. Flower spray secondary termination of nerve ending (fibers appear as a
flower)
The intrafusal muscle fibers receive motor innervation by gamma motor neurons

Efferent Innervation of Skeletal Muscles

Motor end plate:
- The termination of a motor nerve on the muscle is called the motor end plate
(neuromuscular junction)
- The axon terminal is rich in mitochondria and synaptic vesicles that release acetyl
choline into the synaptic cleft, causing depolarization of sarcolemma and initiation
of a nerve impulse
- There are receptors for acetylcholine on the sarcolemma of a muscle cell.
- The sarcolemma is folded junctional folds
- Deficiency of receptors for acteylcholine leads to weak muscular contraction: a
disease known as myasthenia gravis.
Types of skeletal muscle:
- Red muscle fibers: (for example the diaphragm) slow contraction for a long time, do
not fatigue easily; plenty of mitochondria, myoglobin and glycogen
- White muscle fibers: strong contraction, fast, but fatigue easily; less mitochondria,
myoglobin, and glycogen
- Intermediate muscle fibers: structurally and functionally in between red and white
types
Most muscles of the body are combination of these types depending on the
functional demands
Regeneration of Skeletal Muscle:
- Skeletal muscles can regenerate through satellite cells that are located between
external lamina (or basement membrane) and sarcolemma.
- They can differentiate into myoblasts (mother cell of muscle). As long as the basal
lamina is intact, the myoblasts fuse and regenerate the affected muscle. If the basal
lamina is disrupted, fibroblasts repair the injured site leading to scar tissue formation.
Hypertrophy: increase in size of skeletal muscles (in athletes): Explain
CARDIAC MUSCLES

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- Are located within the heart (myocardium)

- Are striated and contract involuntarily
Differences between Cardiac and Skeletal
1. Presence of intercalated disks (most characteristic feature)
2. Short cylindrical cells
3. Branches between the fibers
4. Nuclei are single/muscle cell and centrally located
5. No nerve is required to initiate contraction
Cardiac contraction is myogenic (impulse generating system inside cardiac muscle)
innervated by ANS (Autonomic Nervous System) that only regulates heart rate and
force of contraction and blood supply
Intercalated discs are cell junctions between 2 cardiac cells:
1. Gap junction: allows the electrical transmission of impulse from one cell to
another
2. Adherent junction: patch-shaped adhering junctions
3. Desmosome: strong adhesion between the cells that does not allow separation
during contraction
Cardiac muscles dont regenerate because:
1. There are no satellite cells
2. There is no cell cycle (do not have mitosis)
Cardiac muscle can undergo hypertrophy due to valvular diseases or hypertension
SMOOTH MUSCLES
1.
2.
3.
4.
5.

Not striated
Involuntary
Spindle-shaped
Single (rod-shaped) central nuclei
Arranged in layers (circular or longitudinal)

Smooth muscles are located in:

1. Walls of hollow organs (organs with lumina)
a. Blood vessel walls
b. Walls of GI tract (lower 1/3 of esophagus down)
c. Respiratory system
d. Urinary system
e. Female reproductive system: fallopian tubes, uterus
f. Male reproductive system: vas deferens, epididymis
2. Arrector pili muscles: in the dermis of the skin
3. In capsules and trabeculae of some organs as spleen and prostate gland
- Myofilaments are not organized no striations, no sarcomeres

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There are 3 types of myofilaments: thin, thick, and intermediate filaments

The contractile apparatus in smooth muscles are the thin and thick filaments
The intermediate filaments form a cytoskeleton
Both thin and intermediate filaments are inserted into dense bodies that transmit
the force of contraction to adjacent smooth muscle cells. This leads to
constriction and ballooning of cell membrane during contraction
Smooth muscles lack a T system
- There are gap junctions between smooth muscle cells (as in cardiac muscle)
Smooth muscles can regenerate through:
1. Mitosis
2. Pericytes: are cells that surround the capillaries and can differentiate to myoblasts
Smooth muscles can undergo hypertrophy (ex. uterus during pregnancy)
NERVOUS TISSUE
Two Parts:
CNS: Brain and spinal cord (protected by bony structures)
PNS: 31 pairs of spinal nerves, 12 pairs of cranial nerves, peripheral ganglia
Nervous Tissue is made up of:
1. Neurons
2. Neuroglia cells
Neurons (nerve cells): are the functional units of the nervous system
- Human body contains over 10 billion neurons
- Neurons are non-dividing cells with 2 prominent features:
o Excitability: action potential (has the power to generate a nerve impulse)
o Conductivity: the nerve impulse rapidly propagates along the nerve.
Functionally there are three main types of neurons:
1. Sensory: carry impulses from receptors to CNS
a. Somatic afferent: from muscles, ligaments, joints and skin (GSA)
b. Visceral afferent: from internal organs, e.g. blood vessels, heart (GVA)
2. Motor: carry impulses away from CNS or ganglia to effector (muscle or gland):
a. Somatic efferent: to skeletal muscles (GSE); they have very long axons
Golgi type I neurons
b. Visceral efferent: to viscera, e.g. heart, intestine and glands (GVE)
3. Interneuron (integrating neurons): integrate between sensory and motor neurons
(99.9% of all neurons are interneurons); they have very short axons Golgi type
II neurons
Structure of Neuron:
- Cell body
The nucleus is large, pale-staining with a prominent nucleolus

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The cytoplasm (perikaryon) contains ribosomes and RER

cytoplasmic basophilia Nissl bodies (present also in dendrites
and not in the axon)
It contains also mitochondria, Golgi apparatus, lysosomes,
lipofuscin pigment (wear and tear), melanin (substantia nigra of
midbrain), microtubules, and intermediate filaments
cytoskeleton
Two types of processes:
o Dendrites (latin: branching):
Short
Numerous
Carry impulses towards the cell body (receptor processes)
Have many fine branches end by spine at sites of synapse
Contain Nissl bodies

o Axon:

Long
Single
No branching except at the terminal end
Transmit impulses away from cell body (effector processes)
Terminal end is bulbous terminal bouton
No Nissl bodies

The Axon:
Its attachment to cell body is a pale staining area of cytoplasm known as axon hillock
Axoplasm: no Nissl bodies, but contains mitochondria and microtubules
Axolemma: cell membrane of the axon
In myelinated nerves: myelin sheath (lipid rich layer) surrounds the axon. It is
interrupted at the Nodes of Ranvier (myelin free gaps)
Outside is a layer of Schwann cell cytoplasm called neurolemma.
Myelin in peripheral nervous system is formed by Schwann cells.
In the CNS, myelin is formed by oligodendrocytes.
Types of Neurons: Based on the number of processes
1. Unipolar or pseudounipolar: one process that divides into 2 processes; a
dendrite and an axon, ex. Spinal Ganglia (dorsal root ganglia: DRG)
2. Bipolar: 2 processes retina
3. Multipolar: more than 2 processes (four subtypes)
a. Stellate: star-shaped autonomic ganglia, AHC
b. Pyramidal: cerebral cortex
c. Piriform: pear-shaped Purkinje cells in cerebellum
d. Granule cells: small with nucleus filling most of the cell cerebellum
N.B.: both pseudounipolar and bipolar neurons are sensory while multipolar
neurons are motor
Synapses:
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CNS:
-

Are sites of contact between neurons or between neuron and end organs (muscles
and glands)
They facilitate transmission of impulses from a presynaptic neuron to a
postsynaptic neuron through a synaptic cleft.
Morphological classification: (4 types)
o Axodendritic
o Axosomatic
o Axoaxonic
o Dendrodendritic: less common (rare)
Depending on mechanism of conduction of nerve impulses
1. Chemical synapses: release of neurotransmitters e.g., acetyl choline &
norepinepherine
2. Electrical synapses: gap junctions as in cardiac and smooth muscles
transmission of ions
o The presynaptic terminals contain synaptic vesicles (neurotransmitters)
and mitochondria
o Ions are transported across cell membranes of neurons and effectors
(muscles or glands) create a membrane potential
o Unequal electrical charges on opposite sides of cell membrane (membrane
potential) polarization
o Initiation of a nerve impulse is accompanied by opening of ion channels
and unequal electrical charges (potential) return to zero depolarization
action potential
Brain and Spinal cord
Develops from neutral plate (ectoderm) neural folds fuse neural tube
The neural tube gives rise to Brain & Spinal cord
At the time of fusion, some ectodermal cells detach neural crest gives rise
to
o Ganglia (dorsal root ganglia, sensory ganglia of cranial nerves and
autonomic ganglia)
o Satellite cells of ganglia
o Schwann cells of peripheral nerves
o Melanocytes of the skin
o Adrenal medulla
o Parafollicular cells of thyroid gland

CNS is formed of two basic components:

o Gray matter: contains cell bodies of neurons, neuroglia, and some nerve
fibers (dendrites) and blood vessels
o White matter: consists mainly of myelinated nerve fibers, neuroglia
cells and blood vessels
Spinal cord:
- Gray matter:
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H-shaped
Central, formed of:
Anterior (ventral horn): contains motor neurons AHC LMN
Posterior horn (dorsal horn): contains sensory neurons
Lateral horn (T1-L2 segments): contains neurons of sympathetic
nervous system
o Gray commissure connects bilateral horns (contains a central canal)
o Neuroglia cells
o
o
o
o
o

White Matter
o Myelinated fibers outside gray matter arranged in ascending and
decending tracts.
o Neuroglia cells

Cerebral cortex:
- The gray matter is external (cortex) and is arranged into six layers containing
different types of neurons
- The large pyramidal cells in layer V; are referred to as Betz cells (UMN)
Cerebellar cortex:
- Characteristic deep grooves (sulci) and folds (gyri) arbor vitae
- Gray matter is formed of 3 layers
o Outer molecular layer small neurons: stellate- shaped
o Inner granular layer small neurons
o Middle layer contains large neurons Purkinje cells
Neuroglia: (glue)
- Derived from ectoderm (like neurons)
- Provide metabolic and structural support to CNS
- Four types:
o Oligodendrocytes:
Small tree like cells
Produce myelin in CNS
Extends cytoplasmic processes around axons cytoplasm is
squeezed go back to the cell leaving double layers of cell
membrane to wrap around axons myelin
One cell can myelinate a whole axon or several near-by axons
o Astrocytes:
Star-shaped
Astrocyte feets adhere to capillaries and neurons
Contain intermediate filaments that support the cell body &
processes
2 types:

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Fibrous astrocytes:
o Have few relatively straight processes
o Situated in the white matter
Protoplasmic astrocytes:
o Have numerous short processes
o Situated in the gray matter
Functions:
Play a role in the movements of metabolites and wastes to
and from neurons
Regulate ionic concentration in intercellular compartment
Maintain the tight junctions of capillaries that form the
blood brain barrier
In CNS damage, they proliferate cellular scar tissue:
gliosis
o Microglia:
Tiny cells with long processes
Phagocytic cells of CNS, mobile
Derived from blood monocytes
o Ependymal cells
Line the brain ventricles and central canal of spinal cord
They form a continuous lining layer called ependyma
Low cuboidal to columnar cells
Ependymal cells also cover choroid plexuses that secrete CSF
Blood-Brain barrier:
- Some antibiotics & large molecules cant reach the brain because of a blood-brain
barrier that protects the brain from harmful substances (Bacterial toxins)
- Continuous tight junctions (zona occludens) exist between endothelial cells of
brain blood capillaries
- Almost all outer surface of brain capillaries is covered with astrocytic feet to
maintain blood-brain barrier
Meninges
Brain and spinal cord are invested with 3 connective tissue membranes called meninges
Pia mater (tender mother):
o Innermost layer
o Tightly adherent to surface of brain and spinal cord (SC)
o Delicate vacular loose CT, conveys blood vessels
Arachnoid mater
o Spider-web like middle layer, made up of:
Membranous roof
Irregular trabeculae
o The space deep to it (between pia and arachnoid roof), is known as
subarachnoid space which contains CSF and blood vessels
o The pia and arachnoid mater are referred to as leptomeninges
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Dura mater (tough mother):

o Thick, tough, nonstrechable, dense irregular CT
o The space outside it, is called epidural (extradural) space
o The space deep to it, is called subdural space
o Dura mater is referred to as packymeninx

Cerebrospinal fluid (CSF):

Fills the brain ventricles, subarachnoid space and central canal of spinal cord.
Secreted by choroid plexuses; invaginated folds of pia mater containing blood
vessels and covered with simple cuboidal epithelium derived from ependyma.
Choroid plexuses are located inside brain ventricles
CSF moves from brain ventricles subarachnoid space drained by arachnoid
villi and granulations venous sinuses of the dura mater where it is absorbed
into venous blood general circulation.
CSF acts as cushion and transports nutrients and waste products
There are no lymphatics in CNS; excess tissue fluid is drained in subarachnoid
space.
Peripheral Nervous System:
Consists of ganglia, nerves and their nerve endings
Ganglion is a collection of neurons (ganglion cells), supporting capsular/satellite
cells and nerve fibers and is surrounded by a CT capsule.
There are 2 types of ganglia in PNS:
Sensory ganglia: contain cell bodies of sensory/afferent neurons
Spinal ganglia DRG (dorsal root ganglia) located along
the dorsal root of spinal nerves
Cranial ganglia associated with cranial nerves V, VII,
VIII, IX, X
Mototr/autonomic ganglia: contain cell bodies of motor (efferent)
neurons to cardiac & smooth muscles & glands.
Spinal ganglia (non synaptic/sensory):
o Surrounded by a CT capsule
o The ganglion cells are pseudounipolar
o Ganglion cells (neurons) are of variable sizes (25-100 microns)
o Ganglion cells are arranged in linear groups separated by CT and nerve
fibers.
o The cells have Nissl granules/bodies/substance, large rounded central
nucleus with an owls eye appearance (prominent nucleolus).
o Flat satellite (capsular) cells surround cell body
o Satellite cells provide electrical insulation and pathway for metabolite
exchange
o Both ganglion cells and satellite cells are derived from neural crest
ectoderm

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o Myelinated nerve fibers, CT fibers and BV are located between cells

Autonomic ganglia (synaptic/motor):

o CT capsule on the outside
o Ganglion cells are smaller (15-40m)
o Ganglion cells are multipolar with less satellite cells
o Nuclei are eccentric
o Cells are scattered throughout ganglia (no grouping)
o More vascular
o Nonmyelinated nerve fibers and CT fibers between cells

Peripheral Nerves:
o Brain tissue and spinal cord have minimal amount of loose CT associated
with its capillaries, hence they are soft and mushy.
o In contrast, peripheral nerves are strong and resilient
o This is due to a series of CT sheaths that surround the peripheral nerves
(strength) and transmit blood vessels:
Epineurium: outer dense CT sheath, surrounds the whole nerve
Perineurium: inner dense CT that surrounds bundles (fascicles) of
nerve fibers
Endoneurium: loose CT that invests each nerve fiber
o Peripheral nerves are formed of variable numbers of nerve fibers (axons or
dendrites) surrounded by epineurium, perineurium and endoneurium.
o Nerve fibers may be myelinated or unmyelinated.

