Histology and Cell Biology: For Dentistry and Physical Therapy

Histology and cell biology
For dentistry and physical therapy

By
Staff members of histology department
Faculty of Medicine
Histology and cell biology
For dentistry and physical therapy
By
Staff members of histology department
Faculty of Medicine
By
Dr. Amal Taha
Dr. Eman Ahmad Abdel-rahim
Dr. Ahmad Mohammad Abdel-aleem
Dr. Essam Omar Kamel
Content
Subject Page
Introduction ----------------------------------------- 1
Cytology -------------------------------------------- 3
Epithelial tissue ------------------------------------ 11
Connective tissue (CT) ---------------------------- 15
Cartilage --------------------------------------------- 24
Bone ------------------------------------------------- 27
Blood ------------------------------------------------ 30
Muscular tissue ------------------------------------- 38
Nervous tissue -------------------------------------- 42
Vascular system ------------------------------------ 46
Skin -------------------------------------------------- 51
Lymphatic tissue ----------------------------------- 55
Oral cavity ------------------------------------------ 61
Digestive glands ----------------------------------- 65
Endocrine system ---------------------------------- 74
‫رقم اإليداع ‪7152/ 75312‬‬
‫‪I.S.B.N. 978-977-13-0432-6‬‬
Histology - for dental students 1
Introduction
Light microscope (LM) and Electron microscope (EM):

 In light microscope (LM) visible light and glass lenses are used to see colored
photos magnified up to 1500 times.
 In electron microscope (EM) invisible electrons and electro-magnetic coils
are used to see non-colored photos magnified up to 400.000 times or more.
Light microscope (LM) Electron microscope (EM)
 Light microscope (LM) is formed of:

o Metallic parts: base, arm and stage.
o Illumination system: light, mirror and condenser.
o Optical system: – Ocular lenses (7 or 10).
– Objective lenses (3.5 - 8 - 10 - 20 - 40 or 100).
 Magnification of LM = power of ocular lens × power of objective lens.
 Units: One meter (m) = million micro-meter (µm) while
One micro-meter (µm) = million pico-meter (pm)
×  cente- ×  milli- ×  micro- ×  nano- ×  Angst- ×  pico-

meter
100 meter 10 meter 1000 meter 1000 meter 10 rom 100 meter
(m)
 ÷ (cm)  ÷ (mm)  ÷ (μm)  ÷ (nm)  ÷ (A )  ÷ (pm)
0
 Resolution: is the capacity of the microscope to discriminate 2 adjacent

points.
 Limit of resolution is the shortest distance to discriminate 2 adjacent points.
Its value in:
o Human eye = 1 mm
o Light microscope (LM) = 0.2 µm
o Electron microscope (EM) = 3 nm
o Atomic force microscope (AFM) = 50 pm
Differences between light microscope (LM) and electron microscope (EM):
Light microscope (LM) Electron microscope (EM)
Body tube non-vacuumed tube vacuumed tube
Illumination visible beam of light (day or invisible beam of electrons
system electric)
Optical system glass lenses electro-magnetic coils
Magnification up to 1500 times up to 400.000 times or more
Resolution around 0.2 µm around 3 nm (0.003 µm)
Examination:  by human eyes  by fluorescent screen
 to see many cells with  to see 1 or 2 cells with non-
colored photo-micro-graphs colored photo-micro-graphs
(according to stains) (only black and white)
Examples: - Ordinary light microscope - Transmission EM 2
- Phase contrast microscope dimensions
- Scanning EM  3 dimensions
Types of stains used in histology:

The stains may be of animal origin (as carmine), of plant origin (as
hematoxylin) or synthetic (as eosin).
1. Acidic stain (for acidophilic cytoplasm): as eosin, orange G, acid fuchsine …
 red color.
2. Basic stain (for basophilic nucleus): as hematoxylin, toluidine blue,
methylene blue …  blue color.
3. Neutral stain (for blood films): as Leishman stain (eosin + methylene blue +
absolute methyl alcohol).
4. Vital stain (for living cells inside the body): as trypan blue (for reticulo-
endothelial cells).
5. Supra-vital stain (for living cells outside the body): as brilliant cresyl blue
(for blood reticulocytes).
6. Physical stain (stain soluble in alcohol but more soluble in fat): as Sudan III
(for fat cells).
7. Meta-chromatic stain (stain  different color): as toluidine blue  violet
color (in mast cells).
8. Silver impregnation (for connective tissue fibers): leading to brown
collagenous fibers - black reticular fibers.
9. Tri-chrome stains (3 stains that differentiate between various structures of the
tissue): as Mallory stain  blue collagenous fibers, yellow smooth muscle
fibers and red nuclei.
=========
☼ Differentiate between: light microscope and electron microscope.
☼ Enumerate: types of stains used in histology.
Cytology
Cells are the structural and functional units of human where cells  tissues 
organs  systems  human.
 Shape of cells: may be round, oval, flat, cubical or columnar.
 Size of cells (4-150 μm): may be small (as cerebellum), medium (as liver) or
large (as ovum).
 Function of cells: absorption, digestion and excretion - respiration, ion
transport and secretion - sensation, conduction and contraction.
 Structure of cells: each cell is composed of cytoplasm and nucleus.
 Cytoplasm is formed of:

1. Cell organelles: permanent components which perform certain function
essential for life.
2. Cell inclusions: temporary materials produced by cell activity and may
disappear.
3. Cyto-skeleton: a supportive network of microtubules, microfilaments
and intermediate filaments.
4. Matrix: a colloidal medium for cellular contents. It is formed of
proteins, fats, carbohydrates, minerals and ions.
 Nucleus is formed of:

1. Chromatin material: the DNA and histone protein that forms the 46
chromosomes.
2. Nuclear membrane.
3. Nucleolus: a site of ribosome synthesis.
4. Matrix: a colloidal medium for nuclear contents. It is formed of
proteins, fats, carbohydrates, minerals and ions.
Cell organelles
Cell organelles are permanent components which perform certain function
essential for life. They may be:
o Membranous (contain enzymes): as cell membrane, mitochondria,
endoplasmic reticulum, Golgi apparatus, lysosomes …
o Non-membranous (do not contain enzymes): as ribosomes, centrioles ...
1. Cell membrane = plasma membrane = plasma lemma:

Membranous cytoplasmic organelles concerned with cell
covering. Its thickness is 7.5-10 nm.
 LM: not seen (except with silver or PAS).
 EM: a tri-lamellar membrane (3 layers): dark - light - dark.
The cell membrane is formed of:
1. Proteins (60%): present as:
 Peripheral proteins: small molecules
(at outer and inner surface).
 Integral (trans-membrane) proteins:
small and large molecules (at the
middle).
2. Lipids (30%): present as:
 Phospholipid bilayer.
each phospholipid molecule has:
 Hydrophilic polar (charged) heads
(at outer and inner surface).
 Hydrophobic non-polar (non-
charged) tails (at the middle).
 Cholesterol molecules: at the inner cytoplasmic surface.
3. Carbohydrates (10%): which form the cell coat (glyco-calyx) by:
 Linking to outer protein  glycoproteins.
 Linking to outer lipid  glycolipids.
 Function of cell membrane:

1. Phagocytosis: engulfing solid materials (called phagosomes) in.
2. Pinocytosis: engulfing fluid materials (called pinocytic vesicles) in.
3. Exocytosis: expulsion of residual bodies out.
4. Passive diffusion (with concentration gradient): for gases, ions ...
5. Active transport (against concentration gradient by using energy of ATP):
for ions, amino acids …
NB: Sodium-potassium pump ( k+ in and Na+ out) is an example of
active transport.
6. Selective transport (through binding material with receptors present on
glyco-calyx): for viruses, drugs, hormones ...
7. Modification to:
– Microvilli: many projections (each contains actin microfilaments) - as
in intestine, liver …
– Cilia: many projections (each contains 20 microtubules "9×2 + 2") - as
in trachea, oviducts ...
– Flagellum: one projection containing 20 microtubules "9×2 + 2" - as in
sperm.
– Basal enfolding for mitochondria: to facilitate active transport of ions -
as in kidney.
8. Role of glycocalyx:
 Receiving chemical massages and neuro-transmitted signals (through its
receptors).
 Antibodies on its surface  immunity or allergy.
 Formation of cellular junction  adhesion of adjacent cells.
 Formation of basal lamina (of basement membrane) with type IV
collagen of CT.
2. Mitochondria: Membranous cytoplasmic organelles concerned with

respiration and energy production.
Mitochondria are contractile, motile and can divide as bacteria (every 10 days).
 LM: mitochondria appear as granules, rods or filaments (blue with iron
hematoxylin and green with Janus green).
 EM: mitochondria are oval with 2 membranes and 2 spaces:
 Outer smooth membrane.
 Inner folded membrane: forming folds
(cristae).
 Inter-membranous space: containing
enzymes of oxidative decarboxylation.
 Inter-cristal space: containing enzymes
of Kreb’s cycle.
 Function of mitochondria:
1. Regulation of calcium and magnesium metabolism.
2. Mitochondria are the power house of the cell as they supply energy to all
cellular activities as muscle contraction, active transport, protein synthesis ...
3. Mitochondria are the site of oxidative decarboxylation and Kreb’s cycle (so
each hepatocyte contains ± 2000 mitochondria).
glycolysis oxidative decarboxylation Kreb’s cycle
Glucose  8 ATP + pyruvic acid  6 ATP + active acetate  24 ATP
in cytoplasm in mitochondria in mitochondria
NB: complete Oxidation of one glucose molecule  38 ATP × 10.000 = 380.000 calories
3. Endoplasmic reticulum: Membranous cytoplasmic organelles concerned with

protein and lipid synthesis.
Types: there are two types of endoplasmic reticulum:
 Rough endoplasmic reticulum (rER): covered with ribosomes.

– LM: a basophilic network beside nucleus (its basophilia is
due to ribosomes).
– EM: communicating wide tubules (cisternae) more
demonstrated in protein-forming cells (as fibroblasts,
plasma cells, pancreatic cells …).
 Function of rER:  Protein synthesis (with the aid of ribosomes).
 Protein storage then delivery to Golgi apparatus as
transfer vesicles.
 Smooth endoplasmic reticulum (sER): not covered by ribosomes.
 LM: not seen (due to absence of ribosomes).
 EM: communicating narrow tubules more demonstrated in steroid-secreting
cells (as endocrine cells …).
 Function of sER:  Lipid synthesis and glycogen storage.
 Detoxification of harmful substances (as drugs …).
 Regulation of mineral metabolism as:
 Calcium in muscle cells  muscle contraction.
 Chloride in gastric cells  Hcl formation.
4. Golgi apparatus (secretory apparatus):

Membranous cytoplasmic organelles concerned
with packaging and secretion of protein.
 LM: Golgi apparatus appears as a network at
the apex of secretory cells and around nucleus
of nerve cells. Golgi apparatus is stained
brown by silver - not stained by hematoxylin
and eosin (giving negative Golgi image).
 EM: It is formed of three types of vesicles:
1. Transfer vesicles (small and rounded): they
contain protein particles coming from rER.
2. Flatted vesicles (Golgi sacules): they are
stack of vesicles with immature convex
(cis) face and mature concave (trans) face.
3. Secretory vesicles (large and rounded): they contain modified condensed
and packed proteins (that comes out by exocytosis).
 Function of Golgi apparatus:
1. Modification, condensation and packaging of secretory products of the cell
(by transferase and sulfatase enzymes).
2. Shares in cell membrane formation and repair after exocytosis.
3. Shares in lysosome formation (with the aid of ribosomes and rER).
5. Lysosomes: Membranous cytoplasmic organelles concerned with intra-

cellular digestion. Its thickness is 0.2-0.4 µm.
 LM: lysosomes appear as dark granules (by acid phosphatase stain) in
phagocytic cells (as macrophages).
 EM: lysosomes appear in two forms:
o Primary homogeneous lysosomes:
They contain only hydrolytic enzymes as lipase, proteases, acid
phosphatase ... (formed by ribosomes and modified by Golgi apparatus).
o Secondary heterogeneous lysosomes:
They contain hydrolytic enzymes and phagosomes (phago-lysosomes).
 Function of lysosomes:
1. Intra-cellular digestion of nutritive phagosomes and old mitochondria, so
they are named "digestive apparatus".
NB: after digestion the remaining parts (residual bodies) are exocytosed.
2. Killing and destruction of phagocytized bacteria and viruses.
3. Hydrolysis of thyroid colloid (in thyroid follicles) to activate its hormone.
4. Hydrolysis of kidney proteins (in glomerular filtrate) to help their
reabsorption.
5. Facilitate penetration of sperm head to ovum (during fertilization).
6. Post-mortem autolysis, so they are named also "suicidal bags".
6. Ribosomes:
Non-membranous cytoplasmic organelles concerned with protein synthesis.
 LM: ribosomes are oval basophilic structures (rRNA) formed in nucleolus.
They are stained blue by hematoxylin and appear in the following forms:
1. Attached ribosomes (on rER): for synthesis of secreted proteins as
hormones, enzymes …
2. Free ribosomes: for synthesis of cytoplasmic proteins.
3. Isolated bodies: as Nissl granules of nerve cells.
4. Spiral structures: named "polysomes".
5. Fragmented structures: named "microsomes".
 EM: each ribosome is formed of:
 Small ribosomal subunit.
 Large ribosomal subunit (formed of two parts
between which there is a groove for the poly-
peptide chain).
 Function of ribosomes:
Protein synthesis (with the aid of tRNA) through translation of mRNA
nucleotides to a sequence of amino acids that bound together to create a poly-
peptide chain (newly formed protein).
Protein synthesis occurs through the following steps:
– Transcription: formation of a complementary mRNA in the nucleus from genetic DNA code in
presence of RNA polymerase enzyme.
– Translation: formation of a polypeptide chain of amino acids (newly formed protein) in the
cytoplasm by the aid of ribosomes, mRNA and tRNA.
– Secretion: the newly formed protein leaves ribosome to enter rER then enters Golgi apparatus as a
transfer vesicle and finally exocytosed as a secretory vesicle.
NB:  Features of "protein-forming cells": euchromatic nucleus with prominent
one or more nucleolus - many mitochondria, many rER, well-developed
Golgi apparatus and many secretory vesicles.
Examples: CT fibroblasts …
 Features of "steroid-forming cells": euchromatic nucleus with prominent
one or more nucleolus - many mitochondria, many sER, well-developed
Golgi apparatus and many lipid droplets.
Examples: suprarenal spongiocytes …
7. Centrioles:
Non-membranous cytoplasmic organelles concerned with cell division -
centrioles are not present in nerve cells and erythrocytes because these cells
cannot divide.
 LM: two tubular structures at right angle with each other
(near the nucleus). They can be stained with hematoxylin.
 EM: each centriole is a hollow cylinder formed of 27
microtubules (arranged as 9 radiating triplets) embedded in a
protein matrix giving cartwheel appearance in cross section.
 Function of centrioles:
1. Cell division by their duplication and movement of each
pair towards one pol to form the mitotic spindle.
2. Formation of cilia and flagella.
Cilia: are motile hair-like processes extending from the cell membrane of
epithelial cells in respiratory system, ♂ and ♀ genital system …
Flagella: are similar to cilia but single, longer and present only in sperms for
their movement.
Each cilium or flagellum is formed of:
 Rootlet: 7 microtubules (embedded in the cytoplasm).
 Basal body: a migrated single centriole formed of 27 microtubules (arranged
as 9 radiating triplets).
 Shaft: 20 microtubules (arranged as 9 radiating doublets + 2 central singlets).
Nucleus
Nucleus is present in all cells except RBCs and platelets.
 Shape of nucleus: may be flat - round - oval - rod-shaped - kidney-shaped -
bilobed - segmented - lobulated.
 Site of nucleus: may be central - eccentric - apical - basal.
 Size of nucleus: may be small, medium or large.
 Number of nuclei: may be one - two (as hepatocytes, superficial cells of
transitional epithelium …) - many (as osteoclasts, skeletal muscle cells …).
 Function of nucleus: carrying of
genetic information (by DNA) - control
of cellular activities (by RNA) -
control of cell division.
 Structure: the nucleus is formed of
chromatin material, nuclear membrane,
nucleolus and matrix.
NB: nuclear membrane, nucleolus and
matrix disappear during cell division.
 Chromatin material:
It is the site of genetic information (the 46 chromosomes).
LM: basophilic granules formed of nucleo-proteins (nucleo-somes) which is
DNA and histone protein.
EM: it is formed of peripheral chromatin, nucleolus associated chromatin and
chromatin islands.
Types of chromatin material: there are two types of chromatin:
Eu-chromatin Hetero-chromatin
LM  Light staining (so cannot be  Dark staining (so can be seen by
seen by LM) LM)
EM  Extended threads (less coiled  Condensed particles (more
DNA) coiled DNA)
Activity  More active (as in hepatocytes)  Less active (as in lymphocytes)
 Nuclear membrane:
LM: it appears as a single basophilic membrane
(due to basophilic peripheral chromatin).
EM: it appears as an envelope formed of two
membranes (separated by peri-nuclear space):
o Inner fibrillar membrane with peripheral
chromatin on its inner surface.
o Outer granular membrane (continuous
with rER) with ribosomes on its outer surface.
o Nuclear pores are present in nuclear membrane and covered by
diaphragms to regulate RNA passage.
 Nucleolus: It is the site of rRNA (ribosome) synthesis. It is well developed in
protein-forming cells and may be numerous.
LM: one or two rounded basophilic masses (due to basophilic nucleolus
associated chromatin).
EM: it is formed of two areas:
o Light area:  Pars amorpha (DNA cod of rRNA).
o Dark area:  Pars fibrosa (early rRNA).
 Pars granulosa (mature rRNA).
 Matrix = nuclear sap = nucleoplasm = karyolymph:
A clear colloidal medium for nuclear contents and RNA movement. It is
formed of proteins, fats, carbohydrates, enzymes, minerals and ions.
According to amount of matrix the nucleus may be:
1. Open-face nucleus: with great amount of matrix (as hepatocytes …).
2. Condensed nucleus: with less amount of matrix (as lymphocytes …).
Nucleic acids (DNA and RNA)

