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• Dr. Abdikadir Omer Rabile

MBBS PGY1 family medicine MD
Amoud –Hope Program
Resdiency at Borama Regional Hospital
Amoud University

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 Connective tissue

o Connective is one of the four basic types

of animal tissue, tissues function primarily to
support the body and to bind or connect
together all types of tissue. The tissue derives
its name from its function in connecting or
binding cells and tissues.

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 FUNCTIONS OF CONNECTIVE
TISSUE

1. Structural support
The connective tissues serve several functions,
of which the most prominent function is
structural support to enable maintenance of
anatomical form of organs and organ systems.
The skeletal tissues (cartilage and bone) are
special forms of connective tissue.

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2. Metabolic functions
o The connective tissues serve a nutritive role.
All the metabolites from the blood pass from
capillary beds and diffuse through the adjacent
connective tissue to cells and tissues.
o Similarly waste metabolites from the cells
and tissues diffuse through the loose
connective tissue before returning to the blood
capillaries.

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o The adipose tissue (especially that of the
hypodermis) serves as an energy store and also
provides thermal insulation.

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3. Blood components and blood
vessels
o The hematopoietic tissues (blood-forming tissues)
are a further specialized form of connective tissue.
o These include the myeloid tissue (bone marrow)
and the lymphoid (lymphatic) tissue.
o The lining of the blood and lymphatic vessels
(endothelial cells) as well as the peripheral blood,
are also specialized forms of connective tissue.

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4. Defensive functions
o Various components of the connective tissue
play roles in the defense or protection of the
body including many of the components of
the vascular and immune systems (plasma
cells, lymphocytes, neutrophils, eosinophils,
basophils, mast cells).

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Connective tissue is composed of:
(a) cells
(b) extracellular matrix.

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o Matrix consists of:
1.connective tissue fibers
2.Ground substance
3.Tissue Fluid

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o The extracellular material of connective
tissue, which plays a major role in the
functioning of the tissue, is the dominant
component of the tissue.
o The dominance of the extracellular
material is a special feature that
distinguishes connective tissue from the
other tissues of the body.

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Cells of the connective tissue

1. Fibroblasts
2. Adipose cells
3. Macrophage or Histiocytes
4. Mast cells
5. Plasma cells
6. Leukocytes

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tissue fluid (
The amount of tissue fluid is fairly constant and
there is an equilibrium between the water
entering and leaving the intercellular substance
of the connective tissue. In pathological
conditions (traumatic injury, inflammation) fluid
may accumulate in the connective tissue, a
condition known as edema.

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 Between cells and fibers.
o The intercellular ground substance is an
amorphous, transparent material composed mainly
of glycoproteins and proteoglycans, with a fairly
high water content, that participate in binding cells
to the fibers of connective tissue
o Viscous clear substance that has a slippery feel
o It acts as a lubricant and a barrier to the
penetration to the tissues by foreign particles.

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o H+E staining: lost during preparation and appears
empty.
o All substances passing to and from cells must pass
through the ground substance.

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 CONNECTIVE TISSUE FIBERS

Connective tissue fibers are composed of

structural proteins. The three main types of
fibers are:
1. collagen fibers
2. reticular fibers
3. elastic fibers.

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 Collagen fibers
o Collagen is the most abundant protein in the
body (up to 30% dry weight).
o There are more than 12 different types of
collagen, though the most common types are
Types I to V.
o Collagen is synthesized by a wide number of cell
types (including: fibroblasts, osteoblasts,
Chondroblasts, odontoblasts, reticular cells,
epithelial cells, endothelial cells, smooth muscle
cells, Schwann cells).
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o The main amino acids of collagen are:
1. glycine (33.5%)
2. proline (12%)
3. hydroxyproline (10%)
o The amino acids, hydroxyproline and
hydroxylysine are characteristic of collagen.
It is the only naturally occurring protein with
both these amino-acids.

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 Collagen type Main sites Special features

Type I Bones, tendons, organ Most abundant,

capsules, dentin Typical collagen fibers
(64nm banding)

Type II Hyaline cartilage Very thin fibrils

Elastic cartilage
Type III Reticular fibers ,smooth Often associated with Type I
muscle,arteries,uterus
,liver,spleen,kidney and
lungs
Type IV Basal lamina associated Amorphous (non-
with epithelial and fibrous)
endothelial cells

Type V Basal lamina associated with Amorphous (non-

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o Collagen fibers consist of closely packed
orderly fibrils and when seen in bundles (as
in tendons, aponeuroses) appear white.
o In histological preparations after regular
staining they are acidophilic (pink staining
with eosin).
o Collagen fibers are flexible, but very inelastic
with extremely high tensile strength.