Myelinated nerve fibers: - surrounded by a lipid-rich layer called myelin sheath.

o External to myelin sheath is a thin layer called the sheath of Schwann or
neurolemma.
o Neurolemma is formed of Schwann cells (derived from neural crest
ectoderm), each has a nucleus and cytoplasmic organelles.
o Schwann cells produces myelin around peripheral nerves as follows:
Each Schwann cell wraps (in a spiral) around one segment of the
axon.
Cytoplasm is squeezed out from between the membrane of the
consecutive layers of Schwann cells. The inner layers of the
plasma membrane then fuse and so are the outer-layers.
Small pockets of trapped cytoplasm create occasional discontinuity
in the myelin of peripheral nerves and are known as Schmidt
Lanterman clefts.
The myelin sheath is segmented; each segment is formed by one
Schwann cell (different from oligodendrocytes, How?)
The area where 2 Schwann cells meet is devoid of myelin and is
know as node of Ranvier and myelin between two successive
nodes of Ranvier is the internodal segment.

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Myelin sheath insulates the axolemma from tissue fluid

At the nodes of Ranvier, contact between axolemma and tissue
fluid depolarization of the membrane and initiation of a nerve
impulse that propagates from depolarized node to a polarized one,
depolarizing it and so on.
Nerve impulses thus jump from node to node, resulting in a fast
form of impulse conduction called saltatory conduction.
Clinical Correlation: Multiple Sclerosis: demyelinating disease

Unmyelinated nerve fibers:

o Slow conduction rate
o Smaller (less than one micron)
o Schwann cells (neruolemma) dont produce myelin around them
o Each Schwann cell accommodates a number of axons in individual
troughs in its cytoplasm, thus Schwann cells cannot wrap around
individual axons and myelin is not produced.
o Microscopic appearance of peripheral nerves:
Hx & E stained cross sections of a peripheral nerve, besides the 3
components of CT, the nerve fibers show a stained center
axoplasm, surrounded by a clear area myelin sheath (lipid layer
that dissolves during preparation), and a outer layer representing
Schwann cell cytoplasm.
The nuclei present within nerve fascicles belong to Schwann cells,
fibroblasts of CT or endothelial cells of blood capillaries.
Peripheral nerves cut longitudinally have a characteristic wavy
appearance.

Nerve Endings
Nerve ending are the terminations of nerve cell processes in relation to other
nerve cells, as in synapses, or in relation to non-nervous structures as skin (e.g.
sensory endings) or muscles (e.g., motor endings) or glands (e.g., secretomotor
endings)
Functionally, nerve endings could be classified into two main categories:
Receptors and Effectors.
o Receptors: can initiate a nerve impulse in response to a stimulus.
Classified as:
Extroceptors: react to stimuli from external environment; e.g.,
pain: nociceptors, temperature: thermoreceptors, touch:
mechanoreceptors
Enteroceptor: react to stimuli from within the body; e.g., the
degree of stretch of blood vessels (baroreceptors), change in
oxygen and carbon dioxide concentration (chemoreceptors)
Proprioceptors: react to stimuli from the body walls and
extremities in relation to sense of position and stretching of a
muscle and movement
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o Muscle spindle, located between skeletal muscle

fibers
o Golgi tendon organ: similar to muscle spindle, but is
found between tendon fibers at musculotendinous
function. They act as stretch receptors.
o Effectors: are nerve endings relaying motor impulses leading to
contraction, e.g., motor end plate or secretion from glands
Autonomic Nervous System:
Is the part of the nervous system that regulates the activity of smooth muscles,
cardiac muscles and glands.
These activities are beyond voluntary control, hence the name autonomic.
It has two parts; sympathetic (fight & flight part), and parasympathetic (rest &
digest part).
It is the motor part of the visceral nervous system
It has 2 motor neuron chains: one inside CNS and one outside CNS in
autonomic ganglia.
Thus the axon of the first neuron is called preganglionic fiber (myelinated), and
that of the second is called postganglionic fiber (umyelinated)
Response of neurons to injury & Neuronal Regeneration:
Degeneration of an axon distal to the site of injury is called antegrade
(Wallerian) degeneration
In PNS, the distal segment becomes beaded and fragments within few days
Myelin also fragments & is removed by phagocytic cells
Schwann cells remain as tubular structures distal to the injury
The body of the injured nerve swells, the nucleus movies to the periphery
(eccentric) and Nissl bodies are lost (chromatolysis); retrograde degeneration
In PNS, CT & Schwann cells form scar tissue in the gap
Muscle atrophy follows the injury.
If the axon is directed towards the Schwann cell tube, regeneration is successful
If regeneration occurs, muscle fibers also regenerate
If regeneration does not occur, the distal part of the axon forms a disorganized
tangled axon process traumatic neuroma.
In CNS, scar tissue derived from proliferating astrocytes (gliosis) prevents
regeneration.
INTEGUMENTARY SYSTEM
Includes the skin and its appendages which are:
Hair follicles and hairs
Sweat glands (2 types)
Sebaceous glands
Nails

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Functions of integumentary system:

Protection against physical, chemical, and biological agents (barrier)
It provides immunologic information to lymphocytes (APC)
It participates in homeostasis by regulating body temperature and water loss
(waterproof superficial layer)
It conveys sensory information to nervous system (receptors)
Production of melanin that protects from damaging effects of ultraviolet light
Synthesis of precursor of vitamin D
Excretory function through secretion of sweat
Lipid-soluble substances may be absorbed through the skin (a property used in
delivery of therapeutic agents)
The skin is the largest organ in the body 15-20% of total body mass
Skin is formed of 2 main layers:
1. Epidermis: stratified squamous keratinized epithelium derived from ectoderm
(avascular)
2. Dermis: CT layer derived from mesoderm, being vascular nourishes deep layers
of epidermis mainly (superficial layers are not well nourished dead flakes of
keratin).
Under the skin, a layer of loose CT with a variable proportion of adipose tissue forms the
subcutaneous tissue (hypodermis = superficial fascia)
Thick skin:
Found on palmar surface of hands and fingers and plantar surface of the feet and
toes
Exhibits a distinctive pattern of whirled pattern of friction ridges finger prints
(unique in each person)
o Primary epidermal ridges overlie primary dermal ridges
o Each primary dermal ridge is subdivided into 2 secondary dermal ridges
o Dermal papillae project from the secondary dermal ridges.
o Epidermal down-growth is called an interpapillary peg.
o The friction ridges serve firm grip
Cells of the Epidermis: 4 types
1. Keratinocytes (arranged in 5 layers)
2. Melanocytes: located between stratum basale cells
3. Langerhans cells: located between stratum spinosum cells
4. Merkels cells: located between stratum basale cells
Epidermal Layers: 5 layers in thick skin
1. Stratum Germinativum (Stratum basale)
a. Single layer of low columnar basophilic cells

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b. Gives rise to new cells (high mitotic activity), leading to the formation of
keratinocytes that undergo gradual transformation into keratin scales.
c. Hemidesmosomes anchor cells of this layer to the underlying CT.
d. Desmosomes strongly attach these cells to each other.
2. Stratum spinosum (prickle cell layer)
a. Many layers of polyhedral cells, attached together by desmosomes leading
to the characteristic light microscope appearance of short processes
extending from cell to cell (spines).
b. Electron microscope examination shows tonofilaments anchored to
desmosomes. They distribute tensile stresses between cells epidermis
withstands rough treatment.
c. Lamellar granules (contain lipid) are present in the uppermost cells of this
layer.
3. Stratum granulosum:
a. Few layers (1-3) of flat cells
b. Cells contain basophilic Keratohyaline granules
c. These granules are the source of the protein component of soft Keratin of
the skin
d. Lipid derived from previously formed lamellar granules is released into
intercellular spaces of this layer.
4. Stratum lucidum:
a. Thin, transparent layer
b. Formed of tightly packed dead cells (nuclei Karyolysis)
c. Cells contain keratin filaments and protein only
5. Stratum Corneum: (soft keratin)
a. Keratinocytes that reach this layer have no organelles or nuclei and they
are transformed into flat scales of keratin (resistant protein)
b. They remain attached to each other by desmosomes.
c. Lipid in the intercellular spaces contribute also to the waterproof property
of this layer.
Clinical Correlation:
- Psoriasis is a chronic skin disorder characterized by dark red lesions with silvery
white scales.
- It results from accelerated keratinocyte turnover
- Mitosis occurs in the 3 deepest layers of the epidermis
- Immature keratinocytes reach the surface in less than one week (normally should
be 4 weeks)
- Stratum corneum fails to become strongly cohesive compact layer of soft keratin.
Melanocytes:
- Neural crest derivatives

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Scattered among cells of stratum basale (germinativum)

Dendritic cells, i.e. they have long cytoplasmic processes that extend between
keratinocytes.
They synthesize melanin through action of tyronsinase enzyme that converts
tyrosine melanin precursor (DOPA: dihydroxyphenylalanin), DOPA
melanin
Melanin produced by melanocytes become transferred to keratinocytes by
phagocytosis (pigment donation)
In light-skinned races, melanin is concentrated deep in the epidermis and is
degraded rapidly.
This pigment protects cells of the epidermis from the carcinogenic effect of
ultraviolet radiation.
Exposure to ultraviolet light (particularly sun rays) accelerates the rate of melanin
production.

Clinical Correlations:
- Increased pigmentation could be due to hormonal imbalance (addisons disease)
- Lack of pigmentation is known as albinism. It is due to absence of tyrosinase
enzyme no pigmentation in the skin or hair of these individuals (albinos)
- Number of Melanocytes decrease with age increased susceptibility to skin
cancer (malignant melanoma)
- Other factors that affect skin color:
o Oxyhemoglobin in dermal vascular bed red color
o Carotenes: exogenous orange pigment
o Endogenous pigments, e.g. bilirubin yellow color (jaundice)
Langerhans Cells:
- Antigen presenting cells (APC) in the epidermis
- They are dendritic cells (cytoplasmic processes)
- Located between cells of stratum spinosum
- They encounter, process and present antigens (entering through the skin) for TLymphocytes
Merkels Cells:
- Epidermal cells that function in cutaneous sensation
- Located in the stratum basale
- A myelinated nerve fiber, loses its Schwann cell covering and expands like a disk
close to the base of the Merkels cell.
- Together with the nerve ending, it forms a mechanoreceptor sensitive to light
touch and is known as Merkels tactile disk.
Dermis: 2 layers
- Papillary layer:
o Superficial layer of loose CT
o Extend into epidermis forming dermal papillae
o Richly vascularized
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o Provide large surface area for nourishment of thick epidermis of thick skin
o Contain Meissners corpuscles.
- Reticular layer
o Deep layer of dense irregular CT
o Contains substantial collagen bundles
o Contains elastic fibers
o Less vascularized
o Contain Pacinian corpuscles
o Contain sweat glands
o Cleavage lines
NB. Skin has a substantial potential for healing skin grafting
Eccrine/merocrine sweat glands:
- Are the only skin appendages present in thick skin
- Simple coiled tubular gland
- Develops as down-growth of epidermis
- Situated deep in the dermis or hypodermis (secretory aicini)
- Regulate body temperature through cooling that results from evaporation of
water from sweat.
- They also serve as excretory organ since sweat contains very high amounts of
sodium chloride, urea, uric acid and ammonia.
- They are formed of 2 parts: secretory acini and ducts
- The acini are lined with low columnar/cuboidal cells and are surrounded by
myoepithelial cells squeeze secretion
- The ducts are lined by 2 layers of cuboidal cells and open on the skin surface.
- Innervated by cholinergic postganglionic sympathetic fibers (acetyl choline)
- Clinical correlation: sympathectomy in hyperhidrosis
Thin skin:
Differs from thick skin in the following:
- The epidermis is thinner
- Epidermis is formed of 4 layers only (no stratum lucidum)
- The stratum corneum is thin
- Lacks friction ridges
- Less eccrine sweat gland
- Contains hairs, hair follicles, sebaceous glands, and apocrine sweat glands
Hair follicles:
- Tubular invaginations from the epidermis
- The growing region of most hairs lies in the hypodermis
- The wall of the hair follicle is made up of 2 layers
o Outer root sheath: Tubular invagination of epidermis
o Inner root sheath: Sleeve-like lining made of soft keratin.
- A connective tissue sheath (derived from the dermis) invests each hair follicle

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The terminal part of the hair follicle is dilated hair bulb

The cells of the hair bulb are derived from stratum germinativum and are called
hair matrix
Hair matrix fits over a nutritive papilla of loose vascular connective tissue.
Matrix cells are proliferating cells with high mitotic activity.
New matrix cells are displaced superiorly, mature and begin forming keratin.
Transition zone between maturing epidermal cells and hard keratin of the hair is
called the keratogenous zone of the hair.