There are two types of nucleic acids:
 RNA (Ribo Nucleic Acid):
– RNA is present in nucleus and
cytoplasm.
– The RNA molecule consists of one
chain (single helix) formed of ribose
sugar and phosphate.
– Types of RNA:
1. Messenger RNA (mRNA): arise
from DNA and act as code carrier.
2. Transfer RNA (tRNA): arise from
DNA and act as amino acid
transporter.
3. Ribosomal RNA (rRNA): arise from nucleolus and act as protein factories.
 DNA (Deoxy-ribo Nucleic Acid):
– DNA is present in nucleus and mitochondria.
– The DNA molecule consists of two chains (double helix) formed of deoxy-
ribose sugar and phosphate.
RNA (Ribo Nucleic Acid) DNA (Deoxy-ribo Nucleic Acid)
Structure  one chain (single helix)  two chains (double helix) formed of
formed of ribose sugar and deoxy-ribose sugar and phosphate
phosphate
 nitrogenous bases (adenine  the two chains are linked transversely
= uracil or cytosine  by nitrogenous bases (adenine =
guanine) extend laterally thymine or cytosine  guanine) that
from sugar groups extend laterally from sugar groups
Types  three types (m,t,r RNA)  one type
Site  nucleus and cytoplasm  nucleus and mitochondria
Function  translation  transcription
☼ Write short notes on: cell membrane - mitochondria - endoplasmic reticulum

- Golgi apparatus - lysosomes - ribosomes - centrioles and cilia - chromatin
material - nucleic acids …
Epithelial tissue
o The basic tissues of the body are: epithelial tissue, connective tissue,
muscular tissue and nervous tissue.
o Epithelial tissue may be:

simple epithelium, stratified epithelium, glandular epithelium, neuro-
epithelium or myo-epithelium.
o Simple and stratified types are named "surface epithelium" as they cover
surfaces or line cavities.
o Epithelial tissue is sensitive, avascular (supplied by diffusion) and

regenerative. Its cells are joined together by cellular junctions and based on
basement membrane.
o Basement membrane is a thin layer (between epithelial tissue and underlying
connective tissue). It is formed of:
 Basal lamina (glycoprotein of cell membrane) from basal layer of
epithelial tissue.
 Reticular lamina (type 4 collagen) from connective tissue.
Simple epithelium:
It is formed of a single layer of cells  6 types:
1. Simple squamous epithelium:
 It is formed of a single layer of flat cells with flat nuclei.
 Sites: endothelium, mesothelium - alveoli, Bowman’s capsule - anterior
chamber of eye, adult ovary…
 Function: concerned with blood flow, intestinal movement, gas diffusion…
2. Simple cuboidal epithelium:
 It is formed of a single layer of cube-like cells with rounded nuclei.
 Sites: salivary acini, thyroid follicles - proximal and distal convoluted
tubules - eye lens, infantile ovary…
 Function: concerned with secretion, reabsorption…
3. Simple columnar epithelium:
 It is formed of a single layer of tall cells with oval nuclei.
 Sites: stomach, intestine, gall bladder, CBD - goblet cells, cervical canal…
 Function: concerned with secretion, absorption…
4. Simple columnar ciliated epithelium:
 It is formed of a single layer of columnar cells with cilia (containing 9×2 +
2 microtubules).
 Sites: bony eustachian tube, bronchioles - uterus, fallopian tube - central
canal…
 Function: concerned with movement of mucous, ova…
5. Pseudo-stratified columnar epithelium:
 It is formed of a single layer of columnar cells with some basal cells.
 Sites: large salivary ducts - upper vas deferens, membranous ♂ urethra…
 Function: concerned with protection…
6. Pseudo-stratified columnar ciliated epithelium:
 It is formed of a single layer of col. ciliated cells with some basal cells.
 Sites: nose, nasopharynx, cartilaginous eustachian tube - trachea, bronchi -
lacrimal sac…
 Function: concerned with movement of mucous…
Simple squamous Simple cubical Simple col. Simple col. Cilia. Pseudo-stratified col. Pseudo-stratified col. Cilia.
NB: Cilia may be:
 Motile (containing microtubules and microfilaments) as trachea.
 Non-motile (containing microfilaments only) as epididymis.
Stratified epithelium: It is formed of many layers of cells  4 types:
1. Stratified squamous epithelium:
 It is formed of many layers with superficial squamous cells (with or
without keratin layer).
 Sites: – Keratinized type: skin, orifices…
– non-keratinized type: oral cavity, esophagus, vagina, cornea…
NB: stratified epithelium is formed of closely packed 3-30 layers of cells
divided into:
o Many superficial layers which are variable
in shape and shed off with regeneration.
o Many intermediate layers which are
polygonal and joined by cellular junctions.
o One basal layer on the basement membrane
which is columnar and germinative.
2. Stratified cuboidal and transitional epithelium:
 It is formed of many layers with superficial Stratified squamous epithelium
cuboidal cells (fixed or transitional).
 Sites: sweat ducts, seminiferous tubules -
kidney calyces, ureter, urinary bladder,
prostatic urethra…
NB: transitional uro-epithelium of urinary tract
contains mucous-like substance which:
 Cover superficial cells leading to: Transitional epithelium
– Protection of epithelium (from acidity or urine).
– Barrier between urine and tissue fluid "osmotic barrier".
 Separate intermediate cells and facilitate their gliding leading to:
– Thick transitional epithelium (6-8 layers) in empty urinary bladder.
Now superficial layer is cuboidal "stratified cuboidal epithelium".
– Thin transitional epithelium (3-4 layers) in full urinary bladder.
Now superficial layer is squamous "stratified squamous epithelium".
3. Stratified columnar epithelium:

 It is formed of many layers with superficial columnar cells.
 Sites: conjunctival fornicies, large ducts - recto-anal junction ...
4. Stratified columnar ciliated epithelium:
 It is formed of many layers with superficial columnar ciliated cells.
 Sites: nasal soft palate, laryngeal epiglottis - fetal esophagus…
Glandular epithelium: the secretory type of epithelium.
Most glands are formed of collections of epithelial cells.
The glands are classified according to their duct system to:
o Exo-crine: giving secretions to duct system.
Example: salivary glands.
o Endo-crine: giving hormones to blood sinusoids.
Example: pituitary gland.
o Mixed: has exocrine part and endocrine part.
Example: pancreas. Pancreas
Neuro-epithelium: the sensory type of epithelium.
 In this type epithelial cells act as sensory receptors for special stimuli.
 Each neuro-epithelial cell has apical
hairlets (to receive sensation) and
basal nerve (to transmit sensation).
 Function and site of neuro-epithelium:
1. Tasting:
Taste buds (in tongue epithelium).
2. Hearing:
Organ of Corti (in cochlea of internal ear).
3. Equilibrium:
o Crista ampularis (in semicircular canals of
internal ear) for circular movements.
o Macula utriculi and macula saculi (in
vestibule of internal ear) for linear
movements.
Myo-epithelium: the contractile type of epithelium.

Myo-epithelial cells (Basket cells) are contractile branched cells.
They are present between secretory cells and their basement membrane 
their evacuation.
Function of epithelial tissue:

1. Protection (by covering surfaces or lining cavities).
2. Absorption (as intestine…).
3. Secretion (as salivary glands…).
4. Excretion (as kidney…).
5. Reproduction (as testis and ovary).
6. Sensation (as neuro-epithelium).
=========
☼ Write short notes on:
Simple epithelium - Stratified epithelium - Neuro-epithelium.
Connective tissue (CT)
 CT is a mesodermal structure concerned with

connection and support of other types of tissues.
 CT is formed of:
CT cells and extracellular matrix formed of CT
fibers and ground substance.
NB: mesoderm  mesenchymal tissues (CT,
muscular tissue and vascular tissue).
Types of CT:
According to matrix there are 4 types of CT:

1. Blood: with fluid matrix.
2. CT proper: with soft matrix (loose CT, mucous CT, adipose CT, dense CT,
reticular CT and elastic CT).
3. Cartilage: with rubbery matrix.
4. Bone: with solid matrix.
According to characters there are 3 types of CT:

1. CT proper: loose CT and dense CT.
2. CT with special properties: mucous CT, adipose CT, elastic CT and
hematopoietic CT.
3. Supportive CT: cartilage and bone.
Connective tissue proper

CT proper is formed of CT cells in a soft matrix (formed of CT fibers and
ground substance).
Ground substance: The ground substance is formed of tissue fluid containing

the following amorphous materials:
1. Glycos-amino-glycans (GAGs): a basophilic un-branched polysaccharide
chain of repeating disaccharides (amino sugar and uronic acid).
It is hydrophilic  exchange of ion and nutrients between CT and blood.
2. Proteo-glycans: a core of protein to

which molecules of GAGs (as
chondroitin sulfate, keratan sulfate Proteo-glycan
and hyaluronic acid) are bound 
bottle brush appearance.
Carbohydrate (90-95%) is greater Glycos-amino-glycan
than protein.
3. Glyco-protains: a globular protein Glyco-protein

molecule to which branched chains
of mono-saccharides are attached.
Protein is greater than carbohydrate.
It binds CT cells and CT fibers together.
Connective tissue fibers:

There are 3 types of CT fibers: all are formed by fibroblasts.
1. White collagenous fibers (the flexible type of CT fibers):

 LM: wavy non-branching colorless soft fibers  flexible
branching white strong bundles.
Formed Formed Formed Formed 3 α peptides
 EM: bundles of  fibers of  fibrils of  tropo-collagen of 
(2α1 & 1α2)
 Staining: blue by Mallory, pink by eosin and red by van Gieson.
Types of collagen:
o Type I collagen (for tension):
– Present in bones and tendons.
– Formed by osteo-blasts.
o Type II collagen (for pressure):
– Present in cartilage.
– Formed by chondro-blasts.
o Type III collagen (for expansion):
– Present in skin, muscles and
blood vessels.
– Function: form reticular fibers.
o Type IV collagen (for support):
– Present in basement membranes.
– Function: support and filtration.
o Type V collagen as type I. the 3 α peptides of tropocollagen (2 α 1 and 1 α 2)
2. Reticular fibers = type III collagen (the delicate type of CT fibers):
 LM: single delicate
fibers that branch to
form the network
(reticulum) of stroma
present in glands.
 EM: as collagenous
fibers (3 α peptides)
but does not form
bundles.
 Staining: dark brown
by silver and purple by PAS.
3. Yellow elastic fibers (the stretchable type of CT fibers):

 LM: single branched yellow stretchable fibers (formed
by fibroblasts and smooth muscle cells).
 EM: each fiber is formed of elastin (protein)
surrounded by fibrils (glyco-protein).
 Staining: brown by Orcein, blue black by Verhoeff and
yellow by van Gieson.
Connective tissue cells:

There are 12 types of cells in CT proper which are classified by two ways:
Fixed or free CT cells:

o Fixed (resident) CT cells (7 types): they are stable (produced in CT) and
long-lived.
UDM cells - fibroblasts - pericytes - endothelial cells - reticular cells -
fixed macrophages - fat cells.
o Free (wandering) CT cells (5 types): they are motile (coming to CT from
other areas) and short-lived.
Leucocytes - plasma cells - mast cells - free macrophages - melanophores.
Branched or rounded CT cells:
o Branched CT cells (8 types): they are mainly fixed cells.
UDM cells - fibroblasts - pericytes - endothelial cells - reticular cells -
fixed macrophages - free macrophages - melanophores.
o Rounded CT cells (4 types): they are mainly free cells.
Leucocytes - plasma cells - mast cells - fat cells.
1. Un-differentiated mesenchymal cells = UDMCs (fixed branched CT cells):

☼ They are present in umbilical cord (Warton’s jelly)
- vitreous humor of eyes - pulp of growing teeth.
☼ LM: pale basophilic cells with central oval nuclei -
cells are surrounded by jelly-like matrix.
☼ EM: many free ribosomes.
☼ Function: embryonic stem (mother) cells that can differentiate to other
CT cells.
NB: Un-differentiated mesenchymal cells (UDM cells) 
 Fibroblasts  reticular cells.
 Pericytes.
 Endothelial cells.
 Lipoblasts  lipocytes (fat cells).
 Osteo-blasts  osteo-cytes.
 Chondro-blasts  chondro-cytes.
 Mesothelial cells.
2. Fibroblasts (fixed branched CT cells arising from UDM cells):

☼ The most active cells in the CT proper. They
are protein-forming cells.
☼ LM: deep basophilic cells with large oval nuclei
- nuclei are pale with prominent nucleolus.
☼ EM: many mitochondria, many rER, well-developed Golgi apparatus and
many secretory granules.
☼ Function: – Synthesis of CT fibers and CT matrix.
– Healing of CT after injury.
3. Pericytes (fixed branched CT cells arising from UDM cells):

☼ Adult mesenchymal cells present in blood capillaries
(between BM and endothelium).
☼ LM: pale basophilic cells with central oval nuclei.
☼ EM: many free ribosomes - many actin and myosin
microfilaments.
☼ Function: can change to endothelial cells or smooth SM = smooth muscle cell (pericyte)
muscle cells (that cause vasoconstriction). En = endothelial cell
4. Endothelial cells (fixed branched CT cells arising from UDM cells):
☼ They line vascular system by simple squamous endothelium.
☼ LM: flat cells with flat nuclei.
☼ Function: – Formation of new blood capillaries (by their division).
– Formation of type IV collagen of basement membrane.
5. Reticular cells (fixed branched CT cells arising from fibroblasts):

☼ Modified fibroblasts that synthetize reticular CT fibers.
☼ LM: pale basophilic cells with central rounded nuclei
and many long thin processes.
☼ Function:
– Formation of stroma that support various organs as
glands, lymph nodes, spleen …
– Change by antigens to phagocytic cells to remove of cellular debris of
lymphatic tissue.
6. Fixed macrophages = Histeocytes (fixed branched CT cells arising from

monocytes): and
7. Free macrophages = migrated monocytes (free branched CT cells arising
from monocytes):
☼ Phagocytic cells (of mono-nuclear phagocytic
system). Can engulf vital stains (as trypan blue).
☼ LM: pale granular amoeboid cells with dark
kidney-shaped eccentric nuclei.
☼ EM: many lysosomes (interferon, collagenase and
elastase) and many phagosomes.
☼ Function: 1. Phagocytosis of micro-organisms and small foreign body.
2. Can fuse together to form giant phagocytic cells for large
foreign body).
3. Destruction of old RBCs in liver and spleen.
8. Melanophores = pigment cells (free branched CT cells arising from

monocytes):
☼ Free CT macrophages present in the dermis of skin.
☼ EM: their cytoplasm is rich in melanosomes.
☼ Function: phagocytosis and storage of melanin pigment (produced by
melanocytes present in the epidermis of skin).
9. Leucocytes (free rounded CT cells arising from PHS cells):

o Leucocytes include basophils, eosinophils, neutrophils, monocytes and
lymphocytes.
o They migrate from blood to CT in presence of infection.
NB: pluri-potential hemato-poetic stem cells (PHS cells) 

 Erythrocytes
 Thrombocytes
 Granulocytes (basophils, eosinophils and
neutrophils)
 Monocytes  fixed macrophages, free
macrophages and melanophores…
 Lymphocytes  plasma cells
 Mast cells
 Osteo-clasts, microglia and Langerhan’s cells
10. Plasma cells = activated B-lymphocytes (free rounded CT cells arising from
B-lymphocytes):
o They are protein-forming cells present mainly in lymphoid tissues.
o LM: large oval basophilic cells with eccentric cartwheel (clock-face)
nuclei.
o EM: many mitochondria, many rER and well-developed Golgi apparatus
(with Hx & E stain Golgi apparatus unstained  negative Golgi image).
o Function: secretion of antibodies (IgG- IgM- IgA- IgE- IgD = Russell
bodes)  humoral immunity.
Leucocytes Plasma cells Mast cells
Fat cells
11. Mast cells (free rounded CT cells arising from PHS cells):
o Paracrine cells present in group around blood vessels in the CT of skin,
RT, GIT….
o LM: oval cells with eccentric rounded nuclei and basophilic granules
(stained purple with toluidine blue  meta-chromasia). These granules
mask other contents of the cell.
o EM: cytoplasmic processes (with receptors for IgE) and many electron-
dense granules.
o Types:
1. Heparin secreting cells (in CT of skin) that secrete heparin
(anticoagulant).
2. Histamine secreting cells (in CT of RT, GIT…) that secrete histamine
( capillary permeability).
12. Fat cells = Adipocytes = Lipocytes (fixed rounded CT cells arising from
UDM cells):
Fat cells are of two types:
Uni-locular fat cells Multi-locular fat cells
(of white adipose CT) (of brown adipose CT)
LM o large and oval in o small and rounded in
shape (50-150 μm) shape
o contain single o contain multiple small
large fat globule  fat droplets 
o peripheral flat nucleus and thin o central rounded nucleus
rim of cytoplasm
o with Hx and E stain they show o with Hx and E stain they show
signet ring appearance multiple vacuoles
EM – few mitochondria  – many mitochondria 
few cytochrome pigments) many cytochrome pigments
Sites Present in white adipose CT at the Present in brown adipose CT at
following sites: the following sites:
 around kidney and blood  in newborn: form 2-5% of
vessels. body weight and present in
 ♀ subcutaneous areas  ♀ back, neck and shoulders
shape contour  in adults: around aorta and in
 omentum and abdominal wall mediastinum
NB: the white color of this type of NB: the brown color of this type
adipose CT is due to: of adipose CT is due to:
–  blood capillaries –  blood capillaries
–  cytochrome pigments in its –  cytochrome pigments in its
mitochondria mitochondria
Function o Heat insulator (storage house of o Heat generator
fat)
o Support some organs as
kidney…
o Energy reservoir ( by
regimen)
Types of CT proper:
There are 6 types of CT proper:
1. Loose (areolar) CT.
2. Mucous (mucoid) CT.
3. Adipose (fatty) CT.
4. Dense (collagenous) CT.
5. Reticular CT.
6. Elastic CT.
1. Loose (areolar) CT:
– It binds tissues together and supports various organs (all over the body
except brain).
– Structure: it is formed of CT cells (fibroblasts, macrophages, mast cells, fat
cells …) and CT fibers in a loose matrix containing areolae (fluid spaces).
– Sites: subcutaneous tissues - submucosa - serous membranes - around
organs and blood vessels …
2. Mucous (mucoid) CT:

– Present mainly in embryonic tissues.
– Structure: it is formed of UDM cells and fine
collagenous fibers in a soft jelly-like matrix (rich in
mucin and hyaluronic acid).
– Sites: umbilical cord (Warton’s jelly) - vitreous
humor of eyes - pulp of growing teeth.
3. Adipose (fatty) CT:

– Structure: it is similar to loose CT but very rich in adipocytes (that present
in groups separated by fibrous septa).
– Types:  White adipose CT that appears yellow (due to presence of few
blood vessels and few mitochondrial pigments).
 Brown adipose CT that appears brown (due to presence of
many blood vessels and many mitochondrial pigments).
4. Dense (collagenous) CT:

– Structure: it is formed of collagenous fibers and fibroblasts in a soft matrix
(characterized by few amounts and poor blood supply).
– Types: it has two types:
Regular dense CT Irregular dense CT

 Collagenous bundles  Collagenous bundles
arranged regularly  arranged irregularly 
 Colorless CT  White CT
 Function: stretch in one  Function: stretch in
direction Regular dense CT different directions
 Sites:  Sites:
– Cornea of eye – Sclera of eye, dura mater
– Tendon of muscle and dermis of skin
– Capsule and septa of
gland stroma
– Perichondrium and
Irregular dense CT periosteum
5. Reticular CT:
– The fine type of CT that forms the network of stroma in bone marrow,
various glands and various organs.
– Structure: it is formed of reticular fibers and reticular cells in a soft matrix
(reticular fibers are enveloped by the cytoplasm of reticular cells).
Reticular CT contains cells of parenchyma.
– Sites:  Bone marrow, lymph nodes, spleen, lungs …
 Salivary glands, liver, testis, ovary …
6. Elastic CT:
– A yellow stretchable CT that form elastic membranes (as in aorta) or
elastic ligaments (as in vocal cords).
– Structure: it is formed of condensed regular elastic fibers and fibroblasts in
a soft matrix.
– Sites: aorta and arteries - bronchi, bronchioles and alveoli - ligaments and
skin ...
Function of CT Proper:
1. Tissue connection and organ support.
2. CT proper carries blood vessels, lymphatics and nerves to all parts of
various organs.
3. Tissue growth and wound healing.
4. Specific functions for CT cells as:
 Formation of ground substance and CT fibers (by fibroblasts).
 defense through allergic reactions (by mast cells, basophils and
eosinophils)
 Phagocytosis (by neutrophils and macrophages).
 Humoral and cell-mediated immunity (by plasma cells and
lymphocytes).
 Energy reservoir and heat production (by fat cells).
=========
☼ Enumerate: branched CT cells - rounded CT cell - fixed CT cells - free CT
cells …
☼ Differentiate between:
 Uni-locular fat cells (of white adipose CT) and multi-locular fat cells (of
brown adipose CT).
 Regular and irregular dense CT.
☼ Discuss: UDM cells - fibroblasts - Pericytes - plasma cells - mast cells -
fixed macrophages …
☼ Comment on: CT fibers - Loose (areolar) CT - Mucous (mucoid) CT -
Reticular CT - Elastic CT …
Cartilage
Cartilage is a firm flexible CT formed of cartilage cells in a rubbery

extracellular matrix (formed of CT fibers "collagen type II" and ground
substance).
It is non-vascular and covered by perichondrium.
Function of cartilage:
1. Support of the body (by skeleton).
2. Protection of essential organs (as CNS, heart, lung ...).
3. Bone growth in length by intra-cartilaginous ossification.
4. Opening of airway (nose, larynx, trachea and bronchi).
5. Formation of smooth surface for joint movement.
Structure of cartilage:
 Cartilage cells:
1. Chondroblasts (immature cartilage cells):
 Origin: arise from UDMCs (un-differentiated
mesenchymal cells).
 Site: present singly at the periphery of cartilage
(under perichondrium).
 LM: oval deep basophilic cells with oval
nuclei.
 EM: features of protein-forming cells (as they
form extracellular matrix).
A. Chondroblasts
 Function: transformed to chondrocytes 
B. Condrocytes
peripheral appositional growth.
C. Lacuna
2. Chondrocytes (mature cartilage cells):
 Origin: arise from chondroblasts.
 Site: present at the center of cartilage in groups
"cell nests" formed of 2, 4 or 8 cells
surrounded by space "lacuna" and capsule (of
condensed matrix).
 LM: rounded pale basophilic cells with rounded
nuclei.
 EM: features of protein-forming cells (as they
form extracellular matrix) with glycogen and A. Chondrocyte
lipid droplets. B. Matrix with elastic fibers
 Function: divide  central interstitial growth. C. Lacuna
NB: chondroblasts and chondrocytes form extracellular
matrix so they have EM features of protein-forming
cells (euchromatic pale nucleus with prominent
nucleoli - many mitochondria, many rER, well-
developed Golgi apparatus and many secretory
vesiclss). Cell nest
(two chondrocytes
 Fibers: collagenous fibers "type II" and elastic fibers. surrounded by lacuna)
 Ground substance: tissue fluid containing glycos-amino-glycans (causing its

basophilia), proteoglycans (as chondroitin sulphate, hyaluronic acid …) and
glycoprotein.
 Perichondrium: vascular CT membrane formed of 2 layers:

1) Outer fibrous layer (formed of collagenous bundles "type I" and
fibroblasts): for muscle attachment.
2) Inner chondrogenic layer (formed of chondroblasts): for nourishment (by
diffusion) and peripheral appositional growth (increase in width by
formation of new chondroblasts and their transformation to chondrocytes).
Types of cartilage:
1. Hyaline cartilage:
 It is translucent and common.
 Present in fetal skeleton - costal cartilage - respiratory passages (nose,
larynx, trachea and bronchi) - articular surfaces of joints (but without
perichondrium).
 Formed of cartilage cells, basophilic matrix (containing collagen fibers)
and perichondrium.
2. Elastic cartilage:
 It is yellow and stretchable.
 Present in ear pinna, external auditory canal, epiglottis and eustachian tube.
 Formed of cartilage cells, basophilic matrix (containing branching elastic
fibers) and perichondrium.
3. Fibro-cartage:
 It is white and flexible.
 Present in inter-vertebral discs and knee joints - symphysis pubis -
mandibular joints - tendon of muscles.
 Formed of rows of cartilage cells separated by few acidophilic matrix
(containing thick collagenous fibers "type I").
NB: White fibro-cartage has no perichondrium (but only vascular dense
fibrous tissue for nourishment).
Hyaline cartilage Elastic cartilage Fibrocartilage
Growth of cartilage:
Growth of cartilage occurs by two ways:
1. Peripheral (appositional) growth:
Formation of new chondroblasts and their transformation to chondrocytes 
increase of cartilage in width.
2. Central (interstitial) growth:
Mitotic division of chondrocytes and secretion of more matrix  increase of
cartilage in length.
Bone
Bone is a hard calcified CT formed of bone cells in a solid extracellular matrix

(formed of CT fibers "collagen type I" and calcified ground substance). It is
highly vascular, covered by periosteum and lined by endosteum.
 Function of bone: 1. Support of the body (by skeleton).
2. Protection of essential organs (as CNS, lung, BM...).
3. Reservoir of calcium.
 Anatomical types of bone: long - short - flat - irregular.
 Histological types of bone: compact bone as shaft of long bones - spongy
bone as ribs.
Bone cells: there are four types of bone cells:
1. Osteogenic cells (osteoprogenator stem cells): arise from UDM cells or

pericytes.
 Site: inner layer of periosteum and endosteum.
 LM: spindle-shaped pale cells with flat nuclei.
 EM: features of mitotically active cells (centrioles and many ribosomes).
 Function: they can divide and differentiate to:
 Osteoblasts (with  vasculature).
 Chondroblasts (with  vasculature).
2. Osteoblasts (bone forming cells): arise from osteogenic cells.

 Site: inner layer of periosteum and endosteum.
 LM: oval basophilic cells with eccentric nuclei and few
processes.
 EM: features of protein-forming cells ( mitochondria, rER
and unstained Golgi). Osteoblasts
 Function: they form organic component of matrix while its
alkaline phosphatase deposit calcium in matrix then change to osteocytes
when trapped inside lacunae.
3. Osteocytes (mature bone cells): arise from osteoblasts.

 Site: between bone lamellae (inside lacunae that
communicate by canaliculi).
 LM: small oval basophilic cells present singly inside lacunae.
 EM: they have thin processes connected by gap junction
inside canaliculi.
 Function: they maintain the bone matrix. Osteocytes
4. Osteoclasts (bone resorbing cells): formed by fusion of 6-20 monocytes.
 Site: at surface (in Howship’s lacunae) and at endosteum.
 LM: foamy acidophilic multinucleated giant cells (120 µm)
with irregular ruffled border (microvilli).
 EM:  mitochondria, rER, Golgi and lysosomes.
 Function: remodeling of bone during growth and after
fractures (by HCO 3 and lysosomal enzymes).
Osteoclasts
NB:  Alkaline phosphatase of osteoblasts  bone calcification.
 Acid phosphatase of osteoclasts  bone decalcification.
Bone matrix: a solid calcified media formed of:

 Inorganic substance (calcium): form 50% of bone.
 Organic substance (glycoprotein): form 25% of bone.
 Water: form 25% of bone.
Compact bone (ivory bone): it is formed of:

1. Haversion system (osteons): each is formed of longitudinal Haversion canal
surrounded by 5-20 concentric interstitial lamellae.
2. Volkmann’s canals: transverse canals connecting periosteum, Haversion
canals and endosteum.
3. Bone lamellae: layers of calcified collagenous bundles between which
osteocytes are present in their lacunae. They are of 3 types:
 External circumferential lamellae: regular lamellae close to periosteum.
 Interstitial lamellae: irregular lamellae present between Haversion systems.
 Internal circumferential lamellae: regular lamellae close to endosteum.
4. Covering periosteum: vascular CT membrane formed of 2 layers:
 Outer fibrous layer (formed of collagenous bundles "type I" and
fibroblasts): for muscle attachment.
 Inner osteogenic layer (formed of osteogenic cells): for nourishment, repair
of bone and peripheral appositional growth (increase of bone in width by
formation of new osteoblasts and their transformation to osteocytes).
5. Lining endosteum: vascular CT membrane surrounding bone marrow
cavities. It is similar to inner osteogenic layer of periosteum.
Spongy bone (concellous bone): it is formed of:

 Bone trabiculae: irregular bone plates containing
osteocytes and multiple bone marrow cavities.
 Multiple bone marrow cavities: lined by endosteum
and containing red active bone marrow with blood
sinusoids.
 Covering periosteum: as that of compact bone.
Differences between bone and cartilage:
Cartilage Bone
 firm flexible CT formed of 2 types  hard calcified CT formed of 4 types
of cartilage cells in a rubbery of bone cells in a solid extracellular
extracellular matrix matrix
 non-vascular CT and receive  highly vascular CT as blood vessels
nourishment from inner are present in Haversion canals and
chondrogenic layer of Volkmann's canals while lacunae
perichondrium and extra-cellular canaliculi contain
(no extra-cellular canaliculi) tissue fluid
 3 types: hyaline cartilage, elastic  2 types: compact bone and spongy
cartilage and fibro-cartilage bone
 chondrocytes are single or grouped  osteocytes are single cells - cannot
cells - can divide - not communicate divide - their processes communicate
inside extra-cellular canaliculi
 matrix: is formed of CT fibers  matrix: is formed of CT fibers
"collagen type II" and flexible "collagen type I" and calcified
ground substance ground substance
 covered by perichondrium  covered by periosteum and lined by
endosteum

 Chondroblasts - chondrocytes - types of cartilage - growth of cartilage.
 Osteogenic cells - osteoblasts - osteocytes - osteoclasts - compact bone.
☼ Differentiate between bone and cartilage.
Blood
Blood is a specialized type of CT formed of blood cells in a fluid matrix

(plasma).
 Blood cells (45%) are of three types:
 Erythrocytes (RBCs): 4-6 million per cubic millimeter.
 Leucocytes (WBCs): 4-11 thousand per cubic millimeter.
 Thrombocytes (platelets): 150-400 thousand per cubic millimeter.
 Plasma (55%) is formed of water, gases, inorganic substances, organic
substances, hormones and enzymes. The volume of blood is about 5 liters.
Functions of the blood:

1. Transport of oxygen, nutrients and hormones to tissues.
2. Removal of carbon dioxide and waste product from tissues.
3. Regulation of body temperature.
4. Regulation of acid-base balance.
5. Protection against infections.
Red blood corpuscles (RBCs) or erythrocytes

 LM: they are rounded biconcave discs (with pale thin center and dark thick
periphery).
 EM: they are corpuscles and not true cells (as they have neither nuclei nor
organelles) so cannot divide.
 Adaptation of red blood corpuscles for their function:
 They contain free spaces for:
 Hemoglobin (33%): to combine easily with O 2 and CO2.
 Enzymes (1%): Hb reductase (for O 2) and carbonic anhydrase (for CO 2).
 The cell membrane is:
 Biconcave (to increase their surface area for gas exchange).
 Formed of lipoprotein (to be highly selective for O 2 and CO2 exchange).
 Elastic and flexible (to allow their squeeze inside narrow capillaries).
 Osmotic pressure of RBCs and plasma is isotonic (0.9% saline) and their life
span is about 4 months.
 Old RBCs are phagocytosed in liver and spleen (after that iron is reused
while pigments are excreted).
Number of RBCs:
Normal number of RBCs:
o In ♀ 4.5-5 million/3mm (due to menstruation and ♀ hormones).
o In ♂ 5-5.5 million/3mm.
Abnormal number of RBCs:
o Anemia (RBCs less than 4 million/3mm): it has many types:
 Deficiency anemia: due to deficiency of iron, vitamin B12, copper,
proteins ...
 Hemolytic anemia: due to destruction of RBCs which may be:
 Congenital:  Abnormal cell membrane (spherocytosis).
 Decrease of G6PD enzymes (favism).
 Abnormal Hb F (thalassemia).
 Abnormal Hb S (sickle cell anemia).
 Acquired: incompatible blood transfusion, malaria, toxins ...
 Hemorrhagic anemia: due to hemorrhage from wound, nose, menses,
piles …
 Aplastic anemia: due to bone marrow depression by radiation, drugs ...
o Polycythemia (RBCs more than 6 million/3mm): occurs with hypoxia (
O2) whether physiological (high attitude and exercise) or pathological
(lung disease or heart disease).
Size of RBCs:
Normal size of RBCs: diameter 6-9 (7.5) µm - central thickness 0.75 µm -
Peripheral thickness 2.6 µm.
Abnormal size of RBCs:
o Increase diameter (macrocytic anemia).
o Decrease diameter (microcytic anemia).
o Different diameters (aniso-cytosis).
Shape of RBCs:
Normal shape of RBCs: rounded biconcave non-nucleated discs showing
rouleaux appearance (as rows of coins).
Abnormal shape of RBCs:
o Rounded biconvex (sphero-cytosis).
o Oval (ovalo-cytosis).
o Pear-shaped (poikilo-cytosis).
Color of RBCs:
Normal color of RBCs: hemoglobin is greenish yellow (if unstained) and
acidophilic (if stained by Leishman stain).
Abnormal color of RBCs: o Increase hemoglobin (hyper-chromic RBCs).
o Decrease hemoglobin (hypo-chromic anemia).
o Central hemoglobin (target cell anemia).
White blood cells (WBCs) or leucocytes
 WBCs are true cells (as they have nuclei, organelles and inclusions).
 They are colorless (not contain hemoglobin) but appear white when packed
together.
 They have amoeboid movement to penetrate capillaries and perform their
phagocytic function in CT.
Number of WBCs:
Normal number of WBCs:
WBCs count 4-11 thousand/3mm and around 16 thousand/3mm at birth.
Abnormal number of WBCs:
o Leucopenia (WBCs less than 4 thousand/3mm): occurs with typhoid fever,
influenza viral infection, some drugs and radiation.
o Leukocytosis (WBCs more than 11 thousand/3mm): which may be
physiological (pregnancy, newborn, cold bath ...) or pathological (acute
and chronic infections).
Types of WBCs: according to types of granules leucocytes are classified to:

1. Granular leucocytes (with specific and non-specific granules): basophils,
eosinophils and neutrophils.
2. Non-granular leucocytes (with only non-specific granules): monocytes and
lymphocytes (T and B).
count diameter specific
life span nucleus
(/ 3mm) (µm) granules
RBCs 4-6 million 7.5 µ 4 months absent absent

platelets 150-400 th. 2-4 µ 5-10 days absent present
WBCs 4-11 th. 6-18 µ day-years present may be
Differential leucocytic count (percentage of each type of leucocytes relative to

total leucocytic count):
basophils 00 -0.75 % 12-15 µ months S-shape histamine

eosinophils 01-03 % 12-16 µ 1-2 weeks bi-lobed histaminase
neutrophils 57-67 % 12-15 µ 1-4 days 2-5 segments collagenase
monocytes 3-7 % 14-18 µ days-years kidney-shape non
lymphocytes 25-33 % 06-18 µ hours-ys 1 segmnt non
 small  15-20 %  06-09 µ  dark
 large  05-10 %  09-18 µ  pale
o T-lymphocytes count 60-80 % of all lymphocytes and can life 2 years while
o B-lymphocytes count 25-30 % of all lymphocytes and can life 3 months.
Counting of blood cells:
 Counting of RBCs, WBCs and platelets are made by:
Haemo-cyto-meter that is formed of: diluting pipette of RBCs, diluting
pipette of WBCs and counting slide.
 Differential leucocytic count is made by:
Examination of blood film (stained by neutral Leishman stain).
1. Basophils (0-0.75 % of leucocytes): concerned with allergy production.