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 Reticular fibers
o Reticular fibers are very thin (diameters
between 0.5 - 2m) and are not visible in
normal histological preparations after
regular staining (H & E), however they can
be visualized and stained black after
impregnation with silver salts.
o This affinity for silver is called
argyrophilia.
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o Reticular fibers are also stained with the
PAS reaction due to the high content of
glycoproteins associated with the fibers (6-
12% hexoses as opposed to 1% in
collagen fibers).
o It is now recognized that reticular fibers
are a special form of collagen (Type III).

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o Reticular fibers form fine-meshed networks
around cells and cell groups.
o in diverse organs. They are abundant in
lymphatic organs (lymph nodes, spleen),
smooth muscle (in the sheath surrounding each
myocyte), in endoneurium (connective tissue
surrounding peripheral nerve fibers), and
supporting epithelial cells of several glands
(liver, endocrine glands).

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 Reticular fibers

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 Elastic fibers
o Elastic fibers, as the name suggests, are highly
elastic and stretch in response to tension.
o In particular they are formed from the protein
elastin.
o The amino acid composition of elastin, similar
to collagen, is rich in glycine and proline, but in
addition has two unusual amino acids,
desmosine and isodesmosine.
o Elastic fibers also have a high content of
valine.
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o Elastic fibers are very prominent in elastic
tissues such as the elastic ligamen
o Sites: Vertebral ligament, Larynx and
Elastic arteries.

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 Elastic Fibers

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Aorta is the example 29
 CONNECTIVE TISSUE CELLS
Fibroblasts
o Fibroblasts are the most common cell type
found in connective tissue.
o The term "fibroblast" is commonly used to
describe the active cell type, whereas the more
mature form, which shows less active synthetic
activity, is commonly described as the
"fibrocyte".
o Fibroblasts are elongated, spindle-shaped cells
with many cell processes.
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o They have oval, pale-staining, regular nuclei
with prominent nucleoli.
o Abundant rough endoplasmic reticulum and
active Golgi bodies are found in the cytoplasm.
o Fibroblasts synthesize collagen, reticular and
elastic fibers and the amorphous extracellular
substance (including the glycosaminoglycans
and glycoproteins).

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 FIBROBLASTS
o Fusiform shaped
o Most common connective tissue cell
o Produces Collagen
i. Reticular fibers
ii. Elastic fibers
iii. Extra cellular matrix

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 FIBROBLASTS

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 Fibroblasts

Fusiform cell with elliptical nuclei

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 Macrophages
o Macrophages show pronounced
phagocytotic activity.
o Macrophages originate from monocytes (from
precursor cells in bone marrow), which migrate
to connective tissue and differentiate into
tissue macrophages.

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o the various macrophages of the body are
grouped in a common system called the
Mononuclear Phagocyte System (MPS).
o A wide range of macrophages are included in
the MPS and include : Kupffer cells of the
liver, alveolar macrophages of the lung,
osteoclasts, microglia etc.

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o The main functions of macrophages are
ingestion by phagocytosis of microorganisms
(bacteria, viruses, fungi), parasites, particulate
matter such as dust, and they also participate in
the breakdown of aged cells including
erythrocytes.
o The intracellular digestion occurs as a result of
fusion of lysosomes with the phagosome
(ingested body).
o of the foreign body and sites of inflammation
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o Macrophages are normally long-lived and
survive in the tissues for several months.
o In some cases where a foreign body (such as a
small splinter) has penetrated the inner tissues
of the body, several macrophages may fuse
together to form multinuclear foreign body
giant cells.
o These large cells accumulate at sites of
invasion.

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Macrophages /Histiocytes

o Resembles Fibroblasts

o Phagocytic

o Ingests Bacteria, cell debris and other

foreign matter

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Histiocyte: A tissue macrophage; the
class includes hepatic Kupffer cells,
alveolar macrophages, giant cells of
granulomas, osteoclasts, and dermal
Langerhans cells.

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 MACROPHAGE

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 MACROPHAGE

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 Mast cells
o Mast cells are oval or round cells (20-30m
diameter) in connective tissue characterized by
cytoplasm packed with large round basophilic
granules (up to 2m diameter).
o The granules are stained metachromatically
(purple after toluidine blue staining).
o Two of the main components of mast cell
granules are histamine and heparin.

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o The granules of mast cells are released in
inflammatory responses.
o Mast cells are abundant in loose connective
tissue (especially adjacent to blood vessels), in
the dermis, and in the lamina propria of the
respiratory and digestive tracts.