Structure of a hair: hairs are composed of keratinized cells that develop from hair
follicles
- Keratinization of the hair occurs shortly after the cells leave the matrix in a region
called keratogenous zone. The hair is formed of:
a. Central narrow medulla of soft keratin
b. Outer cortex: made up of hard keratin (contains sulphur)
c. Outermost layer called cuticle (hard keratin): it anchors the hair to the inner
root sheath, i.e. to the hair follicle.
- Both cortex and cuticle are composed of hard keratin.
- Medulla and inner root sheath are formed of soft keratin
- Hair color is due to presence of melanin
- Different forms of melanin exist: red or yellow pheomelanins and brown or
black eumelanins
- Melanin is incorporated into hard keratin of hair as follows:
o Melanocytes located between matrix cells synthesize melanin and pass it
to matrix cells
o The progeny of melanin-containing matrix cells transform into hard
keratin and keep their content of melanin.
o Melanocytes fail to produce melanin at certain age and that is the
reason why human hair commonly turns gray/white in old age.
Sebaceous glands
- Are simple alveolar glands
- Lie on the side of the obtuse angle between the hair follicle and the skin surface
- Each gland opens in the upper part of the hair follicle
- It secretes oily material called sebum that keeps thin skin and its hair soft. Sebum
may have bacteriostatic & barrier functions too.
- They secrete by the holocrine mode of secretion and regenerate from the basal
cells of the gland.
- Holocrine secretion is an example of apoptosis (programmed cell death)
- Clinical correlation:
o Acne at puberty the size and activity of sebaceous glands increase under
the effect of sex hormones.
o Accumulated secretion leads to rupture of gland into the surrounding
dermis (instead of being discharged into the hair follicle).
o This leads to an inflammatory reaction acne

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Arrector pili muscle:

- A bundle of smooth muscle that extends obliquely between the base of the
connective tissue sheath to the papillary layer of the dermis
- It lies on the side pointed to by the hair (side of obtuse angle).
- Contraction of this muscle causes the hair to stand up on end and squeezes the
sebaceous glands.
- It is supplied with postganglionic sympathetic fibers.
Apocrine sweat glands:
- The name is misleading because they secrete by merocrine mode of secretion
- Differ from merocrine/eccrine sweat glands in the follow ways:
o Limited to the axilla, breast, pubic & perineal regions
o Open into the upper part of the hair follicle
o Secrete only after puberty
o Their secretion is viscous (not watery)
o Secretion is initially odorless, but may acquire a distinctive odor if acted
upon by bacteria
o Have larger secretory units with wide lumina & narrow ducts.
o Are innervated by adrenergic postganglionic sympathetic fibers, where
as merocrine sweat glands are innervaterd by cholinergic
postganglionic sympathetic fibers
o Are stimulated to secrete under conditions of stress, emotions, or sexual
excitement (merocrine glands secrete under same conditions plus in
response to temperature changes).
Blood supply of the skin:
- Arteries from subcutaneous tissue form a cutaneous plexus at the junction of
dermis and hypodermis
- Arteries from the cutaneous plexus form a subpapillary plexus between the
papillary and reticular layers of the dermis
- Pink color of the skin is due to the blood seen in the venules of this plexus
- The dermis is richly supplied by arteriovenous anastomosis that bypass the
superficial plexus, thus conserving body heat in cold weather.
- Arteriovenous anastomosis are numerous in fingertips and toes
- If the body needs to lose heat, it flushes. This is due to blood entering the
superficial plexus that dilates. Blood is cooled through evaporation of sweat from
merocrine sweat glands.
- The activity of both blood vessels and sweat glands is under the control of the
sympathetic part of the autonomic nervous system.
Nails:
- Plates of keratinized epidermal cells containing hard keratin on the dorsal
surface of each distal phalanx.
- The proximal part of the nail (hidden in the nail groove) is the nail root.

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The edge of the skin fold that covers the root of the nail is known as eponychium
or cuticle (stratum corneum/hard keratin); it does not desquamate and it has to
removed
The nail plate (stratum corneum of the skin) rest on a bed of epidermis called the
nail bed.
The nail bed consists of stratum basale and stratum spinosum
The stratum basale/germinativum under the nail root is called the matrix
Cells of the matrix divide, move distally, and cornify forming the nail plate.
The distal end of the plate becomes free of the nail bed and is worn away or cut
off.
The transparent nail plate and the thin epithelium of the nail bed show the color of
the blood in the dermal vessels.
The crescent-shaped opaque area at the root (base) of the nail is the lunula. It
appears white because the color of blood can not be seen through the thick nail
matrix.
Hyponychium: stratum corneum under the free edge of the nail plate at the
fingertips (protection).
Hard keratin contains sulphur and does not desquamate (unlike soft keratin
of the skin)
Nails grow at a rate of 0.5-1.2 mm/day
Clinical correlation:
o Ingrown nail

Cutaneous sensory receptor:

- Skin is richly provided with different sensory receptors
- Sensory receptors are made up of afferent nerve endings and special arrangement
of the surrounding tissue
- Seven types are recognized; 3 uncapsulated and 4 capsulated
1. Free nerve endings:
a. No CT or Schwann cell sheath
b. In the epidermis
c. They act as nociceptors (receptors of pain) and thermoreceptors
(heat & cold receptor)
2. Merkels disk:
a. On palms & soles, disk-like expanded afferent nerves are attached
Merkel cells of the epidermis
b. They act as touch receptor (mechanoreceptors)
3. Peritrichial nerve endings: mechanoreceptors around hair follicles
Encapsulated nerve endings:
4. Pacinian corpuscle:
a. Located in dermis, hypodermis, joint capsules, & internal organs.

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b. Formed of a central afferent nerve fiber surrounded by concentric

inner layers of Schwann cells, outer layers of C.T. fibers, cells, & a
capsule on the outside (sliced onion appearance)
c. It acts as a receptor for vibration & deep pressure
(mechanoreceptor)
5. Meissners corpuscles:
a. Touch receptors (mechanoreceptors)
b. Located in dermal papillae of thick skin
c. Capsulated nerve ending formed of flat layers of Schwann cells
and terminal branches of the afferent nerve
6. Ruffini corpuscle:
a. Spindle-shaped small capsulated nerve endings
b. Located in deep dermis & hypodermis
c. Afferent nerve ending ramify between bundles of collagen fibers
d. It responds to tension in collagen fibers and continuous pressure
(mechanoreceptors)
7. Krause end bulb:
a. Known as mucocutaneous receptors (in the lip)
b. Afferent nerve fiber branches repeatedly within thin capsule
c. Considered as mechanoreceptors (touch receptors)

CIRCULATORY SYSTEM
-

Circulatory system is formed of the heart and blood vessels complete circle
Blood vessels are either arteries that receive blood from the heart and distribute it
to tissues, or veins that receive blood from tissues and carry it to the heart

Blood Flow of the Heart:

Unoxygenated blood from the body is collected by:
1. Superior and inferior vena cava
2. Then into the right atrium
3. Through the tricuspid valve

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4. To the right ventricle

5. Through the pulmonary valve
6. To the pulmonary artery
7. Out to the Lung
In the lungs, blood picks up oxygen Oxygenated Blood that passes:
1. Through pulmonary veins
2. To the left atrium
3. Through the mitral valve
4. To the left ventricle
5. Through the aortic valve
6. To the Aorta
7. Out to the body
General structure of blood vessels:
The wall of blood vessels is formed of 3 layers (tunics)
1. Tunica intima (inner layer):
a. Endothelium: single layer of flat squamous cells lying on a basement
membrane
b. Subendothelium: loose CT containing collagen & elastic fibers
c. Internal elastic lamina: absent in veins
2. Tunica Media (middle layer)
a. Smooth muscles:
i. Arranged circularly
ii. Innervated by sympathetic nervous system
iii. Contraction causes vasoconstriction
b. Collagen and elastic fibers
c. External elastic lamina: absent in veins
3. Tunica adventitia (outer layer)
a. Collagen fibers
b. Elastic fibers
c. Vasa vasorum (in large vessels only)
Arteries:
- Carry blood away from the heart
- Thickest layer is the media
- Regular-shaped lumina
Three sizes:
1. Large, elastic, conducting arteries (aorta): very thick wall
a. Tunica intima: wide subendothelial layer
b. Tunica media:
ii. Widest zone 75-80% of the thickness of the wall
iii. Made up of corrugated, fenestrated, elastic lamina, smooth muscle
and collagen fibers
d. Tunica adventitia: contains vasa vasorum
2. Medium-sized, muscular, distributing arteries:

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a. Tunica intima: endothelium, subendothelial CT and internal elastic lamina

b.
Tunica media:
i. More than of the thickness of the wall
ii. Composed mainly of smooth muscles
iii.
Contraction vasoconstriction in cold weather and relaxation
(dilation of arteries) in hot weather
iv. Collagen & elastic fibers
v. External elastic: lamina
c. Tunica adventitia: less than of the wall thickness
Clinical correlation:
Atherosclerosis:
o Affects elastic and muscular arteries mainly
o Focal damage to arterial endothelium invasion of monocytes
macrophages that accumulate lipids inside of their cytoplasm foam
cells
o Migration of smooth muscles from media intima
o Proliferation of smooth muscles in intima
o Proliferation of collagen fibers in intima sclerosis (hardening)
o Intra and extracellular deposition of LDL- cholesterol
o Local calcification, hardening Atherosclerosis, narrowing, and
weakness of vessel wall
3. Arterioles: small lumen, thick wall
- Tunica intima: endothelium & very prominent internal elastic lamina
- Tunica media: thickest layer
ii. 2-5 layers of smooth muscles
iii. No external elastic lamina
- Tunica adventitia: very thin
Clinical correlation:
- Arterioles are involved in hypertension: narrow lumen and thick wall, if
accompanied by increased tone high peripheral resistance to blood flow
hypertension (high blood pressure)
Blood Capillaries:
- Tubes of endothelium (60,000 miles of capillaries in the body)
- Exchange gases and nutrients between blood & tissues
- Only layer is the tunica intima
- Diameter 7-9 microns
- Pericytes surround capillary endothelium and may differentiate into smooth
muscles or fibroblasts
There are three types of blood capillaries:
1.
Continuous:
a. In most body tissues (muscle, CT, and nervous tissue)
b.
There are no fenestrations in the cytoplasm of their
endothelial cells
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2. Fenestrated:
a.
In endocrine glands, GI mucosa and kidney
glomeruli
b.
There are holes (fenestrations) in their cytoplasm.
c.
The fenestrations are covered with diaphragms
d.
Fenestrated capillaries in kidney glomeruli are not
covered with diaphragms to facilitate filtration.
-

3. Sinusoidal capillaries = Blood Sinusoids:

Are wide capillaries (30-40 microns in diameter)
Have a tortuous path (slows blood circulation)
Endothelium cells are separated from one another by wide spaces
Cytoplasm of endothelial cells is fenestrated without diaphragms
Macrophages are located between or outside endothelial cells
Are found mainly in liver, bone marrow, and spleen

Metarterioles:
- Capillaries are not always supplied by arterioles
- Many capillaries are supplied by metarterioles that have a discontinuous layer of
smooth muscle cells
- The distal portion of a metarteriole is known as thoroughfare channel; channels
the blood past the network of capillaries.
- There is a precapillary sphincter at the beginning of a capillary formed of
smooth muscle cells that on contraction, diverts the blood through a thoroughfare
channel.
Arteriovenous anastomosis (A-V shunts)
- Direct communication between arterioles and venules bypassing capillaries.
- The shunts have thick muscular walls with short and thick smooth muscle cells.
- Located in tips of finger & toes, nose, lips, ears, and some internal organs as
digestive system and thyroid gland.
- In the fingers and toes, A-V shunts are more complex, made up of branching
convoluted vessels inside a CT capsule forming the glomus.
Veins:
- Thin walls (compared to arteries)
- Wide collapsed lumina
- No internal or external elastic laminae
Venules:
- Wider than capillaries
- Collect blood from capillaries
- Small venules lack a media
- Endothelium, basement membrane and a thin adventitia
- Larger venules have a media with few smooth muscle cells

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Medium-sized veins:
- Tunica intima: thin
- Tunica media: thin
- Tunica adventitia: widest zone
Large veins:
- Same features as other veins
- Tunica adventitia contains smooth muscle
- Tunica adventitia contains vasa vasorum
Venous valves:
- All antigravity veins (below heart level) are provided with valves that direct
blood toward the heart and prevent backing into lower areas.
- Made up of folds of tunica intima with a core of CT and a covering of
endothelium
Heart: Layered like a blood vessel (formed of 3 layers)
1. Endocardium:
a. Simple squamous endothelium
b. Subendocardial CT containing Purkinje muscle fibers
2. Myocardium: cardiac muscle
3. Epicardium:
Is the visceral layer of the pericardium. Is formed of:
a. CT layer
b. Subepicardial layer: between myocardium and epicardium. Contains
coronary blood vessels and adipose tissue.
Cardiac valves:
Are derived from the endocardium and are formed of a core of CT covered by
endothelium

Conducting system of the heart

- Specialized cardiac muscle cells that can initiate and propagate cardiac impulse
- Formed of:
S-A node (pace maker)
A-V node
A-V bundle of His
Right and left bundle branches
Purkinje muscle fibers
Purkinje Fibers:
- Terminal part of conducting system of heart
- Located in subendocardial CT layer
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Conduct cardiac impulse 4-5 times faster than cardiac muscles

Larger in size than cardiac muscle fibers
Paler in color; cytoplasm has few peripheral myofibrils and is rich in glycogen
Continuous with cardiac muscle at intercalated disks.

LYMPHATIC SYSTEM
-

Unlike cardiovascular (circulatory) system, lymphatic system is not a complete

circuit, it is a one-way system: it returns tissue fluid (lymph) to circulation.
LYMPH

At the tissue side, the arterial and venous vessels communicate through a vast
network of very small vessels called capillaries.
Blood capillaries are the only site where exchange of materials occurs between
blood and tissue.

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There are 2 forces that control the passage of fluids between tissues and blood
capillaries:
o Capillary blood pressure: forces fluids from blood to the tissues
o Osmotic pressure of plasma proteins: withdraws fluids from tissue to the
blood
At the arterial side of capillaries, the capillary blood pressure is about 30-40 mm
Hg, while osmotic pressure is equivalent to 20-25 mm Hg. Thus, fluids and
substances of small molecular weight are forced through capillary wall to the
tissues tissue fluid (interstitial fluid)
At the venous side of capillaries, the capillary blood pressure drops to 10-15mm
Hg, thus tissue fluid is pulled back to capillaries.
Not all of the tissue fluid is recovered back by capillaries, and tissue fluid that
contains substances with large molecular weight forms lymph that returns
through lymphatic vessels to the circulation.