 The diameter of basophils is 12-15 µm and their life span is months.
 LM: Nucleus of basophil is single, irregular and S-shaped.
 EM: Granules:
1. 1ry non-specific azurophillic granules (primary lysosomes).
2. 2ry specific basophilic large granules as that of mast cells (histamine,
heparin and eosinophil chemotactic factor "ECF") - these granules
mask nucleus and can stained by Gimsa.
 Functions: production, storage and secretion of histamine (capillary

vasodilator released during allergy), heparin (anticoagulant) and eosinophil
chemotactic factor "ECF" (attract eosinophils to terminate allergy).
 Basophilia (increase number of basophils):
It occurs in allergic diseases, parasitic infestations, liver cirrhosis ...
2. Eosinophils (1-3 % of leucocytes): concerned with allergy termination.

 The diameter of eosinophils is 12-16 µm and their life span is 1-2 weeks.
 LM: Nucleus of eosinophil is single, horseshoe and bilobed.
 EM: Granules:
1. 1ry non-specific azurophillic granules (primary lysosomes).
2. 2ry specific acidophilic large granules (histaminase and sulphatase).
 Functions: o Attracted to allergic sites (by ECF of basophils and mast cells)
to terminate allergy by destruction of histamine and
phagocytosis of allergic antigen-antibody complexes.
o Inactivate and kill parasitic larvae.
 Eosinophilia (increase number of eosinophils):
It occurs in allergic diseases and parasitic infestations.
 Eosinopenia (decrease number of eosinophils):
It occurs with cortisone therapy that inhibits bone marrow.
NB: Eosinophils are present under skin and mucosa of respiratory, intestinal and
♀ genital treats.
3. Neutrophils (57-67 % of leucocytes): concerned with non-specific immunity.

 The diameter of neutrophils is 12-15 µm and their life span is 1-4 days.
 LM: Nucleus of neutrophil is single and formed of connected 2-5 segments
(so neutrophils are called "polymorph-nuclear leucocytes").
Neutrophils are classified according to number of their nuclear segments into:
 Two classes by Schilling count: immature with non-segmented nuclei
(4%) and mature with segmented nuclei (96%).
 Five classes by Arneth count: class I, II, III, IV and V with 1, 2, 3, 4
and 5 segments in their nuclei respectively.
Class I 1 segment 5%
Class II 2 segments 35%
Class III 3 segments 41%
Class IV 4 segments 17%
Class V 5 segments 2%
Arneth classification of neutrophils amoeboid movement of neutrophils
 EM: Granules:
1. 1ry non-specific azurophillic granules (1ry lysosomes).
2. 2ry specific pale large granules (bactericidal phagocytin,
bacteriostatic lactoferrin, collagenase and alkaline phosphatase).
 Functions: non-specific immunity (which is the first line of defense

mechanism) through the following:
1. They leave blood vessels and enter CT (through their amoeboid
movement) to phagocytose bacteria by their pseudopodia.
2. Thy destruct bacteria by proteolytic enzymes present in their granules (that
dissolve bacterial proteins).
3. They attract monocytes to inflamed areas to remove pus (dead neutrophils,
dead bacteria and tissue debris).
4. Thy stimulate bone marrow (to form neutrophils).
5. They secrete trephine substance (that perform healing).
 Neutrophilia (increase number of neutrophils):
It occurs in appendicitis, tonsillitis, abscess ...
 Neutropenia (decrease number of neutrophils):
It occurs in typhoid fever, drugs, radiation ...
NB: In appendicitis TLC is > 11.000/3mm and neutrophils are > 67%
(leucocytosis with neutrophilia) while in typhoid fever TLC is <
4.000/3mm and neutrophils are < 57 % (leucopenia with neutropenia).
4. Monocytes (3-7 % of leucocytes): concerned with non-specific immunity.

 The diameter of monocytes is 14-18 µm and their life span is 3 days in blood,
3 months in CT proper and years outside them.
 LM: they have large pale kidney-shaped nuclei with pseudopodia.
 EM: few organelles with many azurophilic granules (lysosomes) and well
developed Golgi apparatus.
 Functions: o Change to macrophage (and other mononuclear phagocytic

cells) to phagocytose small foreign bodies.
o Fuse together to form giant cells (as osteoclasts) to phagocytose
large foreign bodies.
 Monocytosis (increase number of monocytes):
It occurs in chronic infections as syphilis, malaria, TB ...
5. Lymphocytes (25-33 % of leucocytes): concerned with specific immunity.

According to size lymphocytes are classified into small & large lymphocytes:
o Small inactive lymphocytes (15-20 % of leucocytes):
 The diameter of small lymphocytes is 6-9 µm (like RBCs).
 LM: they have dark rounded nuclei with pale scanty cytoplasm (forming a
thin rim around nucleus).
 EM: few organelles with many free ribosomes and microvilli.
o Large active lymphocytes (5-10 % of leucocytes):

 The diameter of large lymphocytes is 09-18 µm.
 LM: they have pale rounded nuclei with clear nucleolus and dark abundant
cytoplasm.
 EM: many mitochondria, many rER and well developed Golgi apparatus.
Function of lymphocytes: specific immunity (which is the second line of

defense mechanism).
NB: Lymphocytes can pass through oral epithelium and appear in oral cavity as
"salivary corpuscles".
According to function lymphocytes are classified into B, T & NK lymphocytes:
(1) B-lymphocytes (25-30% of circulating small lymphocytes):
 They can life for 3 months.
 They are bursa dependent as they develop in bursa of fabricius (of birds)
and in bone marrow (of human).
 They originate from B-type colony forming cells of bone marrow that
differentiate (to B-lymphoblasts then B-lymphocytes) and acquire surface
receptors then migrate from bone marrow to peripheral lymphoid organs
(lymph nodes, spleen, tonsils ...) as small inactive B-lymphocytes.
 Antigens are picked by T-helper lymphocytes then delivered to small B-
lymphocytes  their activation to:
o Plasma blasts  plasma cells  antibodies (gamma globulins "IgG,
IgM, IgA, IgE and IgD")  primary humoral immunity.
o B-memory cells  rapid response after further exposure to the same
antigen  secondary humoral immunity.
(2) T-lymphocytes (60-80% of circulating small lymphocytes):

 They can life for 2 years.
 They are thymus dependent (as they require thymus gland for their
development and maturation).
 They originate from T-type colony forming cells of bone marrow that
differentiate (to T-lymphoblasts) then migrate from bone marrow to the
cortex of thymus gland.
In the cortex of thymus gland they proliferate, differentiate (to T-
lymphocytes) and acquire surface receptors (T-cell receptors "TCRs").
o In early life: small inactive T-lymphocytes migrate from the cortex of
thymus gland to its medulla to post-capillary venules and enter
circulation to reach thymus depended zones of lymph nodes (in para-
cortex) and spleen (in peri-arteriolar lymphatic sheath "PALS" of white
pulps).
o In adult life: thymus depended zones of lymph nodes and spleen give
small inactive T-lymphocytes throughout life.
 Antigens or foreign cells (viruses, fungi or tumor cells)  activation of
small T-lymphocytes to:
1. T-cytotoxic cells (T-killer cells): that performs primary cellular
immunity (by secretion of perforins which produce pores in the cell
membrane of foreign cells leading to their lyses).
2. T-memory cells: that performs perform rapid response after further
exposure to the same antigen (secondary cellular immunity).
3. T-helper cells: that helps in humoral immunity of B-lymphocytes.
4. T-suppressor cells: that suppresses both humoral and cellular immunity.
5. T-lymphokines producing cells: that secrete the following hormone-like
factors:
– Interferon (anti-viral) and cytotoxic factor (anti-bacterial).
– Chemotactic factor (that attract macrophages to the site of infection).
– Colony stimulating factor and mitogenic factor (that stimulate
proliferation of bone marrow cells).
(3) Natural killer lymphocytes (5% of circulating lymphocytes):

 They can life for 3 months.
 They have non-B non-T receptors and can kill some tumor cells and
infected cells.
 Lymphocytosis (increase number of lymphocytes):
It occurs in chronic diseases (as pertussis, TB, syphilis ...) and in leukemias.
Differences between RBCs and WBCs

RBCs WBCs
Types:  one type  5 types

Number:  4-6 million/3mm  4-11 thousand/3mm
Size:  6-9 (7.5) µm  6 to 18 µm
Shape:  biconcave discs with  spherical without rouleaux
rouleaux appearance appearance
Color:  greenish yellow  colorless
Osmotic pressure:  liable to hemolysis  resist hemolysis
LM:  corpuscles:  true cells:
 no nuclei  contain nuclei
 no cell organelles  contain cell organelles
 contain hemoglobin  not contain hemoglobin
Function:  carrying O2 and CO2 inside  phagocytosis outside blood
blood vessels (so they have vessels (so they have
no amoeboid movement) amoeboid movement)
Development:  in red bone marrow  in red bone marrow and in
lymphatic tissues
Site:  in blood  in blood, in CT and in
lymphatic tissues
Life span:  4 months  few dyes to many years
☼ Write short notes on the following: functions of blood - red blood corpuscles
(RBCs) - neutrophils - T-lymphocytes.
☼ Differentiate between: RBCs and WBCs.
☼ Differentiate between various types of leukocytes.
Muscular tissue
The muscles of the body are classified (according to their site and shape) into:
1. Skeletal muscles: they are voluntary striated muscles attached to skeleton.
2. Cardiac muscles: they are involuntary striated muscles present in the heart.
3. Smooth muscles: they are involuntary plane muscles present in the viscera.
Skeletal muscles
 They are skeletal, because they are attached to the skeleton.

 They are voluntary, because they contract by the will.
 They are striated, because their cells show transverse dark and light bands in
EM of longitudinal section.
NB:  All skeletal muscles are attached to skeleton (except in face, tongue and
pharynx) and voluntary (except in upper ⅓ of esophagus, diaphragm and
cremastric muscle).
 All muscles are mesodermal in origin and formed of:
1. Muscle cells:
 Long cylindrical cells (called muscle fibers).
 They produce contraction (by actin and myosin microfilaments).
2. CT covering:
 It carries blood vessels, lymphatics and nerves to muscle cells.
 It connects muscle cells together and pulls them to their attachment.
Connective tissue covering of skeletal muscle: CT is located in the muscle as:

 CT epi-mysium: A dense CT that cover one skeletal muscle.
 CT peri-mysium: A loose CT that cover one muscle bundle.
 CT endo-mysium: A reticular CT that cover one muscle fiber.
(epi = upon, peri = around, endo = inside, mys = muscle).
NB: – Skeletal muscle (surrounded by epimysium) formed of› muscle bundles
(surrounded by perimysium) formed of› muscle fibers (surrounded by
endomysium) formed of› myofibrils (surrounded by Cohenheim’s area)
formed of
› myofilaments (actin and myosin).
– In musculo-tendons junction: muscle fibers stop abruptly while CT
endomysium, perimysium and epimysium attach and continue with CT
of tendon.
LM of skeletal muscle cells (skeletal muscle fibers):

 They are long cylindrical cells.
 Each cell measures 1-30 mm in length and 10-100 m in diameter.
 The cell membrane (sarcolemma) is attached to CT by basement membrane.
 The cytoplasm (sarcoplasm) contains multiple peripheral elongated nuclei.
EM of skeletal muscle cells (skeletal muscle fibers):

 Cell organelles: many mitochondria and well-developed sER.
 Cell inclusions: glycogen (to provide energy) and myoglobin (to provide O2).
 Cytoskeleton: micro-filaments (myo-filaments) called actin and myosin.
In longitudinal section they cause transverse striations formed of alternating
dark and light bands.
o Dark band (Q disc): it appears dark in fresh state. It is also called
anisotropic or (A) band due to its double refraction to polarized light.
In the middle of dark band, there is a pale zone called (H) zone.
o Light band (J disc): it appears pale in fresh state. It is also called isotropic
or (I) band due to its single refraction to polarized light.
In the middle of light band, there is a dark line called (Z) line.
Sarcomere (the segment between two Z-lines): is the functional and structural
contractile unit of muscle fibers. The sarcomere is formed of actin and myosin.
 Actin: thin myo-filaments (5 nm) attached to Z-line at both sides and
present in both light and dark bands.
 Myosin: thick myo-filaments (10 nm) present only in the middle of
sarcomere which is the dark band.
NB: The dark band contains both actin and myosin while H-zone (Hensen’s
disk) contains myosin only - this H-zone disappears during muscle
contraction because actin glides over myosin  shortening of sarcomere
(i.e. narrowing of the distance between actin of both Z-lines).
Triad tubular system of skeletal muscle fiber:
 It is formed of three tubules:
– One transverse tubule:
1 transverse invagination of sarcolemma to
sarcoplasm at Z-line (around myofibrils).
– Two sarcoplasmic tubules:
2 modified tubules formed of sER at both
sides of the transverse tubule.
 It plays an important role in conducting nerve impulse to muscle fiber.
Nerve impulse  sarcolemma  transverse tubule  2 sarcoplasmic tubules
 calcium ions pump between myosin and actin myo-filaments in the
cytoplasm  their overlapping and shortening of sarcomere  contraction of
muscle fiber (required energy comes from break down of ATP to ADP).
Cardiac muscles
They are involuntary striated muscles present in the heart.
LM of cardiac muscle cells (cardiac muscle fibers):
 They are short and branched to form a network.
 They are joined together by intercalated discs.
 The nucleus is single, prominent, oval and central.
 The cytoplasm has cross striations like skeletal muscles.
Intercalated disc:
 It is the site of cell to cell junction (at the
level of Z lines of cardiac muscle cells).
 It appears as dark staining transverse line
crossing the muscle fiber in a step-like
manner formed of:
1. Transverse portion: run across the fiber - the junction here is mainly
adhering junction (20 nm).
2. Longitudinal portion: run parallel to the myofibrils - the junction here is
mainly gap junction (2 nm).
 Functions: binds cells together and transmits nerve impulses to other cardiac
muscle cells leading to rapid spread of excitation throughout the heart.
Smooth muscles
They are involuntary plane (not striated) muscles present in the
viscera (blood vessels, GIT, RT ...).
LM of smooth muscle cells (smooth muscle fibers):
 They are fusiform (spindle-shaped).
 Each cell is 30-200 m in length and 5-10 m in diameter.
 The nucleus is single, central and snake-shaped.
 The cytoplasm is homogenous, acidophilic without striations.
Functions of smooth muscles:
1. Synthesize collagen type III and synthesize elastic fibers of blood vessels.
2. Produce rhythmic contractions (in uterus) or peristaltic movement (in GIT).
3. Regulate luminal size of hollow organs by maintaining partial contraction
(tonus) for very long periods.
Differences between skeletal, cardiac and smooth muscles

Skeletal muscle Cardiac muscle Smooth muscle
General  attached to skeleton  present in heart  present in viscera
 voluntary (with motor  involuntary (with  involuntary (with
innervation) autonomic autonomic
innervation) innervation)
 striated cells  striated cells  plan (smooth) cells
LM  large cells  medium cells  small cells
cylindrical-shaped cylindrical-shaped spindle-shaped
diameter: 10-100 µm diameter: 10-20 µm diameter: 5-10 µm
length: 1-30 mm length: 50-100 µm length: 30-200 µm
 non-branching (except  branching leading to  non-branching
face, tongue, …) continuous sheet
 cells:  cells:  cells:
- thick sarcolemma - very thin sarcolemma - thin sarcolemma
- red or pale sarcoplasm - red sarcoplasm - pale sarcoplasm
- multiple peripheral - multiple central - single central nuclei
nuclei nuclei
EM  regular sarcomeres  irregular sarcomeres  dense bodies
 conduction:  conduction:  conduction:
– triad system – died system – dense bodies
– no intercalated discs – intercalated discs – gap junction
 regenerate from  can not regenerate  regenerate from
satellite cells pericytes

1. Connective tissue covering of skeletal muscle.
2. Triad tubular system of skeletal muscle fiber.
3. LM of skeletal muscle fibers.
4. EM of skeletal muscle fibers.
☼ Differentiate between skeletal, cardiac and smooth muscles.
Nervous tissue
Anatomically the nervous system is formed of two parts:

1. Central nervous system (CNS) that is formed of:
 Brain:  Cerebrum.
 Cerebellum.
 Brain stem (mid brain - pons - medulla oblongata).
 Spinal cord: 31 segments (8 Cervical - 12 Thoracic - 5 Lumber - 5 Sacral -
1 Coccygeal).
2. Peripheral nervous system (PNS) that is formed of:
 Peripheral nerves:
 12 pairs of cranial nerves (Olfactory nerves - Optic nerves - Oculomotor
nerves - Trochlear nerves - Trigeminal nerves - Abdocent nerves -
Facial nerves - Auditory nerves - Glossopharyngeal nerves - Vagus
nerves - Accessory nerves - Hypoglossal nerves).
 31 pairs of spinal nerves (8 Cervical - 12 Thoracic - 5 Lumber - 5 Sacral
- 1 Coccygeal).
 Ganglia: spinal ganglia and sympathetic ganglia.
 Nerve endings:
 Sensory receptors: epidermal receptors, dermal receptors, hypodermal
receptors, muscle spindle and tendon spindle.
 Motor effectors: motor end plate.
Histologically the nervous system is formed of two types of cells:

1. Nerve cells: the structural and functional units of nervous system.
2. Glial cells: supportive, nutritive and protective cells for nerve cells.
Nerve cells (neurons): Bipolar Multipolar pseudo-unipolar

Neurons are the structural and functional units
of nervous system.
LM of neurons:
There are many shapes of neurons:
 Unipolar: in trigeminal nucleus…
 Pseudo-unipolar: in spinal ganglia…
 Bipolar: in retina, olfactory epithelium…
 Multipolar: which may be:
 Stellate-shaped: in sympathetic ganglia...
 Pyramidal-shaped: in cerebrum (pyramidal cells)…
 Pyriform-shaped: in cerebellum (Purkinje cells)…
NB: the size of neurons may be small (4 µm) as granular cells of cerebellum or
large (100 µm) as pyramidal cells of cerebrum.
EM of neurons: the neuron is formed of cytoplasm, nucleus and processes.