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 MAST CELL

o Spherical to round

o Sites: CT of Skin, Digestive tract and respiratory tract

o Functions: Secrets Heparin and Histamine

Heparin is anticoagulant and Histamine is mediator of

inflammation

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 Mast cell

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 Plasma cells
o are responsible for antibody production.
o These large cells have eccentric nuclei, basophilic
cytoplasm (much rough endoplasmic reticulum
associated with protein synthesis) and well-
developed Golgi bodies.
o Plasma cells are relatively short-lived (10-20 days)
and are found in sites of chronic inflammation or
sites of high risk of invasion by bacteria or foreign
proteins (such as the lamina propria of the
intestinal and respiratory tracts).
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o Sites :Respiratory and Digestive tract

o Arises from Lymphocytes

o Functions: Secretes antibodies into

circulation

Participate in the defense

mechanism
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 Plasma cell

Almost oval shape and large, offset nucleus with chromatin

clumped in a "clockface" pattern, and an adjacent pale patch of
clear cytoplasm.
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 Leukocytes

o The white blood corpuscles are commonly

found in connective tissue.
o They migrate from the blood vessels to the
connective tissue, especially to sites of injury or
inflammation.

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 o Neutrophils: Bacterial invasion
o Eosnophils: Allergic reaction
o Basophils:Heparin and
histamines
o Lymphocytes: Defense
o Monocytes: Defense

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 Adipose cells

o Single or in groups

o Forms adipose tissue

o Functions: 1. stores fat

2.Protective packing material

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Classification of Connective
tissue
1. Connective tissue proper

2. Specialized Connective Tissue

3. Supportive Connective Tissue

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 Classification of Connective
tissue proper

1. Loose Connective tissue

2. Dense connective tissue

irregular
Regular

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 Loose connective tissue
(Cellular Connective tissue)
o Abundance of cells
o Loosely arranged fibers
o Abundant Ground Substance

Sites: Beneath the epithelia that line the

internal surfaces of the body.
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 Dense Connective Tissue
• Dense connective tissue, also called dense
fibrous tissue, is a type of connective tissue
with fibers as its main matrix element

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 Dense Irregular Connective
tissue
• Dense irregular connective tissue has fibers that
are not arranged in parallel bundles
• Dense irregular connective tissue consists of mostly
collagen fibers. Fibroblasts are prodominant cell
type scattered sparsely across the tissue.
• This type connective tissue is found mostly
in the dermis

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 Dense Regular Connective
Tissue
o Orderly and densely packed arrays of fibers
and cells.
eg: Tendons, ligaments and
aponeurosis

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Specialized Connective tissue
o Adipose tissue
o Blood
o Bone
o Cartilage
o Lymphatic tissue
o haemopoetic tissue

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Supportive Connective tissue

1. Cartilage

2. Bone

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 CARTILAGE

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 Cartilage basics
o Special form of connective tissue
o Main function is to support soft tissues
o Matrix contains collagen(Type 2) or elastic
fibers which gives the cartilage firmness
and resilience.
o Cartilage provides structural support and
allows flexibility without distortion.

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o Cells: Chondrocytes
o Highly specialized ECM
o Avascular
o Matrix is solid and firm.
o Glycosaminoglycans in the matrix permits
diffusion of substances.
o Hyaluronic acid makes it well adapted for
weight bearing capacity(Synovial joints)

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 Classification

1. Hyaline

2. Elastic

3.Fibrocartilage

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 Hyaline Cartilage
Lacunae

Homogenous matrix, small nests of chondrocytes,

surrounding perichondrium
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 Sites
o Articular surface of bones
o Costal cartilages
o Trachea
o Nose
o Larynx
o Bronchus
o Embryo: Skeletal model for most bones

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 Elastic cartilage

Numerous elastic fibers

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 Sites

o External Ear
o Auditory Tube
o Epiglottis
o Larynx

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 Fibrocartilage

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 Sites
o Intervertebral Disc
o Symphisis Pubis

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 Bone
o Specialized form of connective tissue
o Matrix Mineralized
Function
o Provide support
o Provides attachment
o Provides protection
o Haemopoesis
o reservoir of ca and P
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 Types of Bone cells

1.Osteoprogenitor cells/Mesenchyme
2.Osteoblasts/Immature bone cells
3.Osteocytes/ Main cell
4.Osteoclasts/ large multinucleated

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• Microscopically section of the bone
contains :
• Osteon
• Lacuna
• Lamellae
• Centaral canal

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• Types of the bones :
According to location
A} axial bones
B} appendicular bones

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• According to shape
A} long bones
B} short bones
C} flat bones
D} irregular bone

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• Long bones is divided into
epiphysis
Diaphysis
Metaphysis

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• Internal structure of bones are
A} compact bones
B}sponge bones contains tubrecule
Which consist
red bone marrow
yellow bone marrow

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