Parts of lymphatic system:

Lymphatic vessels
- Start as lymphatic capillaries (blind ended tubes), wider than capillaries, no
Pericytes
- Unite to form larger vessels with a structure similar to that of veins
- Larger lymphatic vessels (thoracic duct and right lymphatic duct) have smooth
muscles both in tunica media and adventitia and may have valves (thoracic duct)
- Clinical Correlation:
1.
Edema excessive tissue fluid could
be due to lymphatic obstruction
2.
Metastasis spread of cancer cells
through lymphatic and blood vessels.
Lymphoid tissue:
Non-encapsulated lymphoid tissue
Partially encapsulated lymphoid tissue (e.g.,tonsils)
Fully encapsulated lymphoid tissue: lymphoid organs (thymus,
spleen, and lymph node)
Non-encapsulated lymphoid tissue
- Found in mucosa & submucosa of digestive and respiratory tracts (MALT)
- It occurs in 2 types:
o Nodular lymphoid tissue:
Collection of densely packed small lymphocytes called lymphatic
(lymphoid) nodule/follicle
Central light areas within lymphatic nodules are called germinal
centers. They contain large lymphocytes (lymphoblasts)
Nodules may be single or in aggregates (Peyers patches of ileum)
o Diffuse lymphoid tissue: Loosely arranged lymphocytes

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Partially encapsulated lymphoid tissue: Palatine Tonsils

Structure of Palatine Tonsil:
- Covered by stratified squamous nonkeratinized epithelium
- Surface epithelium dips inside lymphoid tissue of tonsil forming tonsillar crypts
- The stroma is formed of a partial capsule (dense CT) that separates the deep part
of tonsil from underlying tissues
- The parenchyma is formed of nodular and diffuse lymphoid tissue
Fully encapsulated lymphoid tissue: thymus, lymph nodes and spleen
Are made up of 2 main components:
1. Stroma:
a. Capsule
b. Trabeculae
c. Fibrous network of reticular tissue
2. Parenchyma: collection of cells and vessels:
a. Lymphocytes
b. Plasma cells
c. Macrophages
d. The vessels are blood vessels and lymph or blood sinusoids
-

THYMUS
Is located in superior and extends into anterior mediastinum
It involutes after the age of puberty and is replaced by fibrofatty tissue.
It is considered as a primary lymphoid organ since its chief role is the
production of T-lymphocytes responsible for cell-mediated immunity
Lymphocytes originating from bone marrow migrate to thymus gland where they
are programmed for antigen recognition
Thymus gland secretes thymic hormones (e.g., thymin) that are essential for the
development of immunologically competent lymphocytes.
Anatomic features:
o Made up of 2 lobes covered by CT capsule
o Each lobe is divided partially by incomplete septa or trabeculae into a
number of lobules.
o The outer zone of each lobule is called the cortex, and appears dark
(formed of densely packed small lymphocytes) and the inner zone is called
medulla, which appears light.
The medulla contains loosely arranged lymphocytes and a cytoreticulum of
epithelial reticular cells, that secrete thymic hormones (thymosin)
Hassalls corpuscles are rounded lamellated acidophilic bodies characteristic of
medulla of thymus and are made up of degenerating epithelial reticular cells
LYMPH NODES

Secondary lymphoid organ

Occur along course of lymphatic vessels (filters of lymph)

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Are bean-shaped with a depression called hilum through which blood &
lymphatic vessels enter or leave
Stroma: is formed of:
o Capsule
o Trabeculae
o Reticular CT
Parenchyma:
o Cortex: is the outer dark zone and is made up of lymphatic nodules that
may show germinal centers ((pale central area that contains lymphoblasts)
o Paracortical zone: contains high endothelial venules and T lymphocytes
o Medulla: is the inner light zone and is made up of lymphocytes are
arranged in branching cords known as medullary cords that contain B
lymphocytes and plasma cells that differentiate from B lymphocytes
o Lymph sinuses: subcapsular, cortical/trabecular, and medullary
lymph sinuses.

Circulation of Lymph:
- In lymph nodes, lymph enters by afferent lymphatics that pierce capsule and run
into subcapsular lymph sinuses cortical/trabecular sinuses medullary
sinuses to efferent lymphatics that exit through the hilum.
N.B. Locally draining lymph nodes enlarge and become tender (painful on touch)
during inflammation. Metastasis into lymph nodes may cause non-tender enlargement.
SPLEEN
-

Secondary lymphoid organ

Largest lymphoid organ in the body
Blood and not lymph circulates in its tissue
Anatomic features:
o Located in left hypochondrium anterior to 9-11 ribs
o Covered by peritoneum and shows an indentation on one side called hilum
where blood vessels enter or leave.
o The cut surface of a fresh spleen shows multiple light spots called white
pulp on a reddish brown background called red pulp.

Histologic structure:
o Stroma:
Capsule of dense CT containing smooth muscle cells
Trabeculae extend from capsule to splenic tissue and contain
smooth muscles also
Reticular CT

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o Parenchyma:
White pulp: made up of lymphatic nodules (B lymphocytes)
called splenic nodules that are scattered in the spleen and show a
characteristic central artery that is always eccentric and is
surrounded by T lymphocytes (peri-arterial lymphatic sheath:
PALS))
Red Pulp: made up of:
Irregular branching cords of lymphoid tissue called splenic
cords that contain B lymphocytes, plasma cells, & RBCs.
Blood sinusoids: lined with fenestrated endothelial cells
and macrophages (filters of blood)
Circulation of blood in spleen:
- Splenic artery enters spleen at the hilum and gives branches that run in trabeculae
as trabecular arteries.
- Trabecular arteries branch and the branches enter the splenic (lymphatic) nodules
as central arteries.
- Central arteries exit lymphatic nodules and branch into straight vessels known as
penecillar arteries:
o Closed circulation: penecillar arteries blood sinusoids
o Open circulation: penecillar arteries spaces between blood sinusoids
- From the blood sinusoids, blood trabecular vein splenic vein
Functions of Lymphatic System:
1. Formation and maturation of lymphocytes (Thymus)
2. Formation of antibodies by plasma cells (from B-Lymphocytes)
3. Filtration of lymph and blood from micro-organisms by phagocytic cells
4. Spleen functions as a reservoir of blood that could be pushed to circulation in
cases of need through contraction of smooth muscles in capsule & trabeculae.
5. Old RBCs are destroyed in the spleen by the phagocytic cells lining its sinusoids,
thus playing a role in hemoglobin metabolism.

DIGESTIVE SYSTEM
-

Performs two main functions: digestion and absorption

Formed of digestive tract and digestive glands

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DIGESTIVE TRACT
I. Oral cavity & Pharynx:
o Lip: (mucocutaneous junction)
Skin side of lip stratified squamous keratinized epithelium,
hair follicles, sebaceous glands, sweat glands.
Mucous side stratified squamous non-keratinized
epithelium, CT layer with mucous glands called labial glands
Orbicularis oris- skeletal muscle
Lip margin no keratin just a thick layer of stratum lucidum. The
underlying CT is rich in capillaries and sensory nerve endings
o Cheek: same structure as the lip, but the muscle is called:
Buccinator skeletal muscle of cheek
Contains mucous glands called buccal glands
o Palate:
Hard palate: anterior part bony
Soft palate: posterior part- formed of muscles
Both parts are covered by mucous membrane
Oral mucous membrane is lined with stratified squamous non
keratinized epithelium
The underlying CT contains palatine mucous glands
o Tongue:
Skeletal (intrinsic) muscles: 3 directions (vertical, transverse,
horizontal)
Serous and mucous glands are present between muscle fibers
(lingual glands)
Superior and inferior surfaces are covered by SSE, the inferior is
smooth and the epithelium is non-keratinized, superior surface is
rough and is keratinized.
The superior surface is divided by the sulcus terminalis into
anterior 2/3 and posterior 1/3
In the posterior 1/3, the CT under epithelium is infiltrated with
lymphoid aggregations forming the lingual tonsil
In the anterior 2/3 there are lingual papillae
Give roughness
Contain taste buds (taste sensation: sweet, salt, sour, bitter
and umami/savory (meaty)
Papillae: 4 types: ALL EXCEPT FILIFORM HAVE TASTE
BUDS
Circumvallate/vallate:
o Largest and fewest (10-14), located anterior to
sulcus terminalis
o Surrounded by deep grooves (trenches)

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o Teeth:

o Groups of serous acini deep to it (Von Ebners

serous glands) and their ducts open in the trenches
Fungiform: Large rounded papillae (mushroom-like)
located at the tips and sides of tongue
Filiform: most numerous, covering most of superior
surface of tongue, conical in shape
Foliate: located posterolaterally, not well developed in
humans

Taste buds: barrel-shaped, light structures among dark stratified

squamous epithelium
Contain 3 types of cells:
Gustatory/ taste/ hair cells in the middle projecting hairs
(microvilli) in the outer taste pore (life span 2 weeks)
Sustentacular/ supporting cells; on the sides
Basal cells (stem cells for the other 2 cells)
Root: Fits inside alveolar sockets in the jaw
Crown: projects upward above gum line
The roots are attached to bony sockets by periodontal membrane
Gums: Gingiva: mucous membrane covering the alveolar
processes of mandible and maxilla
The mineralized parts of the teeth are:
a. Dentin: fills the crown and root
b. Cementum: hard bone tissue that covers the dentin of the root
c. Enamel is the hardest part of the tooth and it covers the
dentin of the crown
Root canal: starts at the apical foramen and contains gelatinous
material and the blood vessels and nerves of the tooth

II. DIGESTIVE TUBE

o Wall: 4 main layers
Mucosa: (3 components)
a. Epithelium: usually simple columnar. It may present
depressions called pits, elevations called villi or crypts called
glands
b. Lamina propria: loose CT layer containing blood vessels,
nerves and lymphatics
c. Muscularis mucosa: inner circular and outer longitudinal
muscle layers of the mucosa: evacuates secretion by
contraction
Submucosa: loose CT that serves in support and transmission of
nerves, BV, lymphatics. It contains Meissners plexus (autonomic
plexus) controls secretion

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Muscularis Externa: formed of two layers: inner circular and

outer longitudinal muscle layers. Its contraction leads to
peristalsis. Myenteric plexus (Auerbachs) is located between
inner and outer muscle layers and controls the muscle contraction
Adventitia/serosa: dense fibrous CT. If it is covered with simple
squamous mesothelium of the peritoneum it is called serosa

1. Esophagus:
a. Mucosa: is also known as mucous membrane. Stratified squamous nonkeratinized epithelium (protection), smooth muscles, and lymphatic
nodules. Lamina propria of the lower end of esophagus contain mucous
glands that neutralize gastric acidity
b. Submucosa: loose areolar CT, and mucous glands. Their secretion
facilitates the passage of bolus of food
c. Muscularis externa: Upper third contains skeletal muscle, the lower
third contains smooth muscles, and the middle third contains mixed
muscles
d. Adventitia: no peritoneum until it passes through the diaphram and
becomes serosa.
Clinical correlations: GERD
2. Stomach:
o 4 parts: cardia, fundus, body, pylorus.
o Capacity gallon, food stays in the stomach for 3-6 hours
o Mucosa shows longitudinal folds called rugae allow for expansion
o Mechanical digestion; 3 muscle layers in muscularis externa
o Chemical digestion (HCL) and enzymes chyme is the product of gastric
digestion
a. Cardiac region:
- Simple columnar mucous secreting cells (protect against HCL)
b. Fundic/Body region:
1. Mucosa: is thick
Surface epithelium is simple columnar mucous
secreting epithelium (are renewed every 3-5 days)
Gastric pits: invaginations of epithelium.
Fundic glands are present in the lamina propria and
open in the bottom of the short gastric pits (1/5 of
thickness of mucosa). They are lined by 5 types of
cells:
a. Mucous neck cells: short columnar cells that
secrete mucous
b. Parietal (oxyntic) cell: acidophilic cells located in
the upper part of the glands, secrete HCl (starts
breakdown of protein, converts pepsinogen into
pepsin & bacteriostatic) and intrinsic factor
(important for absorption of vitamin B12 in the
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ileum which is essential for maturation of RBC and

health of nervous tissue). Its deficiency causes
pernicious anemia and subacute combined
degeneration of the spinal cord
c. Chief cell: are basophilic cells (RER), located at the
bottoms of fundic glands. They secrete
Pepsinogen pepsin protein digestion. They
also secrete a weak lipase that starts fat digestion
d. Entroendocrine (entrochromaffin) cells secrete
hormones (gastrin) stimulates gastric secretion
and motility (locally and through the blood)
e. Stem cells: are located in the neck of the gland
(regenerative cell)
2. Submucosa
3. Muscularis Externa: 3 layers to aid in mechanical digestion
o Oblique layer: innermost
o Circular layer: middle
o Longitudinal layer: outer
4. Serosa
c. Pyloric region: Gate-keeper
Gastric pits are longer than fundic gastric pits (1/2 length of
mucosa)
Is lined with 2 types of cells only:
a. Simple columnar mucous secreting cells.
b. Entroendocrine cells secrete gastrin (stimulates
secretion of gastric juice)
Ends at pyloric sphincter formed by thickening of circular
muscle layer.
Clinical Correlation: Peptic ulcer
3. Small intestine: (mucosa: villi and glands)
- 4 Factors increase surface area for absorption:
o Villi: are outgrowth/finger-like projections of the mucosa projecting into
the lumen of the small intestine. Covered with simple columnar
absorptive cells/Entrocytes and goblet cells (goblet cells increase in
number toward the ileum), core of CT containing blood vessels, nerves,
smooth muscles and lymphatic vessels called lacteals)
o Microvilli: folds of cell membrane striated border=brush border
o Plicae circularis: Transverse mucosal folds that increase surface area
o The lengh: 7 meters
o Cells lining intestinal glands: Simple tubular glands
Intestinal glands (crypts of Lieberkuhn) that are lined by the following
types of cells:

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Simple columnar absorptive cell/Enterocytes: 1.Secretion of

intestinal digestive enzymes. 2. Absorption of digested
carbohydrates and proteins; have microvilli = brush border to
increase surface area for absorption: transport of digested food
from the lumen of intestine to the circulatory system
Goblet cells: mucous secretion (for lubrication)
Paneth cells: secrete antibacterial lysozymes
Entroendocrine cells: secrete the following hormones
1.
Cholecystokinin(CCK) contraction of
gallbladder release of bile into duodenum (bile
emulsifies fat) and stimulates pancreas to release pancreatic
enzymes
2.
Secretin stimulates release of HCO3
from pancreas
3.
Motilin stimulates peristalsis
Stem cells = regenerative cells: renew surface epithelium every
5-7 days, located at the bottom of the intestinal glands
M cells are the cells that overlie Peyers patches and convey
microorganisms to them
Major features of each of the 3 parts of the small intestine:
a. Duodenum broad villi (leaf-like), Brunners glands in submucosa
secrete alkaline mucous to protect duodenal mucosa and neutralize
gastric acidity
b. Jejunum Narrow villi, no Brunners glands, no Peyers patches
c. Ileum Narrow villi, Peyers patches (lymphatic nodules) in submucosa

4.
-

Large Intestine
No villi
Crypts of Leiberkuhn
Simple columnar absorptive cell with predominance of goblet cells
Outer longitudinal layer of the muscularis externa is incomplete, it is formed of 3
longitudinal bands of smooth muscles called (teniae coli). Teniae coli are
absent in appendix and rectum
Lymphocytic infiltration of the mucosa (diffuse and nodular)
a. Cecum
b. Appendix blind ended tube (closed from one side)
i. Complete layer of lymphoid follicles in submucosa (immune
mechanism)
ii. Short crypts
iii. Few goblet cells
iv. Diffuse lymphatic infiltration of mucosa
c. Colon
i. Ascending colon
ii. Transverse colon