 The cytoplasm of neuron (neuroplasm) contain:
 Cytoplasmic organelles: as cell membrane - mitochondria - free ribosomes
and rER (basophilic Nissl granules) - Golgi apparatus - lysosomes - no
centrioles (as the neuron not divide).
 Cytoplasmic inclusions: as glycogen, fat droplets, melanin, lipofuscin (that
increase with age)...
 Cytoskeleton: as neuro-fibrils (for support) and neuro-tubules (for
transport of neurotransmitters).
 The nucleus of neuron is central spherical large and pale (with thick
membrane and clear nucleolus).
 The processes of neuron: each neuron has one axon and many dendrites.
Axons Dendrites
o Single, long and thin o Multiple, short and thick
o Uniform diameter without Nissl o Gradually  diameter with Nissl
granules granules
o Branch at the end and may give o Branch like a tree and have many
collaterals side projections (spines)
o Transport impulses in both directions o Receive impulses from other
(ante-grade and retro-grade) neurons
Function of neurons: the neurons are classified according to their functions to:
 Motor neurons: they transmit motor impulses from CNS to muscles (as
anterior horn cells).
 Sensory neurons: they transmit sensory impulses from receptors to CNS
(as posterior horn cells).
 Associative neurons (interneurons): they connect both motor and sensory
neurons (at one side of the same level).
NB: o Tract: is a collection of axons inside CNS.
o Nerve trunk: is a collection of axons outside CNS.
o Nucleus: is a collection of neurons inside CNS.
o Ganglion: is a collection of neurons outside CNS.
Ganglia:
There are two types of ganglia:
Spinal ganglia Sympathetic ganglia

Spinal ganglia Sympathetic ganglia
General  present at dorsal roots of  present at sympathetic chain
spinal cord
 have thick CT capsule poor in  have thin CT capsule rich in
blood supply blood supply
 have many satellite cells on its  have few satellite cells on its
neurons neurons
Nerve  rounded (pseudo-unipolar)  irregular (multi-polar with
cells stellate-shape)
 few and variable in size (20-  many and uniform in size (30
120 µm) µm)
 arranged in groups or rows  scattered without arrangement
Axons  thick and myelinated  thin and un-myelinated
 there is convolution  there is no convolution (no
(glomerulus) glomerulus)
 there is no synapse between  there is synapse between
neurons neurons
Function  ascending sensory function  descending autonomic function
Axon covering:
The cell membrane of axon is named axo-lemma while its cytoplasm is named
axo-plasm. The axons may be:
1. Naked without any sheath (as that of grey matter).
2. Covered with myelin sheath only (as that of white matter).
3. Covered with neurolemmal sheath only (as that of postganglionic
sympathetic nerves).
4. Covered with both myelin sheath and neurolemmal sheath (as that of
peripheral nerves).
 Myelin sheath:
 A lipo-protein substance that speed transmission of nerve impulses.
 It is formed by mneurolemal Schwan cells (in PNS) or by oligo-
dendrocytes (in CNS).
 Neurolemmal Schwan cells rotate around the axon  myelin sheath
formation.
 Myelin sheath is dissolved with Hx and E staining - appeared black with
osmic acid stain.
 Lunter-mann’s clefts are areas of discontinuities in myelin sheath that
facilitate passage of nutrition from mneurolemal Schwan cells to myelin.
Axon
Axolemma
Myelin sheath
Neurolemmal sheath
CT endo-neurium
CT peri-nurium
CT epi-neurium
 Neurolemmal sheath:
 A sheath formed by collection of neurolemmal Schwan cells.
 Neurolemmal Schwan cells have oval nucleus and basophilic cytoplasm.
 Each cell corresponds to inter-nodal segment and contact with the axon at
node of Ranvier.
 Connective tissue covering: the CT is located in peripheral nerve as:
 CT endo-nurium (Henl’s sheath): a reticular CT which covers one axon.
 CT peri-nurium: a loose CT which covers one nerve bundle (collection of
axons).
 CT epi-neurium: a dense CT which covers peripheral nerve (collection of
nerve bundles).
Nervr trunk (Hx and E) Nervr trunk (osmic acid)

=========
 LM and EM structure of neuron.  Axon covering.
 Axon and dendrites.  Spinal and sympathetic ganglia.
Vascular system
Vascular system is formed of:

 Arterial blood vessels (>10 μm in diameter):
Large arteries  medium-sized arteries  small arteries  arterioles.
 Connecting channels (4-10 μm in diameter):
Blood capillaries - blood sinusoids - arterio-venous anastomosis.
 Venous blood vessels (>10 μm in diameter):
Venules  small veins  medium-sized veins  large veins.
NB: – Diameter of arterial blood vessels decrease gradually while diameter of

venous blood vessels increase gradually.
– Arteries of lower limbs have more developed muscular wall than
arteries of upper limbs.
Types of blood vessels:

1. Large (elastic) arteries as aorta (>10 mm in diameter):
Conduct blood from the heart under pressure.
2. Medium-sized (muscular) arteries (10-1 mm in diameter):
Distribute blood to all organs and maintain blood flow.
3. Small arteries (1-0.1 mm in diameter):
Adjust blood flow to arterioles by vaso-dilatation and vaso-constriction.
4. Arterioles (100-10 μm in diameter):
Control blood flow to capillaries (control blood pressure).
5. Capillaries (4-10 μm in diameter):
Exchange metabolites by diffusion to and from cells.
6. Venules (10-100 μm in diameter):
Drain capillary beds and pass blood cells to the inflamed tissue.
7. Small veins (0.1-1 mm in diameter):
Collect blood from venules.
8. Medium-sized (muscular) veins (1-10 mm in diameter):
Carry blood to larger veins without backflow.
9. Large veins as inferior vena cava (>10 mm in diameter):
Return blood to the heart.
Histologically the wall of blood vessels is formed of three layers:

 Tunica intima (the inner layer): it is formed of simple squamous endothelium
and sub-endothelial loose CT (with or without internal elastic lamina). This
smooth layer contacts with blood.
 Tunica media (the middle layer): it is formed of circular smooth muscle fibers
separated by elastic fibers (with or without external elastic lamina). This
contractile layer regulates blood flow.
 Tunica adventitia (the outer layer): it is formed of loose CT containing
collagenous fibers, elastic fibers, nerves, lymphatics and vasa vasorum. This
supporting layer prevents over distention of vessels.
NB: – Vasa vasorum are small arteries present in adventitia of large vessels to
nourish its outer part.
– Internal elastic lamina is present between intima and media while
external elastic lamina is present between media and adventitia.
Large arteries and large veins:

Characteristics of large (elastic) arteries:
They are long arteries with wide lumen and thick elastic wall (as aorta,
pulmonary artery, innominate artery and subclavian arteries).
Each is formed of:
 Intima (10 %):
It is formed of simple squamous endothelium and sub-endothelial loose CT
(containing smooth muscle fibers, elastic fibers and non-clear internal elastic
lamina).
 Very thick media (70 %):
It is formed of 40-70 layers of fenestrated elastic sheets separated by few
smooth muscle fibers (it maintains diastolic blood pressure).
 Thin adventitia (20 %):
It is formed of loose CT containing vasa vasorum, lymphatics and vasomotor
nerves.
Aorta Inferior vena cava

Characteristics of large veins:
It has wide lumen with many valves (as inferior vena cava).
 Each valve is formed of two intimal projections (formed of fibro-elastic CT
covered by endothelium).
 Media: is thin without elastic lamina.
 Adventitia: is thick by longitudinal smooth muscle bundles to facilitate its
elongation during respiration.
Medium-sized (muscular) arteries and medium-sized (muscular) veins:

Medium-sized (muscular) artery Medium-sized (muscular) vein
General  function: rapid flow of arterial  function: slow flow of venous
blood blood
 wall: thick  wall: thin
 lumen: narrow and rounded  lumen: wide and collapsed
(without valves) (with valves)
 not contain blood after death  contain blood after death
Intima  thick and more folded due to:  thin and less folded due to:
 presence of internal elastic  absence of internal elastic
lamina lamina
Media  thick  thin
 presence of external elastic  absence of external elastic
lamina lamina
Adventitia  thin with elastic fibers and  thick with collagenous fibers
vasomotor nerves and vasa vasorum
 absence of lymphatic capillaries  presence of lymphatic
capillaries
Differences between various blood vessels:
Large (elastic) arteries (e.g. Aorta): >10 mm in diameter.
Intima: Endothelium - sub-endothelial CT.
Media: Many elastic lamellae - few smooth muscle layers.
Adventitia: Thinner than media - with vasa vasorum.
Function: Conduct blood from the heart under pressure.
Medium-sized (muscular) arteries: 10-1 mm in diameter.
Intima: Endothelium - sub-endothelial CT - internal elastic lamina.
Media: Few elastic materials - many smooth muscle layers.
Adventitia: Thinner than media - vasa vasorum may be present.
Function: Distribute blood to all organs - maintain blood flow under pressure.
Small arteries: 1-0.1 mm in diameter.
Media: 10-3 layers of smooth muscle fibers.
Adventitia: Thinner than media - no vasa vasorum.
Function: Adjust blood flow to arterioles by vaso-dilatation and vaso-
constriction.
Arterioles: 100-10 μm in diameter.
Intima: Endothelium - thin elastic lamina.
Media: 3-1 layers of smooth muscle fibers.
Adventitia: Very thin CT layer.
Function: Control blood flow to capillaries and determine blood pressure.
Capillaries: 4-10 μm in diameter.
Intima: Endothelium only.
Media: Pericytes only.
Adventitia: None.
Function: Exchange metabolites by diffusion to and from cells.
Venules (postcapillary, collecting and muscular): 10-100 μm in diameter.
Intima: Endothelium without valves - sub-endothelial CT rich in actin.
Media: Scattered smooth muscle cells.
Adventitia: None.
Function: Drain capillary beds - pass blood cells to the inflamed tissue.
Small veins: 0.1-1 mm in diameter.
Media: 2-3 loose layers of smooth muscle fibers.
Adventitia: Thicker than media.
Function: Collect blood from venules.
Medium-sized (muscular) veins: 1-10 mm in diameter.

Intima: Endothelium with valves - sub-endothelial CT.
Media: 3-5 distinct layers of smooth muscle fibers.
Adventitia: Thicker than media - longitudinal smooth muscle bundles may be
present.
Function: Carry blood to larger veins without backflow.
Large veins (e.g. inferior vena cava): >10 mm in diameter.
Intima: Endothelium with prominent valves - sub-endothelial CT.
Media: More than 5 layers of smooth muscle fibers - much collagen.
Adventitia: The thickest layer - longitudinal smooth muscle bundles are
present.
Function: Return blood to the heart - its muscle bundles facilitate elongation
of inferior vena cava during respiration.
Medium-sized (muscular) artery and vein
=========
☼ Write short notes on: aorta - inferior vena cava.
☼ Differentiate between medium-sized artery and medium-sized vein.
Skin
Skin is the protective covering of the whole body that form 2.3 m2 of surface
area and 16 % of body weight (so skin is the largest and heaviest organ in the
body).
Functions of skin:
1. Protection against trauma, infection, ultraviolet rays and dehydration.
2. Reception of stimuli.
3. Regulation of body temperature by sweating.
4. Excretion of water and some waste products in sweat.
5. Vitamin D formation.
6. Diagnosis of exanthemata, urticaria, anemia ...
7. Personal identification by finger printing (dermatographics).
Histological structure of skin:

 Epidermis: - Keratinocytes (form 85 % of epidermis): for regeneration.
- Non-keratinocytes: o Langerhans’s cells: for phagocytosis.
o Melanocytes: for pigmentation.
o Merkel’s cells: for sensation.
 Dermis: - Papillary layer: thin superficial loose CT rich in blood capillaries.

- Reticular layer: thick deep dense CT rich in sweat glands.
NB:
– Outer epidermis is ectodermal and thin
while inner dermis is mesodermal and
thick.
– Epidermis is fixed to dermis by hemi-
desmosomes, basement membrane and
dermal papillae.
– Hypodermis is not a part of skin and is
formed of subcutaneous fascia of adipose
CT that facilitates skin movement.
Epidermis
– Epidermis is rich in free nerve endings.
– It is avascular and receives its nutrition
by diffusion from the vascular superficial papillary layer of dermis.
– It is formed of 5 types of keratinocytes (85 %) and 3 types of non-
keratinocytes (3-8 %).
Keratinocytes: they form keratinized stratified squamous epithelium of skin and
arranged in 5 layers:
1. Horny layer (stratum cornium): superficial and shed continuously.
 Acidophilic horny scales rich in mature keratin filaments.
 Nuclei and cell organelles are disappeared by lysosomes.
2. Clear layer (stratum lucidum):
 Acidophilic flat non-nucleated cells rich in immature keratin filaments.
 A translucent layer present only in thick skin.
3. Granular cell layer (stratum granulosum): form skin barrier.
 2-3 layers of flat cells rich in basophilic granules (keratohyaline granules,
lamellar granules, phospholipid granules and muco-polysaccharide
granules).
 These granules form a cement intercellular space  skin barrier.
NB: lamellar granules produce a lipid-rich impermeable layer around cells
to prevent water loss.
4. Prickle cell layer (stratum spinosum):
 4-8 layers of basophilic polyhedral cells rich
in keratin filaments called "tonofibrils".
 These cells have spine-like processes joined
to each other by desmosomes.
5. Basal cell layer (stratum germinativum): deep
and divide for renewal of epidermis every 15-
30 days.
 A single layer of basophilic columnar cells
on a clear wavy besement membrane.
 These cells are attached together by
junctional complex.
NB:  Prickle cell layer and basal cell layer are
named Malpigian layer.
 Langerhans cells are present in prickle cell layer while melanocytes and
merkel’s cells are present in basal cell layer.
Non-keratinocytes:
They include: Langerhans cells, Merkel’s cells and melanocytes.
1. Langerhans cells: branched macrophages between prickle cells.
 Origin: mesoderm.
 LM: star-shaped cells with pale cytoplasm and dark nuclei - can be
identified by vital stains.
 EM: prominent Golgi apparatus with many lysosomes containing
hydrolytic enzymes.
 Function: phagocytosis and act as antigen presenting cells to T-
lymphocytes  allergic dermatitis.
2. Merkel’s cells: large polygonal cells between basal cells.
They are ectodermal cells acting as fine touch receptors.
Sensory nerve fibers are present as disc-shaped expansion (called Merkel’s
disc) under each Merkel’s cell.
3. Melanocytes: branched cells between basal cells.