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iii. Descending colon

iv. Sigmoid colon
d. Rectum
e. Anal canal
i. Stratified squamous non-keratinized epithelium (becomes
keratinized at anal orifice)
ii. Sphincters
1. Internal anal sphincter (smooth muscle): involuntary
control
2. External anal sphincter (skeletal muscle): voluntary
control
Clinical Correlations: cancer colon, irritable bowel syndrome
Digestive Glands
1. Salivary glands: compound tubule-alveolar glands
- Two groups of glands:
1. Accessory (minor salivary glands): labial, buccal, lingual and palatine
mucous glands
2. Main (major salivary glands): Parotid, Submandibular, Sublingual
glands (one pair of each)
- 2 structural components:
o Stroma: supporting framework, consists of:
Capsule dense irregular CT
Trabeculae CT septa, divide the gland into lobes and lobules
Reticular network fine supporting network of reticular fibers
o Parenchyma: (functioning cell) consists of:
Acini: 3 types:
Serous lined by pyramidal cells, round central nuclei,
apices contains zymogen granules watery secretion
Mucous lined by cuboidal cells, flat basal acini, secretes
mucous
Mixed - mucous acinus with serous demilune
Myoepithelial cells surround secretory acini
Ducts:
Intercalated duct simple cuboidal; intralobular
Striated/secretory ducts lined by high cuboidal cells,
basal striations, secrete potassium (K) and bicarbonate;
intralobular
Interlobular duct simple columnar, between lobules in
interlobular CT.
Interlobar duct psuedostratified columnar or stratified
cuboidal lining with a stratified squamous lining at opening
- Purely serous digestive glands:
1. Von Ebners serous glands (open at the bottom of vallate papillae)
3.
Parotid gland
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4.
Pancreas
Parotid gland:
o Divided into lobes by CT, subdivided into lobules
o Purely serous (100% serous acini)
o Contain intercalated, striated, interlobular and interlobar ducts
o Some adipose tissue

Submandibular gland:
o Contains serous acini (80%) and mucous acini (20%)
o Contain the same duct system as the parotid
o Some mucous acini have serous demilune
- Sublingual gland:
o Contains mucous acini (80%) and serous acini (20%)
o Located under tongue
o Less striated ducts
o Some mucous acini have serous demilune
N.B.: Saliva contains salivary amylase that starts carbohydrate digestion in the
oral cavity and antimicrobial lysozyme. It also contains IgA antibodies,
calcium, potassium and bicarbonate (buffer)
2.
-

Pancreas: Mixed gland (Endocrine and Exocrine functions)

Its exocrine part is a purely serous gland
Surrounded by a delicate capsule. It has thin trabeculae that divide it into lobules
Pacinian corpuscles are located in the CT trabeculae
Exocrine part secretes lipases, amylases, peptidases
Contain serous acini (the basal part is basophilic due to RER, and the apical part
is acidophilic due to zymogen granules)
Centro-acinar cells are intercalated ducts located inside the acinus
No striated ducts

Endocrine part: Islets of Langerhans

o Secrete hormones into capillaries (no ducts)
o 3 Types of cells:
Beta cells: insulin decrease glucose levels
Alpha cells: secrete glucagon increase glucose levels
D cells: secrete somatostatin inhibits insulin and glucagon
secretion

3.
-

Liver (Mixed exocrine and endocrine gland)

Second largest organ of the body
Largest gland in the body
Functions:
o Metabolism Carbohydrates, Proteins, and Lipids
Portal Vein carries venous blood containing digestive products of
carbohydrates and proteins from the intestine

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 Hepatic Artery carries oxygenated blood and digested fats

o Detoxification alcohol and drugs
o Exocrine bile
o Endocrine plasma proteins, glucose, lipoproteins
o Hemopoiesis in the fetus
- The liver is surrounded by a thin capsule called Glissons capsuler. Thin
trabeculae divide the liver into hepatic lobules
- Hepatic Lobule: hexagonal/pentagonal in shape, surrounded by Portal triads
that contain 3 main structures:
Portal vein largest
Hepatic artery
Bile duct
o Central vein: in the center of the lobule
o Hepatocytes Hepatic cells: are arranged as plates of cells
o Some hepatocytes may have 2 nuclei
o Blood sinusoids between plates of hepatic cells
o Bile canaliculi between hepatocytes (to drain bile secreted by them)
o Space of Disse: between hepatocytes and blood sinusoids
Blood flow: Blood from portal vein and hepatic artery (at the
periphery of lobule) drain into blood sinusoids central vein
sublobular veins hepatic veins IVC (inferior vena cava)
Bile Bile canaliculi drain bile from hepatic cells to bile duct
Hepatic ducts combines with cystic duct (of gallbladder to
form the common bile duct that unites with pancreatic duct
(forming hepatopancreatic ampuula) that opens in the second part
of the duodenum
Kupffer cell located in blood sinusoids between fenestrated
endothelial cells; phagocytic cell
4. Gallbladder stores bile and concentrates it
o Bile imulsifies fat
o Three layers: mucosa, musculosa and serosa
o Lined by simple columnar cells

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RESPIRATORY SYSTEM
I.

The main function of the respiratory system is to exchange gases between air and
blood. Oxygen of air is exchanged for carbon dioxide of blood.
It also functions in air conduction, air filtration, smell sensation (nose) and
phonation (larynx).
Respiratory system is made up of 2 main parts:
Conducting Portion:
o Formed of a system of tubes that convey air to and from the lungs.
o This includes:
A. Extrapulmonary passages:
1. Nasal cavity
2. Nasopharynx
3. Larynx
4. Trachea
5. Main/primary bronchi (right and left)

B. Intrapulmonary passages:
1. Intrapulmonary bronchi (secondary/lobar and
tertiary/segmental)
2. Bronchioles that end by terminal bronchioles
II.
Respiratory Portion:
- This is the part where gas exchange between blood and air takes place.
It includes:
1. Respiratory bronchioles
2. Alveolar ducts
3. Alveolar sacs
4. Alveoli
Nasal Cavity:
- The nose has a skeleton of bones and cartilages
- Covered externally by skin
- Lined internally by mucous membrane
- Nasal mucous membrane has 3 parts:
1. Vestibular mucous membrane:
i. Lined with stratified squamous non-keratinized epithelium
containing hair follicles, sebaceous, and sweat glands
2. Respiratory mucous membrane:
i. Lined with pseudostratified columnar ciliated epithelium with
goblet cells.

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ii. The lamina propria is rich in venous plexuses ( Its congestion

leads to nasal blockage)
iii. It also contains mucoserous glands that moisten the mucous
membrane and humidify air.
Serves 3 functions:
a. Filtration of air: cilia and goblet cells
b. Warming of air: mucosal blood vessels
c. Humidifaction of air: mucoserous secretion

3. Olfactory mucous membrane: (organ of special sense: smell)

i. It lines the roof, upper parts of medial and lateral walls of nasal
cavity.
ii. It contains 3 types of cells:
1. Olfactory cells: Bipolar nerve cells. Their Dendritic
processes have long cilia that are bathed in serous
secretion of Bowmans glands in the lamina propria.
Odoriferous substances when dissolved in the serous
secretion, they stimulate receptors on cilia and a nerve
impulse is transmitted through axons of olfactory cells
(olfactory nerves) to CNS.
2. Supporting/sustentacular cells: have microvilli and
yellow pigment (lipofuscin granules).
3. Basal cells: renew damaged cells. Life span of olfactory
cells is one month.
Nasopharynx:
- Lined with pseudostratified columnar ciliated epithelium with goblet cells
- Muco-serous glands in underlying CT
- Pharyngeal tonsil: lymphoid tissue in CT adenoids covered by..
What do you know about Waldeyers ring?
Larynx = voice box
- An organ of phonation
- An air passage
- Formed of skeleton of nine cartilages
- Some cartilages are hyaline:
o Thyroid (1)
o Cricoid (1)
o Arytenoids (2)
- Some cartilages are elastic:
o Epiglottis (1)
o Corniculate (2)
o Cuneiform (2)
- Cartilages are connected by ligaments and moved by muscles
- Larynx is lined by a mucous membrane that shows 2 folds:
o Vestibular fold: sound resonance
o Vocal cords: voice production
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Lining epithelium of larynx is pseudostratified columnar ciliated with goblet cells.

BQ: Vocal cords: are covered with stratified squamous epithelium
Trachea:
- BQ: Downward continuation of larynx and ends by dividing into 2 main (Rt & Lt)
bronchi at the level of T4-T5 IVD
- Its wall is supported by up to 20 C-shaped cartilaginous rings (hyaline cartilage)
- Cartilages are incomplete posteriorly where the esophagus is located.
- The posterior ends of cartilaginous rings are bridged by the trachealis muscle
(smooth).
- Tracheal wall is formed of mucosa, submucosa, hyaline cartilage and adventitia
- Trachea is lined with the respiratory epithelium (pseudostratified columnar
ciliated epithelium with goblet cells: BQ).
- Neuroendocrine cells are present between lining epithelium. They secrete?
- The lamina propria contains elastic fibers and lymphocytic infiltration.
- The submucosa contains mucoserous tracheal glands
Bronchi:
- Extrapulmonary bronchi: extend from the bifurcation of trachea to hilum and
lung. They resemble trachea in histological structure.
- Intrapulmonary bronchi: inside lung. Their histological structure is different from
trachea.
Lungs:
- Are covered externally by visceral pleura that become continuous with parietal
pleura at hilum.
- The hilum of the lung is the area on the medial surface where vessels and air tubes
enter or leave the lung.
- Inside the lung, primary (main) bronchi divide into secondary and tertiary
bronchi.
- Tertiary bronchi divide into bronchioles that further divide and end as terminal
bronchioles.
- Terminal bronchioles divide into two or more respiratory bronchioles which
divide into 2-9 alveolar ducts (corridor) alveolar sacs (lobby) alveoli (rooms)
Structure of an intrapulmonary Bronchus:
1. Mucosa
- Epithelium: pseudostratified columnar ciliated epithelium with goblet cells.
- Lamina propria: rich in elastic fibers
2. Muscularis: bundles of spirally arranged smooth muscles
3. Submucosa: loose CT and mucoserous glands
4. Cartilage: Plates of hyaline cartilage
5. Adventitia: CT containing BV, nerves, and lymphatics
Bronchioles: are different from intrapulmonary bronchi in the following:
1. Epithelium: simple columnar ciliated (large ones) or simple cuboidal nonciliated (smaller ones).

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2. Clara cells are located between the lining epithelium. They secrete proteins that
protect bronchioles against inflammation and lipoprotein that prevent
luminal adhesion.
3. No cartilage
4. No glands
5. No goblet cells
6. Well-developed smooth muscle layer arranged spirally around bronchioles
(contraction of which leads to bronchoconstriction during asthmatic attacks).
7. Terminal bronchioles are the last part of the conducting passages
Respiratory Bronchioles: are involved in air conduction and exchange of gases
- Alveoli open in their walls
- The wall is lined by simple cuboidal partially ciliated epithelium.
- Clara cells are present between lining epithelium
- Smooth muscle and elastic CT lie beneath the epithelium
Alveoli
- The basic structural and functional gas exchange unit is the pulmonary alveolus
which is an air space
- The interalveolar walls are the partitions (septa) between alveoli.
- Alveolar pores are openings in the septa that communicate alveolar cavities
together
- Alveoli are lined by 2 types of cells:
o Type I pneumocytes: simple squamous epithelial cells function: gas
exchange. They form the majority of cells
o Type II pneumocytes:
Cuboidal cells with vacuolated cytoplasm and microvilli. They
project into the lumina of alveoli.
They secrete surfactant that decrease surface tension and avoid
collapse of alveoli during expiration.
Immaturity of these cells at the time of delivery (a common
complication of premature birth) respiratory difficulty in the
newborn known as respiratory distress syndrome (RDS).
Structure of interalveolar septum:
- Each side of the septum is covered by alveolar epithelium of adjacent alveoli
- The core of the septum is made up of CT rich in elastic and reticular fibers,
fibroblasts, and macrophages and blood capillaries
- Macrophages may migrate through alveolar walls to alveolar lumen to
phagocytose dust particles or RBCs and are called dust cells or heart failure
cells.
- A rich capillary network lies in the CT of the alveolar septa.
- At sites where the basement membranes of simple squamous epithelium (of
alveoli) and that of simple squamous endothelium (of capillaries) lie in intimate
apposition blood-air barrier.
- Thus blood air barrier is formed of 3 layers:
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1. Simple squamous epithelium of alveoli (type I pneumocytes)

2. Fused basement membrane of epithelium and endothelium
3. Simple squamous endothelium of blood capillaries
What is the effect of cigarette smoking on the lung?
What do you know about emphysema and bronchial asthma?

ENDOCRINE SYSTEM
Components:
- Pituitary gland (anterior and posterior lobes, related parts of hypothalamus)
- Thyroid gland (follicular & parafollicular cells)
- Parathyroid glands
- Adrenal gland (cortex: 3 zones and medulla)
- Pancreatic islets of Langerhans
- Pineal body/gland
- Ovaries
- Testes
- Others:
o Thymus
o Gut enteroendocrine cells
o Tracheobronchial neuroendocrine cells
o Kidneys erythropoietin
Pituitary = hypophysis cerebri: (master of endocrine system)
- Lies within the sella turcica of the sphenoid bone (skull base)
- It is an endocrine extension of the hypothalamus (part of the brain involved in
regulation of autonomic nervous system & visceral functions)
- It is attached superiorly by the infundibular stalk to the hypothalamus
- It is made up of 2 different parts
1. Anterior pituitary (adenophypophysis): glandular part
a. Develops from oral ectoderm by an upward growth of a diverticulum
from the roof of the oral cavity (Rathkes pouch)
b. It includes:
i. Pars distalis: principal part of anterior lobe
ii. Pars tuberalis: collar-like extension of the pars distalis around
the infundibular stalk
iii. Pars intermedia
2. Posterior pituitary (neurohyophysis): neural part
- Develops by downward growth of part of the hypothalamus (neural
ectoderm)
- When the ectodermal and neural components become closely apposed, epithelial
continuity with the oral cavity is lost.
- Along the posterior border of the anterior lobe, the pars intermedia develops from
the dorsal portion of Rathkes pouch and its cells invade the anterior lobe and is
separated from it by a residual lumen of Rathkes pouch.
- It includes:
i. Infundibulum= neural stalk
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ii. Pars nervosa

Pars Distalis
- In contrast to the pale-staining posterior lobe of the pituitary, the pars distalis (that
forms the major part of the anterior lobe) stains darker.
- It contains anastomosing cords of large secretory cells and wide fenestrated
capillaries.
- Three types of cells are identified according to their staining properties:
o Basophils (10%), acidophils (40%), chromophobes (50%)
- Chromophobes represent quiescent, degranulated or temporarily exhausted phase
of secretion.
- Acidophils:
o Constitute 40% of the cells of pars distalis
o They are moderate in size with central nuclei and acidophilic cytoplasmic
granules (pink)
o They secrete two hormones:
Growth hormone (GH) or somatotrophic hormone (STH): It
promotes body growth and protein synthesis and carbohydrate and
lipid utilization.
Prolactin (PRL) or lactogenic hormone: It stimulates milk
secretion from mammary glands after labor.
- Basophils:
o Constitutes about 10% of the cells of the pars distalis
o They are large cells with eccentric nuclei and basophilic cytoplasmic
granules (purple)
o Their hormones promote growth & secretory activity in other glands
trophic hormones.
o They secrete the following 4 hormones:
1. Thyroid stimulating hormone (TSH): promotes growth and
secretion of thyroid follicular epithelium
2. Adrenocorticotrophic hormone (ACTH): promotes growth and
secretion of adrenal cortex
3. Follicle-stimulating hormone (FSH): promotes growth and
maturation of ovarian follicles. In males it promotes
spermatogenesis.
4. Luteinizing hormone (LH): promotes ovulation and corpus
luteum formation, and in males it promotes secretion of
testosterone from interstitial cells of Leydig.
Melanocyte stimulating hormone (MSH):
o Is secreted by the cells of the pars intermedia in lower
vertebrates (e.g. frogs).
o This hormone increases skin pigmentation through
stimulation of pigment production by Melanocytes.

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o In humans and most mammals, the pars intermedia is

rudimentary.
VASCULAR AND NEURAL CONNECTIONS OF THE HYPOTHALAMUS
-

Hormone secretion from the anterior lobe of the pituitary gland is under control of
the hypothalamus.
The hypothalamus secretes regulating hormones (releasing/inhibiting) into the
hypophyseal portal circulation. It includes small veins that connect the primary
capillary plexus in the median eminence and secondary capillary plexus in pars
distalis. A simple negative feedback mechanism controls the synthesis and
discharge of the releasing hormones.
For examples: if blood level of thyroid hormone is high, thyroid-releasing
hormone (TRH) is not produced. If blood level of thyroid hormone is low, the
hypothalamus discharges TRH into the hypophyseal portal circulation. This
stimulates the pituitary gland to produce TSH, which in turn stimulates the
thyroid gland to produce and release more thyroid hormones. As the thyroid
hormone level rises, the negative feedback system stops the hypothalamus from
discharging the TRH.

Posterior lobe/ Neurohypophysis:

- Pale-staining neural part of the pituitary gland
- It consists of the pars nervosa and neural stalk (infundibular stalk)
- It is composed of unmyelinated axons of secretory neurons of the hypothalamus
(supraoptic & paraventricular nuclei)
- The neurosecretions are transported along the axons that form the
hypothalamohypohyseal tract and accumulate at their ending as Herring
bodies.
- Cells of the neurohypophysis are the pituicytes (highly branched glial cells)
supporting function (they dont secrete hormones).
- Hormones of the neurohypophysis:
1. Oxytocin:
o Synthesized by neurons in the paraventricular and supraoptic nuclei
of hypothalamus. It has 2 actions:
a. Induces uterine contractions during labor
b. Induces contraction of myoepithelial cells of mammary glands
during nursing, causing milk ejection from the secretory acini
2. Vasopressin:
o Is also known as antidiuretic hormone (ADH)
o Is synthesized by neurons in the paraventricular and supraoptic
nuclei of the hypothalamus. It has 2 actions:
a. It increases water reabsorption by the collecting tubules of the kidney
decreases urine volume.
b. It stimulates contraction of smooth muscles in the walls of arterioles
increases blood pressure.
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Clinical correlation:
- Pituitary disorders may cause:
o Increase in growth hormone levels gigantism before puberty or
acromegaly after puberty.
o Decrease in growth hormone levels dwarfism (short stature)
o Decrease in ADH levels diabetes insipidus (polyurea)
Thyroid gland:
- Located in the neck on either side of the trachea and larynx
- Made up of 2 lobes connected by an isthmus located anterior to the upper trachea.
- Histologically the gland is made up of:
o Stroma: contains the blood vessels, nerves, & lymphatics
Capsule: thin, loose CT
Trabeculae: divide the gland into lobes & lobules
Reticular CT
o Parenchyma:
Thyroid follicles & fenestrated blood capillaries
There are 2 types of cells in the thyroid:
A. Follicular cells:
o Derived from endoderm
o Arranged in the form of thyroid follicles (unit structure)
o Secrete thyroid hormone (thyroxin): T4 (tetraiodothyronine) and some T3 (tri-iodothyronine)
o Thyroid follicles are filled with thyroglobin (colloid),
which is stored secretion.
B. Parafollicular cells:
o Derived from neural crest ectoderm
o Large, pale-staining cells, are either present between
follicular cells that line thyroid follicles or as isolated
clusters between thyroid follicles.
o They secrete calcitonin hormone that decreases calcium
level by inhibiting bone resorption by osteoclasts.
-

Synthesis of thyroid hormones:

1. Synthesis of thyroglobulin: takes place in the rough endoplasmic reticulum
(protein part) and Golgi apparatus (carbohydrate is added). This is followed
by release of the formed thyroglobulin into lumen of thyroid follicle.
2. Uptake of circulating iodide
3. Oxidation of iodide iodine (inside the cells) follicular cavity
4. Iodination of thyroglobulin in follicular cavity.
Release of thyroid hormones:
Under the effect of TSH of the pituitary, follicular cells take up the colloid
by a process of endocytosis.
Colloid is acted upon lysosomal enzymes leading to liberation of T4 & T3.

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Free T4 & T3 are discharged into the fenestrated capillaries that

surround thyroid follicles blood stream.
Action of thyroid hormones:
They increase the basal metabolic rate
They increase absorption of carbohydrates from intestine
They regulate lipid metabolism.
They influence body growth and development of nervous system during
fetal life and childhood.

Clinical correlation:
o Goiter: thyroid hypertrophy in response to low iodine diet
o Hypothyroidism: in adults myxedema, in children cretinism (mental &
physical retardation)
o Hyperthyroidism = Graves disease exophthalmos
Parathyroid glands:
- Four small glands located posterior to thyroid gland.
- Stroma: capsule, trabeculae and reticular CT.
- Parenchyma: made up of branching cords of cells separated by fenestrated blood
capillaries.
- Two types of cells:
1. Chief cells: small, round, basophilic cells (majority) that secrete parathyroid
hormone (PTH)
o PTH increases blood calcium level by 3 mechanisms
Stimulates osteoclastic activity increase bone resorption
Decreases Ca excretion by the kidney
Increases formation of vitamin D that promotes intestinal
reabsorption of Ca.
2. Oxyphil cells:
a. Large, acidophilic cells (minority)
b. Function not known
c. They may represent chief cells that reached nonsecretory stage
Clinical Correlation:
o Tetany: decrease blood Ca level due to lesions of parathyroid
spasmodic contraction of muscles that may be fatal if laryngeal spasm
occurs leading to asphyxia (cut off the bodys air supply)
Adrenal glands:
o Two adrenal (suprarenal) glands each one lies on top of the upper pole of one
kidney.
o The cut surface shows an outer cortex and an inner medulla
o Histological structure:
Stroma:
Capsule
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 Trabeculae: thin
Reticular fibers
Parenchyma:
A. Cortex: Derived from mesoderm, secretes steroid hormones
(corticosteroids). Made up of 3 zones:
1. Zona glomerulosa:
a. Made up of collections of cells in the form of arches or
oval groups separated by fenestrated blood capillaries.
b. The cells are columnar
c. The cells of this zone secrete mineralocorticoids, e.g.
aldosterone.
d. These hormones control water and electrolyte balance
through influencing water & Na reabsorption by the
distal convoluted tubules of the kidney.
2. Zona fasciculata:
a. The widest zone of the cortex
b. Made up of long cords of cells separated by fenestrated
blood capillaries & sinusoids.
c. The cells are polyhedral with vacuolated cytoplasm
(lipid droplets) spongiocytes.
d. The cells of this zone secrete glucocorticoid hormones
(cortisol) that control carbohydrate and protein
metabolism.
3. Zona reticularis:
a. The cells are arranged in branching cords separated by
fenestrated blood capillaries.
b. They are polyhedral cells with slightly vacuolated
cytoplasm.
c. Cells of this zone secrete gonadocorticoids (sex
hormones) and some glucocorticoids
B. Medulla: Derived from neural crest ectoderm
- Formed of anastomosing cords of cells separated by fenestrated
capillaries.
- Cells of adrenal medulla secrete epinephrine & norepinephrine
hormones that stimulate sympathetic nervous system in
emergency situations.
- Sympathetic ganglion cells are also present among secretory
cells of adrenal medulla.
o Pineal body/pineal gland/ Epiphysis cerebri
A cone-shaped body attached to the roof of the third ventricle.
The cells of pineal gland pinealocytes secrete melatonin.
Melatonin regulates day/night cycle (circadian rhythm)
Melatonin is released in the dark and it induces sleep.
Melatonin is given to people to overcome jet lag.

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Melatonin also has a suppressor effect on gonadotrophic hormones

(prevents precocious puberty)

URINARY SYSTEM
o Principal components:
- Kidneys: (represent large compound tubular glands)
Cortex
Medulla

Renal Pelvis
Ureters
Urinary Bladder
Urethra
o Functions of Urinary System:
1. Produces, stores, and voids urine
2. Elimination of waste products (toxic nitrogenous end-products of protein
catabolism)
3. Regulation of bodys electrolyte balance and water content
4. Secretion of renin that stabilizes blood pressure
5. Secretion of erythropoietin that regulates erythropoiesis in bone marrow.
(secreted by endothelial cells of peritubular capillaries)
o
Histological structure of the kidney:
The kidneys are retroperitoneal structures located on each side of
the vertebral columns
Each kidney is surrounded by a tough fibrous dense irregular CT
capsule
The outer region is the cortex granular appearance
The inner region is the medulla striated appearance
The indentation on the medial border hilum where renal artery,
renal vein, ureter, lymphatic vessels and nerves emerge.
The kidney is formed of renal tubules (uriniferous tubules)
A renal tubule is formed of a nephron and a collecting tubule.
The nephron is the structural and functional unit of the kidney.
It is responsible for filtration, reabsorption and excretion.
- Each kidney is made up of more than a million nephrons
Each nephron is made up of 4 parts:

Renal corpuscle located in renal cortex

Proximal convoluted tubule located in renal cortex

Loop of Henle located in renal cortex and medulla

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Distal convoluted tubule located in renal cortex

The kidney is formed of about 16-18 lobes/pyramids
Each pyramid is made up of medullary tissue capped with cortical

tissue
-

The lateral margins of the pyramids are marked by renal columns

(of Bertin) which are interlobar cortical tissues that penetrate deep into
medulla.
The apex of each pyramid is termed the papilla
The papilla drains into the minor calyx.
2-3 minor calyces drain into a major calyx.
The major calyces drain into the renal pelvis.
The renal pelvis (funnel-shaped tube) leads to the ureter.
Each lobe of the kidney is made up of several lobules.
A kidney lobule is made up of a number of nephrons that open into one main
collecting duct (duct of Bellini = papillary duct)
Kidney lobules are demarcated from each other by interlobular vessels
Medullary tissue that project between cortical tissue form the medullary rays.
o Histological Structure of Nephron: 4 parts
I. Renal corpuscle:
- Is formed of Bowmans capsule and glomerular capillaries.
- It has a vascular pole and a urinary pole
A.
The Bowmans capsule:
o Is formed of an inner visceral layer that covers the glomerular
capillaries and an outer parietal layer.
o Glomerular filtrate formed by glomerular capillaries passes
through the visceral layer of epithelium into the capsular space.
o The parietal layer of Bowmans capsule is made up of simple
squamous epithelium.
o The visceral layer of Bowmans capsule is made up of special
cells called podocytes (modified branching epithelial cells)
o A thick basement membrane lies between podocytes and
capillary endothelial cells.
o Podocytes have their cell bodies projecting into the capsular
space and their primary processes bear secondary processes
called podocyte feet that extend to outer surface of glomerular
basement membrane.
o The foot processes of podocytes are separated by narrow
filtration slits.
o Filtration slit diaphragms extend across the filtration slits.
B. Glomerular capillaries:
o Glomerular capillaries are lined by simple squamous fenestrated
endothelial cells facilitates passage of blood plasma
o They are supplied by afferent arterioles that enter the renal
corpuscle at the vascular pole.

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o They drain into efferent arterioles (and not in venules as usual).

This maintains high pressure in glomerular capillaries that
facilitates filtration process.
o Glomerular capillaries are supported by mesangeal cells and
mesangeal matrix (collectively known as mesangium)
o Functions of Mesangeal Cells:
1. Support of glomerular capillaries & podocytes
2. Production of growth factors
3. Phagocytosis (removal of macromolecular deposits that
might interfere with filtration).
4. Maintenance of glomerular basement membrane.
o Glomerular filtration barrier: is formed of:
1. Endothelium of glomerular capillaries
2. Glomerular basement membrane (main filtration barrier)
3. Foot processes of podocytes with filtration slits between
them and diaphragms extending across. Any molecule in
the glomerular capillaries has to pass through those 3 layers
before entering the capsular space.
N.B.: 99% of glomerular filtrate is reabsorbed into the blood in the nephron, the
remaining 1% is excreted as urine
o Juxtaglomerular complex:
- Is found at the vascular pole of the renal corpuscle
- Is formed of 3 parts:
1. Juxtaglomerular (JG) cells: these are modified smooth
muscle cells in the wall of the afferent arteriole. They
contain secretory granules (renin) and the nuclei are
rounded (instead of rod-shaped nuclei of smooth muscles).
2. Macula densa: is the part of the distal convoluted tubule
close to the afferent arteriole. It is packed with cells
crowdness of nuclei hence the name
3. Lacis cells: pale-stained mesangeal cells. Connected with
juxtaglomerular cells by gap junctions.
- Function of Juxtaglomerular complex: MONITORS BLOOD
PRESSURE
Low blood pressure release of renin from JG cells
converts angiotensinogen (from liver) angiotensin
o Vasospasm elevates blood pressure
o Release of aldosterone from zona glomerulosa of
adrenal cortex increase renal reabsorption of
sodium and water restores blood pressure
II. Proximal convoluted tubule (PCT):
- Longest part of the nephron
- Starts at the urinary pole of renal corpuscle
- Lined by (3-5) large cuboidal cells with rounded central nuclei.

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Cytoplasm is darker than that of distal CT

Lumen is narrow
The luminal border has microvilli extensive striated/brush
border.
- Cells of PCT reabsorb glucose, amino acids, sodium, chloride,
and water from the glomerular filtrate.
- They reabsorb 85% of water from the glomerular filtrate
III. Loop of Henle: is made up of
b. Thick descending portion: lined with simple cuboidal epithelium
c. Thin descending portion: lined with simple squamous epithelium
d. Thin ascending portion: lined with simple squamous epithelium
e. Thick ascending portion: lined with simple cuboidal epithelium
IV. Distal convoluted tubule (DCT):
- It starts at macula densa and ends by joining a collecting duct
- It is shorter than PCT.
- It is lined with small cuboidal cells, paler than PCT
- Larger number of cells (5-8)
- Few microvilli, no brush border
- Wider lumen
- It reabsorbs sodium and water in response to aldosterone of
adrenal cortex
Collecting tubules:
- Lie in the medullary rays and medulla
- Lined by large number of cuboidal or columnar cells
- Have wide lumina
- The main collecting ducts open into renal papillae
- They reabsorb water in response to vasopressin/ADH hormone
of posterior pituitary
Renal blood supply:
- Renal artery (at the hilum) segmental arteries interlobar
arteries arcuate arteries (at corticomedullary junction
interlobular arteries afferent arterioles efferent arterioles
capillaries renal vein IVC (inferior vena cava)
Ureters
- Long, straight, muscular tube
- Runs retroperitoneally from the renal pelvis (its proximal funnelshaped end) to the urinary bladder.
- The wall is made up of 3 layers
1. Mucosa: shows longitudinal folds stellate appearance of
lumen. Lined by transitional epithelium. Supported by
fibroelastic lamina propria.

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2. Muscular coat: Two layers of smooth muscles in upper 2/3:

inner longitudinal and outer circular. Three layers in lower
1/3: with an additional outer longitudinal layer.
3. Adventitia: Fibroelastic CT with BV, nerves, and
lymphatics
Urinary bladder:
- Has a wide lumen and thick wall made up of:
1. Mucosa: Transitional epithelium with a wide lamina propria.
2. Muscular coat: is known as detrusor muscle. Formed of 3 layers
of smooth muscles (as the ureter) arranged in bundles separated by
wide areas of CT.
3. Adventitia: Dense CT containing BV, nerves, and lymphatics.
Urethra:
- Male urethra (20cm) is shared and will be studied with male
reproductive organs
- Female urethra is shorter (4cm)
Lined with transitional epithelium towards the bladder &
stratified squamous epithelium towards the external
urethral sphincter.
Lamina propria contains mucous glands.
Muscle coat: inner longitudinal & outer circular layers of
smooth muscle.
Near the neck of the bladder, the circular muscle layer
thickens internal urethral sphincter (involuntary)
Surrounding the external urethral orifice, skeletal muscles
form a voluntary external urethral sphincter.

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MALE REPRODUCTIVE SYSTEM

Components
Main sex organ:Testes (2)
Male ducts:
a. Epididymis (2)
b.Vas deferens/ductus deferens (2)
Accessory glands:
o Prostate (1)
o Seminal vesicles (2)
o Bulbourethral glands (2)
o Urethral glands of Littre (many)
Copulatory organ: penis
Functions
Production of spermatozoa (male germ cells)
Production of androgens (male sex hormones) mainly testosterone
Facilitate fertilization (penis)
Testis:
- Mixed gland (endocrine testosterone, exocrine sperms; cellular
secretion)
- Considered as a compound tubular gland
- Location: Inside the scrotum (outside abdominal cavity) to provide an optimal
environment for spermatogenesis (2-3 C below body temperature)
- Structure:
o Stroma:
Capsule: formed of dense irregular CT tunica albuginea
(white color), covered on its outer surface by simple squamous
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mesothelial cells (visceral layer of tunica vaginalis testis). The

posterior aspect of capsule is thickened mediastinum testis.
Inner layer of capsule is vascular tunica vasculosa
Septa: extend from the capsule & divide the testis incompletely
into pyramidal lobules. Septa converge at the mediastinum testis.
Interstitial connective tissue
o Parenchyma:
Convoluted seminiferous tubules: produce sperm (exocrine part)
Interstitial cells of Leydig: secrete testosterone (endocrine part)
-

Convoluted seminiferous tubules:

Lined with spermatogenic cells and Sertoli cells
Functions in the production of spermatozoa through a process called
spermatogenesis that involves 2 processes:
o Spermatocytogenesis: development of spermatogonia spermatids
o Spermiogenesis: metamorphosis of spermatids spermatozoa.
Spermatocytogenesis: includes the following spermatogenic cells
a. Spermatogonia:
- Rest on the basement membrane
- Are small rounded cells containing 46 chromosomes (diploid)
- Originate from primordial germ cells that arise from yolk sac endoderm
and migrate to developing testis and become incorporated into epithelial
cords that develop into seminiferous tubules.
- At sexual maturity, spermatogonia start dividing by mitosis producing
successive generations of cells.
- There are 2 types of spermatogonia:
o Type A spermatogonia reserve cells
o Type B spermatogonia give rise to primary spermatocytes

b. Primary spermatocytes:
Are the largest cells of the spermatogenic lineage
Contain 46 chromosomes (diploid number)
Chromosomes are very characteristic of this stage and they announce the
beginning of the prophase of the first meiotic division.

c. Secondary spermatocytes:
Develop as a result of the first meiotic division
Are smaller than primary spermatocytes
Contain haploid number of chromosomes (23)

d. Spermatids:
Arise from mitotic division (second meiotic division) of secondary spermatocytes
Contain haploid number of chromosomes (23)
Are the smallest of the spermatogenic lineage.

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Spermiogenesis
- Rounded spermatids transform into elongated spermatozoa
- The nucleus forms the head of a spermatozoon (condenses and elongates)
- Organoids involved are:
o Golgi apparatus: forms acrosome vesicle that forms a flattened cupshaped head cap for the nucleus. Acrosome contains hyaluronidase &
lysosomal enzymes that facilitate spermatozoal penetration of corona
radiate & zona pellucida of the ovum.
o Centrioles: form the flagellum (tail)
o Mitochondria: become arranged as a collar around the proximal part of
flagellum forming a mitochondrial sheath (middle piece of a
spermatozoon) provides ATP needed for motility.
o Residual cytoplasm is discarded & phagocytosed by Sertoli cells.
Spermatozoa:
- Each spermatozoon consists of a head, middle piece and a flagellum
- A normal sperm count is at least 100 million spermatozoa/ml of semen, with an
average ejaculate volume of 3 ml.
- The larger the sperm count, the greater is the probability of successful
fertilization.
- Men with sperm counts below 20 million/ml are usually sterile
- 20% of sperms produced by fertile men may be morphologically imperfect
without affecting their fertility level.
- Immotile cilia syndrome: (immotile sperm) sterility
Sertoli Cells:
- Elongated pyramidal cells that partially envelop cells of spermatogenic lineage.
- They extend from the basement membrane to the lumen of seminiferous tubule.
- Sertoli cells have basal, large, elongated, pale-staining nuclei, Golgi apparatus,
RER, & SER
- Functions of Sertoli cells:
1. Support, protection, and nutritional regulation of developing
spermatozoa.
2. Secretion of:
Testicular fluid rich in fructose and flows in the direction of genital
ducts and is used for sperm transport
Androgen-binding protein (ABP) under the control of FSH of the
anterior pituitary and serves to concentrate testosterone in the
seminiferous tubules, where it is necessary for spermatogenesis.
3. Phagocytosis: of degenerating germ cells and surplus cytoplasm remaining
from spermiogenesis.
4. Formation of blood-testis barrier:
o Tight occludens junctions exist between basal regions of adjacent
Sertoli cells preventing macromolecules and antigenic substances
from reaching inner aspects of seminiferous tubules where
spermatogenesis is in progress.
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Interstitial cells of Leydig:

Are located, as groups of cells, in the CT between seminiferous tubules.
They are polyhedral cells with vacuolated cytoplasm and are separated by
fenestrated blood capillaries.
They secrete testosterone hormone and are under the control of LH (interstitial
cell stimulating hormone ICSH) of the anterior pituitary (basophils)
Factors affecting spermatogenesis:
1. FSH: acts on Sertoli cells stimulating the release of ABP that binds to
testosterone.
2. LH: acts on interstitial cells of Leydig production of testosterone
which is necessary for normal development of spermatogenic lineage.
3. Temperature is very important in the regulation of spermatogenesis
which occurs only below the body temperature of 37C (testicular temp. is
35C); this explains the location of the testis in the scrotum.

Male Genital Passages:

Seminiferous tubules open into a maze of anastamosing channels called rete testis
(located in mediastinum testis)
Rete testis efferent ductules ductus epididymis
Epididymis:
o Is a very long (4-6 meters), highly convoluted duct
o Located behind and above the testis
o Formed of a body and a tail
o The lining epithelium is pseudostratified columnar epithelium with
stereocilia (non-motile). Stereocilia are microvilli.
o Surrounded by smooth muscle cells
o It functions as a storage reservoir for sperms
o It has partly secretory activity that promotes maturation of sperms
(maturation-promoting factor)
Vas deferens = ductus deferens
o A straight, thick, muscular tube, that starts from the tail of the epididymis
and proceeds through the spermatic cord into the inguinal canal to the
pelvis to open in the prostatic urethra.
o It is lined with pseudostratified columnar epithelium with stereocilia.
o Lamina propria is rich in elastic fibers
o The muscle layer is very thick & is formed of 3 layers: inner & outer
longitudinal and middle circular. The thick smooth muscle produces
contraction during ejaculation (innervated by sympathetic nervous system)
o Its terminal part is dilated ampulla of the vas deferens that unites with
the duct of seminal vesicle ejaculatory duct that open in prostatic
urethra.

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Accessory Sex Glands:

- Seminal vesicles (2):
o Are turtuous, secreting tubes, about 15 cm each, located behind
urinary bladder
o The section shows glandular appearance due to high convolutions
o Mucosa is lined with tall simple columnar or pseudostratified
columnar.
o Smooth muscles surround the secretory tubules; their contraction
adds the secretion to the seminal fluid during ejaculation.
o The secretion of the seminal vesicle is alkaline, viscus, slightly
yellowish and contains fructose and nutrients
o Secretory activity is under control of testosterone
o Its secretion accounts for 60% of the seminal fluid.
-

Prostate:
o Located below the bladder, in the pelvis
o Surrounds the first part of the urethra (prostatic urethra)
o It is a compound tubuloalveolar gland
o It is formed of five lobes
o The ducts of the glands open into the prostatic urethra
o It is about the size & shape of a walnut
o The prostatic acini are arranged in 3 distinct zones:
Central (Mucosal): surround the urethra & small in size
Transitional (submucosal): middle layer
Peripheral: constitutes about 70% of the glandular tissue
of the prostate, large in size.
o Acini in the mucosal & submucosal zones often hypertrophy after
the age of 50 and cause benign prostatic hyperplasia (BPH)
o Acini in the peripheral zone are the site of prostatic cancer
(posterior lobe).
o Prostatic acini are irregular in size and shape and the lining varies
from simple cuboidal to pseudostratified columnar epithelium.
o Some acini may show stored calcified secretion referred to as
prostatic concretions.
o The capsule & stroma between the acini is fibromuscular
o The prostate secretes a milky secretion rich in prostatic acid
phosphatase (PAP) and prostatic specific antigen (PSA) and
fibrinolysin
o It forms about 30% of the seminal fluid
o It is under the control of testosterone hormone.

Bulbourethral glands of Cowper:

o Compound tubuloalveolar glands located behind membranous
urethra.

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o Their ducts open in the proximal part of penile urethra.

o Their mucous secretion lubricates the penile urethra.
o Lined with simple cuboidal cells.
Penis
-

Male copulatory organ

Covered with delicate skin
Its tip is called glans penis
A skin fold over the glans is called prepuce removed during
circumcision
- Penis is formed of 3 cylindrical masses of erectile tissue.
- The 2 dorsally located are called corpora cavernosa.
- One is ventrally located corpus spongiosum that terminates as the
glans penis and is traversed by the penile urethra.
- Each of the 3 erectile tissues is surrounded by a tough connective tissue
sheath tunica albuginea (inextensible).
- Each erectile tissue is formed of irregular vascular spaces, lined y
endothelium and separated by CT & smooth muscles.
- Under the effect of parasympathetic NS (nitric oxide), cavernous blood
spaces dilate, become engorged with blood erection
Male urethra: 18-20 cm long, has 3 parts:
1. Prostatic urethra (3 cm): lined with transitional epithelium,
receives the openings of prostatic glands and ejaculatory ducts
2. Membranous urethra (1.25 cm): lined with stratified columnar
epithelium
3. Penile/spongy/cavernous urethra: longest part (15cm)
a. Lined with stratified columnar epithelium.
b. Its terminal part is lined with stratified squamous epithelium
c. Bulbourethral glands of Cowper open in its proximal part
d. Urethral glands of Littre open along its distal part (minor
mucous-secreting glands)

FEMALE REPRODUCTIVE SYSTEM

Includes the following components:
- Ovaries (2)
- Oviducts (2)
- Uterus (1)
- Vagina (1)
- External genitalia
- Mammary glands
Functions of this system:
1. Production of ova (female germ cells) through oogenesis
2. Secretion of estrogen & progesterone
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3. Facilitate meeting of ova & sperms fertilization

4. Maintain the embryo throughout pregnancy
5. Nurture infants postnatally through lactation
Oogenesis
- In females, primordial germ cells, arising from yolk sac endoderm, migrate to
the developing ovaries and differentiate into oogonia.
- Oogonia increase in number by mitotic division and some of them develop into
larger cells called primary oocytes.
- Thus, primary oocytes are formed during early fetal life (in males, primary
spermatocytes are formed at puberty).
- Primary oocytes (diploid cells) start the first meiotic division (meiosis I) during
fetal life.
- The prophase of meiosis I is very long.
- Primary oocytes start meiosis I with 46 chromosomes (diploid number).
- In response to LH of anterior pituitary (at puberty), meiosis resumes in the
preovulatory oocyte and this stage of division gives rise to two daughter cells
with haploid number of chromosomes. One of the two daughter cells is large
secondary oocyte and the smaller cell is called first polar body.
- In the second meiotic division (meiosis II), the secondary oocyte gives rise to one
ovum with haploid number of chromosomes and the second polar body.
- All polar bodies degenerate
- Thus each primary oocyte gives rise to one ovum (in males, each primary
spermatocyte, gives rise to 4 sperms).
OVARIES:
- Mixed glands (endocrine estrogen & progesterone, exocrine ova)
- Are almond-shaped bodies, about 3cm in length
- Located in the pelvis behind the broad ligament of the uterus
- The surface of the ovary is covered by simple cuboidal germinal epithelium.
- Under the epithelium is a layer of dense CT called tunica albuginea
(albus=white)
- The cortex of the ovary is deep to tunica albuginea and contains the ovarian
follicles.
- The follicles are surrounded by spindle-shaped fibroblast-like stromal cells and
collagen fibers.
- The central part of the ovary is the medullary region that contains large blood
vessels.
Ovarian follicles:
- Around puberty, the ovaries contain about 300,000 primary oocytes that are
surrounded by a layer of flat cells called follicular cells forming what is called
primordial follicles.
- During the reproductive life of a woman that lasts about 30-40 years (between age
of menarche; 15 to age of menopause; 45-55), and considering that one ovum is

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liberated each menstrual cycle of (28days), thus only about 450 oocytes are
liberated.
All other primordial follicles degenerate through a process called atresia.
At puberty, under the effect of FSH, ovarian follicles start to grow and ripen, thus
a section of the ovary shows the following stages of follicular growth:
o Primordial follicles:
Are located deep to tunica albuginea
Most numerous type
Each follicle is made up of a primary oocyte surrounded by a
single layer of flat follicular cells
o Primary follicles:
Primary oocyte enlarges in size
Its cell membrane thickens to form the zona pellucida
Follicular cells increase in size cuboidal and increase in number
forming 2 layers
o Growing/secondary follicles:
The follicle increases in size
Primary oocyte increases in size
Zona pellucida becomes thicker
Follicular cells proliferate and form a stratified epithelium called
granulosa cells
Follicular cells secrete follicular fluid that accumulates in a large
cavity called antrum.
Supporting and connecting the oocyte to the wall of the growing
follicle is the cumulus oophorus of the granulosa cells.
Surrounding the oocyte, a group of granulosa cells is called corona
radiata.
The stromal cells and CT around the follicle forms a capsule called
theca folliculi.
o Mature/tertiary/Graafian follicle:
Largest follicle in the ovary (2.5cm) that bulges towards the
surface.
The theca folliculi differentiates into cellular vascular theca
interna, formed of cells capable of secreting sex hormones, and
fibrous theca externa.
Cells of theca interna secrete androgens and pass it to granulosa
cells that convert it estrogen.
A thick basement membrane separates the theca interna cells from
granulosa cells.
At the time of ovulation (under effect of LH of pituitary)
accumulation of more fluid leads to detachment of the oocyte with
its corona radiata and the completion of meiosis I.

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Rupture of the mature follicle (ovulation) extrudes the secondary

oocyte into the peritoneal cavity which is grasped by the uterine
tube and already started its second meiotic division (meiosis II).
Unless fertilization occurs, this division stops at the metaphase.
The second important action of LH is transformation of ruptured
mature Graafian follicle into corpus luteum.

Corpus luteum: (yellow body); a temporary endocrine gland

After ovulation, the remaining wall of the follicle appears folded.
The follicular cavity may contain some blood
The granulosa cells hypertrophy and are transformed into
granulosa lutein cells
The theca interna becomes transformed into theca lutein cells.
Corpus luteum secretes both progesterone & estrogen
Estrogen secretion is a FSH response while progesterone
secretion is a LH response
Progesterone is necessary for preparing the endometrium for
implantation.
Corpus luteum continues to enlarge, but involutes around the 4th
day unless fertilization occurs.
The resulting drop in estrogen & progesterone levels
menstruation.
Following involution, the corpus luteum becomes replaced by a
small white fibrous scar called corpus albicans.
If fertilization occurs corpus luteum continues to grow till the third
month of pregnancy when the placenta takes over its function
Follicular Atresia:
- Atresia is degeneration of ovarian follicles.
- Since only one follicle matures every 28 days, and since there are about 300,000
primordial follicles at puberty, thus those follicles that do not reach maturity
degenerate.
Clinical Correlations:
- Ovarian Cysts
- Cancer ovary
UTERINE TUBE (FALLOPIAN TUBE/OVIDUCT): 12.5cm
- There are 2 tubes extending from each side of the uterus toward each ovary.
- The uterine tube is the usual site of fertilization of ovum
- It is made up of 4 parts:
o Infundibulum that opens in peritoneal cavity and has finger-like
extensions called fimbrae
o Ampulla: larger, thin-walled & wider (site of fertilization of ovum)
o Isthmus: shorter, thick-walled.
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o Intramural portion: that extends through uterine wall

- The wall of oviduct is made up of 3 layers:
o Mucosa:
Highly folded having primary, secondary, and tertiary folds
labyrinthine appearance.
Epithelium: is simple columnar ciliated (moves ovum),
alternating with simple columnar nonciliated secretory (nutritive
function)
o Muscle layer: inner circular or spiral & outer longitudinal smooth muscle
layers peristaltic.
o Serosa: peritoneal mesothelium with underlying CT.
Clinical correlation:
In vitro fertilization (IVF)
Salpingitis (complication of sexually transmitted diseases; STDs)
UTERUS
- A muscular pear-shaped organ situated in the pelvis
- Consists of a body and a lower cylindrical structure cervix. The dome-shaped
upper part of the body fundus.
- The wall of the uterus is made up of 3 layer:
o Endometrium: mucosa
o Myometrium: musculosa
o Perimetrium: serosa of peritoneum with BV, nerves, & lymphatics
- Endometrium:
o Varies in structure according to the phase of menstrual cycle.
o Basically, it is formed of:
Surface epithelium: simple columnar partially ciliated
epithelium.
Uterine glands: simple tubular glands lined with simple columnar
cells secreting mucoid secretion and glycogen, the amount of
which increase in the second half of menstrual cycle.
Lamina propria: substantial layer described as endometrial stroma
containing fibroblast cells, collagen type III fibers and blood
vessels.
o Functionally; the endometrium is made up of:
A thick superficial functional layer: sheds off during
menstruation.
A thin basal layer that is retained and subsequently regenerates a
new functional layer.
o Blood vessels supplying the endometrium are of special significance in the
periodic sloughing of the functional layer.
o Uterine arteries supply the myometrium (arcuate arteries), from these
vessels, 2 sets of arteries arise and supply endometrium:
Straight arteries supply basal layer
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 Spiral arteries supply the functional layer

o Endometrium during menstrual cycle:
Menstruation cycle is about 28days, it is divided into 3 phases
It is under the control of FSH & LH of anterior pituitary.

Menstrual phase: Lasts about 4-5 days

o Severe intermittent spasm of the spiral arteries
Ischaemia degeneration and sloughing of the
functional layer of endometrium
Proliferative phase (estrogenic/follicular phase): FSH
o Lasts about 9 days
o Estrogen is secreted by granulosa cells of growing
ovarian follicles
o Endometrium doubles or triples in thickness
o Uterine glands are straight
o Stroma between them appears more cellular
Secretory phase: (progestational/luteal phase): LH
o Beings at ovulation
o Lasts about 14 days
o Progesterone is secreted by the corpus luteum
o Uterine glands become tortuous, sacculated and
highly coiled; corkscrew appearance
(characteristic feature).
o The cells lining uterine glands are hypertrophied
and accumulate glycogen.
o Secretion dilates the lumina of the glands
o Stroma is edematous
o Degeneration of the corpus luteum leads to drop in
progesterone level vasospasm of the spiral
arteries ischemic necrosis of the functional layer
of endometrium sloughing bleeding.

o Myometrium:
Very thick layer of smooth muscles arranged in 3 layers:
Outer and inner layers are longitudinally arranged
Middle layer is thick and circularly arranged around large
blood vessels vascular layer.
o Uterine cervix
Lower cylindrical part of the uterus
Opens into the upper part of the vagina
Lined by simple columnar mucus-secreting cells
The part of the cervix that bulges into the lumen of the vagina is
covered by stratified squamous epithelium

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Mucosa of the cervix contain mucus-secreting glands that

proliferate and secrete a more viscous and abundant mucus during
pregnancy.
Mucosa of the cervix does not shed during menstruation.
The cervix is narrower than the uterine body, it has few smooth
muscle fibers and consists mainly (85%) of dense CT.
During labor, softening of CT takes place under the effect of
relaxin hormone that leads also to laxity of pelvic ligaments.

VAGINA:
o Fibromuscular tube; mucosa, musculosa, and adventitia
o Mucosa is lined by stratified squamous non-keratinized epithelium that
contains glycogen vacuolated appearance.
o Bacteria in the vagina acts on glycogen lactic acid acidic vaginal
environment has a protective effect against microorganisms.
o The laminal propria is rich in elastic fibers lymphocytes and neutrophils
o The Muscle layer is composed of thin inner circular layer and thicker outer
longitudinal layers
o Vagina has no mucus glands in its wall but is kept moist by mucus of
cervical glands and by mucus secreted by Greater vestibular glands of
Bartholin that open in the lower end of vagina.

Clinical Correlations: Pap smear

FEMALE EXTERNAL GENITALIA/VULVA

CLITORIS: is the homologue of the penis and is formed of 2 erectile bodies ending in a
rudimentary glans clitoris
LABIA MINORA: paired hairless folds of skin that border the vaginal opening
(vestibule), sebaceous and sweat glands are present on both sides. No fat cells but
numerous blood vessels and elastic fibers are present in the connective tissue core
LABIA MAJORA: 2 large folds of hairy skin and adipose tissue
MONS PUBIS: rounded prominence of adipose tissue over the pubic symphysis

Mammary Glands
-

Are modified sweat glands, apocrine, compound alveolar, exocrine glands

The mammary gland is covered with skin (skin & mammary gland breast)
The areola is a circular hyperpigmented area of the skin over the gland containing
sebaceous & sweat glands.

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The color of the areola darkens during pregnancy (accumulation of melanin)

The nipple is a protrusion at the center of the areola at the summit of which are
the openings of the lactiferous ducts (15-20).
Each lactiferous duct drains a lobe of the gland, each lobe contains a number of
lobules.
The nipple is richly supplied with sensory nerve endings
The dermis under the nipple contains smooth muscle cells, the contraction of
which erection of the nipple.
Histological structure of mammary gland varies with age, menstrual cycle,
pregnancy, and lactation.
4 main hormones target the mammary gland namely: estrogen, progesterone,
prolactin, and oxytocin.

Histologicaly mammary gland is made up of:

A. Stroma: CT component containing blood vessels, nerves, lymphatics, and adipose
cells
a. Interlobar CT: dense CT separating about 20 lobes
b. Interlobular CT
c. Intralobular CT
B. Parenchyma:
- Differs in structure depending on the physiological status of the gland.
1. In the inactive/resting mammary gland:
- The parenchyma is formed of ducts only
- No acini are detected
- In girls during puberty, the breasts increase in size due to accumulation of
adipose tissue in the interlobular CT.
- The gland is formed of about 20 lobes
- The duct system:
o The intralobular ducts: drain the acini and found inside the
lobules. Lined with simple cuboidal epithelium.
o Interlobular ducts: result from union of intralobular ducts & run
between the lobules. They are lined with simple columnar
epithelium.
o Interlobar/lactiferous ducts: Result from union of interlobular
ducts. They are lined with pseudostratified columnar epithelium
except at their termination where each duct dilates into lactiferous
sinus & is lined with stratified squamous epithelium.
2. During pregnancy:
- Marked growth of the mammary gland takes place under the effect of
estrogen & progesterone.
- Secretory alveoli (acini) bud from the intralobular ducts
- Acini are spherical collections of simple columnar epithelium cells that
become active milk-secreting structures during lactation.

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Myoepithelium cells are located between the lining epithelium cells and
the basement membrane
Contraction of these cells leads to ejection of milk during lactation.
Contraction of these cells is under control of oxytocin hormone
By the second half of pregnancy, well-developed lobules with secretory
acini and ducts are evident.
Enlargement of the lobules reduces the interlobular CT.
In the third trimester of pregnancy, the secretory cells produce colostrum
(a serous fluid containing immunoglobulin IgA that confers passive
immunity to the newborn).
Milk is not secreted until a few days after labor

3. Lactating mammary glands:

- Breast enlarges further
- Under the effect of prolactin hormone, milk is produced by the epithelial
cells of the acini and accumulate in their lumina
- Milk appears acidophilic & vacuolated due to its content of fat.
- The secretory cells become low cuboidal due to disintegration of the
apical portions of columnar cells in the process of milk secretion
(apocrine).
- Some acini appear empty as a result of evacuation.
4. Mammary glands in the menstrual cycle:
- Proliferation of the duct system at about the time of ovulation (circulating
estrogen is at its peak).
- Edema (hydration) of CT in the premenstrual phase produces breast
enlargement.
5. Mammary glands after menopause
- They atrophy, and are formed mainly of CT, few ducts & adipose tissue.
Hormonal control:
1. Estrogen: stimulates the growth of the duct system
2. Progesterone: stimulates the growth of the acini
3. Prolactin (from acidophils of the anterior pituitary): stimulates milk secretion by
the acini.
4. Oxytocin (from posterior pituitary): stimulates contraction of myoepithelial cells
around secretory acini ejection of milk.
N.B. Suckling afferent impulses hypothalamus release of Oxytocin
hormone pass through hypothalamic hypophyseal tract pars nervosa
(Herring bodies) circulation stimulate contraction of myoepithelial
cells leading to ejection of milk from acini
- Suckling stimulates also the hypothalamus to secrete prolactin releasing
hormone (PRH) that travel through the hypophyseal portal circulation to
pars distalis, stimulating the secretion of prolactin by acidophils

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Lactation amenorrhea:
- High levels of circulating Prolactin inhibit LH no ovulation
Clinical correlations:
Fibrocystic disease of the breast
Breast cancer

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