 Origin: ectoderm. They are protein-forming cells.
 LM: rounded cells with pale (euchromatic) nuclei, prominent nucleolus
and long irregular processes between keratinocytes.
 EM: as protein-forming cells they have many mitochondria, many rER,
well developed Golgi apparatus and melanosome granules.
 Function: formation of melanin pigments from amino acid "tyrosine".
Tyrosine tyrosinase enzyme
 melanin (that give positive DOPA reaction).
 Melanin goes through processes of
melanocytes to epidermal
keratinocytes (above), dermal hair
cortex (at the middle) and dermal
melanophores (below).
 Melanin:
 Gives skin its color (eu-
melanin is dark brown
while pheo-melanin is red).
 Protects DNA (of actively
dividing basal cells) from
ultraviolet rays of sun.
NB:
o Melanocytes are ectodermal cells
present in epidermis and form melanin.
o Melanophores are mesodermal cells
present in dermis and phagocytose
melanin.
Dermis
Dermis is the connective tissue under
epidermis that is formed of 2 layers:
1. Papillary layer: thin superficial loose
CT (formed of many cells and type III
collagenous fibers) - it is more vascular Melanin granules migrate to the tips of the
(to nourish epidermis). melanocyte’s processes and are then transferred
2. Reticular layer: thick deep dense CT to the keratinocytes of the malpighian layer
(formed of few cells, type I collagenous
fibers and elastic fibers) - it is less vascular but rich in sweat glands.
Types of skin
Thick non-hairy skin Thin hairy skin
 Present in palms and soles (as tip of  Present in other body areas (as scalp,
finger) eyelid …)
 Thick epidermis (400-1400 m):  Thin epidermis (75-150 m):
o All layers of keratinocytes are o No clear layer (other keratinocytes
present are present)
o Very thick horny layer - other o Very thin horny layer - other
layers are thick layers are thin
 Dermis:  Dermis:
o Regular large papillae   ridges o Irregular small papillae  
and furrows ridges and furrows
o More sweat glands o Less sweat glands
o Absence of:  Hair follicles o Presence of:  Hair follicles
 Sebaceous glands  Sebaceous glands
 Errector pilli  Errector pilli
muscles muscles
Horny layer
Clear layer Epidermis

Granular cell layer
Prickle cell layer
Dermis
Langerhans cell
Dermis Basal cell layer
Merkel’s cell Hypodermis
Melanocyte
=========
☼ Differentiate between thick skin and thin skin.
☼ Write short notes on: histological structure of skin - keratinocytes -
melanocytes.
Lymphatic tissue
Human protective mechanisms:

Human body is protected against microorganisms and foreign substances by:
1. Protective surfaces:
 Skin: many layers - many receptors - many glands.
 Mucous membrane: acidic environment (stomach and vagina) - cilia (RT) -
secretions (lysozyme).
2. Non-specific immune response:
 Vascular changes: vasodilatation.
 Cellular changes: migration of neutrophils and monocytes (macrophages).
3. Specific immune response:
 Humoral immunity: B-lymphocytes  plasma-blasts then plasma cells 
antibodies (IgG, IgM, IgA, IgE and IgD)  Ag-Ab reaction.
 Cellular immunity: T-lymphocytes  T-cytotoxic cells (T-killer cells) 
perforins  destruction of foreign cells.
Immune system: is formed of:

1. Cells of reticulo-endothelial system "RES": mononuclear phagocytic cells
scattered in various organs.
2. Mucosa associated lymphatic tissues "MALT": non-capsulated lymphatic
nodules scattered in sub-mucosa of respiratory, gastro-intestinal and genito-
urinary tracts  local defense by Ag-Ab reaction.
3. Capsulated lymphatic organs:
 Primary lymphatic organs: bone marrow and thymus gland.
 Secondary lymphatic organs: lymph node, spleen and tonsils.
Lymph nodes
 They are kidney-shaped lymphatic structures (of variable size) present in:
neck - axilla and cubital fossa - thorax and abdomen - groin and popliteal
fossa (to filter lymph).
 Histologically each lymph node is
formed of stroma of CT and parenchyma Cortical follicles
Cortical sinuses
of lymphatic tissue.
CT Stroma: is formed of:

– Capsule formed of CT cells, CT fibers
and smooth muscles. Medullary cords
– Trabeculae descending from this capsule. Medullary sinuses
– Network of reticular CT containing
parenchyma - can stained brown by silver.
Parenchyma: is formed of:
Outer dark cortex formed of:
 Cortical follicles: formed of regular collections
of B-lymphocytes. They may be:
 Primary follicles formed of non-activated
small B-lymphocytes.
 Secondary follicles (exposed to antigen)
formed of:
o Dark peripheral part rich in non-activated
small B-lymphocytes.
o Pale germinal center rich in activated large
B-lymphocytes and plasma cells.
 Cortical sinuses: spaces that separate cortical
follicles from capsule (sub-capsular sinuses) and
from trabeculae (trabecular sinuses). They are
lined by endothelial cells and macrophages.
They contain lymph, B-lymphocytes and plasma
cells.
 Thymus dependent zones "TDZ": deep parts of
the cortex (para-cortex) which is rich in T-lymphocytes.
Inner pale medulla formed of:

 Medullary cords: formed of irregular collections of B-lymphocytes and
plasma cells.
 Medullary sinuses: spaces between medullary cords lined also by endothelial
cells and macrophages.
They contain lymph, lymphocytes and plasma cells.
Cells in lymph nodes:

1. Fibroblasts: in capsule and trabeculae.
2. Reticular cells and reticular fibers: in reticular CT.
3. Endothelial cells and macrophages: lining of sinuses.
4. Non-activated small B-lymphocytes: in cortical follicles and medullary cords.
5. Activated large B-lymphocytes, plasma-blasts and plasma cells: in germinal
center of secondary cortical follicles.
6. T-lymphocytes: in thymus dependent zone "TDZ" of para-cortex.
Vascular supply of lymph node:

 Blood: hilar artery  arterioles  cortical capillaries (around cortical
follicles)  venules  hilar vein.
 Lymph: cortical afferent arterioles  cortical sinuses  medullary sinuses
 hilar efferent arterioles  thoracic duct  blood stream.
NB:
 Lymphatic vessels are formed of:
intima (of endothelium), media
(of circular smooth muscle fibers)
and adventitia (of areolar CT).
They contain valves.
 Blood capillaries  tissue fluid
 lymphatic capillaries  lymph
(which is the tissue fluid inside
lymphatic vessels).
Function of lymph nodes:

1. Production and proliferation of lymphocytes.
2. Filtration of lymph (from micro-organisms and foreign bodies).
3. Humoral immunity: antigens  activation of small B-lymphocytes 
plasma-blasts then plasma cells  antibodies (immuno-globulins G, M, A,
E and D) to blood  antigen-antibody reactions.
4. Cellular immunity: foreign cells (cancer cells, TB ...)  activation of small
T-lymphocytes (migrated from thymus gland to TDZ)  T-cytotoxic cells
(T-killer cells)  perforins  destruction of foreign cells.
Spleen
 A single haemo-lymphatic intra-abdominal organ that filter blood.
 Histologically spleen is formed of stroma of CT and parenchyma of
lymphatic tissue.
Red pulp White pulp

Blood sinusoids Central arteriole
CT stroma: is formed of:

 Capsule formed of CT cells, CT fibers and smooth muscles - it is thin in
human.
 Long thick trabeculae rich in smooth muscles - they radiate from the hilum.
 Network of reticular CT containing parenchyma - can stained brown by
silver.
Parenchyma: is formed of:
 White pulps (Malpighian corpuscles): appear white in fresh section.
They are lymphatic follicles with eccentric "central arterioles".
Each is formed of four concentric zones from inside outwards:
1. Thymus depended zone "TDZ" (around central arteriole forming peri-
arteriolar lymphatic sheath "PALS"): it is rich in T-lymphocytes.
2. Germinal central zone (around TDZ): it is rich in activated large B-
lymphocytes.
3. Follicular zone (around germinal central zone): it is rich in non-
activated small B-lymphocytes.
4. Marginal zone (in the periphery of the white pulp): it is rich in
lymphocytes and macrophages.
– Red pulps (the areas between white pulps): appear red in fresh section (due to
presence of RBCs) and is formed of:
 Blood sinusoids: wide irregular blood spaces with non-continuous
basement membrane. They are lined by non-continuous endothelium
with phagocytic Littoral cells.
 Splenic cords (Billroth cords): lymphatic tissue present between white
pulps and blood sinusoids. They contain blood cells - plasma blasts and
plasma cells - macrophages (fixed and free).
Vascular supply of spleen:

The spleen is supplied by splenic artery which branches to small arteries and
arterioles to supply white and red pulps.
NB: Coeliac artery  splenic artery  trabecular arteries  smaller arteries 
central arterioles  white and red pulps.
 In white pulps  fine capillaries.
 In red pulps  penicillar arterioles
 2-3 capillaries (ellipsoids) 
4 ways (open circulation - closed
circulation - open when relaxed -
open with shunts)  blood
sinusoids  red pulps veins 
trabecular veins  splenic vein.
Function of the spleen:

1. Intrauterine formation of blood cells.
2. Storage of blood cells and platelets to pour them into circulation during
hemorrhage (by splenic contraction).
3. Phagocytosis of old RBCs by macrophages and storage of their iron for reuse.
4. Filtration of blood (from micro-organisms and foreign bodies).
5. Humoral and cellular immunity (as that of lymph nodes).
Thymus depended zones of lymph node and spleen:
T-lymphoblasts (formed in the bone marrow) migrate to the cortex of thymus
gland to proliferate, differentiate (to small inactive T-lymphocytes) and acquire
T-cell receptors "TCRs".
o In early life: small inactive T-lymphocytes migrate from the cortex of
thymus gland to its medulla to post-capillary venules and enter circulation
to reach thymus depended zones of lymph nodes (in para-cortex) and
spleen (in peri-arteriolar lymphatic sheath "PALS" of white pulps).
o In adult life: thymus depended zones of lymph nodes and spleen give small
inactive T-lymphocytes throughout life.
Differences between lymph nodes and spleen:

Lymph nodes Spleen
General: General:
 Multiple lymphatic structures  Single haemo-lymphatic organ (with
(without RBCs) RBCs)
 Present in groups all over the body  Present in the upper left abdomen
 Have many lymph vessels (afferent  Has few lymph vessels (only
and efferent) efferent)
 Functions: - Filtration of lymph.  Functions: - Filtration of blood.
- Immunity y. - Immunity.
Stroma: Stroma:
 Covered by adipose tissue  Covered by peritoneum
 Capsule is thin and not adherent  Capsule is thick (smooth muscles)
and adherent
 Trabeculae are thin, short and arise  Trabeculae are thick, long and arise
from capsule from hilum
Parenchyma: Parenchyma:
 Cortical follicles with germinal  White pulp (Malpighian corpuscles)
centers with central arterioles
 Cortical sinuses  Red pulp
 Medullary cords - Blood sinusoids (all over the spleen)
 Medullary sinuses - Splenic cords (Billroth cords)
Thymus depended zone "TDZ": Thymus depended zone "TDZ":
present in para-cortex (between present in peri-arteriolar lymphatic
cortex and medulla) sheath "PALS" of white pulps
NB: NB:
T-Lymphocytes / B-Lymphocytes T-Lymphocytes / B-Lymphocytes
= 60% / 40% = 45% / 55%
Tonsils
They are incompletely capsulated lymphatic structures. Each is formed of:
 Lymphatic follicles (with or without germinal center).
 Diffuse lymphocytes and plasma cells between follicles.
They are present as:

1) One pharyngeal tonsil (adenoid):
– Present in naso-pharynx.
– Covered by pseudo-stratified
columnar ciliated epithelium with
goblet cells.
– It is formed of diffuse lymphatic
tissue (without follicles).
– It has many folds (without crypts).
2) Two palatine tonsils:
– Present in oro-pharynx.
– Covered by non-keratinized stratified
squamous epithelium.
– They are formed of lymphatic
follicles.
– They have primary and secondary
crypts - mucous glands open to the
surface (so they can inflame easily).
3) Many lingual tonsils:
– Present below the tongue root.
– Covered by non-keratinized stratified
squamous epithelium.
– They are formed of lymphatic follicles
with germinal center.
– Their mucous glands open to the bottom of their crypts (so they cannot
inflame).
Function of tonsils:
Protection of digestive tract and respiratory tract against infections (by forming
antibodies).
NB: Lymphocytes of tonsils can penetrate epithelium and appear in oral cavity
as "salivary corpuscles".
=========
☼ Write short notes on: human protective mechanisms - immune system -
lymph nodes - spleen - tonsils.
☼ Discuss vascular supply and functions of: lymph node - spleen.
☼ Differentiate between lymph nodes and spleen.
Oral cavity
 The oral cavity is the entrance to alimentary canal that concerned with food
mastication and mixing it to saliva.
 It is bounded anteriorly by lips and teeth, posteriorly
by pharynx and superiorly by palate. It contains
tongue and openings of salivary glands.
 The oral cavity is lined by stratified squamous
epithelium (which may be keratinized, partially
keratinized or non-keratinized depending on the
location).
Lips:
The 2 lips are formed of orbicularis oris muscle which is covered by:
 Outer thin hairy skin: (keratinized Outer thin hairy skin
stratified squamous epithelium) with
free nerve endings, hair follicles and
sweet glands.
 Inner thick mucous membrane:
(non-keratinized stratified squamous Middle free
epithelium containing glycogen) red margin
with free nerve endings and labial
salivary glands.
 Middle free red margin: (partially- Inner thick mucous membrane
keratinized stratified squamous
epithelium) with many free nerve endings and many blood capillaries (so it
is more sensitive and red). It is present only in human.
NB: The dermis of skin and the CT corium of mucous membrane are rich in
elastic fibers, blood capillaries and lymphatic capillaries.
Tongue:
The tongue is formed of skeletal muscle bundles arranged in three directions
and supplied with hypoglossal nerve (the 12th cranial nerve). It has two surfaces:
 Loose ventral surface: lined by non-keratinized stratified squamous
epithelium. It is smooth.
 Adherent dorsal surface: lined by keratinized stratified squamous
epithelium. It is rough due to presence of tongue papillae.
The dorsal surface is divided by v-shaped groove (sulcus terminals) into:
 Posterior ⅓ (base or pharyngeal portion) that contain lingual tonsils.
 Anterior ⅔ (body or palatine portion) that contain lingual papillae.
Lingual papillae (tongue papillae):
- Lingual papillae are little projections of mucous membrane lick intestinal villi.
- Each papilla is formed of central connective tissue core covered by stratified
squamous epithelium and taste buds. There are four types of lingual papillae
(all are present on the anterior ⅔ of the dorsum of the tongue):
Fungiform Filiform Foliate Circumvallate
papillae papillae papillae papillae
 Have narrow base  Have broad base  Parallel,  As fungiform
and broad top and pointed top separated by deep papillae but large
(mushroom- (conical-shaped) grooves and have (1-3 mm) and
shaped) 2ry papillae deep (in a valley)
 Covered by:  Covered by:  Covered by:  Covered by:

 Non-keratinized  Heavily-  Keratinized  Non-keratinized
stratified keratinized stratified stratified
squamous stratified sq. squamous squamous
epithelium epithelium epithelium epithelium
 Some taste buds  No taste buds  Many taste buds  Many taste buds
 Few  Very numerous  More in rabbits  8-12 in number
(only in human)
 Present more at  Present more  Present more  Present in front of
tip (they are more anteriorly laterally and sulcus terminals
vascular and posteriorly over Von-Ebner
highly nervous) minor serous
salivary glands
Functions of lingual papillae: 1. Taste sensation (in human).
2. Licking of materials (in animals).
Taste buds:
Flask-shaped or onion-lick structures present on
tongue, oropharynx and soft palate.
Each tast bud is formed of:
 Neuro-epithelial taste cells (gustatory cells):
columnar pale cells with apical hairlets
(microvilli) and basal sensory nerve fibers.
 Supporting cells (sustentacular cells):
columnar dark cells present in the outer part.
 Basal cells: stem cells (for previous two types) present at the base.
Minor (accessory) salivary glands:
Branched tubulo-alveolar small salivary glands scattered in lamina propria
under mucous membrane of tongue, lips, tonsils and oral cavity.
Types: Serous salivary glands (with serous acini) as Von-Ebner’s salivary
glands under circumvallate papillae.
Mucous salivary glands (with mucous acini).
Lingual tonsils:
Groups of lymphoid follicles under the non-keratinized stratified squamous
epithelium of posterior ⅓ of the dorsum of the tongue.
NB:  Between the follicles there are many lymphocytes and plasma cells (if
these lymphocytes come out to saliva they are called "salivary
corpuscles").
 Minor salivary glands open into crypts of lingual tonsils washing them
and preventing their infection.
Teeth:
There are 20 teeth in children and 32
teeth in adults.
Each tooth is formed of:
 Crown (projecting part).
 Root (embedded part).
 Neck (junction zone between them).
The dental calcified tissues are present

as:
 Enamel (the hardest substance in
the body): a non-cellular calcified
material (95 % of which is
inorganic). It is formed by
ameloblasts.
 Dentine (the main part of the tooth): a calcified CT surrounding pulp
cavity. It is formed by odontoblasts present between dentine and pulp. The
pulp cavity contains vascular gelationous basophilic CT.
 Cement: a calcified bone covering dentin of root. It is connected to
alveolar bone by calcified collagenous fibers called "periodontal ligament".
NB: gingiva (gum): is a mucous membrane connecting enamel to periosteum of

alveolar bone. It is covered by partially-keratinized stratified squamous
epithelium.
Pharynx:
The pharynx lies next to oral cavity to conduct food to
esophagus and air to larynx.
Anatomically the pharynx is formed of three parts:
 Naso-pharynx: continuous with the nose and lined
by pseudo-stratified columnar ciliated epithelium
with goblet cells and muco-serous glands.
 Oro-pharynx: continuous with the oral cavity and
lined by non-keratinized stratified squamous epithelium with mucous glands.
 Laryngo-pharynx: continuous with the larynx and lined by non-keratinized
stratified squamous epithelium.
Histologically the pharynx is formed of three layers:

 Mucosa: formed of epithelium and CT rich in lymphocytes and elastic fibers.
 Musculosa: formed of skeletal muscles and elastic fibers.
 Fibrosa: formed of loose CT.
Palate:
The palate forms the roof of oral cavity and is formed of:
 Anterior hard palate: formed of fixed bone and lined by keratinized
 Posterior soft palate: formed of movable skeletal muscle and lined by:
 Non-keratinized stratified squamous epithelium (in inferior surface as
oral cavity).
 Pseudo-stratified columnar ciliated epithelium (in superior surface as
nose).
=========
☼ Differentiate between different types of lingual papillae (tongue papillae).
☼ Write short note on:
Lips - Tongue - Taste buds - Minor (accessory) salivary glands - Lingual
tonsils - Teeth - Pharynx - Palate.
Digestive glands
The digestive glands include: salivary glands, pancreas and liver.
Salivary glands
They are compound tubulo-alveolar exocrine glands that secrete about one litter
of saliva per day.
Saliva: is a sero-mucous secretion containing antibodies and enzymes. It has the
following functions:
 Washing, moistening and lubrication of oral cavity and lips  easy tasting
and easy swallowing.
 Food digestion: salivary amylase (convert starch to maltose) and lingual
lipase (convert lipids to glycerol, fatty acids and monoglycerides).
 Protection against bacteria (by IgA, lysozyme and lactoferrin) and
buffering of acidic food (by its alkalinity).
Types of salivary glands:
There are two types of salivary glands:
1. Main (major) salivary glands: compound
tubule-alveolar exocrine glands secreting
90% of saliva. They include two parotid
glands, two submandibular glands and two
sublingual glands.
2. Accessory (minor) salivary glands: branched
tubule-alveolar exocrine glands secreting
10% of saliva. They are scattered in
submucosa of oral cavity, tongue, tonsils and
lips (as buccal, lingual, palatine and labial Salivary glands and ducts
accessory salivary glands respectively).
Histology of main salivary glands: Each main salivary gland is formed of:
 CT stroma:  Thick capsule formed of CT cells (mainly fibroblasts and fat
cells) and CT fibers (mainly collagenous fibers).
 Thick trabiculae (CT septa) arise from the capsule to divide
the gland to lobes and lobules. They carry blood vessels,
nerves and ducts.
 Reticular CT forming a network for parenchyma. It can be
stained brown by silver.
 Parenchyma:  Secretory part (salivary acini): that secretes saliva.
 Excretory part (salivary duct system): that conducts saliva to
the oral cavity.
Salivary acini may be serous or mucous:
Serous acini Mucous acini
 Small diameter and narrow lumen  Large diameter and wide lumen
 Less numerous cells which are:  More numerous cells which are:
o High cuboidal with central o Low cuboidal with basal flat
rounded nuclei nuclei
o More basophilic ( rER and o Pale and vacuolated (dissolved
zymogen granules) mucinogen granules)
o Non-clear boundaries o Clear boundaries
 Secretion is serous needing:  Secretion is mucous needing:
o Few basket cells o Many basket cells
o Many canaliculi o Few canaliculi
 Examples:  Examples:
 Parotid glands  Submandibular salivary glands
 Von-Ebner minor salivary glands  Sublingual salivary glands
 Muco-serous acini are made of mucous acini with a

cap of serous cells (called serous demilune or crescent
of Gianuzzi) under basement membrane of mucous
acini.
NB: serous demilune and their inter-cellular canaliculi
secrete anti-bacterial enzymes called "lysozyme and lactoferrin".
 Basket cells (myo-epithelial cells) are branched contractile cells (rich in actin
and myosin filaments) present between secretory cells and their basement
membrane  their evacuation.
Duct system of main salivary glands:

Two secretory ducts (inside lobules) and three excretory ducts (in CT septa):
1. Inter-calated ducts (arising from acini):
They are lined by simple cuboidal epithelium.
2. Intra-lobular striated secretory ducts (inside lobules):
They secrete lysozymes and peptides so they have basal striations (basal
enfolding with mitochondria).
3. Inter-lobular ducts (between lobules):
They are lined by simple columnar epithelium.
4. Inter-lobar ducts (between lobes):
They are lined by pseudo stratified
columnar epithelium.
5. Main salivary ducts:
They are lined by stratified columnar then
1. Parotid gland (purely serous gland):

 2 large-sized compound tubulo-alveolar
exocrine glands (in front of both ears).
 Formed of serous acini only.
 They secrete watery saliva into oral cavity
through Stenson’s duct (opposite to upper
second molar teeth). Parotid gland
Their secretion is rich in:
 Salivary amylase enzyme.
 Parotin hormone (which is anti-insulin).
 ∂ Globulin (from CT plasma cells).
 Electrolytes.
2. Submandibular gland (sero-mucous gland):

 2 medium-sized compound tubulo-alveolar
exocrine glands (inner to both mandibular
bodies).
 Formed of many serous acini (90%) and
few mucous and muco-serous acini (10%).
Serous acini ∕ mucous acini = 5 ∕ 1.
 They secrete sero-mucous saliva into oral Submandibular gland
cavity through Wharton’s duct (posterior to
lower incisor teeth). They produce ⅔ of all
saliva.
3. Sublingual gland (muco-serous gland):

 2 small-sized compound tubulo-alveolar
exocrine glands (under mucosa of mouth
floor near the midline).
 Formed of many mucous acini and few
muco-serous acini (no purely serous acini).
Mucous acini ∕ muco-serous acini = 3 ∕ 2.
 They secrete muco-serous saliva into oral
cavity through many ducts (more posterior
to lower incisor teeth).
Sublingual gland
Pancreas
Pancreas is an abdominal digestive gland present in concavity of duodenum.
It is a mixed gland formed of:

 Exocrine part: a compound tubule-alveolar
gland (formed of acini and ducts) that secretes
about 1.5 litters of alkaline pancreatic juice
rich in enzymes.
 Endocrine part: islets of Langerhans that
secrete glucagon, insulin, somatostatin and
polypeptide hormones directly to fenestrated
blood capillaries (from α, β, D and F cells
respectively).
Histologically pancreas is formed of:
 CT stroma: Thin capsule formed of CT cells and CT fibers. It is covered
partially by peritoneum.
Thin trabiculae (CT septa) that divide pancreas to lobes and
lobules. They carry blood vessels, nerves and ducts.
Reticular CT forming a network for parenchyma. It can be
stained brown by silver.
 Parenchyma: Pancreatic acini and ducts (exocrine part of pancreas) that
form 98% of pancreas.
Islets of Langerhans (endocrine part of pancreas) that form 1-
2% of pancreas.
Pancreatic acini (purely serous acini):

 Formed of pyramidal cells with:
 Non-clear boundaries adherent together by junctional complex.
 Apical acidophilia (zymogen granules) with microvilli.
 Basal basophilia (pale nucleus and mitochondrial striations).
 Inter-calated duct is telescoped inside the acinus - its cuboidal cells are
called "centro-acinose cells".
Duct system of pancreas: pancreas has small number of ducts.
1. Inter-calated ducts (telescoped in acini):
2. Intra-lobular ducts (inside lobules):
They are not secretory and not apparent.
3. Inter-lobular ducts (between lobules):
4. Inter-lobar ducts (between lobes):
They are lined by simple columnar epithelium.
5. Main pancreatic duct:
It is lined by simple columnar epithelium with goblet cells and entero-
endocrine cells. It joins common bile duct to open in duodenum.
Islets of Langerhans (more than 1 million - each measures 100-200 µm):

 Pale-stained areas scattered between pancreatic acini (mainly in pancreatic
tail).
 They are formed of ABCD-FG cells (separated by fenestrated blood
capillaries):
 A (alpha) α cells (20%): large cells (15-25 µm) with acidophilic granules -
present peripherally and secrete glucagon hormone that  blood glucose.
 B (beta) β cells (70%): small
cells (10-15 µm) with
basophilic granules - present
centrally and secrete insulin
hormone that  blood glucose.
 C (clear) cells (3%): small
cells which may be stem cells
or exhausted cells.
 D (delta) δ cells (5%): large
cells stained by silver -
present peripherally and
secrete somatostatin hormone
that  secretion of glucagon,
insulin, GH, TSH and HCl of
stomach.
 F (pp) cells (2%): secrete pancreatic polypeptide hormones that  gastric
enzymes,  pancreatic enzymes and  intestinal motility.
 Ganglion nerve cells: multipolar nerve cells that control the secretory
function of islets.
 By EM these cells are protein-forming cells (with many mitochondria, many
rER, well developed Golgi apparatus and many secretory granules).
Differences between parotid and pancreas:
Parotid Pancreas
 2 exocrine salivary glands (in front of  1 mixed digestive gland (in concavity
both ears) of duodenum)
 Capsule: very thick with many fat  Capsule: very thin with few fat cells
cells
 Acini: the cells of acini have:  Acini: the cells of acini have:
 Basophilic cytoplasm  Acidophilic cytoplasm (apical
zymogen granules)
 Central nucleus  Basal nucleus
 No basal striations  Basal striations (mitochondria)
 Ducts:  Ducts:
 Inter-calated ducts: multiple and  Inter-calated ducts: long and
not telescoped telescoped
 Intra-lobular ducts: secretory and  Intra-lobular ducts: not secretory
striated and not apparent
 Inter-lobular ducts: lined by simple  Inter-lobular ducts: lined by simple
columnar epithelium cuboidal epithelium
 Inter-lobar ducts: lined by pseudo-  Inter-lobar ducts: lined by simple
stratified columnar epithelium columnar epithelium
 Main duct: lined by stratified  Main duct: lined by simple
columnar then stratified squamous columnar epithelium with goblet
epithelium cells and entero-endocrine cells
 No endocrine cells (parotin is  ABCD-FG cells form islets of
secreted from acini) Langerhans
Liver
Liver is a digestive gland present in the upper
right abdomen.
It is the largest gland in the body (about 1.5 kg).
Liver is a compound tubular mixed gland that
secretes:
 Bile (through biliary passages).
 Plasma proteins, lipoproteins and glucose
(directly to blood sinusoids).
Functions of the liver:
1. Secretion of bile.
2. Protein synthesis: albumin - globulin (IgA and IgM) - fibrinogen -
prothrombin - amino acids - lipoproteins - urea - uric acid.
3. Regulation of carbohydrate, protein and fat metabolism.
4. Storage of glycogen, fatty acids, vitamins (A-D-E-K) and minerals (iron -
copper).
5. Detoxification of drugs.
Histologically the liver is formed of:

 CT stroma:
 Thin strong Glisson’s capsule (covered partially by peritoneum).
 Thin trabiculae (CT septa) that divide liver to hepatic lobes and lobules.
 Reticular CT forming a network for parenchyma. It can be stained
brown by silver.
 Parenchyma:
 Hepatocytes (arranged in branching plates or cords).
 Blood vessels (arteries, veins, sinusoids and lymphatic vessels).
 Biliary passages (intra hepatic and extra hepatic).
NB: CT septa of the liver are thick in pig - camel - human with liver fibrosis
or liver cirrhosis.
Parenchyma of the liver is organized (according to structure and function) into:

 Hepatic lobule:
A hexagonal area surrounding 1 central vein. Rows of hepatocytes radiate
from central vein (each row is facing blood sinusoid at one side and bile
canaliculus at the other side).
Hepatic lobule Hepatic lobule Portal lobule Hepatic acinus
Zone III
Zone II
CV Zone I
 Portal tract = portal canal = portal area:

A triangular area (between 3 hepatic lobules) containing branch of hepatic
artery, branch of portal vein, branch of lymphatic vessel and branch of bile
duct.
 Portal lobule:
A triangular area (between 3 central veins) surrounding portal tract.
 Hepatic acinus:
A diamond-shaped area (between 2 central veins) surrounding branches of
hepatic artery and portal vein (so zone I is rich in blood while zone III is poor
from blood).
Portal tract Parenchyma of the liver Hepatic lobule

Hepatocytes:
 Hepatocytes are arranged as rows radiating from central veins  branching
plates or cords.
 LM:  Large polyhedral cells (20-30 µm) with large rounded nuclei and
acidophilic vacuolated cytoplasm. Nuclei are active (pale with
prominent nucleoli) and multiple in 25% of hepatocytes.
 Each hepatocyte faces bile canaliculus at one side (with few short
microvilli) and peri-sinusoidal space of Disse at the opposite side
(with numerous long microvilli). Other 2 sides face adjacent
hepatocytes and join them by junctional complex.
 EM:  Organelles:
o Many mitochondria (up to 2000 in each cell) to supply energy.
o Many rER with many ribosomes for protein synthesis.
o Well-developed Golgi apparatus (near nucleus) for protein secretion
and lysosome formation.
o Many lysosomes for digestion and removal of waste products.
o Many sER for detoxification, lipid synthesis and glycogen storage.
 Inclusions: glycogen (acidophilic with PAS or Best’s carmine) and fat
(black with osmic acid or sudan III).
Blood vessels of the liver:
 The liver receives 1500 ml blood every minute from which:
o 400 ml (about 25%) comes from hepatic artery as "oxygen rich blood".
o 1100 ml (about 75%) comes from portal vein as "nutrient rich blood"
from stomach and intestines.
 Branches of hepatic artery and portal vein (in portal tracts)  blood
sinusoids  central veins  sub-lobular veins  2 hepatic veins  IVC.
Blood sinusoids:
 They are wide irregular vascular spaces
present between hepatocyte rows.
 They are lined by fenestrated simple
squamous endothelium and phagocytic
von kupffer cells.
 Each blood sinusoid receives blood
(from hepatic artery and portal vein)
and drains it to central vein.
Von kupffer cells: Hepatic lobule Portal tract

 Large branched phagocytic cells arising from blood monocytes and line
hepatic blood sinusoids.
 LM: irregular shape due to pseudopodia.
 EM: many lysosomes (so can be stained by vital stains as trypan blue).
 Functions:
 phagocytosis of microorganisms and foreign bodies coming from
intestines.
 phagocytosis of old RBCs and formation of bile pigments.
Peri-sinusoidal space of Disse:

It is the space between blood sinusoids (lined by endothelial cells and von
kupffer cells) and hepatocytes (with numerous long microvilli). Its function is
exchange of materials. It contains:
 Supporting reticular fibers: toward blood sinusoid.
 ITO (fat storing) cells: supporting stellate-shaped adipocytes containing fat
soluble vitamin A.
 Plasma (lymph)  lymphatic vessels of portal tract  sub-lobular
lymphatic vessels  main lymphatic vessels.
 Pit cells: stellate-shaped phagocytes.
 Non-myelinated nerve fibers: toward numerous long microvilli of
hepatocytes.
=========
 Serous acini and mucous acini.
 Parotid gland and pancreas.
☼ Comment on:
 Parotid gland - submandibular salivary gland - sublingual salivary gland.
 Duct system of main salivary glands - duct system of pancreas.
 Islets of Langerhans - liver parenchyma - hepatocytes - peri-sinusoidal
space of Disse.
Endocrine system
Endocrine system is responsible for production and release of hormones directly

to blood to influence target cells. It includes:
 Diffuse neuro endocrine cells (DNECs): scattered in epithelium of digestive
tract and respiratory tract.
 Non-capsulated clusters of endocrine cells (in certain organs): as islets of
Langerhans (in pancreas).
 Capsulated endocrine glands: ductless glands formed of endocrine cells
present in groups and separated by blood sinusoids.
They include:  One pituitary gland.
 Two suprarenal glands.
 One thyroid and four parathyroid glands.
 One pineal body.
Pituitary gland
A small gland presents in a bone cavity at the base of skull (sella turcica) to
regulate other endocrine glands.
Pituitary gland (hypophysis cerebri) is divided to:

1. Anterior lobe (adeno-hypophysis):
Derived from oral ectoderm as an upward growth from the roof of the buccal
cavity (Rathke’s pouch).
It is formed of pars distalis, pars tuberalis and pars intermedia.
2. Posterior lobe (neuro-hypophysis):

Derived from neuro ectoderm as a downward growth from the floor of the
third ventricle of the brain.
It is formed of infundibulum and pars nervosa.
Histologically pars distalis of anterior lobe is formed of:
 CT stroma:  Very thin CT capsule.
 Reticular CT network containing parenchyma.
 Parenchyma:  Collections of cells which are divided to:
o 48% Chromo-phils (with secretory granules):
 8% Baso-phils or beta cells (with many rER):
1. Thyro-trophs  TSH.
2. Cortico-trophs  ACTH, MSH and others.
3. Gonado-trophs  FSH, LH and ICSH.
 40% Acido-phils or alpha cells (with many sER):
4. Somato-trophs  GH.
5. Mammo-trophs  prolactin.
o 50% Chromo-phobes (with few or no secretory granules).
o Other cells as glial cells, macrophages, stem cells …
 Fenestrated blood capillaries and blood sinusoids.
1. Thyro-trophs:
Basophilic cells characterized by:
 Large angular cells with rounded nuclei
and small basophilic granules.
 Stimulated by hypothalamus to release
thyroid stimulating hormone (TSH) that
control functions of thyroid gland (to
secrete thyroid hormones "T3 and T4").
2. Cortico-trophs:
 Large oval cells with rounded nuclei
and large basophilic granules.
 Stimulated by hypothalamus to release:
o Adreno-cortico-trophic hormone
(ACTH) that control functions of
zona fasciculata and zona reticularis
of supra-renal gland (to secrete cortisol).
o Melanocyte stimulating hormone (MSH) that stimulate epidermal
melanocytes (to secrete melanin).
o Lipotropic hormone that regulate lipid metabolism.
o Beta endorphin hormone that is a pain killer.
3. Gonado-trophs:
 Large fusiform cells with oval nuclei and medium-sized basophilic
granules.
 Stimulated by hypothalamus to release:
o Follicle stimulating hormone (FSH) that stimulate either follicular
development in ovary (to secrete estrogen) or spermatogenesis in testes
(to form spermatozoa).
o Luteinizing hormone (LH) that stimulate ovulation and corpus luteum
formation in ovary (to secrete progesterone).
o Interstitial cells stimulating hormone (ICSH) that stimulate interstitial
cells of Laydigs in testes (to secrete testosterone).
4. Somato-trophs:
Acidophilic orange G positive cells (orango-phils) characterized by:
 Medium-sized oval cells with rounded nuclei and large acidophilic
granules.
 Controlled by hypothalamus to release growth hormone (GH) that regulate
growth of long bone and influences many metabolic processes.  of GH 
gigantism (before puberty) or acromegaly (after puberty) while  of GH 
pituitary dwarfism.
5. Mammo-trophs:
Acidophilic carmine positive cells (carmino-phils) characterized by:
 Small spindle cells with oval nuclei and small acidophilic granules.
 They secrete prolactin which is necessary for alveolar development (of
maternal mammary glands) and milk production (hypothalamus inhibits
prolactin secretion).
The following cells are also present in pars distalis:

 Glial stellate-shaped cells: they form the supportive
network of pars distalis stroma.
 Macrophages: they are branched phagocytic cells.
 Stem cells: they can differentiate to chromo-phil cells.
 De-granulated cells: they regulate electrolyte balance.
The hypothalamus secret the following hormones:

1. Thyro-trophin releasing hormone (TRH) that stimulate
thyro-trophs to secrete TSH.
2. Cortico-trophin releasing hormone (CRH) that
stimulate cortico-trophs to secrete ACTH and MSH.
3. Gonado-trophin releasing hormone (GRH) that
stimulate gonado-trophs to secrete FSH, LH and ICSH.
4. Somato-trophin releasing hormone (SRH) and somato-
trophin inhibiting hormone (SIH) that control somato-
trophs to secrete growth hormone.
5. Prolactin inhibiting hormone that inhibit prolactin secretion from mammo-
trophs.
6. Oxytocin hormone secreted from para-ventricular nucleus to controls
contraction of uterus (after childbirth) as well as contraction of myoepithelial
cells around alveolar acini and ducts of mammary glands (during lactation).
NB: prolactin  milk production (secretion) while oxytocin  milk ejection
(excretion).
Suprarenal glands
o Two small glands above the two kidneys. Each has peripheral yellow cortex
and central pink medulla.
o Each is formed of :
 CT stroma:  Thick fibrous capsule covered with renal adipose CT.
 Thin trabeculae (CT septa) which divide the cortex to
three zones.
 Reticular CT network containing parenchyma.
 Parenchyma:  Suprarenal cortex (formed of three zones).
 Suprarenal medulla (formed of chromaffin cells).
The suprarenal cortex:

It includes three zones (named according to cell arrangement):
1. Zona glomerulosa: a thin outer (sub-capsular) zone representing 15% of
cortical thickness.
 LM: it is formed of columnar cells arranged as arches (glomeruli) and
surrounded by fenestrated blood capillaries. Columnar cells have
basophilic cytoplasm and basal nuclei.
 EM: many mitochondria, many sER, few fat droplets and peripheral Golgi.
 Function: stimulated by kidney renin ( angiotensin II) to secrete
mineralo-corticoids (aldosterone) that regulate sodium and potassium level
in blood.
2. Zona fasciculate: a thick middle zone representing 75% of cortical thickness.
 LM: it is formed of large polyhedral cells (spongiocytes) arranged as
straight cords (fascicles) perpendicular to capsule and separated by straight
fenestrated blood capillaries. Polyhedral cells have vacuolated cytoplasm
(rich in fat droplets) and central nuclei.
 EM: many mitochondria, many sER, cholesterol and vitamin C.
 Function: stimulated by pituitary ACTH to secrete gluco-corticoids
(cortisol) and some androgen. The cortisol regulates carbohydrate, fat and
protein metabolism. It also suppresses immunity.
3. Zona reticularis: a thin inner zone representing 10% of cortical thickness.
 LM: it is formed of small polyhedral cells arranged as cords that branch
and anastomose as a reticulum and contain fenestrated blood capillaries.
Polyhedral cells have acidophilic cytoplasm and central nuclei
 EM: many mitochondria, few sER, few fat droplets and much lipofuscin
pigment.
 Function: stimulated by pituitary ACTH to secrete sex hormones
(androgen and estrogen) and some cortisol.
NB: transition zone (between zona glomerulosa and zona fasciculata) and x
zone (between cortex and medulla) are present in newborn and secrete
androgen.
The suprarenal medulla: It is considered as a sympathetic ganglion (that

innervated by preganglionic sympathetic nerve fibers) and composed of three
types of cells:
1. Chromaffin cells (pheochromocytes):
 LM: modified sympathetic nerve cells that have lost their process and
become large secretory polyhedral cells arranged in groups or branching
cords and separated by fenestrated blood capillaries.
They have pale central nuclei and basophilic granular cytoplasm.
 EM: many mitochondria, many rER, well-developed Golgi apparatus and
fin secretory granules (adrenaline and noradrenaline which are stained
brown with chromium salts = chromaffin reaction). There are two types of
chromaffin cells:
o Adrenaline-secreting cells: with faint small granules.
o Noradrenaline-secreting cells: with dark (electron-dense) large granules.
2. Ganglion cells (sympathetic nerve cells): large pale stellate nerve cells
scattered between chromaffin cells to control their secretory function.
3. Lymphocytes: present around blood capillaries.
NB:  During emotion (fight or flight) adrenalin and noradrenalin are released
in large amounts.
 Paraganglia: are collections of chromaffin cells and nerve cells beside
sympathetic ganglia, kidney, liver, uterus and ovary.
 Pheochromocytoma: is tumor of suprarenal medulla or paraganglia.
 Chromaffin reaction:
A staining test for adrenaline and noradrenaline granules.
Fresh section + potassium bichromate or chromic acid  brown medulla (chromaffin cells)
 Cramer’s test:
A staining test for adrenaline and noradrenaline granules also for fat
droplets.
Fresh section + osmic acid vapor  black medulla (chromaffin cells) & black cortex (spongiocytes)
Difference between suprarenal cortex and suprarenal medulla:

Suprarenal cortex Suprarenal medulla
 Develops from mesoderm.  Develops from ectoderm.
 In fetal life it is enlarged to secrete  In fetal life its cells come from
corticosteroids and estrogen. neural crest (as sympathetic ganglia).
 Formed of zones glomerulosa,  Formed of chromaffin cells and
fasciculata and reticularis. ganglion cells.
o Secretes aldosterone, cortisol, o Secretes adrenaline, nor-
androgen and estrogen. adrenaline and opioid.
o Their secretions are essential to o Their secretions are less essential
life. to life.
 Supplied with arterial blood.  Supplied with arterial and venous
blood from cortex
 Give negative reactions with  Give positive reactions with
chromaffin, iodine and ferric chromaffin, iodine and ferric
chloride tests. chloride tests.
Thyroid gland
A large endocrine gland, in front of the neck,
formed of two lobes connected by isthmus.
Histologically thyroid gland is formed of:
 CT stroma:
 Two capsules:
1. Outer capsule: per-tracheal fascia.
2. Inner capsule: fibro-elastic adherent
true capsule.
 Thin trabiculae for blood vessels,
nerves and lymphatics.
 Reticular CT network containing
parenchyma.
 Parenchyma:
 Thyroid follicles surrounded by
fenestrated blood capillaries.
 Inter-follicular tissues (between thyroid follicles).
Thyroid follicles:
They are the structural and functional units of thyroid gland.
They are spherical, filled with acidophilic colloid (iodinated thyroglobulin) and
lined by follicular epithelium (on a thin basement membrane) that is formed of:
C cell
C cell
1. Principal follicular cells (98%):

 LM: cuboidal basophilic cells with round central nuclei and microvilli.
 EM: many mitochondria, many rER, apical Golgi and lysosomes.
 Function: stimulated by pituitary TSH to secrete thyroid hormones (T3 and
T4) that  basal metabolic rate.
  Thyroid function  cretinism (in children) and myxedema (in
adults).
  Thyroid function  thyrotoxicosis.
 Synthesis of thyroid hormones:
Amino acids Amino acids rER and Golgi  thyroglobulin Thyroglobulin

 Iodide Iodide peroxidase enzyme  Iodine Iodine 
Blood Colloid
 T and T T3 and T4  TSH and lysosome
Colloid Colloid 
3 4
  Iodide in diet  simple goiter (thyroid enlargement with normal

function).
2. Para-follicular C cells (2%):

 LM: larger and paler cells present in follicular wall and inter-follicular CT.
 EM: moderate amount of rER, large Golgi and many basal small granules.
 Function: secrete calcitonin hormone (anti parathyroid) that  blood
calcium.
Inter-follicular tissues:
They are tangentially cut thyroid follicles and blood capillaries.
Parathyroid glands
Parathyroid glands are 4 small oval yellow glands posterior to thyroid gland.
Histologically each parathyroid gland is formed of:
 CT stroma:  Thin capsule.

 Thin trabiculae.
 Reticular CT network.
 Parenchyma:  Anastomosing cords of cells.
 Fenestrated blood capillaries.
Each gland is formed of two types of cells:

Chief cells:
They are numerous.
 LM: small polygonal cells with
basophilic cytoplasm and vesicular
nuclei.
 EM: many mitochondria, rER, Golgi and
secretory granules.
 Function: they secrete parathyroid
hormone that regulates calcium and
phosphorous level in blood.
 Hyper-para-thyroidism   blood
calcium  osteitis fibrosa cystica.
 Hypo-para-thyroidism   blood
calcium  tetany.
Oxyphil cells:
They are less numerous and increase with age.
 LM: large polygonal cells with
acidophilic cytoplasm and dark nuclei.
 EM: many mitochondria with acidophilic
granules.
 Function: they have no function and may
secrete calcitonin hormone that  blood calcium.
=========
☼ Differentiate between suprarenal cortex and suprarenal medulla.
☼ Comment on:
 Basophils of pars distalis - Acidophils of pars distalis.
 Suprarenal cortex - Suprarenal medulla.
 Principle follicular cells - Para-follicular C cells - Chief cells - Oxyphil
cells.
Histology - for dental students A
Light microscope and electron microscope
In light microscope (LM): In electron microscope (EM):

Visible light and glass lenses are used Invisible electrons and electro-magnetic
 colored photos magnified up to coils are used  non-colored photos
1500 times. magnified up to 400.000 times.
Transmission EM (2 dimensions) Scanning EM (3 dimensions)
Colored photo-micro-graph Non-colored photo-micro-graph

showing many cells showing one cell
Histology - for dental students B
Cell membrane
Mitochondria
Outer smooth membrane

Inner folded membrane
Inter-membranous space
Inter-crestal space
Histology - for dental students C
Golgi apparatus
Protein synthesis
Histology - for dental students D
Centrioles
9 radiating triplets
Cilia and flagella
9 radiating doublets
2 central singlets
Flagellum (tail of sperm)
Ribosomes and Nucleus

Histology - for dental students E
Epithelial tissue
Simple squamous Simple cubical Simple columnar
Simple col. ciliated Pseudo-stratified columnar Pseudo-stratified columnar ciliated

Histology - for dental students F
Non-keratinized stratified squamous Keratinized stratified squamous

epithelium epithelium
Transitional
epithelium
Glandular Neuro-
epithelium epithelium
Histology - for dental students G
Connective tissue cells
Undifferentiated mesenchymal cell Fibroblast
Blood
vessel
Pericytes Endothelial cells
Reticular cells Macrophage

Histology - for dental students H
Leucocytes Plasma cells
Mast cells Fat cells

Histology - for dental students I
Connective tissue fibers
Collagen fibers Reticular fibers Elastic fibers
Types of connective tissue
Loose (areolar) CT Mucous (mucoid) CT Adipose (fatty) CT
Dense (collagenous) CT Reticular CT Elastic CT

Histology - for dental students J
Cartilage and Bone

Types of cartilage
Hyaline cartilage Elastic cartilage Fibrocartilage
Chondrocyte Osteoblast Osteocyte Osteoclast
Compact bone
Histology - for dental students K
Blood
Blood film Red blood corpuscles (RBCs) are rounded biconcave non-nucleated discs
7.5 µm
2.6 µm 0.75 µm
RBCs have pale thin center and dark thick periphery Rouleaux appearance of RBCs (as rows of coins)
White blood cells (WBCs) 4-11 thousand /3mm Nucleus Granules

irregular and Large and basophilic
Basophils s-shaped (histamine, heparin and
(0-0.75 %) ECF)
bi-lobed and Large and acidophilic

Eosinophils horse-shoe (histaminase and
(1-3 %) sulphatase)
formed of Large and pale

Neutrophils connected 2-5 (collagenase and alkaline
(57-67 %) segments phosphatase)
large and Non-granular

Monocytes kidney-shaped
(3-7 %)
Lymphocytes large and rounded Non-granular

(25-33 %)
Histology - for dental students L
Muscular tissue
Types of muscles
Skeletal muscle Cardiac muscle Smooth muscle
Structure of skeletal muscle LM of skeletal muscle
LM and EM of skeletal muscle

Histology - for dental students M
Nervous tissue
Structure of nerve cell (neuron)

Histology - for dental students N
Spinal ganglia (Hx and E - silver stains) Sympathetic ganglia (Hx and E stain)
Axon
Axolemma
Myelin sheath
Neurolemmal sheath
CT endo-neurium
CT peri-nurium
CT epi-neurium
Axon covering and nervr trunk
Nervr trunk (Hx and E stain) Nervr trunk (osmic acid stain)
Histology - for dental students O
Vascular system
Aorta Inferior vena cava
Medium-sized artery and vein

Histology - for dental students P
Skin
Horny layer
Clear layer Epidermis

Granular cell layer
Prickle cell layer
Dermis
Langerhans cell
Dermis Basal cell layer
Merkel’s cell Hypodermis
Melanocyte
Thick skin Thin skin
melanocyte
Melanin granules migrate to the tips of the melanocyte’s processes and are
then transferred to the keratinocytes of the malpighian layer
Histology - for dental students Q
Lymphatic tissue
Cortical follicles
Cortical sinuses
Medullary cords
Medullary sinuses
Histology - for dental students R
Central arteriole
White pulp
Red pulp
Blood sinusoids
Spleen
Vascular supply of spleen
Tonsil
Histology - for dental students S
Oral cavity
Tongue Minor (accessory) salivary glands
Types of tongue papillae (lingual papillae)
Fungiform papillae Filiform papillae Foliate papillae Circumvallate papillae
Outer thin hairy skin
Inner thick mucous membrane Middle free red margin
Lip Tooth
Histology - for dental students T
Digestive glands
Stenson’s duct
Parotid gland
Wharton’s duct Many secretory ducts

Submandibular gland Sublingual gland
Salivary glands and their secretory ducts
Parotid gland Submandibular gland Sublingual gland

(purely serous acini) (mainly serous acini) (mainly mucous acini)
Serous acini (small with central rounded nuclei) Mucous acini (large with basal flat nuclei)
Muco-serous acini
Histology - for dental students U
Pancreas with islets of Langerhans inside serous acini
α cells
β cells
δ cells
pp cells
Types of cells in islets of Langerhans (inside pancreatic serous acini)
Parotid gland (2 exocrine salivary glands) Pancreas (1 mixed digestive gland)
Serous acini without islets of Langerhans Serous acini with islets of Langerhans
Histology - for dental students V
Hepatocytes
Blood sinusoid
Hepatic artery
Portal vein
Bile duct
Central vein
Anatomical sites of liver and pancreas Parenchyma of the liver (hepatocytes, blood vessels and biliary passages)
Hepatic lobule Portal lobule Hepatic acinus
Branch of hepatic artery CV

Branch of bile duct
Zone III
Branch of portal vein Zone II
CV Zone I
Organization of liver parenchyma (according to structure and function)
Portal tract Parenchyma of the liver Hepatic lobule

Histology - for dental students W
Endocrine system
Pars nervosa
Development of pituitary gland
Chromo-phils and chromo-phobes of pars distalis Relation between hypothalamus, pituitary and other endocrine glands
Zona glomerulosa
Zona fasciculate
Zona reticularis
Suprarenal medulla
Anatomical site of suprarenal glands Suprarenal gland

Histology - for dental students X
4 Parathyroid glands
Thyroid gland
Posterior view 
 Anterior view
Anatomical sites of thyroid and parathyroid glands Thyroid and parathyroid glands
C cell
C cell
Thyroid gland Parathyroid gland
Amino acids Amino acids rER and Golgi  thyroglobulin Thyroglobulin

 Iodide Iodide peroxidase enzyme  Iodine Iodine 
Blood Colloid
 
T3 and T4 T3 and T4  TSH and lysosome Colloid Colloid
Synthesis of thyroid hormones (T3 = tri-iodo-thyronine and T4 = tetra-iodo-thyronine)

Histology and Cell Biology: For Dentistry and Physical Therapy

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Histology and Cell Biology: For Dentistry and Physical Therapy

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Histology and cell biology

For dentistry and physical therapy

Light microscope (LM) and Electron microscope (EM):

Light microscope (LM) Electron microscope (EM)

 Light microscope (LM) is formed of:

×  cente- ×  milli- ×  micro- ×  nano- ×  Angst- ×  pico-

 Resolution: is the capacity of the microscope to discriminate 2 adjacent

Types of stains used in histology:

 Cytoplasm is formed of:

 Nucleus is formed of:

1. Cell membrane = plasma membrane = plasma lemma:

 Function of cell membrane:

2. Mitochondria: Membranous cytoplasmic organelles concerned with

3. Endoplasmic reticulum: Membranous cytoplasmic organelles concerned with

 Rough endoplasmic reticulum (rER): covered with ribosomes.

4. Golgi apparatus (secretory apparatus):

5. Lysosomes: Membranous cytoplasmic organelles concerned with intra-

Nucleic acids (DNA and RNA)

☼ Write short notes on: cell membrane - mitochondria - endoplasmic reticulum

o Epithelial tissue may be:

o Epithelial tissue is sensitive, avascular (supplied by diffusion) and

3. Stratified columnar epithelium:

Myo-epithelium: the contractile type of epithelium.

Function of epithelial tissue:

Connective tissue (CT)

 CT is a mesodermal structure concerned with

According to matrix there are 4 types of CT:

According to characters there are 3 types of CT:

Connective tissue proper

Ground substance: The ground substance is formed of tissue fluid containing

2. Proteo-glycans: a core of protein to

3. Glyco-protains: a globular protein Glyco-protein

Connective tissue fibers:

1. White collagenous fibers (the flexible type of CT fibers):

3. Yellow elastic fibers (the stretchable type of CT fibers):

Connective tissue cells:

Fixed or free CT cells:

1. Un-differentiated mesenchymal cells = UDMCs (fixed branched CT cells):

2. Fibroblasts (fixed branched CT cells arising from UDM cells):

3. Pericytes (fixed branched CT cells arising from UDM cells):

5. Reticular cells (fixed branched CT cells arising from fibroblasts):

6. Fixed macrophages = Histeocytes (fixed branched CT cells arising from

8. Melanophores = pigment cells (free branched CT cells arising from

9. Leucocytes (free rounded CT cells arising from PHS cells):

NB: pluri-potential hemato-poetic stem cells (PHS cells) 

2. Mucous (mucoid) CT:

3. Adipose (fatty) CT:

4. Dense (collagenous) CT:

Regular dense CT Irregular dense CT

Cartilage is a firm flexible CT formed of cartilage cells in a rubbery

 Ground substance: tissue fluid containing glycos-amino-glycans (causing its

 Perichondrium: vascular CT membrane formed of 2 layers:

Hyaline cartilage Elastic cartilage Fibrocartilage

Bone is a hard calcified CT formed of bone cells in a solid extracellular matrix

Bone cells: there are four types of bone cells:

1. Osteogenic cells (osteoprogenator stem cells): arise from UDM cells or

2. Osteoblasts (bone forming cells): arise from osteogenic cells.

3. Osteocytes (mature bone cells): arise from osteoblasts.

Bone matrix: a solid calcified media formed of:

Compact bone (ivory bone): it is formed of:

Spongy bone (concellous bone): it is formed of:

Differences between bone and cartilage: