Histology 2

LYMPHATIC ORGANS
Primary Lymphatic Organs : Thymus & bone marrow.

Secondary Lymphatic Organs : Lymph nodes, spleen and tonsils.
Lymph Node :
Definition: small oval, bean or kidney-shaped lymphatic organs.
Sites : found in groups in axilla, neck, thorax, abdomen and groin.
Structure: Stroma - Parenchyma.
(I) Stroma :
- Capsule :
• Comprised of C.T. fibers as collagen and elastic fibers, with C.T. cells like fibroblasts.
• Smooth muscles may be present at the hilum.
• Surrounded by adipose tissue.
- C.T. septa (Trabeculae) :
• Extend from the deep surface of the capsule.
• Divide the cortex into regular compartments and the medulla into irregular compartments.
- Reticular C.T. :
• Forms the background of the organ.
• Appears brown when stained with silver.
(II) Parenchyma :
- Cortex : Outer zone under the capsule.
1. Lymphatic Nodules (Follicles) :
• Aggregations of small lymphocytes forming rounded, oval, or pyramidal structures.
• Located in the outer part of the cortex except the area of the hilum.
• Primary lymphatic follicles (without germinal center)
• Secondary lymphatic follicles (having germinal center).
• Secondary follicles form from exposure to antigen or infection.
• Peripheral dark regions of small lymphocytes & central pale region (germinal center) containing
activated B lymphocytes, plasmablasts, plasma cells, and macrophages.
2. Cortical Lymph Sinuses :
• Spaces separating lymph nodules from the capsule (subcapsular sinuses) and trabeculae
(trabecular sinuses).
• Lined with endothelial cells & macrophages.
3.Paracortex (Thymus dependent zone) :
• Deep part of cortex, between cortex and medulla.
• Contains T-lymphocytes migrating from the thymus through post-capillary venules lined with
simple cubical epithelium.
- Medulla : appears lighter in staining due to fewer packed lymphocytes.
1. Medullary Cords:
• Irregular branching cords of aggregated B-lymphocytes, plasmablasts, and plasma cells.
2. Medullary Sinuses:
• Spaces between the medullary cords and trabeculae.
• Lined with endothelium and macrophages.
• Contain lymph received from cortical sinuses.
Lymph Circulation :
- Afferent lymphatic vessels transport lymph to the convex surface of the lymph node.
- These vessels feature valves that facilitate one-directional flow of lymph.
- Within the lymph node, lymph circulates from cortical to medullary sinuses.
- Efferent lymphatic vessels exit the lymph node from the concave surface located at the hilum.
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Functions of lymph nodes :
1- Filter lymph from microorganisms.
2- Proliferation & production of lymphocytes.
3- Immunological functions :
a- Humoral immunity :
» The site of activation of B-Iymphocytes, plasma blasts, plasma cells which secrete antibodies.
b- Cell mediated immunity :
» where the activated T-lymphocytes change into cytotoxic cells which destroy the foreign cells.
Clinical notes :
Lymphadenitis : Infection can lead to inflammation of lymph nodes draining that area.
Carcinoma : usually spread from its primary sites through lymphatic vessels.
Spleen :
Definition: Single intra-abdominal hemolymphatic organ.
Structure: Stroma - Parenchyma.
(I) Stroma :
- Capsule :
• Comprised of C.T. fibers, including collagen and elastic fibers, with C.T. cells as fibroblasts.
• Exhibits thickness and richness in smooth muscles.
- C.T. septa (Trabeculae) :
• Abundant in elastic fibers and smooth muscles.
• Long and thick structures that mainly radiate from the hilum.
• Responsible for dividing the spleen into irregular compartments.
- Reticular C.T. :
• Provides the foundational structure or background of the organ.
(II) Parenchyma : It is formed of white pulp & red pulp.
(A) White Pulp (Malpighian Corpuscles) :
• White in fresh section.
• Rounded or oval lymphatic nodules.
• Each pulp contains an arteriole at one side called central arteriole.
• Pulp structure: Each pulp consists of 4 concentric zones around a central arteriole.
» Zone 1 : Thymus-dependent zone (PALS) containing T-lymphocytes.
» Zone 2 : Germinal center, lightly stained, containing activated B-lymphocytes, plasmablasts,
plasma cells, macrophages.
» Zone 3 : Follicular zone (Corona) potentially housing B-lymphocytes.
» Zone 4 : Marginal zone, the peripheral zone, consisting of a mixture of B and T lymphocytes
along with macrophages.
(B) Red Pulp :
• Red in fresh sections due to large number of RBCs.
• It is formed of :
Splenic cords (Billroth cords) Blood sinusoids

In between the white pulps & blood sinusoids. Irregular wide blood channels.
- Lined with fenestrated endothelium.

- Rest on non-continuous basement membrane
Contain blood cells, plasma cells, macrophages
- Macrophages (Littoral cells) are present in &
around the walls of blood sinusoids.
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Functions of Spleen :
1- Filters blood from any organism by macrophages.
2- Storage of blood cells and platelets.
3- Formation of blood elements in fetal life.
4- Production of lymphocytes throughout life.
5- Destruction of old RBCs and storage of iron.
6- Immunological functions: through B &T lymphocytes (Humoral & Cell mediated).
Tonsils :
Definition : Incompletely encapsulated lymphatic tissue.
Types of Tonsils :
- Palatine Tonsils : Two oval masses located in the lateral wall of the oropharynx.
- Lingual Tonsils : Multiple masses of lymphatic tissue at the back of the tongue.
- Pharyngeal Tonsils : A single mass of lymphatic tissue in the nasopharynx, at the midline.
Structural Features :
- Palatine Tonsils :
• Covered with non-keratinized stratified squamous epithelium forming tonsillar crypts.
• Composed of lymphatic nodules and diffuse lymphatic tissue.
• Presence of mucous glands in connective tissue leading to common inflammation (tonsillitis).
• Incomplete connective tissue capsule.
- Lingual Tonsils :
• Covered with non-keratinized stratified squamous epithelium with crypts.
• Composed of lymphatic nodules and diffuse lymphatic tissue.
• Mucous glands open at the base of the crypts, reducing inflammation occurrence.
• No connective tissue capsule.
- Pharyngeal Tonsils :
• Covered with pseudostratified columnar ciliated epithelium with goblet cells.
• Consist only of diffuse lymphatic tissue without lymphatic nodules.
• No crypts present.
• Incomplete connective tissue capsule.
Functions of Tonsils : Protection of the digestive and respiratory systems against bacteria and viruses
by producing antibodies.
LYMPH NODE
SPLEEN
TONSILS
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CH 1 MCQS
1) What are the primary lymphatic organs?
a) Spleen and tonsils
b) Thymus and bone marrow
c) Lymph nodes and spleen
d) Tonsils and bone marrow
2) Which lymphatic organ is characterized by small oval, kidney-shaped structures ?
a) Spleen
b) Thymus
c) Lymph nodes
d) Tonsils
3) What forms the stroma of a lymph node?
a) Blood vessels
b) White blood cells
c) Capsule, reticular tissue, and septa
d) Lymphatic vessels
4) What is the function of the capsule in a lymph node?
a) It stores lymphocytes
b) It filters lymph
c) It provides structural support
d) It produces antibodies
5) Which of the following is NOT a component of the stroma of a lymph node?
a) Capsule
b) Parenchyma
c) Reticular tissue
d) Trabeculae
6) What type of tissue forms the reticular framework of a lymph node?
a) Elastic fibers
b) Adipose tissue
c) Reticular tissue
d) Smooth muscle
7) Where are lymph nodes typically found in the body?
a) In the heart
b) In the liver
c) In the axilla, neck, thorax, abdomen, and groin
d) In the brain
8) What divides the cortex of a lymph node into regular compartments?
a) Reticular tissue
b) Adipose tissue
c) Capsule
d) Trabeculae
9) What type of muscle may be found at the hilum of a lymph node?
a) Cardiac muscle
b) Smooth muscle
c) Skeletal muscle
d) Striated muscle
10) Which staining method is used to visualize the reticular tissue in a lymph node?
a) Hematoxylin and eosin
b) Gram stain
c) Silver stain
d) Wright stain
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11) Which part of the lymph node contains primary and secondary lymphatic follicles?
a) Cortex
b) Medulla
c) Paracortex
d) Sinuses
12) What is the function of the paracortex in the lymph node?
a) It contains T-lymphocytes
b) It filters lymphatic fluid
c) It produces antibodies
d) It contains macrophages
13) Which cells are found in the germinal center of secondary lymphatic follicles?
a) B-lymphocytes and macrophages
b) T-lymphocytes and dendritic cells
c) Plasma cells and neutrophils
d) Natural killer cells and eosinophils
14) What separates the lymph nodules from the capsule in the lymph node?
a) Medullary cords
b) Medullary sinuses
c) Cortical lymph sinuses
d) Paracortex
15) What is the main cell type found in the medullary cords of the lymph node?
a) NK cells
b) T-lymphocytes
c) Macrophages
d) Plasma cells
16) Which part of the lymph node appears lighter in staining due to fewer packed lymphocytes?
a) Cortex
b) Medulla
c) Paracortex
d) Sinuses
17) Which cells line the medullary sinuses in the lymph node?
a) Endothelial cells
b) Macrophages
c) B-lymphocytes
d) Plasma cells
18) Which type of lymphatic follicle lacks a germinal center?
a) Primary lymphatic follicle
b) Secondary lymphatic follicle
c) Tertiary lymphatic follicle
d) Quaternary lymphatic follicle
19) Where are the T-lymphocytes found in the lymph node?
a) Cortex
b) Medulla
c) Paracortex
d) Sinuses
20) What is the function of cortical lymph sinuses in the lymph node?
a) They separate the medulla from the cortex
b) They contain T-lymphocytes
c) They filter lymphatic fluid
d) They provide spaces for lymph nodules
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21) Which direction does lymph flow in afferent lymphatic vessels?
a) Bidirectional
b) Multi-directional
c) Unidirectional
d) Random
22) Which part of the lymph node filters lymph from microorganisms?
a) Cortical sinuses
b) Medullary sinuses
c) Afferent lymphatic vessels
d) Efferent lymphatic vessels
23) What is the primary function of plasma cells in lymph nodes?
a) Phagocytosis
b) Antibody secretion
c) Cytokine production
d) Antigen presentation
24) Lymphadenitis is characterized by:
a) Enlargement and inflammation of lymph nodes
b) Decreased lymph production
c) Increased lymphatic vessel permeability
d) Accumulation of lymph in the bloodstream
25) How do carcinomas typically spread through the body?
a) Blood vessels
b) Nerves
c) Lymphatic vessels
d) Muscles
26) Which of the following is a function of the spleen?
a) Filters lymph
b) Stores bile
c) Produces insulin
d) Filters blood
27) What is the main structural difference between the spleen and lymph nodes?
a) The presence of multiple capsules in the spleen
b) The thickness of the trabeculae
c) The absence of smooth muscles in the spleen
d) The presence of lymph sinuses in the spleen
28) Which part of the spleen is responsible for the filtration of blood through macrophages?
a) White pulp
b) Red pulp
c) Central arteriole
d) Lymph follicles
29) What cells are primarily found in the white pulp of the spleen?
a) Erythrocytes
b) Platelets
c) B-lymphocytes
d) Granulocytes
30) What is the main function of the red pulp in the spleen?
a) Storage of blood cells
b) Production of lymphocytes
c) Destruction of old RBCs
d) Synthesis of iron
31) Which component of the spleen is responsible for its immunological functions?
a) White pulp
b) Red pulp
c) Capsule
d) Trabeculae
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32) Which zone of the white pulp contains activated B-lymphocytes?
a) Thymus-dependent zone
b) Germinal center
c) Follicular zone
d) Marginal zone
33) What is the structural component of the spleen that divides it into irregular compartments?
a) Central arteriole
b) Trabeculae
c) Lymph follicles
d) Parenchyma
34) Which type of muscle is abundant in the stroma of the spleen?
a) Skeletal muscle
b) Cardiac muscle
c) Smooth muscle
d) Striated muscle
35) Which of the following is NOT a function of the spleen?
a) Storage of blood cells and platelets
b) Production of insulin
c) Destruction of old RBCs
d) Immunological functions through B and T lymphocytes
36) Which cells line the blood sinusoids in the spleen?
a) Erythrocytes
b) Endothelial cells
c) Macrophages
d) Fibroblasts
37) What is the function of the reticular connective tissue in the spleen?
a) Storage of iron
b) Formation of blood elements in fetal life
c) Production of lymphocytes
d) Formation of the background of the organ
38) Which part of the spleen contains splenic cords and blood sinusoids?
a) White pulp
b) Red pulp
c) Capsule
d) Trabeculae
39) What is the main site of the spleen within the body?
a) Along lymphatic vessels
b) Intra-abdominal
c) Subcutaneous tissue
d) Thoracic cavity
40) What stains brown with Silver (Ag) in the spleen?
a) Erythrocytes
b) Lymph follicles
c) Reticular connective tissue
d) Macrophages
41) What type of epithelium covers the surface of palatine tonsils?
a) Simple squamous epithelium
b) Non-keratinized stratified squamous epithelium
c) Pseudostratified columnar epithelium
d) Transitional epithelium
42) Which of the following tonsils has crypts where desquamated cells and bacteria may accumulate?
a) Palatine tonsils
b) Lingual tonsils
c) Pharyngeal tonsils
d) Adenoids
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43) Which tonsils are covered with pseudostratified columnar ciliated epithelium?
a) Palatine tonsils
b) Lingual tonsils
d) Adenoids
44) Which tonsils are located at the back of the tongue?
a) Palatine tonsils
b) Lingual tonsils
d) Adenoids
45) Which tonsils are also known as adenoids when hypertrophied?
a) Palatine tonsils
b) Lingual tonsils
d) All of the above
46) What type of tissue forms the bulk of the tonsils and contains lymphatic nodules?
a) Connective tissue
b) Muscle tissue
c) Nervous tissue
d) Epithelial tissue
47) In which tonsils are mucous glands present in the connective tissue?
a) Palatine tonsils
b) Lingual tonsils
d) Adenoids
48) Which tonsils have an incomplete connective tissue capsule?
a) Palatine tonsils
b) Non of them
d) All of the above
49) What is the function of tonsils?
a) To aid in digestion
b) To produce hormones
c) To protect against bacteria and viruses
d) To regulate body temperature
50) Which type of tonsils is characterized by having multiple masses of lymphatic tissue?
a) Palatine tonsils
b) Lingual tonsils
d) Adenoids
ANSWERS
1. B 11. A 21. C 31. A 41. B
2. C 12. A 22. B 32. B 42. A
3. C 13. A 23. B 33. B 43. C
4. C 14. C 24. A 34. C 44. B
5. B 15. D 25. C 35. B 45. C
6. C 16. B 26. D 36. B 46. A
7. C 17. A 27. B 37. D 47. A
8. D 18. A 28. B 38. B 48. D
9. B 19. C 29. C 39. B 49. C
10. C 20. D 30. C 40. C 50. B
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DIGESTIVE GLANDS
Glands associated with the digestive tract include : Salivary Glands - Pancreas - Liver
Salivary Glands :
• Salivary glands are exocrine glands responsible for saliva production.
• Saliva consists of mucus, enzymes (amylase and lysozyme), antibodies, and inorganic ions.
• Functions of saliva include :
» Wetting and lubricating the oral mucosa, lips, and ingested food.
» Providing protective substances such as immunoglobulin A (IgA) and lysozyme.
» Initiating the digestion of carbohydrates and lipids through amylase and lingual lipase activities.
Types of Salivary Glands :
Major Salivary Glands :
- Compound tubulo-alveolar exocrine glands.
- Secrete %90 of total saliva volume in humans.
- Comprise :
» Two parotid glands located in front of both ears.
» Two submandibular glands situated against the inner aspect of the mandible.
» Two sublingual glands positioned under the oral mucosa of the floor of the oral cavity.
Minor Salivary Glands :
- Branched tubulo-alveolar exocrine glands.
- Secrete %10 of total saliva volume.
- Open directly or via short ducts onto the surface of the oral epithelium.
- Scattered in the oral mucosa :
» Lips, cheeks, palate, tonsils, tongue, and tongue papillae.
» Types include labial, buccal, palatine, lingual, and Von Ebner's glands.
General Structure of Salivary Glands :
(I) Stroma :
- Capsule : Composed of C.T. cells and fibers.
- Trabeculae : Consist of C.T. cells and fibers, dividing the gland into lobes and lobules.
- Reticular C.T. :
• Forms the background of the organ.
(II) Parenchyma :
- Secretory portion (Acini): Contains serous, mucous, and mucoserous cells.
- Excretory portion (Branched Duct System).
Differences between serous and mucous acini :
Serous acini :
• Small diameter, Narrow lumen, Pyramidal secretory cells, Rounded & central nuclei
• Basophilic cytoplasm with apical acidophilic zymogen granules
• Non-clear boundaries
• Secretion: Serous secretion
• Few myoepithelial (basket) cells
Mucous acini :
• Large diameter, Wide lumen, Cuboidal secretory cells, Flat & basal nuclei
• Pale vacuolated cytoplasm (dissolved mucin)
• Clear boundaries
• Secretion: Mucous secretion
• Numerous myoepithelial (basket) cells
Mucoserous Acini :
• Mixed secretory acini containing both mucous and serous cells
• Crescent of Gianuzzi "Serous Demilune": serous cells found on one side of a mucous acinus like crescent.
• Secrete mucoserous secretion
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Myoepithelial (Basket) Cells :
- They are branching cells that surround the acini & ducts as an octopus.
- Their cytoplasm contains actin and myosin filaments.
- They squeeze the secretory cells to release their secretion to the duct system.
Parotid Gland :
Location : Situated bilaterally in front of both ears.
Size : Largest major salivary gland.
Histological Structure :
(I) Stroma :
• Thick capsule composed of collagenous fibers and fibroblasts, rich in fat cells.
• Trabeculae : Thick structures dividing the gland into lobes and lobules; containing nerves, blood
vessels, and ducts.
(II) Parenchyma :
• Secretory Portion: Consists of serous acini.
• Excretory Portion: Comprises the duct system.
Secretory Nature : Parotid gland is a purely serous gland.
Duct System :
• Intercalated ducts :
- Located inside lobules.
- Lined with simple cubical epithelium.
• Striated (intralobular) ducts:
- Within lobules.
- Lined with cuboidal or low columnar cells with central rounded nuclei.
• Interlobular (excretory) ducts:
- Large ducts in connective tissue septa between lobules.
- Lined with columnar cells.
• Interlobar ducts:
- Found in connective tissue septa between lobes.
- Lined with pseudostratified columnar epithelium.
• Main duct (Stenson's duct):
- Initially lined with stratified columnar epithelium, transitioning to stratified squamous towards
- Opens on the inner surface of the cheek opposite the second upper molar tooth.
Submandibular Gland :
Location : located against the inner aspect of the mandible.
(I) Stroma :
• Thick capsule.
• Trabeculae (septa) divide the gland into lobes & lobules.
(II) Parenchyma :
• Submandibular gland is a Seromucous gland.
Secretory Portion (Duct System) :
• Comprises :
- 90% Serous Acini
- 10% Mucous & Mucoserous acini
• Note: In dogs, submandibular glands mostly consist of mucous acini.
Duct System :
• Similar to that of the parotid gland.
• The main duct (Wharton's duct) opens into the floor of the mouth cavity.
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Sublingual Gland : is the smallest among the major salivary glands.
Location : beneath the oral mucosa in the floor of the mouth.
(I) Stroma :
• Thin connective tissue capsule.
• Thick trabeculae divide the gland into lobes and lobules.
(II) Parenchyma :
• Submandibular gland is a Mucoserous gland.
Secretory Portion (Acini) :
• Mainly composed of mucous with mixed mucoserous acini.
• Lacks purely serous acini.
Excretory Portion (Duct system) :
• Duct system resembles that of the parotid gland.
• The main duct often connects with the submandibular main duct or may open separately on the
floor of the mouth.
Pancreas :
Pancreas is a mixed digestive gland located in the abdomen.
It comprises two main portions: Exocrine and Endocrine.
The Exocrine portion consists of compound tubulo-alveolar glands that secrete pancreatic juice.
The Endocrine portion is the Islets of Langerhans, responsible for hormone secretion.
(I) Stroma :
- Capsule : Thin, delicate covering made of C.T. cells and fibers, covered by peritoneum.
- Trabeculae : Thin structures composed of C.T. fibers and cells, containing fat cells, dividing the gland
into lobes and lobules, and carrying blood vessels, nerves, and ducts.
(II) Parenchyma :
- Exocrine portion consisting of Acini (clusters of secretory cells) and Ducts.
- Endocrine portion consisting of Islets of Langerhans.
(A) Exocrine portion :
- Serous (pancreatic) acini :
• Small diameter, Narrow lumen.
• Lining cells : pyramidal cells with non-clear cell boundaries.
• Cytoplasm : basal basophilia, apical acidophilic zymogen granules.
• Nucleus : Basal rounded pale nucleus with prominent nucleolus.
- Duct System :
• Intercalated ducts : Small, narrow, lined with simple squamous cells, inside acini.
• Intra-lobular Duct s: Not apparent.
• Inter-lobular Ducts : Lined with simple cubical epithelium.
• Inter-lobar Ducts : Lined with simple columnar epithelium.
• Main Pancreatic Duct : Lined with columnar cells, goblet cells, and few entero-endocrine cells.
Joins the common bile duct to open in the duodenum.
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(B) Exocrine portion : (Islets of Langerhans)
• The Islets of Langerhans are pale stained areas scattered between the darkly stained
pancreatic acini.
• They are formed of groups of cells separated by fenestrated blood capillaries and supported by
a reticular network.
• Beta cells constitute the majority at %70, Alpha cells at %15, and Delta cells at %10.
- Beta cells :
• small, centrally located in the islets, and have cytoplasm with basophilic granules.
• They secrete insulin, which decreases blood glucose levels.
- Alpha cells :
• larger, located peripherally in the islets, and have cytoplasm with acidophilic granules.
• They secrete glucagon, which increases blood glucose levels.
- Delta cells :
• large, peripherally in the islets, and have cytoplasm with granules that stain only with silver.
• They secrete somatostatin, which controls the release of insulin, growth hormone, and glucagon.
- Clear cells :
• very few (about %3), contain few granules, and may represent stem cells or exhausted cells.
- G cells :
• secrete gastrin, which stimulates HCL secretion by the stomach.
- PP cells :
• secrete pancreatic polypeptide, which reduces pancreatic secretion.
- Ganglion cells :
• nerve cells responsible for the autonomic control of the Islets of Langerhans.
Liver :
The liver is a digestive gland located in the abdomen.
It is a mixed compound tubular gland.
The blood supply of the liver is mainly through the portal vein (%75) and the hepatic artery (%25).
The portal vein brings O2 poor but nutrient-rich blood to the liver from the small intestine.
The hepatic artery supplies O2 rich blood to the liver.
(I) Stroma :
- Capsule : also known as Glisson's capsule, is thin, strong and partially covered by the peritoneum
- Trabeculae : thin structures that may not be clear in humans but are thick in some animal species
and in pathological conditions like liver cirrhosis.
(II) Parenchyma :
- Consists of liver cells called hepatocytes,
- Arranged to form classic hepatic lobules, which are the structural and functional units of the liver.
Classic Hepatic Lobule :
Classic hepatic lobule is a hexagonal mass of liver tissue.
It contains a central vein in the middle.
Hepatocytes are arranged radially from the central vein to the periphery of the lobule.
The lobule is demarcated by thin connective tissue trabeculae.
Thickened connective tissue at the angles forms the portal tracts.
Portal Tract components :
1. Branch of the portal vein
2. Branch of hepatic artery
3. Branch of bile duct
4. Lymph vessel
Arrangement of Hepatocytes :
Hepatocytes form hepatic plates or cords.
Each plate contains two or more rows of liver cells.
Blood sinusoids separate hepatic plates and drain into the central vein.
Bile canaliculi are located between rows of liver cells.
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Liver Cell (Hepatocyte) :
L.M. :
- Large, polyhedral shape.
- Acidophilic cytoplasm, vacuolated due to dissolved glycogen.
- Pale, rounded, central nucleus with prominent nucleolus.
E.M. :
(A) Cell Membrane :
- Junctional complexes facing adjacent hepatocytes.
- Short microvilli facing bile canaliculi.
- Long microvilli facing blood sinusoids.
(B) Cytoplasm : Rich in organelles and inclusions.
(C) Organelles : mitochondria, rER and ribosomes, G.A, lysosomes, sER.
(D) Inclusions : glycogen granules and lipid droplets.
Blood Sinusoids :
- Wide irregular vascular spaces between hepatic plates.
- Lined by fenestrated endothelial cells and Kupffer cells.
- Drain into the central vein.
Von–Kupffer Cells :
- Kupffer cells are large, branched phagocytic cells found in the hepatic blood sinusoids.
- They originate from blood monocytes.
- In light microscopy, they have an irregular outline due to pseudopodia.
- It can be stained with vital stains like Trypan blue.
- In electron microscopy, they exhibit pseudopodia and numerous lysosomes.
- Their functions include :
• Phagocytosis of bacteria and foreign bodies from the intestine.
• Phagocytosis of old red blood cells and formation of bile pigments.
Space of Disse (Perisinusoidal Space) :
Definition : It is the space between the hepatocyte and the wall of blood sinusoid.
It contains :
1. Long microvilli of hepatocytes.
2. Plasma.
3. Reticular fibers for support.
4. Ito cells (fat storing cells) can store fat soluble vitamin A.
PAROTID GLAND SUBMANDIBULAR GLAND
PANCREAS LIVER
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CH 2 MCQS
1) Which type of glands produce saliva?
a) Endocrine glands
b) Exocrine glands
c) Endocrine and exocrine glands
d) Lymphatic glands
2) What is the function of saliva in the oral cavity?
a) To aid in vision
b) To initiate digestion of carbohydrates and lipids
c) To regulate body temperature
d) To transport oxygen to cells
3) Which enzyme found in saliva aids in the digestion of carbohydrates?
a) Protease
b) Lipase
c) Amylase
d) Nuclease
4) Where are the parotid glands located?
a) Under the tongue
b) Infront of both ears
c) Against the inner aspect of the mandible
d) Under the oral mucosa of the floor of the oral cavity
5) Which of the following is NOT a major salivary gland?
a) Parotid gland
b) Submandibular gland
c) Sublingual gland
d) Von Ebner's gland
6) What is the function of the sublingual glands?
a) To produce saliva for initial digestion
b) To regulate blood sugar levels
c) To produce insulin
d) To produce tears
7) Where are minor salivary glands typically located?
a) In the lungs
b) In the stomach
c) In the oral mucosa
d) In the liver
8) How do minor salivary glands differ from major salivary glands?
a) Minor salivary glands are larger in size.
b) Minor salivary glands secrete a greater volume of saliva.
c) Minor salivary glands are located deeper within the oral cavity.
d) Minor salivary glands secrete a smaller volume of saliva.
9) What type of glands are the salivary glands?
a) Endocrine glands
b) Ductless glands
c) Exocrine glands
d) Both endocrine and exocrine glands
10) Which substance found in saliva helps protect against bacterial infections?
a) Amylase
b) Lysozyme
c) Mucus
d) Immunoglobulin A (IgA)
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11) What is the function of the stroma in salivary glands?
a) Secretion of saliva
b) Formation of lobes and lobules
c) Storage of enzymes
d) Regulation of blood flow
12) Which type of cells form the capsule of the salivary glands?
a) Serous cells
b) Reticular cells
c) Myoepithelial cells
d) Endothelial cells
13) What is the primary difference between serous and mucous acini in salivary glands?
a) Nuclei shape
b) Secretory cells shape
c) Cytoplasm color
d) Lumen width
14) Which type of acini has a wider lumen?
a) Serous
b) Mucous
c) Mucoserous
d) None of the above
15) What type of cells surround the acini and ducts like an octopus?
a) Reticular cells
b) Myoepithelial cells
c) Serous cells
d) Cuboidal cells
16) What is the function of myoepithelial cells in salivary glands?
a) Synthesis of saliva
b) Secretion of mucin
c) Squeezing the secretory cells to release their secretion
d) Formation of the capsule
17) Which type of acini secretes mucoserous secretion?
a) Serous
b) Mucous
c) Mucoserous
d) Excretory
18) What is the shape of nuclei in mucous acini?
a) Rounded & central
b) Flat & basal
c) Pyramidal
d) Cuboidal
19) What is the primary difference in the boundaries between serous and mucous acini?
a) Non-clear vs. clear
b) Narrow vs. wide
c) Serous secretion vs. mucous secretion
d) Few myoepithelial cells vs. numerous myoepithelial cells
20) What forms the background of the salivary glands and can be demonstrated with silver?
a) Serous cells
c) Reticular C.T.
d) Branched Duct System
21) Which gland is the largest major salivary gland?
a) Sublingual gland
b) Submandibular gland
c) Parotid gland
d) Lacrimal gland
16
22) Which of the following is NOT a component of the stroma of the parotid gland?
a) Capsule
b) Trabeculae
c) Reticular C.T.
d) Serous acini
23) What is the epithelial lining of the intercalated ducts in the parotid gland?
b) Simple cuboidal epithelium
c) Simple columnar epithelium
d) Pseudostratified columnar epithelium
24) Which ducts lined with cuboidal or low columnar cells with central nuclei and basal striations?
a) Intercalated ducts
b) Striated (intralobular) ducts
c) Interlobular (excretory) ducts
d) Interlobar ducts
25) Where does the main duct of the parotid gland open?
a) Floor of the mouth
b) Roof of the mouth
c) Inner surface of the cheek
d) Underneath the tongue
26) What is the main duct of the submandibular gland called?
A) Stensen's duct
B) Wharton's duct
C) Bartholin's duct
D) Sialolith duct
27) Which type of acini make up approximately %90 of the submandibular gland in humans?
A) Mucous acini
B) Serous acini
C) Mucoserous acini
D) Salivary acini
28) In which part of the mandible are the submandibular glands situated?
A) Outer aspect
B) Lower aspect
C) Inner aspect
D) Upper aspect
29) What is the function of the trabeculae in the submandibular gland?
A) To secrete saliva
B) To divide the gland into lobes and lobules
C) To facilitate blood flow
D) To protect the gland from infections
30) Where does the main duct of the submandibular gland open into the oral cavity?
A) Opposite the upper molars
B) Opposite the lower middle incisors
C) Opposite the canines
D) Opposite the premolars
31) What is the main histological characteristic of the sublingual gland?
A) Thin connective tissue capsule
B) Presence of purely serous acini
C) Lack of duct system
D) Thin trabeculae dividing the gland into lobes and lobules
32) Which type of acini is predominantly found in the sublingual gland?
A) Purely serous
B) Purely mucous
C) Mixed mucoserous
D) Exocrine
17
33) Where is the sublingual gland located?
A) Under the tongue
B) Behind the ear
C) Near the nasal cavity
D) Along the jawline
34) Which of the following statements about the sublingual gland is true?
A) It is the largest major salivary gland.
B) It lacks a duct system.
C) Its main duct often joins the submandibular gland duct.
D) It is composed mainly of purely serous acini.
35) What is the main function of the sublingual gland?
A) Production of saliva for lubrication
B) Production of digestive enzymes
C) Filtration of blood
D) Regulation of body temperature
36) What is the main function of the exocrine portion of the pancreas?
a) Secretion of hormones
b) Digestion of carbohydrates
c) Secretion of pancreatic juice
d) Regulation of blood sugar levels
37) Which part of the pancreas is responsible for secreting hormones?
a) Serous acini
b) Islets of Langerhans
c) Intercalated ducts
d) Main pancreatic duct
38) Which type of cells line the serous (pancreatic) acini?
a) Simple squamous cells
b) Simple cuboidal cells
c) Pyramidal cells
d) Columnar cells
39) Which duct of the pancreas joins the common bile duct before opening into the duodenum?
a) Intra-lobular ducts
b) Inter-lobular ducts
c) Inter-lobar ducts
d) Main pancreatic duct
40) What is the main histological component forming the stroma of the pancreas?
a) Epithelial cells
b) Adipose tissue
c) Muscle cells
d) Connective tissue
41) Which type of cells in the Islets of Langerhans secrete insulin?
a) Alpha cells
b) Beta cells
c) Delta cells
d) G cells
42) Which type of cells in the Islets of Langerhans secrete glucagon?
a) Alpha cells
b) Beta cells
c) Delta cells
d) G cells
43) What is the function of somatostatin secreted by the Islets of Langerhans?
a) Decreases blood glucose level
b) Increases blood glucose level
c) Controls the release of insulin, growth hormone, and glucagon
d) Stimulates HCL secretion by stomach
18
44) Which cells in the Islets of Langerhans secrete pancreatic polypeptide?
a) Clear cells
b) PP cells
c) Ganglion cells
d) Delta cells
45) What is the function of clear cells found in the Islets of Langerhans?
a) Secret insulin
b) Secret glucagon
c) Represent stem cell or exhausted cells
d) Stimulate HCL secretion by stomach
46) What is the primary source of blood supply to the liver?
a) Renal artery
b) Coronary artery
c) Portal vein
d) Pulmonary artery
47) Which structure forms the background of the liver gland?
a) Capsule
b) Trabeculae
c) Reticular network
d) Hepatic lobules
48) What are the basic structural components of the liver parenchyma?
a) Hepatocytes
b) Kupffer cells
c) Sinusoids
d) Bile ducts
49) What is the primary function of the liver?
a) Blood filtration
b) Digestion
c) Detoxification
d) Oxygenation
50) Which component partially covers the liver capsule?
a) Peritoneum
b) Trabeculae
c) Reticular network
d) Hepatic lobules
51) What is the central vessel found in the classic hepatic lobule?
A) Hepatic artery
B) Bile duct
C) Central vein
D) Lymph vessel
52) What structures demarcate the classic hepatic lobule?
A) Hepatocytes
B) Sinusoids
C) Portal tracts
D) Connective tissue trabeculae
53) Which of the following is NOT found in a portal tract?
A) Portal vein branch
B) Hepatic artery branch
C) Central vein
D) Bile duct branch
54) How are hepatocytes arranged in the classic hepatic lobule?
A) In a circular pattern
B) In a random pattern
C) Radially from the central vein
D) In layers perpendicular to the central vein
19
55) What separates hepatic plates in the liver?
A) Bile canaliculi
B) Sinusoids
C) Central veins
D) Portal tracts
56) What is the shape of liver cells (hepatocytes)?
A) Cuboidal
B) Columnar
C) Polyhedral
D) Spherical
57) Which stain is used to demonstrate glycogen in liver cells?
A) Hematoxylin and eosin (H&E)
B) Periodic acid-Schiff (PAS)
C) Giemsa
D) Mallory's trichrome
58) What is the primary function of Von Kupffer cells in the liver?
A) Protein synthesis
B) Phagocytosis
C) Lipid storage
D) Detoxification
59) What is the function of Ito cells in the liver?
A) Phagocytosis
B) Protein synthesis
C) Fat storage
D) Detoxification
60) Which organelle is responsible for detoxification in liver cells?
A) Mitochondria
B) Golgi apparatus
C) Smooth endoplasmic reticulum
D) Lysosomes
61) What type of cells line the hepatic blood sinusoids?
A) Hepatocytes
B) Kupffer cells
C) Fat cells
D) Ito cells
62) What is the space between hepatocytes and the wall of the blood sinusoid called?
A) Space of Disse
B) Perisinusoidal space
C) Interstitial space
D) Sinusoidal space
63) Which stain can be used to visualize Von Kupffer cells?
A) Hematoxylin and eosin (H&E)
B) Periodic acid-Schiff (PAS)
C) Trypan blue
D) Oil Red O
64) Which of the following organelles is abundant in hepatocytes for energy production?
A) Ribosomes
B) Golgi apparatus
C) Mitochondria
D) Lysosomes
20
65) What is the primary function of the Golgi apparatus in liver cells?
A) Energy production
B) Protein synthesis
C) Secretion
D) Phagocytosis
66) Which cells store fat-soluble vitamin A in the liver?
A) Hepatocytes
B) Kupffer cells
C) Ito cells
D) Endothelial cells
67) Which type of cells are responsible for phagocytosis in the liver?
A) Hepatocytes
B) Kupffer cells
C) Ito cells
68) What type of cells are found in the Space of Disse?
A) Hepatocytes
B) Kupffer cells
C) Ito cells
69) Which structure drains blood sinusoids in the liver?
A) Central vein
B) Hepatic artery
C) Portal vein
D) Bile duct
70) What is the primary function of lysosomes in liver cells?
A) Protein synthesis
B) Detoxification
C) Digestion and waste removal
D) Phagocytosis
ANSWERS
1. B 15. B 29. B 43. C 57. B
2. B 16. C 30. B 44. B 58. B
3. C 17. C 31. A 45. C 59. C
4. B 18. B 32. C 46. C 60. C
5. D 19. A 33. A 47. C 61. B
6. A 20. C 34. C 48. A 62. A
7. C 21. C 35. A 49. C 63. C
8. D 22. D 36. C 50. A 64. C
9. C 23. B 37. B 51. C 65. C
10. B 24. B 38. C 52. D 66. C
11. B 25. C 39. D 53. C 67. B
12. B 26. B 40. D 54. C 68. C
13. B 27. B 41. B 55. B 69. A
14. B 28. C 42. A 56. C 70. C
21
ENDOCRINE SYSTEM
Pituitary Gland :
• Location : Situated at the base of the skull within a bony cavity called the sella turcica.
• Components :
- Anterior Pituitary (Adenohypophysis) :
» Derived from the oral ectoderm.
» Subdivided into Pars distalis, Pars intermedia, and Pars tuberalis.
- Posterior Pituitary (Neurohypophysis) :
» Derived from neuroectoderm.
» Consists of the Pars nervosa and the infundibulum.
(1 Pars Distalis (Anterior Pituitary) :
- Histological Structure :
• Stroma : Thin fibrous capsule and supporting reticular connective tissue.
• Parenchyma : Consists of cords of cells separated by fenestrated blood capillaries.
- Cell Types :
• Chromophobes : Weak staining affinity, possibly stem cells or degranulated chromophils.
• Chromophils : Strong staining affinity, secretory cells.
• Acidophils : Stain pink with eosin.
» Somatotrophs : Produce Growth Hormone (GH).
» Mammotrophs : Produce Prolactin (PRL).
• Basophils : Stain with basic dyes, most give PAS positive reaction.
» Gonadotrophs : Produce Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH).
» Thyrotrophs : Produce Thyroid-Stimulating Hormone (TSH).
» Corticotrophs : Produce Adrenocorticotropic hormone (ACTH), Lipotrophins, and Endorphins.
(2 Pars Nervosa (Posterior Pituitary) :
- Components :
• Infundibulum : Nerve fibers descending from the hypothalamus.
• Pars nervosa : Contains non-myelinated nerve fibers, Herring bodies (hormone storage),
fenestrated blood capillaries, and pituicytes (supporting cells).
- Hormones :
• Antidiuretic hormone (ADH) and Oxytocin are produced by hypothalamic cells and stored in the
posterior pituitary.
- Clinical Note :
• Pituitary Adenoma : Benign tumor of the pituitary gland that may cause hormone overproduction.
Adrenal Glands:
• Location : Paired endocrine glands located at the superior poles of both kidneys.
• Histological Structure:
• Stroma :
» Capsule: Thick fibrous covering with fat cells.
» Trabeculae: Thin extensions from the capsule carrying blood vessels, nerves, and lymphatics.
» Reticular Connective Tissue: Forms the background of the gland.
• Parenchyma :
» Divided into two concentric layers: Cortex and Medulla.
- Adrenal Medulla :
• Chromaffin Cells :
» Origin : Neuro-ectoderm.
» Secrete adrenaline and noradrenaline.
» Chromaffin Reaction: Positive staining with chromium salts.
• Sympathetic Nerve Cells (Ganglion Cells) :
» Control the secretory activity of chromaffin cells.
22
- Adrenal Cortex :
Zone Zona Glomerulosa Zona Fasciculata Zona Reticularis
Narrow outer zone under the
Site Thick middle zone Thin innermost zone
capsule
Large Polyhedral cells
arranged in narrow straight
cords (fascicles), separated by
Small Polyhedral cells,
Columnar cells arranged in long straight fenestrated blood
arranged in branching &
arched cords (glomeruli) capillaries; Nuclei are central,
anastomosing cords
surrounded by fenestrated rounded & vesicular; Some
L.M. (reticulum), separated by
blood capillaries; Nuclei are cells are binucleated;
fenestrated blood capillaries;
basal & oval; Cytoplasm is Cytoplasm appears
Nuclei are central &, rounded;
pale acidophilic vacuolated as it is rich in lipid
Cytoplasm is acidophilic
droplets which dissolve
during preparations, thus
named Spogiocytes
- sER: abundant; - Golgi complex: highly developed; - Mitochondria: many with tubular cristae;
E.M.
- Lipid droplets: most numerous
Secretion of glucocorticoids
Secretion of
mainly cortisol which regulates
mineralocorticoids mainly
carbohydrate metabolism, Secretion of small amount of
aldosterone, which controls
Function
induces fat breakdown in fat androgens and

blood pressure through
cells, induces protein glucocorticoids; Under control
absorption of water & Na and
breakdown in muscle, and of ACTH from anterior
excretion of K by the cells of
suppresses the immune pituitary
the kidney tubules; Under
response; Under control of
control of Angiotensin II
ACTH from anterior pituitary
- Differences between Adrenal Cortex and Medulla:

Adrenal Cortex Adrenal Medulla
Origin: Mesodermal Origin: Ectodermal
Formed of three zones Formed of chromaffin and sympathetic cells
Essential for life Less essential for life
Mineralocorticoids, glucocorticoids, sex hormones Adrenaline, Noradrenaline, Enkephalins
Chromaffin reaction: Negative Chromaffin reaction: Positive
Thyroid Gland :
• Location : Located in the cervical region anterior to the larynx.
• Structure : Formed of two lateral lobes connected by an isthmus.
• Histological Structure :
• Stroma :
» Capsule : Dense fibrous connective tissue covering the gland.
» Trabeculae : Thin fibrous structures descending from the capsule to divide the gland into lobes.
» Reticular Connective Tissue : Background of the gland, formed of reticular cells and fibers.
• Parenchyma :
» Thyroid Follicles :
» Spherical structures lined by follicular epithelium with a central lumen filled with colloid.
» Surrounded by fenestrated blood capillaries.
» Follicular Epithelium Consists of Two Types of Cells:
1. Follicular cells (Principal Cells) :
» Cubical cells with basophilic cytoplasm.
» Synthesize and store thyroid hormones (T3 and T4).
23
2. Parafollicular cells (Clear cells or C cells) :
» Larger cells with paler cytoplasm.
» Synthesize and secrete thyrocalcitonin hormone.
• Interfollicular Tissue :
• Found between thyroid follicles.
• Contains reticular C.T. , interfollicular cells, occasional C-cells, and fenestrated blood capillaries.
• Clinical Note : Insufficient intake of dietary iodine causes thyroid gland enlargement (simple goiter).
Parathyroid Glands :
• Stroma :
» Capsule : Thin layer of connective tissue cells and fibers surrounding the gland.
» Trabeculae : Thin structures of C.T. cells and fibers carrying blood vessels, lymphatics, and nerves.
» Reticular C.T. : Background of the gland, composed of reticular cells and fibers, stains with silver.
• Parenchyma :
» Anastomosing cords of cells separated by fenestrated blood capillaries.
» Composed of two types of cells: Chief cells and Oxyphil cells.
Cells Chief (Principal) Cells Oxyphil Cells
Number Numerous Less numerous
Small, polygonal, central, round-vesicular Larger, oval or round, eccentric-dark nucleus,
L.M.
nucleus, basophilic cytoplasm deep acidophilic cytoplasm
Rich in mitochondria, RER, Golgi, secretory
E.M. Mitochondria & acidophilic granules
granules
Secretion of Parathormone that increases
Function Unknown
calcium level
ADRENAL GLAND
PITUITARY GLAND
THYROID AND PARATHYROID GLAND
24
CH 3 MCQS
1) Where is the pituitary gland located?
a) In the nasal cavity
b) In the abdominal cavity
c) In a bony cavity called sella turcica
d) In the thoracic cavity
2) The posterior pituitary is also known as the:
a) Pars nervosa
b) Pars distalis
c) Pars tuberalis
d) Pars intermedia
3) The anterior pituitary is derived from:
a) Mesoderm
b) Oral ectoderm
c) Endoderm
d) Neuroectoderm
4) The largest part of the anterior pituitary is:
a) Pars nervosa
b) Pars distalis
c) Pars tuberalis
d) Pars intermedia
5) What is the main function of the posterior pituitary?
a) Production of growth hormone
b) Storage and release of oxytocin and vasopressin
c) Secretion of thyroid-stimulating hormone
d) Regulation of adrenal gland function
6) Which cells of the anterior pituitary have weak staining affinity and few or no secretory granules?
a) Chromophobes
b) Chromophils
c) Acidophils
d) Basophils
7) The stroma of the anterior pituitary is formed by:
a) Reticular connective tissue
b) Dense irregular connective tissue
c) Adipose tissue
d) Hyaline cartilage
8) Which part of the pituitary gland is derived from the neuroectoderm?
a) Pars distalis
b) Pars intermedia
c) Pars nervosa
d) Pars tuberalis
9) What is the main embryological origin of the anterior pituitary?
a) Ectoderm
b) Mesoderm
c) Endoderm
d) Neural crest
10) Which part of the pituitary gland forms cords of cells separated by fenestrated blood capillaries?
a) Pars distalis
b) Pars intermedia
c) Pars nervosa
d) Pars tuberalis
25
11) Which type of cells within the pituitary gland have strong staining affinity in their cytoplasm?
a) Chromophobes
b) Chromophils
c) Acidophils
d) Basophils
12) Which stain would typically highlight acidophils within the pituitary gland?
a) Eosin
b) Hematoxylin
c) Orange G
d) Carmine
13) Acidophils and basophils within the pituitary gland are further classified based on:
a) Size and shape
b) Secretory granules
c) Hormone production
d) Reaction to special stains
14) Which hormone is produced by somatotrophs in the pars distalis?
a) Growth hormone (GH)
b) Prolactin (PRL)
c) Follicle-stimulating hormone (FSH)
d) Thyroid-Stimulating Hormone (TSH)
15) The hormone prolactin (PRL) is primarily associated with:
a) Growth of long bones
b) Promotion of milk secretion
c) Thyroid hormone synthesis
d) Lipid metabolism regulation
16) Which type of cells within the pars distalis produce thyroid-stimulating hormone (TSH)?
a) Somatotrophs
b) Mammotrophs
c) Thyrotrophs
d) Corticotrophs
17) The hormone ACTH stimulates the secretion of which organ?
a) Thyroid gland
b) Adrenal cortex
c) Ovaries
d) Testes
18) Lipotrophins within the pituitary gland regulate:
a) Blood sugar levels
b) Lipid metabolism
c) Calcium absorption
d) Growth of adipose tissue
19) The posterior pituitary gland (neurohypophysis) is formed by the:
a) Pars distalis
b) Pars intermedia
c) Infundibulum and pars nervosa
d) Herring bodies
20) Which of the following is produced by hypothalamic cells and stored in the posterior pituitary?
a) Growth hormone (GH)
b) Thyroid-Stimulating Hormone (TSH)
c) Antidiuretic hormone (ADH)
d) Adrenocorticotropic hormone (ACTH)
21) What structures are found in the pars nervosa of the posterior pituitary?
a) Myelinated nerve fibers
b) Herring bodies
c) Acidophilic granules
d) Chromophobes
26
22) Which of the following is a function of luteinizing hormone (LH) in females?
a) Promotion of ovarian follicle development
b) Stimulation of androgen secretion by interstitial cells
c) Promotion of milk secretion
d) Regulation of lipid metabolism
23) What is the primary function of follicle-stimulating hormone (FSH) in males?
a) Stimulation of ovulation
b) Promotion of spermatogenesis
c) Regulation of thyroid hormone synthesis
d) Promotion of adrenal cortex secretion
24) Which cell type within the pituitary gland secretes oxytocin?
a) Thyrotrophs
b) Corticotrophs
c) Gonadotrophs
d) Hypothalamic cells
25) Pituitary adenoma, a benign tumor of the pituitary gland, can lead to:
a) Hyperfunction of the affected hormones
b) Hypofunction of the affected hormones
c) Growth of long bones
d) Regulation of lipid metabolism
26) What is the primary function of the adrenal glands?
a) Regulation of blood glucose levels
b) Production of reproductive hormones
c) Regulation of electrolyte balance
d) Production of bile
27) Which part of the adrenal glands is responsible for secreting cortisol and aldosterone?
a) Capsule
b) Trabeculae
c) Cortex
d) Medulla
28) Which component of the adrenal gland forms the background and stains brown with silver?
a) Capsule
b) Trabeculae
d) Medulla
29) What is the function of the trabeculae in the adrenal glands?
b) Support and transportation of blood vessels, nerves, and lymphatics
c) Storage of fat cells
d) Protection against pathogens
30) Which zone of the adrenal cortex is producing mineralocorticoids like aldosterone?
a) Zona glomerulosa
b) Zona fasciculata
c) Zona reticularis
d) Zona medullaris
31) Which adrenal zone is responsible for the secretion of glucocorticoids primarily?
a) Zona Glomerulosa
b) Zona Fasciculata
c) Zona Reticularis
d) Zona Medullary
32) Which adrenal zone is characterized by large polyhedral cells with vacuolated cytoplasm?
a) Zona Glomerulosa
b) Zona Fasciculata
c) Zona Reticularis
d) Zona Corticalis
27
33) Which adrenal zone primarily secretes hormones responsible for controlling blood pressure?
a) Zona Glomerulosa
b) Zona Fasciculata
c) Zona Reticularis
d) Zona Medullary
34) Which adrenal zone secretes glucocorticoids primarily?
a) Zona Glomerulosa
b) Zona Fasciculata
c) Zona Reticularis
d) Zona Medullary
35) Which hormone primarily regulates carbohydrate metabolism and induces fat breakdown?
a) Aldosterone
b) Cortisol
c) Androgens
d) Angiotensin II
36) Which adrenal zone is under the control of ACTH from the anterior pituitary?
a) Zona Glomerulosa
b) Zona Fasciculata
c) Zona Reticularis
d) B,C
37) Which adrenal zone is the widest?
a) Zona Glomerulosa
b) Zona Fasciculata
c) Zona Reticularis
d) Zona Medullary
38) Which adrenal zone contains columnar cells arranged in arched cords?
a) Zona Glomerulosa
b) Zona Fasciculata
c) Zona Reticularis
d) Zona Medullary
39) Which adrenal zone secretes aldosterone primarily?
a) Zona Glomerulosa
b) Zona Fasciculata
c) Zona Reticularis
d) Zona Medullary
40) Which hormone controls blood pressure through absorption of water and Na and excretion of K?
a) Aldosterone
b) Cortisol
c) Androgens
d) Angiotensin II
41) Which cells in the adrenal medulla are responsible for secreting adrenalin and noradrenalin?
a) Ganglion cells
b) Chromaffin cells
c) Sympathetic nerve cells
d) Stellate cells
42) What is the origin of chromaffin cells in the adrenal medulla?
a) Endoderm
b) Mesoderm
c) Ectoderm
d) Neuro-ectoderm
43) Which staining technique results in the brown coloration of the medulla?
a) H&E staining
b) Hematoxylin staining
c) Chromaffin reaction
d) Golgi staining
28
44) Which cells control the secretory activity of chromaffin cells in the adrenal medulla?
a) Chromaffin cells
b) Sympathetic nerve cells
c) Adrenalin-secreting cells
d) Noradrenalin-secreting cells
45) What is the characteristic appearance of chromaffin cells under light microscopy?
a) Round nuclei and eosinophilic cytoplasm
b) Basophilic cytoplasm and central nuclei
c) Large nuclei and granular cytoplasm
d) Irregular nuclei and acidophilic cytoplasm
46) Which structure connects the two lateral lobes of the thyroid gland?
a) Isthmus
b) Capsule
c) Trabeculae
d) Reticular C.T.
47) Which type of cells form the majority of the follicular cells in the thyroid gland?
a) Parafollicular cells
b) Reticular cells
c) Follicular cells
d) Interfollicular cells
48) What is the function of the thyroid follicle?
a) Synthesis of thyrocalcitonin
b) Storage of blood vessels and lymphatics
c) Synthesis and storage of thyroid hormones
d) Production of reticular fibers
49) Which substance fills the central lumen of the thyroid follicles?
a) Blood
b) Colloid
c) Lymph
d) Plasma
50) Which cells are responsible for synthesizing thyrocalcitonin?
a) Follicular cells
b) Parafollicular cells
c) Reticular cells
51) What stimulates the secretion of thyrocalcitonin?
a) Elevated blood glucose levels
b) Elevated blood calcium levels
c) Low blood calcium levels
d) High blood pressure
52) Which type of cells form the reticular background of the thyroid gland?
a) Follicular cells
b) Parafollicular cells
c) Reticular cells
53) Insufficient intake of dietary iodine may lead to:
a) Hyperthyroidism
b) Hypothyroidism
c) Simple goiter
d) Thyroid cancer
54) What is the primary function of follicular cells?
a) Synthesis of thyrocalcitonin
b) Storage of thyroid hormones
c) Synthesis and storage of thyroid hormones
d) Production of reticular fibers
29
55) Which hormone suppresses bone resorption by osteoclasts?
a) T3
b) T4
c) Thyrocalcitonin
d) TSH
56) What is the primary function of chief cells in the parathyroid gland?
a) Secretion of oxyphilic granules
b) Production of calcitonin
c) Secretion of parathormone that increases calcium level
d) Formation of reticular fibers
57) Which of the following is a characteristic feature of oxyphil cells in the parathyroid gland?
a) Small, polygonal shape
b) Basophilic cytoplasm
c) Round-vesicular nucleus
d) Presence of acidophilic granules
58) What is the primary histological function of the capsule in the parathyroid gland?
b) Support and protection
c) Transport of nutrients
d) Cellular respiration
59) Which type of cells in the parathyroid gland increases in number with age?
a) Chief cells
b) Oxyphil cells
c) Reticular cells
d) Endodermal cells
60) What is the primary histological component forming the background of the parathyroid gland?
a) Trabeculae
b) Capsule
d) Fenestrated blood capillaries
ANSWERS
1. C 13. D 25. A 37. B 49. B
2. A 14. A 26. C 38. A 50. B
3. B 15. B 27. C 39. A 51. B
4. B 16. C 28. C 40. A 52. C
5. B 17. B 29. B 41. B 53. C
6. A 18. B 30. A 42. D 54. C
7. A 19. C 31. B 43. C 55. C
8. C 20. C 32. B 44. B 56. C
9. A 21. B 33. A 45. B 57. D
10. A 22. A 34. B 46. A 58. B
11. B 23. B 35. B 47. C 59. B
12. A 24. D 36. D 48. C 60. C
30
RESPIRATORY SYSTEM
Respiratory system can be divided into two portions :
Conducting portion :
• Conducts air to and from the lungs.
• No gas exchange happens in this portion.
• nasal cavities, nasopharynx, oropharynx, larynx, trachea, bronchi, bronchioles.
• Functions :
» Warming of air facilitated by rich blood capillaries.
» Moistening of air through secretions from goblet cells and mucous glands.
» Cleaning air by trapping dust with mucus.
Respiratory portion :
• Site of gas exchange between blood and air.
• Components consist of respiratory bronchioles, alveolar ducts, alveolar sacs, and lung alveoli.
Trachea :
• The trachea is a long tube approximately 12 cm in length.
• It originates at the lower end of the larynx and terminates by bifurcating into two bronchi.
The tracheal wall comprises four layers :
• Mucosa :
» Epithelium : Pseudostratified columnar ciliated epithelium with numerous goblet cells.
» Lamina propria : Loose C.T. containing blood vessels, nerves, and elastic fibers.
» Elastic membrane : Comprised of condensed elastic fibers.
• Submucosa :
» Contains loose C.T. housing blood vessels, nerves, mucoserous glands, and lymphoid nodules.
• Fibrocartilaginous coat :
» Comprises 16-20 incomplete rings of hyaline cartilage covered by perichondrium.
» These cartilage rings maintain the tracheal lumen open.
» The open ends of the cartilage rings face the esophagus posteriorly and are linked by trachealis
smooth muscle.
• Adventitia :
» Formed of loose connective tissue surrounding the trachea.
Pulmonary Alveoli :
» They are the structural and functional unit of gas exchange.
» They open into alveolar ducts and respiratory bronchioles.
» There are pores between lung alveoli that equalize air pressure in alveoli.
» They are separated by inter alveolar septa.
» They are lined by two types of cells called pneumocyte type I & type II.
Pneumocyte type I Pneumocyte type II

Number 97% 3%
Flat simple squamous cells They are cuboidal cells with central rounded
LM
Flat nuclei and scanty cytoplasm. nuclei and acidophilic vacuolated cytoplasm.
Few organelles grouped around the
nucleus. Their cytoplasm is rich in rER, Golgi,
EM Connected to adjacent cells by tight mitochondria, multilamellar bodies.
junction to prevent escape of tissue fluid Their apical surfaces carry microvilli.
into the alveoli.
Secrete pulmonary surfactant that forms a
Gas exchange thin film over the epithelial lining.
Functions
They cannot divide. They act as stem cells which can divide and
give two types of pneumocytes.
31
Premature Labour and Respiratory Distress Syndrome:
• linked to pulmonary surfactant deficiency.
• occurs due to insufficient surfactant, resulting in alveolar collapse, respiratory difficulty in newborns.
Interalveolar Septum :
• Definition : Delicate partitions separating adjacent alveoli.
• Structure :
» Highly vascularized connective tissue.
» Contains a network of blood capillaries, elastic and reticular fibers, macrophages, leukocytes.
Blood-Air Barrier:
• Definition : The interface facilitating gas exchange between blood capillaries and lung alveoli.
• Structure :
» Thin film of pulmonary surfactant.
» Cytoplasm of type I pneumocyte.
» Fused basement membrane of type I pneumocyte and endothelium.
» Cytoplasm of capillary endothelium.
Alveolar Phagocytes:
• Macrophages residing within lung alveoli or inter-alveolar septa.
• Origin : Developed from blood monocytes.
• Staining : Can be visualized using vital stains like trypan blue.
• Types :
» Dust Cells : Phagocytose dust particles, visible as black particles in the cytoplasm.
» Heart Failure Cells : Phagocytosis of RBCs in congestive heart failure, brick-red.
ADULT LUNG TRACHEA
32
CH 4 MCQS
1) Which portion of the respiratory system conducts air to and from the lungs without gas exchange?
a) Conducting portion
b) Respiratory portion
c) Nasopharynx
d) Alveolar sacs
2) What is the primary function of the conducting portion of the respiratory system?
a) Gas exchange
b) Warming and moistening of air
c) Formation of alveoli
d) Absorption of oxygen
3) Which structures are included in the conducting portion of the respiratory system?
a) Respiratory bronchioles
b) Alveolar sacs
c) Trachea
d) Lung alveoli
4) Where does gas exchange occur within the respiratory system?
a) Nasal cavities
b) Trachea
c) Alveolar sacs
d) Oropharynx
5) What is the primary function of the respiratory portion of the respiratory system?
a) Conduction of air
b) Gas exchange between blood and air
c) Cleaning air from dust
d) Conditioning of inspired air
6) What type of epithelium lines the mucosa of the trachea?
b) Pseudostratified columnar ciliated epithelium
c) Stratified squamous epithelium
7) Which layer of the tracheal wall contains loose C.T. with blood vessels, nerves, and elastic fibers?
a) Mucosa
b) Submucosa
c) Fibrocartilaginous coat
d) Adventitia
8) What forms the fibrocartilaginous coat of the trachea?
a) Dense irregular connective tissue
b) Hyaline cartilage rings
c) Elastic fibers
d) Smooth muscle cells
9) How many incomplete rings of hyaline cartilage form the fibrocartilaginous coat of the trachea?
a) 10-12
b) 20-24
c) 16-20
d) 8-10
10) What keeps the tracheal lumen open?
a) Elastic fibers
b) Smooth muscle cells
c) Hyaline cartilage rings
d) Collagen fibers
33
11) Which layer of the tracheal wall surrounds the trachea and is formed of loose connective tissue?
a) Mucosa
b) Submucosa
d) Adventitia
12) What is the function of the trachealis muscle?
a) Contraction and relaxation to regulate air flow
b) Maintenance of the tracheal lumen's diameter
c) Production of mucus for trapping particles
d) Facilitation of gas exchange
13) Where does the trachea begin and end anatomically?
a) Begins at the upper end of the larynx and ends at the diaphragm
b) Begins at the upper end of the larynx and ends at the lower thoracic region
c) Begins at the lower end of the larynx and ends by dividing into two bronchi
d) Begins at the lower end of the pharynx and ends at the upper thoracic region
14) What is the function of the elastic membrane in the trachea?
a) Facilitates gas exchange
b) Provides structural support and elasticity
c) Secretes mucus for lubrication
d) Initiates smooth muscle contraction
15) Which layer of the tracheal wall contains a rich network of blood capillaries, nerves, elastic fibers
and no lymphatic nodules?
a) Mucosa
b) Submucosa
d) Adventitia
16) What is the main function of pneumocyte type I?
a) Secretion of pulmonary surfactant
b) Gas exchange
c) Formation of multilamellar bodies
d) Division and regeneration
17) Which type of pneumocyte is more numerous in the alveoli?
a) Pneumocyte type I
b) Pneumocyte type II
c) Both types are equally numerous
18) What is the primary function of pneumocyte type II?
a) Gas exchange
b) Phagocytosis
c) Secretion of pulmonary surfactant
d) Connective tissue support
19) Which type of pneumocyte possesses acidophilic vacuolated cytoplasm?
c) Both types
20) Which type of pneumocyte cannot divide?
c) Both types
34
21) What is the role of pulmonary surfactant?
a) Increases surface tension of alveoli
b) Prevents alveolar collapse during expiration
c) Promotes alveolar collapse during inspiration
d) Stimulates gas exchange
22) What structural feature prevents the escape of tissue fluid into the alveoli?
a) Multilamellar bodies
b) Tight junctions
c) Microvilli
d) Acidophilic vacuoles
23) Which cell type acts as stem cells in the alveoli?
c) Both types
24) Premature labor is associated with the deficiency of which substance?
a) Pulmonary surfactant
b) RBCs
c) Macrophages
d) Multilamellar bodies
25) What is the primary function of interalveolar septa?
a) Gas exchange
b) Phagocytosis
c) Structural support
d) Surfactant secretion
26) Which cell type is characterized by flat simple squamous cells?
c) Both types
27) Which type of pneumocyte possesses a rich endoplasmic reticulum?
c) Both types
28) What is the function of pores between lung alveoli?
a) Prevent tissue fluid escape
b) Equalize air pressure
c) Facilitate gas exchange
d) Secrete pulmonary surfactant
29) What is the primary function of interalveolar septa?
a) Gas exchange
b) Phagocytosis
d) Surfactant secretion
30) Which type of pneumocyte secretes pulmonary surfactant?
c) Both types
31) What is the primary function of the interalveolar septum in the lungs?
a) Gas exchange
b) Blood filtration
c) Immune response
d) Structural support
35
32) Which component is part of the blood-air barrier facilitating gas exchange in the lungs?
a) Thick layer of mucus
b) Cytoplasm of type II pneumocyte
c) Fused basement membrane of type I pneumocyte and endothelium
d) Elastic fibers
33) What is the origin of alveolar phagocytes?
a) Alveolar epithelial cells
b) Blood monocytes
c) Endothelial cells
d) Type II pneumocytes
34) Which type of cells phagocytose dust particles in the lungs?
a) Type I pneumocytes
b) Type II pneumocytes
c) Dust cells
d) Heart failure cells
35) What stain is commonly used to visualize alveolar phagocytes?
a) Hematoxylin and eosin
b) Giemsa stain
c) Trypan blue
d) Crystal violet
36) Which structure is responsible for maintaining the elasticity and support of the lung tissue?
a) Blood capillaries
b) Reticular fibers
c) Pulmonary surfactant
d) Elastic fibers
37) Which type of cells is crucial for producing and secreting pulmonary surfactant?
a) Type I pneumocytes
b) Type II pneumocytes
c) Macrophages
d) Endothelial cells
38) What is the primary function of the blood-air barrier in the lungs?
a) Filtration of blood
b) Regulation of blood pressure
c) Facilitation of gas exchange
d) Secretion of hormones
39) What is the primary role of heart failure cells found in the lungs?
a) Phagocytosis of dust particles
b) Maintenance of alveolar integrity
c) Phagocytosis of RBCs
d) Production of surfactant
40) Which cell type is involved in the immune response within the interalveolar septum?
a) Eosinophils
b) Macrophages
c) Neutrophils
d) Mast cells
ANSWERS
1. A 9. C 17. A 25. C 33. B
2. B 10. C 18. C 26. A 34. C
3. C 11. D 19. B 27. B 35. C
4. C 12. B 20. A 28. B 36. D
5. B 13. C 21. B 29. C 37. B
6. B 14. B 22. B 30. B 38. C
7. B 15. A 23. B 31. D 39. C
8. B 16. B 24. A 32. C 40. B
36
URINARY SYSTEM
Urinary System Components :
• Two kidneys
• Urinary passages (ureters, urinary bladder, and urethra)
Functions of the Urinary System :
• Formation and excretion of urine (elimination of waste products & excess water)
• Filtration of foreign substances from the blood
• Regulation of water and electrolyte balance (acid-base equilibrium)
• Secretion of renin (regulation of blood pressure) and erythropoietin (stimulation of erythropoiesis)
Kidney Structure :
• Stroma:
– Capsule: Dense fibrous C.T. covering the kidney's outer surface, surrounded by renal fat.
– Minimal Connective Tissue (renal interstitium) around nephrons, collecting tubules, and ducts.
– Reticular Connective Tissue: Forms the background, stained brown with silver.
• Parenchyma:
– Cortex: Red appearance due to glomeruli presence, granular due to convoluted tubules.
– Medulla:
» Light grey, radially striated due to tubules and vessels arrangement, 10-18 medullary pyramids.
» Renal papilla: Apex of the pyramid, surrounded by a cup-like minor calyx, opening into a major
calyx that empties into the renal pelvis.
Nephron Structure :
– Malpighian Renal Corpuscle:
» Contains a glomerulus surrounded by Bowman's capsule.
» Consists of a vascular pole (afferent and efferent arterioles) and a urinary pole.
– Proximal Convoluted Tubule (PCT): Follows the urinary pole of the renal corpuscle.
– Distal Convoluted Tubule (DCT): Follows the PCT.
– Thin and Thick Limbs of Henle's Loop: Part of the nephron, aiding in the concentration of urine.
Components of Malpighian Renal Corpuscle:
• Bowman's Capsule:
» Double-walled epithelial capsule.
» Inner layer (visceral) consists of podocytes.
» Outer layer (parietal) lined with simple squamous epithelium.
» Capsular space receives glomerular filtrate.
» Reception of glomerular filtrate.
• Podocytes:
» Modified squamous cells lining Bowman's capsule.
» Have primary and secondary processes with filtration slits.
» Functions in filtration and basement membrane renewal.
• Glomerulus:
» Tuft of capillaries lined by fenestrated endothelial cells.
» Rests on a continuous basement membrane.
» Comprises the blood renal barrier.
» Filtration of blood and formation of the blood renal barrier.
• Blood Renal Barrier:
» Formed by the glomerular endothelium, basement membrane, and filtration slit diaphragms.
• Mesangial Cells:
» Branched cells between glomerular capillaries.
» Provide structural support, renew basement membrane, and have phagocytic roles.
37
• Proximal Convoluted Tubule (PCT):
» Length: 15mm, Diameter: 60 microns, narrow lumen.
» More convoluted.
» Lined with 3-5 cuboidal cells, non-clear cell boundaries.
» Deeply acidophilic & granular cytoplasm, basal & rounded nuclei, apical brush border, basal striations.
» EM shows many apical microvilli, basal infoldings with associated mitochondria.
• Distal Convoluted Tubule (DCT):
» Length: 5mm, Diameter: 20-50 microns, wide lumen.
» Less convoluted.
» Lined with 5-8 cubical cells with clear cell boundaries.
» Less acidophilic & less granular cytoplasm, central nuclei, non-clear brush border, less clear striations.
» EM shows fewer & shorter microvilli, fewer mitochondria.
• Loop of Henle:
» U-shaped tubule connecting PCT and DCT.
» Upper thick parts : simple cubical epithelium, lower thin parts : simple squamous epithelium.
» Function: concentration and formation of hypertonic urine.
• Collecting Tubules & Ducts:
» Urine passes from DCT to collecting tubules opening into larger, straight collecting ducts.
» Small collecting tubules : cuboidal epithelium, larger tubules & ducts : simple columnar epithelium.
» Responsible for water reabsorption under the control of ADH from the posterior pituitary.
KIDNEY
38
CH 5 MCQS
1. Which of the following is NOT a component of the urinary system?
A) Liver
B) Kidneys
C) Ureters
D) Urinary bladder
2. What is the primary function of the urinary system?
A) Digestion of food
B) Formation and excretion of urine
C) Regulation of body temperature
D) Production of hormones
3. Which hormone is secreted by the urinary system to regulate blood pressure?
A) Insulin
B) Renin
C) Estrogen
D) Testosterone
4. Which of the following is responsible for filtration of foreign substances from blood?
A) Kidneys
B) Ureters
C) Urinary bladder
D) Urethra
5. What is the role of erythropoietin secreted by the urinary system?
A) Regulation of blood sugar levels
B) Stimulation of erythropoiesis
C) Regulation of body temperature
D) Control of muscle contractions
6. What type of tissue covers the outer surface of the kidney?
A) Dense fibrous connective tissue
B) Adipose tissue
C) Reticular connective tissue
D) Minimal connective tissue
7. Which part of the kidney has a red appearance due to the presence of glomeruli?
A) Medulla
B) Renal papilla
C) Cortex
D) Minor calyx
8. What structures are radially arranged in the medulla of the kidney?
A) Glomeruli
B) Tubules and vessels
C) Renal papillae
D) Renal corpuscles
9. What is the apex of the medullary pyramid called?
A) Glomerulus
B) Renal papilla
C) Major calyx
D) Bowman's capsule
10.Which part of the nephron contains a glomerulus surrounded by Bowman's capsule?
A) Proximal convoluted tubule
B) Distal convoluted tubule
C) Malpighian renal corpuscle
D) Loop of Henle
39
11. Which tubule follows the urinary pole of the renal corpuscle?
A) Proximal convoluted tubule
B) Distal convoluted tubule
C) Thin limb of Henle's loop
D) Thick limb of Henle's loop
12. What is the function of the thin and thick limbs of Henle's loop?
A) Filtration of blood
B) Reabsorption of water and ions
C) Secretion of hormones
D) Storage of urine
13. What structures form the vascular pole of the renal corpuscle?
A) Afferent and efferent arterioles
B) Proximal and distal convoluted tubules
C) Loop of Henle
D) Renal papilla
14.Which part of the kidney is surrounded by a cup-like minor calyx?
A) Glomerulus
B) Renal papilla
C) Major calyx
D) Renal pelvis
15. What is the function of the renal capsule?
A) Secretion of urine
B) Protection of the kidney
C) Reabsorption of nutrients
D) Filtration of blood
16. What is the primary function of Bowman's capsule?
b) Reception of glomerular filtrate
c) Formation of blood renal barrier
d) Basement membrane renewal
17. Which type of epithelium lines the outer layer of Bowman's capsule?
b) Simple cuboidal epithelium
c) Stratified squamous epithelium
18. What are podocytes primarily responsible for within Bowman's capsule?
b) Basement membrane renewal
d) a,b
19. Which component forms the blood renal barrier in the nephron?
a) Glomerulus
b) Bowman's capsule
c) Parietal layer
d) Podocytes
20. What type of cells are mesangial cells?
a) Squamous cells
b) Cuboidal cells
c) Branched cells
d) Columnar cells
40
21. Which layer of Bowman's capsule is composed of podocytes?
a) Inner layer
b) Outer layer
c) Middle layer
d) Basement membrane
22. What is the function of mesangial cells in the nephron?
a) All of answers
b) Basement membrane renewal
d) Phagocytosis
23. Which structure comprises the filtration slit diaphragms in the nephron?
a) Parietal layer
b) Glomerular endothelium
c) Podocytes
d) Mesangial cells
24. What is the primary role of the glomerulus in the nephron?
a) Formation of blood renal barrier
b) Reception of glomerular filtrate
c) Filtration of blood
d) Basement membrane renewal
25. Which part of the nephron receives the glomerular filtrate?
a) Glomerulus
b) Parietal layer
c) Capsular space
d) Podocytes
26. What lines the outer layer of Bowman's capsule?
a) Parietal layer
b) simple squamous epithelium
c) Mesangial cells
d) Glomerular endothelium
27. Which cells provide phagocytic roles in the nephron?
a) Podocytes
b) Mesangial cells
c) Parietal cells
d) Glomerular endothelial cells
28. What forms the double-walled epithelial capsule of Bowman's capsule?
a) Mesangial cells
b) Podocytes
c) b,d
d) Parietal layer
29. Which cells have primary and secondary processes with filtration slits?
a) Mesangial cells
b) Podocytes
c) Parietal cells
d) Glomerular endothelial cells
30. What rests on the continuous basement membrane within the nephron?
a) Glomerulus
b) Parietal layer
c) Podocytes
d) Mesangial cells
31. What is the length of the Proximal Convoluted Tubule (PCT)?
A) 5mm
B) 15mm
C) 20mm
D) 10mm
41
32. Which tubule is more convoluted?
A) Proximal Convoluted Tubule (PCT)
B) Distal Convoluted Tubule (DCT)
C) Loop of Henle
D) Collecting Tubules
33. What type of cells line the Proximal Convoluted Tubule (PCT)?
A) Squamous
B) Cuboidal
C) Columnar
D) Ciliated
34. Which tubule has deeply acidophilic and granular cytoplasm?
C) Loop of Henle
35. What is the function of the Loop of Henle?
B) Secretion of hormones
C) Concentration and formation of hypertonic urine
D) Reabsorption of water
36. Which part of the Loop of Henle is lined with simple cubical epithelium?
A) Upper thick parts
B) Lower thin parts
C) Both upper and lower parts
D) None of the above
37. What controls water reabsorption in the collecting tubules and ducts?
A) Adrenal glands
B) Thyroid gland
C) Antidiuretic hormone (ADH)
D) Parathyroid gland
38. Which part of the nephron has a wider lumen?
C) Loop of Henle
39. Which tubule has fewer and shorter microvilli?
C) Loop of Henle
40. What is the diameter of the Proximal Convoluted Tubule (PCT)?
A) 60 microns
B) 20-50 microns
C) 30 microns
D) 100 microns
41. Which part of the nephron is responsible for water reabsorption under the influence of ADH?
C) Loop of Henle
42. What type of cells line the Distal Convoluted Tubule (DCT)?
A) Squamous
B) Cuboidal
C) Columnar
D) Ciliated
42
43. Which part of the nephron has a narrow lumen?
C) Loop of Henle
44. What type of epithelium lines the larger tubules and collecting ducts?
A) Cuboidal
B) Squamous
C) Columnar
D) Transitional
45. What are the functions of the Loop of Henle?
C) Reabsorption of water and ions
D) Formation of hypertonic urine
46. Which part of the nephron has basal striations?
C) Loop of Henle
47. What is the function of the Collecting Tubules and Ducts?
C) Reabsorption of water and ions
D) Concentration of urine
48. Which tubule has central nuclei?
C) Loop of Henle
49. What controls the water reabsorption in the collecting tubules and ducts?
A) Aldosterone
B) Parathyroid hormone (PTH)
C) Antidiuretic hormone (ADH)
D) Thyroid-stimulating hormone (TSH)
50. Which tubule has fewer mitochondria?
C) Loop of Henle
ANSWERS
1. A 11. A 21. A 31. B 41. D
2. B 12. B 22. A 32. A 42. B
3. B 13. A 23. C 33. B 43. A
4. A 14. B 24. C 34. A 44. C
5. B 15. B 25. C 35. C 45. D
6. D 16. B 26. B 36. A 46. A
7. C 17. A 27. B 37. C 47. C
8. B 18. D 28. C 38. B 48. B
9. B 19. A 29. B 39. B 49. C
10. C 20. C 30. A 40. A 50. B
43
REPRODUCTIVE SYSTEM
Male Genital System :
Components of The Male Genital System :
• Primary sex organs : Two testes that produce sperms, testosterone.
• Excretory Genital Ducts : Storage and transport of sperms.
• Accessory Genital Glands : Secrete the seminal fluid, essential formotility and nutrition of sperms.
» They include: Seminal Vesicles - Prostatec - Bulbo-urethral glands of Cowper
• External Genitalia : Formed of Penis and Scrotum.
Prostate :
• Location and Histological Structure :
» Exocrine, compound tubule-alveolar gland.
» Surrounds the neck of the urinary bladder.
» Comprises stroma and parenchyma.
• Stroma :
» Capsule: Thick fibromuscular capsule with smooth muscle fibers.
» Trabeculae: Thick fibromuscular septa dividing the gland into lobes and lobules.
» Reticular network: Formed of supporting reticular fibers and cells stained with silver.
• Parenchyma :
» Acini
» Ducts
• Parenchymal Components :
» Prostatic Acini
» Numbering 30-50.
» Arranged in three concentric groups around the prostatic urethra.
• Types :
» Mucosal group (central zone)
» Submucosal group (Transition zone)
» Main group (peripheral zone) - constitutes %70 of the gland.
• L.M. Characteristics :
» Lined with simple columnar or pseudostratified columnar epithelium.
» Presence of prostatic concretions (corpora amylacea) in the lumen.
• E.M. Features of Cells :
» Features of protein-synthesizing cells (Golgi complex, rER, mitochondria, secretory granules).
• Prostatic Ducts :
» Lined by simple cuboidal or columnar cells.
• Function of the Prostate :
» Secretion of prostatic fluid:
» Thin and milky.
» Imparts characteristic odor to semen.
» Rich in acid phosphatase, amylase, and fibrinolysin.
» Fibrinolysin aids in liquefaction of coagulated semen after deposition in the female vagina,
facilitating movement of sperm towards the uterus.
Clinical note :
• Benign Prostatic Hyperplasia (BPH):
» Enlargement of mucosal and submucosal acini in the prostate.
» Compression of the urethra.
» Symptoms include difficulties in micturition (urination).
» In severe cases, can lead to urine retention.
• Prostatic Carcinoma:
» Affects the main group of acini in the prostate.
» Symptoms often arise late due to the location of affected acini, far from the urethra.
» Advanced stages may lead to blockage of the urethra.
44
Female Genital System :
Components of The Female Genital System :
• Primary Sex Organs : Two ovaries produce oocytes, estrogen, progesterone.
• Genital Tract : Fallopian tubes - Uterus - Vagina
• External Genitalia
• Accessory Organs : Placenta - Mammary Glands.
Uterus :
• It is a pear-shaped organ
• Receives the fallopian tubes from upper part and its lower part opens into the vagina.
• It is divided into three parts : Fundus, body, cervix.
• Structure of Fundus & Body of Uterus :
• Endometrium :
» Lining Epithelium : Simple columnar partially ciliated and partially secretory.
» Lamina propria of C.T. rich in fibroblasts and ground substance, containing simple tubular glands
lined by the same surface epithelium but with very few ciliated cells.
» Functionally divided into two zones :
– Functional Zone :
• Superficial part of endometrium, containing surface epithelium, upper part of lamina propria,
and superficial part of endometrial glands.
• Supplied by spiral arteries and undergoes marked changes during the menstrual cycle.
– Basal Zone :
• Deep part of the endometrium, adjacent to the myometrium, containing deep part of lamina
propria and basal parts of endometrial glands.
• Supplied by straight arteries and remains unchanged during the menstrual cycle.
• Myometrium :
» Thickest layer of the uterus, composed of three poorly-defined layers of smooth muscles:
» Stratum submucosum: Longitudinal layer of muscles.
» Stratum vasculare: Circular, oblique muscles arranged in 8-shaped enclosing large blood vessels.
» Stratum supravasculare: Longitudinal layer of muscles.
– Clinical notes :
• Hormone-sensitive cells undergo hyperplasia and hypertrophy during pregnancy, returning to
normal size (involution) within weeks after delivery.
• Undergoes atrophy with cessation of hormonal stimuli after menopause.
• Perimetrium :
» Loose connective tissue covered by simple squamous mesothelium.
• Structure of Cervix of the Uterus :
» Lower cylindrical part of the uterus protruding into the vagina, approximately 3 cm long.
• Mucosa:
– Lining Epithelium :
• Consists of simple columnar mucus-secreting cells.
• Changes into non-keratinized stratified squamous epithelium just above the external os where
the cervix bulges into the vagina.
– Lamina Propria:
• Contains branched tubulo-alveolar cervical mucous glands.
• Stroma:
» Formed of dense C.T. rich in elastic fibers and few smooth muscles, making it firm and rubbery.
» During labor, cervical softening and dilatation occur due to loss of parallel arrangement of collagen
fibers (collagenolysis).
• Cervical Mucus:
– Changes with the menstrual cycle:
• At ovulation: Mucus is thin and watery to facilitate spermatozoa movement.
• During pregnancy: Mucus becomes more viscous, preventing passage of spermatozoa
and microorganisms into the uterine body.
45
Menstrual Cycle :
• Menstrual (destructive) phase (1st to 5th day) :
» Rapid drop in estrogen and progesterone levels
causes constriction of spiral arteries supplying
the functional zone, leading to ischemia.
» Rupture of blood vessels and shedding of the
dead functional zone occurs, leaving behind the
basal zone (approximately 0.5 mm thickness).
• Proliferative (follicular-estrogenic) phase (5th to
14th day) :
» Ovarian follicles begin secreting estrogen.
» Estrogen stimulates mitotic activity of basal
zone cells, resulting in endometrial regeneration.
» Endometrium regains its covering of simple
columnar partially ciliated epithelium.
» Regenerated glands are straight with narrow
lumens.
» Endometrial thickness increases to about 2-3
mm by the end of this phase.
• Secretory (Luteal-progestational) phase (14th day
until onset of next bleeding) :
» Begins after ovulation under the influence of progesterone.
» Endometrial glands become long and highly tortuous, with distended lumina filled with glycoprotein secretion.
» Endometrial thickness increases to its maximum of 5 mm.
» Spiral arteries elongate and become highly coiled and congested with blood.
» Stroma becomes highly edematous.
Vagina :
• Fibromuscular tube measuring 7-9 cm in length.
• Extends from the cervix to the external genitalia.
• Histological Structure :
• Mucosa :
» Comprises epithelium and lamina propria.
– Epithelium :
• Non-keratinized stratified squamous epithelium.
• Stimulated by estrogen, it synthesizes glycogen.
• Shed vaginal cells deposit glycogen into the lumen.
• Lactobacilli bacteria break down glycogen into lactic acid.
• Lactic acid creates an acidic environment in the vagina, offering protection.
– Lamina Propria :
• Loose connective tissue rich in elastic fibers.
• Musculosa:
» Inner circular and outer longitudinal smooth muscle fibers.
• Adventitia:
» Dense connective tissue abundant in elastic fibers.
» Imparts great elasticity to the vagina, facilitating distension, especially during labor.
46
Mammary Gland :
• Exocrine gland with compound alveolar structure.
• Exhibits apocrine secretion.
• Histological Structure:
• Resting State (Non-Pregnant, Non-Lactating):
» Nipple:
– Conical projection with dense connective tissue (C.T.) and smooth muscle fibers.
– Covered by pigmented skin with sensory nerve endings.
– Contains 12-20 lactiferous duct openings.
» Areola:
– Modified pigmented skin surrounding the nipple.
– Large modified sebaceous glands (Montgomery glands) present.
» Parenchyma of the Breast:
– Comprises 12-20 distinct lobes separated by dense C.T. septa rich in fat cells.
– Each lobe contains branching ducts emptying into a large lactiferous duct.
– Ducts lined with simple cuboidal epithelium and surrounded by myoepithelial cells.
– Lactiferous duct dilates near nipple to form lactiferous sinus lined with stratified cuboidal
epithelium, transitioning to stratified squamous epithelium at external opening.
• Pregnant and Lactating State:
» Hormonal changes induce the following:
– Breast enlargement.
– Increased pigmentation of nipple and areola.
– Proliferation of alveoli from duct ends.
– Light Microscopy (L.M.):
• Alveoli lined with simple columnar cells.
• Milk secretion appears as acidophilic with vacuoles of dissolved fat.
– Electron Microscopy (E.M.):
• Cells exhibit abundant rough endoplasmic reticulum (rER) and Golgi (for protein synthesis),
smooth endoplasmic reticulum (sER), mitochondria, and lipid droplets (for lipid synthesis).
– Thinning of C.T. septa and reduction in fat cells.
• Note (N.B.):
• First secretion post-delivery is colostrum.
• Contains less lipids, more proteins, rich in antibodies (IgA) providing passive immunity for newborns.
UTERUS VAGINA LACTATING MAMMARY GLAND PROSTATE
47
CH 6 MCQS
1. Which of the following is NOT a component of the male genital system?
A) Seminal Vesicles
B) Uterus
C) Prostate
D) Bulbo-urethral glands of Cowper
2. What is the primary function of the testes in the male genital system?
A) Production of testosterone
B) Storage and transport of sperms
C) Secretion of prostatic fluid
D) Liquefaction of coagulated semen
3. Which part of the male genital system surrounds the neck of the urinary bladder?
A) Seminal Vesicles
B) Testes
C) Scrotum
D) Prostate
4. What is the primary function of the accessory genital glands in the male genital system?
A) Production of sperms
B) Secretion of prostatic fluid
C) Liquefaction of coagulated semen
D) Storage and transport of sperms
5. Which histological type describes the prostate gland?
A) Exocrine, compound alveolar gland
B) Endocrine, simple tubular gland
C) Exocrine, compound tubule-alveolar gland
D) Endocrine, compound tubule-alveolar gland
6. What is the function of the stroma in the prostate gland?
A) Production of prostatic fluid
C) Surrounding the neck of the urinary bladder
D) Dividing the gland into lobes and lobules
7. Which zone of the prostate gland constitutes 70% of its volume?
A) Central zone
B) Transition zone
C) Peripheral zone
D) Mucosal group
8. Which type of epithelium lines the prostatic acini?
A) Simple squamous
B) Stratified squamous
C) Simple columnar or pseudostratified columnar
D) Simple cuboidal
9. What aids in the liquefaction of coagulated semen after deposition in the female vagina?
A) Fibrinolysin
B) Testosterone
C) Acid phosphatase
D) Amylase
10.Which condition involves the enlargement of mucosal and submucosal acini in the prostate?
A) Prostatic carcinoma
B) Benign prostatic hyperplasia (BPH)
C) Seminal vesicle inflammation
D) Cowper gland dysfunction
48
11. What symptom is commonly associated with benign prostatic hyperplasia (BPH)?
A) Erectile dysfunction
B) Difficulties in micturition (urination)
C) Pain during ejaculation
D) Reduced libido
12. Which gland is primarily affected by prostatic carcinoma?
A) Seminal Vesicles
B) Bulbo-urethral glands of Cowper
C) Prostate
D) Testes
13. What is the characteristic feature of advanced stages of prostatic carcinoma?
A) Blockage of the urethra
B) Reduced sperm motility
C) Increased prostatic fluid production
D) Thickening of the scrotum
14.Which of the following is NOT an external genitalia component?
A) Scrotum
B) Penis
C) Seminal Vesicles
D) No right answer
15. What is the primary function of the external genitalia in the male reproductive system?
C) Formation of seminal fluid
D) Delivery of sperms to the female reproductive tract
16. Which component of the male genital system produces sperms and testosterone?
A) Seminal Vesicles
B) Prostate
C) Testes
17. What is the function of the excretory genital ducts in the male reproductive system?
A) Production of seminal fluid
C) Formation of testosterone
D) Secretion of prostatic fluid
18. Which gland secretes the seminal fluid for sperm motility and nutrition?
A) Seminal Vesicles
B) Prostate
C) Testes
19. What is the primary function of the external genitalia in males?
C) Formation of seminal fluid
D) No right answer
20. Which histological type characterizes the prostate gland?
A) Exocrine, compound alveolar gland
B) Endocrine, simple tubular gland
C) Exocrine, compound tubule-alveolar gland
D) Endocrine, compound tubule-alveolar gland
21. Where is the prostate gland located in the male body?
A) Surrounding the neck of the urinary bladder
B) Within the scrotum
C) Adjacent to the testes
D) Within the penile shaft
49
22. Which component divides the prostate gland into lobes and lobules?
A) Capsule
B) Trabeculae
C) Reticular network
D) Acini
23. How are prostatic acini arranged around the prostatic urethra?
A) Radially
B) In parallel
C) In concentric groups
D) Randomly
24. What is the primary function of the prostatic fluid?
A) Production of testosterone
B) Imparting characteristic odor to semen
C) Liquefaction of coagulated semen
D) Facilitating movement of sperms towards the uterus
25. What are the primary sex organs in the female genital system?
a) Fallopian tubes
b) Uterus
c) Ovaries
d) Vagina
26. Which part of the uterus opens into the vagina?
a) Fundus
b) Body
c) Cervix
d) Fallopian tubes
27. Which layer of the uterus undergoes marked changes during the menstrual cycle?
a) Myometrium
b) Endometrium
c) Perimetrium
d) Lamina propria
28. What is the function of the basal zone of the endometrium?
a) Menstrual blood expulsion
b) Hormone secretion
c) Glandular secretion
d) Regenration of functional zone
29. Which layer of the uterus contains poorly-defined layers of smooth muscles?
a) Endometrium
b) Myometrium
c) Perimetrium
d) Cervix
30. What type of epithelium lines the cervix?
a) Simple squamous
b) Stratified squamous
c) Simple columnar
d) Pseudostratified columnar
31. What happens to cervical mucus during ovulation?
a) Becomes thicker
b) Becomes watery
c) Becomes more viscous
d) No change
32. What causes cervical softening and dilatation during labor?
a) Increase in collagen fibers
b) Parallel arrangement of collagen fibers
c) Decrease in collagen fibers
d) Formation of elastic fibers
50
33. Which part of the uterus is covered by simple squamous mesothelium?
a) Fundus
b) Cervix
c) Myometrium
d) Perimetrium
34. What is the primary function of the endometrial glands in the uterus?
a) Hormone secretion
b) Nutrient absorption
c) Menstrual blood expulsion
d) Secretion of mucus and other substances
35. Which part of the uterus remains unchanged during the menstrual cycle?
a) Functional zone
b) Basal zone
c) Myometrium
d) Cervix
36. What type of cells line the mucosa of the cervix?
a) Simple squamous
b) Stratified squamous
c) Simple columnar
37. What is the composition of cervical mucus during pregnancy?
a) Thin and watery
b) Thick and viscous
c) Thin and viscous
d) Thick and watery
38. Which layer of the uterus undergoes hyperplasia and hypertrophy during pregnancy?
a) Endometrium
b) Myometrium
c) Perimetrium
d) Lamina propria
39. What happens to the cervix during labor due to collagenolysis?
a) Softening and dilatation
b) Hardening and contraction
c) Thickening and narrowing
d) No change
40. What is the primary function of the lamina propria in the cervix?
b) Nutrient absorption
c) Glandular secretion
d) Structural support
41. Which part of the uterus is pear-shaped?
a) Fundus
b) Body
c) Cervix
d) Perimetrium
42. During which phase of the menstrual cycle does the endometrium undergo marked changes?
a) Menstrual phase
b) Proliferative phase
c) Secretory phase
d) Ovulatory phase
43. What happens to the myometrium with cessation of hormonal stimuli after menopause?
a) Hyperplasia
b) Hypertrophy
c) Atrophy
d) Proliferation
51
44. What is the function of the fallopian tubes?
b) Oocyte production
c) Sperm maturation
d) Fertilization and transportation of ova
45. Which phase of the menstrual cycle do estrogen and progesterone levels experience a rapid drop?
A) Proliferative phase
B) Secretory phase
C) Menstrual phase
D) Follicular phase
46. What happens to the endometrium during the menstrual phase of the menstrual cycle?
A) Endometrial thickness increases
B) Spiral arteries elongate
C) Endometrial degeneration occurs
D) Glycoprotein secretion increases
47. Which phase of the menstrual cycle is characterized by the shedding of the dead functional zone
of the endometrium?
B) Secretory phase
C) Menstrual phase
D) Follicular phase
48. During which phase of the menstrual cycle do ovarian follicles begin secreting estrogen?
A) Menstrual phase
B) Secretory phase
C) Proliferative phase
D) Follicular phase
49. What is the maximum thickness reached by the endometrium during the proliferative phase?
A) 5 mm
B) 2-3 mm
C) Approximately 0.5 mm
D) 3-5 mm
50. Which phase of the menstrual cycle begins after ovulation under the influence of progesterone?
B) Secretory phase
C) Menstrual phase
D) Follicular phase
51. What happens to the endometrial glands during the secretory phase of the menstrual cycle?
A) They become long and highly tortuous
B) They undergo mitotic activity
C) They become straight with narrow lumens
D) They shed off completely
52. Which phase of the menstrual cycle is characterized by the constriction of spiral arteries
supplying the functional zone of the endometrium?
B) Secretory phase
C) Menstrual phase
D) Follicular phase
53. What happens to the stroma during the secretory phase of the menstrual cycle?
A) It becomes highly edematous
B) It regains its covering of simple columnar partially ciliated epithelium
C) It experiences a rapid drop in estrogen and progesterone levels
D) It becomes thin and atrophic
52
54. Which phase of the menstrual cycle is characterized by the presence of glycoprotein secretion in
the distended lumina of the endometrial glands?
B) Secretory phase
C) Menstrual phase
D) Follicular phase
55. What causes the rapid drop in estrogen and progesterone levels during the menstrual phase?
A) Ovulation
B) Fertilization
C) Hormonal imbalance
D) Degeneration of corpus luteum
56. Which phase of menstrual cycle is associated with the maximum thickness of the endometrium?
A) Menstrual phase
B) Proliferative phase
C) Secretory phase
D) Follicular phase
57. Which phase of the menstrual cycle do the endometrial glands exhibit straightness with narrow lumens?
B) Secretory phase
C) Menstrual phase
D) Follicular phase
58. What stimulates the mitotic activity of basal zone cells leading to endometrial regeneration
during the menstrual cycle?
A) Estrogen
B) Progesterone
C) Luteinizing hormone (LH)
D) Follicle-stimulating hormone (FSH)
59. Which phase of the menstrual cycle is characterized by elongation and coiling of spiral arteries
supplying the endometrium?
A) Menstrual phase
C) Secretory phase
D) Follicular phase
60. What is the thickness of the basal zone of the endometrium during the menstrual phase?
A) 5 mm
B) 2-3 mm
C) 0.5 mm
D) 3-5 mm
61. During which phase of the menstrual cycle do the endometrial glands become highly tortuous?
B) Secretory phase
C) Menstrual phase
D) Follicular phase
62. What is the primary influence behind the beginning of the secretory phase of the menstrual cycle?
A) Decrease in estrogen levels
B) Increase in progesterone levels
C) Ovulation
D) Degeneration of corpus albicans
63. What happens to the stroma during the menstrual phase of the menstrual cycle?
A) It becomes highly edematous
B) It regains its covering of simple columnar partially ciliated epithelium
C) It experiences a rapid drop in estrogen and progesterone levels
D) It becomes thin and atrophic
53
64. Which phase of the menstrual cycle is characterized by the rupture of blood vessels and shedding
of the dead functional zone of the endometrium?
A) Menstrual phase
C) Secretory phase
D) Follicular phase
65. What is the histological composition of the vagina's mucosa?
A) Epithelium and submucosa
B) Epithelium and lamina propria
C) Epithelium and muscularis
D) Lamina propria and muscularis
66. Which type of epithelium lines the vaginal canal?
A) Simple squamous epithelium
B) Simple cuboidal epithelium
C) Non-keratinized stratified squamous epithelium
D) Transitional epithelium
67. What stimulates the epithelium of the vagina to synthesize glycogen?
A) Progesterone
B) Testosterone
C) Estrogen
D) Prolactin
68. Which type of bacteria breaks down glycogen into lactic acid in the vagina?
A) Streptococci
B) Lactobacilli
C) Staphylococci
D) Bacilli
69. What does lactic acid create in the vaginal environment, offering protection?
A) Alkaline pH
B) Neutral pH
C) Acidic pH
D) Basic pH
70. What is the main component of the lamina propria in the vagina?
A) Dense connective tissue
B) Loose connective tissue
C) Adipose tissue
D) Bone tissue
71. Which layer of the vagina imparts great elasticity to facilitate distension, especially during labor?
A) Mucosa
B) Muscularis
C) Adventitia
D) Submucosa
72. What are the muscle fibers found in the muscular layer of the vagina?
A) Striated muscle fibers
B) Cardiac muscle fibers
C) Smooth muscle fibers
D) Skeletal muscle fibers
73. What is the average length of the vagina?
A) 5-7 cm
B) 10-12 cm
C) 15-18 cm
D) 7-9 cm
54
74. What is the primary function of the acidic environment in the vagina?
A) Facilitate sperm survival
B) Prevent bacterial growth
C) Enhance glycogen synthesis
D) Promote estrogen production
75. What type of secretion does the mammary gland exhibit?
a) Merocrine
b) Holocrine
c) Apocrine
d) Endocrine
76. Which structure surrounds the lactiferous duct near the nipple?
a) Simple cuboidal epithelium
c) Stratified cuboidal epithelium
d) Smooth muscle fibers
77. What is the primary function of Montgomery glands in the breast?
a) Milk production
b) Pigmentation regulation
c) Sensory perception
d) Sebum secretion
78. Which state induces the proliferation of alveoli from duct ends in the mammary gland?
a) Resting state
b) Non-lactating state
c) Pregnant and lactating state
d) Post-delivery state
79. Which microscopy technique reveals alveoli lined with simple columnar cells?
a) Scanning electron microscopy (SEM)
b) Transmission electron microscopy (TEM)
c) Fluorescence microscopy
d) Light microscopy (L.M.)
80. What characterizes the secretion of milk in the alveoli under light microscopy?
a) Basophilic with vacuoles of dissolved fat
b) Acidophilic with vacuoles of dissolved fat
c) Eosinophilic with vacuoles of dissolved fat
d) Acidophilic with vesicles of dissolved fat
81. What is the main type of epithelium lining the lactiferous ducts?
a) Stratified squamous
b) Simple cuboidal
c) Simple columnar
82. During lactation, what undergoes a reduction due to hormonal changes?
a) Pigmentation of the nipple
b) Number of lactiferous duct openings
c) Thickness of connective tissue septa
d) Presence of Montgomery glands
83. What is the primary function of colostrum, the first secretion post-delivery?
a) Provides essential nutrients
b) Initiates lactation process
c) Contains antibodies for passive immunity
d) Stimulates alveoli proliferation
84. What type of gland is the mammary gland?
A) Endocrine
B) Exocrine
C) Mixed
55
85. Which type of secretion does the mammary gland exhibit?
A) Merocrine
B) Apocrine
C) Holocrine
D) Eccrine
86. What is the histological structure of the mammary gland during the resting state?
A) Simple alveolar structure
B) Compound tubuloalveolar structure
C) Simple tubular structure
D) Compound acinar structure
87. How many lactiferous duct openings are typically present in the nipple during the resting state?
A) 5-10
B) 10-15
C) 12-20
D) 20-25
88. What type of epithelium lines the lactiferous ducts in the mammary gland?
A) Simple squamous
B) Simple cuboidal
C) Simple columnar
D) Pseudostratified columnar
89. During pregnancy and lactation, what induces the proliferation of alveoli from duct ends in the
mammary gland?
A) Increased blood flow
B) Hormonal changes
C) Decreased fat storage
D) Reduced connective tissue density
90. What type of cells line the alveoli in the mammary gland during lactation, as observed under light
microscopy?
A) Simple squamous cells
B) Simple cuboidal cells
C) Simple columnar cells
D) Stratified squamous cells
ANSWERS
1. B 19. D 37. B 55. D 73. D
2. A 20. C 38. B 56. C 74. B
3. D 21. A 39. A 57. A 75. C
4. B 22. B 40. C 58. A 76. C
5. C 23. C 41. B 59. C 77. D
6. D 24. B 42. C 60. C 78. C
7. C 25. C 43. C 61. B 79. D
8. C 26. C 44. D 62. B 80. B
9. A 27. B 45. C 63. D 81. B
10. B 28. D 46. C 64. A 82. C
11. B 29. B 47. C 65. B 83. C
12. C 30. C 48. D 66. C 84. B
13. A 31. B 49. B 67. C 85. B
14. C 32. C 50. B 68. B 86. B
15. D 33. D 51. A 69. C 87. C
16. C 34. D 52. C 70. B 88. B
17. B 35. B 53. A 71. C 89. B
18. A 36. C 54. B 72. C 90. C
56
CNS
Nervous system subdivisions and characteristics :
Peripheral Nervous System (PNS): Includes peripheral nerves, ganglia, and nerve endings.
Central Nervous System (CNS):
• Consists of the spinal cord and the brain.
• Developed from the neural tube.
• Covered by three protective membranes called meninges (pia, arachnoid, and dura mater).
• Protected by bones: the brain by the skull and the spinal cord by the vertebral column.
• Comprised of grey and white matter.
Brain Components:
• Cerebrum / Cerebellum
• Diencephalon (thalamus, metathalamus, hypothalamus, subthalamus, and epithalamus)
• Brain stem (midbrain, pons, and medulla)
Spinal Cord :
• Consists of 31 segments: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and one coccygeal.
• Cylindrical shape, protected by the vertebral column.
• Continuous above with the medulla, with a conical lower end called the conus medullaris.
• Covered by meninges (pia, arachnoid, and dura mater).
• Transverse section shows a central canal, H-shaped grey matter in the center, and outer white matter.
• Contains a ventral median fissure and dorsal median sulcus.
Grey Matter:
• Contains sensory nuclei in posterior horns and motor nuclei in anterior horns.
• Additional lateral horns in thoracic and upper lumbar segments contain sympathetic nuclei.
• Posterior and anterior horns joined by transverse commissural neurons.
White Matter:
• Consists of myelinated nerve fibers arranged into ascending and descending tracts.
• Divided into longitudinal columns of funiculi: anterior, lateral, and posterior columns.
• Posterior column contains ascending tracts only.
• Anterior and lateral columns contain both ascending and descending tracts.
Tracts in the CNS : Groups of myelinated axons with the same origin, termination, and function.
Classification of Long Spinal Cord Tracts:
• Long Ascending Sensory Tracts:
» Gracile Tract » Lateral Spinothalamic Tract
» Cuneate Tract » Ventral Spinothalamic Tract
• Long Descending Motor Tracts:
» Dorsal Spino-Cerebellar Tract » Spino-Olivary Tract
» Ventral Spino-Cerebellar Tract » Spino-Tectal Tract
• Descending Motor Tracts to the Cerebral Cortex:
» Crossed Cortico-Spinal Tract » Direct Cortico-Spinal Tract
• Descending Motor Tracts to Subcortex (Extrapyramidal):
» Rubro-Spinal Tract » Lateral Reticulo-Spinal Tract » Ventral Reticulo-Spinal Tract
» Olivo-Spinal Tract » Lateral Tecto-Spinal Tract » Ventral Tecto-Spinal Tract
» Sulcomarginal Tract » Lateral Vestibulo-Spinal Tract » Ventral Vestibulo-Spinal Tract
Long Ascending (Sensory) Tracts to the Cerebral Cortex:
Gracile and Cuneate Tracts:
• Carry proprioceptive sensations (sense of position, movement, and vibration) and fine touch.
• Sensations originate from the same side of the body.
Lateral Spinothalamic Tract:
• Carries pain and temperature sensations.
• Sensations originate from the opposite side of the body.
Ventral Spinothalamic Tract:
• Carries simple (crude) touch sensations.
• Sensations originate from the opposite side of the body.
57
58
Simple(crude)touch
Proprioception & fine touch from Pain &temperature from the
from the opposite side of
the opposite side of the body opposite side of the body
the body
For proprioception:
1-Muscle spindle in muscle.
2-Tendon spindle in tendon. 1-Free nerve endings
3-Pacinian corpuscles. Free nerve endings 2-Merkel›s disc.
For fine touch: 3- Meissner›s corpuscles.
1-Meissner›s corpuscles. 4-Peritrichial nerve endings.
Receptors
2-Ruffini›s corpuscles.
3-Merkel›s disc.
- Large cells in Spinal Ganglia receive
Impulses by thick myelinated nerve fibers. - Medium sized cells in Spinal Ganglia
- Impulses enter the spinal cord via - Small cells in Spinal Ganglia receive receive impulses by medium sized
Medial division of posterior roots. impulses by thin myelinated nerve fibers. myelinated nerve fibers.
- Branches from sacral, Lumbar &thoracic - Impulses enter the spinal cord via lateral - Impulses enter the spinal cord via Medial
segments ascend as Gracile tract on the division of post. roots. division of posterior roots.
same side. - Fibers form short Lissauer›s tract that
neurone
-Branches from upper thoracic &cervical ascend or descend for few segments. - Fibers ascend for few Segments in the
First order
segment. ascend as Cuneate tract on the post. column
same side.
- Gracile & Cuneate nuclei in the Medulla. - Main sensory nucleus.
- Axons from both nuclei cross to the Their axons cross to the opposite side &
opposite side ant. to the central canal as - Nuclei of Substantia gelatinosa of Rolandi -ascend
- Their axons cross to the opposite side & ant. to the central canal as Vent.
internal arcuate fibers. spinothalamic in the ventral column ,
- These fibers cross to the opposite side as ascend ant. to the central canal as Lateral which ascend intract
The brain stem.
order
Second
neurone
sensory decussation &form the Medial spinothalamic tract in the lateral column. - Fibers from lat. &vent. Spinothalamic
lemniscus. tracts form The Spinal lemniscus.
- Posterolateral ventral nucleus of the thalamus (PLVNT)
- Their axons ascend to the sensory areas of cerebral cortex (area 3, 1, 2) in postrocentral gyrus.
Third
order
neurone
LEMNISCI :
• They are ascending sensory bundles in the brain stem
Medial Lemniscus:
• Ascending sensory bundle in the brainstem, including the midbrain.
• Formed by fibers from the lateral and ventral spinothalamic tracts.
• Arises from internal arcuate fibers originating from gracile and cuneate nuclei.
• Fibers cross to the opposite side in the sensory decussation of the closed medulla.
• Ascends in the brainstem in a medial position as the medial lemniscus.
• Terminates in the posterolateral ventral nucleus (PLVN) in the thalamus.
• Axons ascend to sensory areas of the cerebral cortex (areas 2 ,1 ,3) in the postcentral gyrus.
• Carries proprioception and fine touch sensations from the opposite side of the body.
Spinal Lemniscus:
• Ascending sensory bundle in the brainstem, including the pons and midbrain.
• Formed by fibers from the lateral and ventral spinothalamic tracts.
• Carries pain, temperature, and crude (simple) touch sensations from the opposite side of the body.
Clinical Notes:
Tabes Dorsalis:
• Bilateral degeneration of the gracile and cuneate tracts due to syphilis.
• Results in loss of proprioception and fine touch.
• Presents with sensory ataxia, marked disturbance in gait.
• Patients fail to identify objects or limb position with closed eyes.
Syringomyelia:
• Congenital cystic dilatation of the central canal of the spinal cord in the lower cervical and upper
thoracic regions.
• Causes pressure on the lateral spinothalamic tract.
• Results in loss of pain and temperature sensations in the upper limbs and chest.
• Touch sensation is retained due to intact gracile and cuneate tracts.
• Leads to dissociated sensory loss, where pain and temperature are lost, touch remains intact.
PROPRIOCEPTION PATHWAY PAIN ,TEMPERATURE & SIMPLE TOUCH

PATHWAYS
59
Long Ascending (Sensory) Tracts To The Sub-cortex :
Dorsal Spinocerebellar Tract:
• Originates from Clark's nucleus in the same and opposite sides of the lower half of the body.
• Ascends as the lateral cerebellar tract in the lateral column of the spinal cord.
• Enters the cerebellum via the inferior cerebellar peduncle.
• Carries proprioceptive sensations from the lower half of the body to the cerebellum.
Ventral Spinocerebellar Tract:
• Originates from Clark's nucleus in the same side cervical and thoracic regions.
• Ascends as the lateral cerebellar tract in the lateral column of the spinal cord.
• Enters the cerebellum via the superior cerebellar peduncle.
• Carries proprioceptive sensations from the upper half of the body to the cerebellum.
Spino-Olivary Tract:
• Collateral branches from Gracile and Cuneate tracts.
• Fibers relay in the main sensory nucleus and send axons to the opposite side.
• Ascends as the spino-olivary tract in the lateral column of the spinal cord.
• Terminates in the inferior olivary nucleus at the level of the open medulla.
• Carries proprioceptive sensations to the cerebellum.
Spino-Tectal Tract:
• Collateral branches from the main sensory nucleus cross to the opposite side.
• Ascends as the spinotectal tract in the lateral column of the spinal cord.
• Terminates in the superior colliculus in the midbrain.
• Carries spino visual reflexes to the superior colliculus in the midbrain (tectum).
Long Descending ( motor ) Tracts Of The Spinal Cord :
• Motor tracts carry orders from the motor areas of the cerebral cortex or subcortical motor areas to
the anterior horn cells of the spinal cord (upper motor neurons).
• The cerebral cortex also controls the motor cranial nuclei through the cortico-bulbar tracts.
• Peripheral motor nerves arising from the anterior horn cells innervate skeletal muscles
(lower motor neurons).
Descending motor tracts are classified into:
• A. Pyramidal tracts
• B. Extrapyramidal tracts
Pyramidal Tracts :
• Descending motor tracts from the cerebral cortex to the anterior horn cells of the spinal cord and
motor nuclei of cranial nerves.
• Classified into:
• Cortico-spinal tracts
• Cortico-bulbar tracts
Cortico-spinal Tracts:
• Originates from Betz cells and other pyramidal nerve cells in the upper 2/3 of motor area 4 in the
precentral gyrus of the cerebral cortex.
• Fibers descend through the corona radiata, internal capsule, midbrain, pons, and medulla.
• Form the pyramid in the upper medulla.
• Majority of fibers cross to the opposite side at the pyramidal (motor) decussation in the closed
medulla, forming the lateral cortico-spinal tract. Some fibers descend uncrossed as the ventral
cortico-spinal tract.
• Terminates at anterior horn cells of the spinal cord.
• Functions include voluntary movements and fine motor skills.
Cortico-bulbar Tracts:
• Originates from motor area 8 in the frontal lobe of the cerebral cortex and lower 1/3 of motor area 4.
• Fibers descend through the corona radiata, genu of internal capsule, and midbrain.
• Terminates in motor nuclei of cranial nerves in the midbrain, pons, and medulla.
• Regulate movements of muscles of the face, mastication, pharynx, and control eye movements.
60
Cervical region of the spinal cord :
Histological Characteristics:
• Oval-shaped section.
• Thin and diverging posterior horns.
• Thick anterior horns.
• Anterior central canal.
• Greater white matter compared to other regions.
Grey Matter Nuclei:
• Commissural nuclei:
» Anterior commissural nucleus.
» Posterior commissural nucleus.
• Motor nuclei in the anterior horn:
» Anterior medial motor nucleus.
» Anterior lateral motor nucleus.
» Posterior lateral motor nucleus.
» Posterior medial motor nucleus.
» Central motor nucleus.
• Sensory nuclei in the posterior horn:
» Substantia gelatinosa of Rolandi.
» Main sensory nucleus.
White Matter Tracts:
• Short tracts (3):
» Fasciculi proprii tract.
» Lissauer's tract.
» Comma-shaped tract.
• Long ascending tracts (8):
» Gracile and cuneate tracts.
» Dorsal and ventral spinocerebellar tracts.
» Lateral and ventral spinothalamic tracts.
» Spinotectal tract.
» Spino-olivary tract.
• Long descending tracts (11):
» Crossed and direct pyramidal tracts.
» Rubrospinal tract.
» Olivospinal tract.
» Sulcomarginal tract.
» Ventral and lateral reticulospinal tracts.
» Ventral and lateral tectospinal tracts.
» Ventral and lateral vestibulospinal tracts.
61
CH 7 MCQS
1. Which of the following is NOT a component of the Central Nervous System (CNS)?
A) Spinal cord
B) Peripheral nerves
C) Brain stem
D) Cerebrum
2. The spinal cord consists of how many segments?
A) 12
B) 31
C) 5
D) 8
3. Which protective membranes cover the Central Nervous System?
A) Epidermis, dermis, hypodermis
B) Pia mater, arachnoid mater, dura mater
C) Ligamentum flavum, annulus fibrosus, nucleus pulposus
D) Periosteum, endosteum, periosteal dura mater
4. Which part of the NS is responsible for processing sensory information and coordinating voluntary
movements?
A) Peripheral Nervous System
B) Autonomic Nervous System
C) Central Nervous System
D) Enteric Nervous System
5. The grey matter of the spinal cord contains:
A) Myelinated nerve fibers
B) Sensory nuclei in anterior horns
C) Motor nuclei in posterior horns
D) Transverse commissural neurons
6. The long ascending sensory tract responsible for carrying proprioceptive sensations is known as:
A) Lateral Spinothalamic Tract
B) Ventral Spinothalamic Tract
C) Gracile Tract
D) Rubro-Spinal Tract
7. The descending motor tract that directly innervates skeletal muscles and controls voluntary
movements is called the:
A) Rubro-Spinal Tract
B) Direct Cortico-Spinal Tract
C) Lateral Reticulo-Spinal Tract
D) Spino-Tectal Tract
8. Which of the following is NOT a part of the brain stem?
A) Medulla
B) Cerebellum
C) Midbrain
D) Pons
9. The grey matter of the spinal cord is primarily composed of:
A) Myelinated nerve fibers
B) Cell bodies of neurons
C) Glial cells
D) White matter
10.Tracts responsible for carrying pain, temperature, crude touch from opposite side of the body are:
A) Lateral Spinothalamic Tract
B) Ventral Spinothalamic Tract
C) Gracile Tract
D) Dorsal Spino-Cerebellar Tract
62
11. Which division of the nervous system includes peripheral nerves, ganglia, and nerve endings?
A) Central Nervous System
C) Somatic Nervous System
D) Peripheral Nervous System
12. The spinal cord is protected by:
A) Cartilage
B) Muscles
C) Vertebral column
D) Skull
13. The white matter of the spinal cord primarily consists of:
A) Cell bodies of neurons
B) Myelinated nerve fibers
C) Glial cells
D) Grey matter
14.The descending motor tract responsible for involuntary movements and postural control is the:
A) Direct Cortico-Spinal Tract
B) Ventral Reticulo-Spinal Tract
C) Rubro-Spinal Tract
D) Lateral Tecto-Spinal Tract
15. Which part of the brain is responsible for relaying sensory, motor signals to the cerebral cortex?
A) Brain stem
B) Cerebellum
C) Diencephalon
D) Medulla
16. The meninges covering the Central Nervous System are composed of:
A) Cartilage
B) Tendons
C) Connective tissue layers
D) Muscles
17. The sensory nuclei responsible for proprioception and fine touch are located in which part of the
spinal cord grey matter?
A) Anterior horns
B) Posterior horns
C) Lateral horns
D) Ventral horns
18. The spinal cord segment responsible for carrying sympathetic nuclei is found in:
A) Lumbar segment
B) Cervical segment
C) Sacral segment
D) Thoracic segment
19. The descending motor tract responsible for involuntary movements and coordination of muscle
activity is the:
B) Lateral Reticulo-Spinal Tract
C) Ventral Tecto-Spinal Tract
D) Sulcomarginal Tract
20. Which part of the nervous system is responsible for controlling involuntary bodily functions such
as heart rate and digestion?
A) Peripheral Nervous System
B) Central Nervous System
C) Autonomic Nervous System
D) Somatic Nervous System
63
21. The ascending sensory tract responsible for carrying pain, temperature sensations is known as the:
A) Gracile Tract
B) Cuneate Tract
C) Lateral Spinothalamic Tract
D) Ventral Spinothalamic Tract
22. The white matter of the spinal cord is primarily composed of:
A) Cell bodies of neurons
B) Myelinated nerve fibers
C) Glial cells
D) Grey matter
23. The descending motor tract responsible for controlling skilled voluntary movements is the:
A) Olivo-Spinal Tract
B) Ventral Reticulo-Spinal Tract
C) Crossed Cortico-Spinal Tract
D) Dorsal Spino-Cerebellar Tract
24. Which part of the brain is responsible for regulating body temperature, hunger, and thirst?
A) Brain stem
B) Cerebrum
C) Diencephalon
D) Cerebellum
25. The tracts responsible for carrying proprioceptive sensations and fine touch from the same side
of the body are:
A) Gracile Tract
B) Cuneate Tract
26. The descending motor tract responsible for modulating pain perception and controlling
involuntary movements is the:
C) Ventral Vestibulo-Spinal Tract
27.The spinal cord is continuous above with which structure?
A) Cerebellum
B) Medulla
C) Brain stem
D) Diencephalon
28. Which division of the nervous system includes cranial nerves and spinal nerves?
A) Central Nervous System
C) Somatic Nervous System
D) Peripheral Nervous System
29. The ascending sensory tract responsible for carrying crude touch sensations is known as the:
A) Gracile Tract
B) Cuneate Tract
30. The descending motor tract responsible for controlling posture and balance is the:
C) Ventral Vestibulo-Spinal Tract
64
31. Which sensory tract carries proprioceptive sensations, fine touch from the same side of the body?
A) Gracile Tract
B) Cuneate Tract
32. Which receptors are involved in proprioception?
A) Free nerve endings
B) Pacinian corpuscles
C) Meissner's corpuscles
D) Muscle spindle in muscle
33. Which first-order neuron receives impulses by thin myelinated nerve fibers?
A) Large cells in Spinal Ganglia
B) Small cells in Spinal Ganglia
C) Medium-sized cells in Spinal Ganglia
34. Where do the axons from Gracile and Cuneate nuclei cross to the opposite side?
A) Sensory decussation
B) Lateral spinothalamic tract
C) Ventral spinothalamic tract
D) Postrocentral gyrus
35. Which sensory tract carries pain and temperature sensations from the opposite side of the body?
A) Gracile Tract
B) Cuneate Tract
36. Which receptors are involved in sensing pain and temperature?
B) Merkel's disc
C) Ruffini's corpuscles
37.Where do the axons from the Main sensory nucleus ascend after crossing to the opposite side?
A) Sensory areas of cerebral cortex
B) Ventral column
C) Medulla
D) Thalamus
38. Which sensory tract carries simple (crude) touch sensations from the opposite side of the body?
A) Gracile Tract
B) Cuneate Tract
39. Which receptors are involved in sensing simple (crude) touch?
A) Peritrichial nerve endings
B) Merkel's disc
C) Meissner's corpuscles
D) Pacinian corpuscles
40. Where do the axons from lateral and ventral spinothalamic tracts form the lemniscus?
A) Pons
B) Medulla
C) Midbrain
D) Thalamus
41. Which first-order neuron receives impulses by medium-sized myelinated nerve fibers?
65
42. Where do the axons from the Nuclei of Substantia gelatinosa of Rolandi ascend after crossing to
the opposite side?
A) Lateral column
B) Ventral column
C) Medulla
D) Thalamus
43. Which sensory tract carries proprioception and fine touch from the opposite side of the body?
A) Gracile Tract
B) Cuneate Tract
44.Where do the axons from the Posterolateral ventral nucleus of the thalamus ascend after crossing
to the opposite side?
B) Medulla
C) Thalamus
D) Midbrain
45. Which sensory tract carries sensations originating from the same side of the body?
A) Gracile Tract
B) Cuneate Tract
46. Which receptors are involved in proprioception and fine touch?
B) Merkel's disc
C) Pacinian corpuscles
47. Where do the axons from the Gracile and Cuneate nuclei cross to the opposite side?
A) Ventral column
B) Lateral column
C) Medulla
D) Thalamus
48. Which sensory tract carries sensations originating from the opposite side of the body?
A) Gracile Tract
B) Cuneate Tract
49. Which first-order neuron receives impulses by thick myelinated nerve fibers?
50. Where do the axons from the lateral and ventral spinothalamic tracts ascend after forming the
lemniscus?
A) Pons
B) Medulla
C) Midbrain
D) Thalamus
51. Which sensory tract carries pain and temperature sensations from the opposite side of the body?
A) Gracile Tract
B) Cuneate Tract
66
52. Which receptors are involved in sensing pain and temperature?
B) Merkel's disc
C) Ruffini's corpuscles
D) Pacinian corpuscles
53. Where do the axons from the Main sensory nucleus ascend after crossing to the opposite side?
B) Ventral column
C) Medulla
D) Thalamus
54. Which sensory tract carries simple (crude) touch sensations from the opposite side of the body?
A) Gracile Tract
B) Cuneate Tract
55. Where do the axons from lateral and ventral spinothalamic tracts form the lemniscus?
A) Pons
B) Medulla
C) Midbrain
D) Thalamus
56. Which first-order neuron receives impulses by medium-sized myelinated nerve fibers?
57. Where do the axons from the Nuclei of Substantia gelatinosa of Rolandi ascend after crossing to
the opposite side?
A) Lateral column
B) Ventral column
C) Medulla
D) Thalamus
58. Which sensory tract carries proprioception and fine touch from the opposite side of the body?
A) Gracile Tract
B) Cuneate Tract
59. Where do the axons from the Posterolateral ventral nucleus of the thalamus ascend after crossing
to the opposite side?
B) Medulla
C) Thalamus
D) Midbrain
60. Which sensory tract carries sensations originating from the same side of the body?
A) Gracile Tract
B) Cuneate Tract
61. Which of the following best describes the function of the medial lemniscus?
A) Carries pain and temperature sensations
B) Carries proprioception and fine touch sensations
C) Carries crude (simple) touch sensations
D) Carries motor signals from the brainstem
67
62. The spinal lemniscus is responsible for carrying which types of sensory information?
A) Pain and temperature sensations
B) Proprioception and fine touch sensations
C) Crude (simple) touch sensations
D) Motor signals from the brainstem
63. Where does the medial lemniscus terminate before transmitting sensory information to the
cerebral cortex?
A) Medulla
B) Pons
C) Thalamus
D) Hypothalamus
64. Tabes dorsalis is characterized by bilateral degeneration of which tracts?
A) Medial lemniscus
B) Spinal lemniscus
C) Gracile and cuneate tracts
D) Lateral spinothalamic tract
65. Which condition results in loss of pain and temperature sensations in the upper limbs and chest,
while touch sensation remains intact?
A) Syringomyelia
B) Tabes dorsalis
C) Multiple sclerosis
D) Parkinson's disease
66. What causes pressure on the lateral spinothalamic tract in syringomyelia?
A) Bilateral degeneration of gracile and cuneate tracts
B) Congenital cystic dilatation of the central canal of the spinal cord
C) Neurosyphilis infection
D) Traumatic injury to the spinal cord
67. In tabes dorsalis, patients may present with which of the following symptoms?
A) Sensory ataxia
B) Loss of proprioception and fine touch
C) Difficulty identifying objects with closed eyes
D) All of the above
68. Which part of the brainstem does the medial lemniscus ascend through?
A) Midbrain
B) Pons
C) Medulla
D) Cerebellum
69. Dissociated sensory loss, where pain and temperature sensations are lost while touch remains
intact, is commonly seen in which condition?
A) Syringomyelia
B) Tabes dorsalis
D) Parkinson's disease
70. Which sensory tracts form the spinal lemniscus?
A) Gracile and cuneate tracts
B) Lateral and ventral spinothalamic tracts
C) Medial lemniscus
D) Dorsal and ventral spinocerebellar tracts
71. Which of the following is NOT a function of the medial lemniscus?
A) Carries proprioception and fine touch sensations
B) Terminates in the hypothalamus
C) Ascends through the brainstem
D) Carries sensory information to the cerebral cortex
68
72. What is the main cause of tabes dorsalis?
A) Traumatic injury to the spinal cord
B) Neurosyphilis infection
C) Congenital anomaly of the spinal cord
D) Multiple sclerosis
73. Which of the following tracts is responsible for carrying proprioception and fine touch sensations
from the opposite side of the body?
A) Spinal lemniscus
B) Medial lemniscus
C) Lateral spinothalamic tract
D) Rubrospinal tract
74. What is the characteristic presentation of syringomyelia?
A) Sensory ataxia and gait disturbance
B) Loss of proprioception and fine touch
C) Loss of pain and temperature sensations in upper limbs and chest
D) All of the above
75. In syringomyelia, which part of the spinal cord is affected?
A) Lower cervical and upper thoracic regions
B) Lumbar region
C) Sacral region
D) Cervical region
76. Which structure in the brainstem does the spinal lemniscus ascend through?
A) Midbrain
B) Pons
C) Medulla
D) Cerebellum
77. Which condition results in dissociated sensory loss?
A) Parkinson's disease
B) Tabes dorsalis
D) Syringomyelia
78. What type of sensory information does the spinal lemniscus primarily carry?
A) Proprioception and fine touch sensations
B) Pain and temperature sensations
C) Crude (simple) touch sensations
D) Motor signals from the brainstem
79. Which tract arises from the lateral spinothalamic tract to form the spinal lemniscus?
A) Medial lemniscus
B) Dorsal spinocerebellar tract
C) Ventral spinocerebellar tract
80. Where do the axons of the medial lemniscus terminate before reaching the sensory areas of the
cerebral cortex?
A) Medulla
B) Pons
C) Thalamus
D) Hypothalamus
81. Which tract carries proprioceptive sensations from the lower half of the body to the cerebellum?
A) Dorsal Spinocerebellar Tract
B) Ventral Spinocerebellar Tract
C) Spino-Olivary Tract
69
82. The Spino-Olivary Tract terminates in which nucleus?
A) Posterolateral ventral nucleus
B) Inferior olivary nucleus
C) Superior colliculus
D) Clark's nucleus
83. Which tract carries spino visual reflexes to the superior colliculus in the midbrain?
84. Descending motor tracts from cerebral cortex to the ant. horn cells of spinal cord are known as:
A) Pyramidal tracts
B) Extrapyramidal tracts
C) Dorsal Spinocerebellar Tracts
D) Ventral Spinocerebellar Tracts
85. Where do cortico-spinal tracts originate from?
A) Betz cells and other pyramidal nerve cells in the lower 3/1 of motor area 4
B) Motor area 8 in the frontal lobe of the cerebral cortex
C) Betz cells and other pyramidal nerve cells in the upper 3/2 of motor area 4
D) Clark's nucleus
86. Which tract regulates movements of muscles of face, mastication, pharynx, eye movements?
A) Cortico-spinal Tracts
B) Cortico-bulbar Tracts
C) Spino-Tectal Tract
D) Dorsal Spinocerebellar Tract
87. The majority of fibers in cortico-spinal tracts cross to the opposite side at the:
B) Sensory decussation in the closed medulla
C) Sensory decussation in the open medulla
D) Spinal lemniscus
88. Which tract carries proprioceptive sensations from the upper half of the body to the cerebellum?
89. The Spino-Tectal Tract terminates in which structure?
D) Clark's nucleus
90. Which tract carries proprioceptive sensations from Clark's nucleus in the same and opposite sides
of the lower half of the body?
91. The lateral cerebellar tract ascends in which column of the spinal cord?
A) Medial column
B) Lateral column
C) Ventral column
D) Posterior column
70
92. Where do cortico-bulbar tracts terminate?
A) Anterior horn cells of the spinal cord
B) Posterolateral ventral nucleus
C) Motor nuclei of cranial nerves
D) Inferior olivary nucleus
93. What is the function of cortico-spinal tracts?
A) Carrying proprioceptive sensations to the cerebellum
B) Regulating movements of muscles of the face, mastication, pharynx, and control eye movements
C) Carrying voluntary movements and fine motor skills
D) Carrying pain, temperature, and crude touch sensations
94. Which tract carries proprioceptive sensations from Clark's nucleus in the same side cervical and
thoracic regions?
95. Where does the Spino-Olivary Tract terminate?
D) Clark's nucleus
96. What is the course of the medial lemniscus?
A) Ascends in the lateral column of the spinal cord
B) Descends in the medial column of the spinal cord
C) Ascends in the pons and midbrain
D) Descends in the brainstem to the spinal cord
97. Which tract carries proprioceptive sensations from the lower half of the body to the cerebellum?
98. The cortico-spinal tracts originate from which area of the cerebral cortex?
A) Motor area 4
B) Motor area 8
C) Sensory area 3
D) Sensory area 1
99. Which tract carries spino visual reflexes to the superior colliculus in the midbrain?
100. The ventral cortico-spinal tract descends:
A) Uncrossed on the same side of the spinal cord
B) Crossed to the opposite side of the spinal cord
C) In the lateral column of the spinal cord
D) In the medial column of the spinal cord
101. Where do cortico-bulbar tracts originate from?
A) Motor area 4
B) Motor area 8
C) Sensory area 3
D) Sensory area 1
71
102. Which tract carries proprioceptive sensations from the upper half of the body to the cerebellum?
103. The lateral cerebellar tract ascends in which column of the spinal cord?
A) Medial column
B) Lateral column
C) Ventral column
D) Posterior column
104. What is the function of cortico-bulbar tracts?
A) Carrying proprioceptive sensations to the cerebellum
B) Regulating movements of muscles of the face, mastication, pharynx, and control eye movements
C) Carrying voluntary movements and fine motor skills
D) Carrying pain, temperature, and crude touch sensations
105. The majority of fibers in cortico-spinal tracts cross to the opposite side at the:
B) Sensory decussation in the closed medulla
C) Sensory decussation in the open medulla
D) Spinal lemniscus
106. Which tract carries proprioceptive sensations from Clark's nucleus in the same and opposite
sides of the lower half of the body?
107. The Spino-Tectal Tract terminates in which structure?
D) Clark's nucleus
thoracic regions?
109. Where does the Spino-Olivary Tract terminate?
D) Clark's nucleus
thoracic regions?
111. What is the shape of the histological section of the cervical region of the spinal cord?
A) Circular
B) Oval
C) Rectangular
D) Triangular
72
112. Which region of the spinal cord has thin and diverging posterior horns?
A) Thoracic
B) Lumbar
C) Cervical
D) Sacral
113. Which nuclei are located in the anterior horn of the grey matter?
A) Sensory nuclei
B) Commissural nuclei
C) Motor nuclei
114. Which tract is responsible for proprioception and fine touch sensations?
A) Dorsal spinocerebellar tract
B) Lateral spinothalamic tract
115. Which tract carries pain and temperature sensations?
A) Gracile tract
B) Rubrospinal tract
D) Lateral spinothalamic tract
116. Which nucleus is found in the posterior horn of the grey matter?
A) Main sensory nucleus
B) Central motor nucleus
C) Anterior commissural nucleus
D) Anterior medial motor nucleus
117. Which tract is responsible for connecting the spinal cord with the cerebellum?
A) Lissauer's tract
B) Rubrospinal tract
D) Spinotectal tract
118. Which descending tract originates from the red nucleus in the midbrain?
A) Rubrospinal tract
B) Lateral reticulospinal tract
C) Ventral tectospinal tract
D) Ventral reticulospinal tract
119. Which nuclei are responsible for crossing sensory fibers in the spinal cord?
A) Commissural nuclei
B) Motor nuclei
C) Sensory nuclei
120. Which tract carries sensory information related to pain, temperature, and crude touch?
A) Gracile tract
B) Ventral spinocerebellar tract
C) Lateral spinothalamic tract
D) Spinotectal tract
121. What is the function of the anterior medial motor nucleus?
A) Proprioception
B) Fine touch
C) Motor control of axial muscles
D) Motor control of upper limbs
122. Which descending tract originates from the olivary nucleus in the medulla oblongata?
A) Rubrospinal tract
B) Olivospinal tract
C) Ventral reticulospinal tract
D) Lateral vestibulospinal tract
73
123. Which tract carries sensory information related to proprioception and fine touch?
A) Lateral spinothalamic tract
B) Ventral spinocerebellar tract
C) Dorsal spinocerebellar tract
D) Gracile tract
124. What is the function of the sulcomarginal tract?
A) Motor control of axial muscles
B) Motor control of upper limbs
C) Integration of sensory information
D) Balance and coordination
125. Which descending tract is involved in motor control of the axial muscles and upper limbs?
A) Lateral reticulospinal tract
B) Ventral tectospinal tract
C) Ventral vestibulospinal tract
ANSWERS
1. B 26. B 51. C 76. B 101. B
2. B 27. B 52. A 77. D 102. B
3. B 28. D 53. A 78. B 103. B
4. C 29. D 54. D 79. A 104. B
5. C 30. C 55. B 80. C 105. B
6. C 31. A 56. C 81. A 106. A
7. B 32. D 57. B 82. B 107. C
8. B 33. B 58. A 83. D 108. B
9. B 34. A 59. A 84. A 109. B
10. A 35. C 60. A 85. C 110. B
11. D 36. A 61. B 86. B 111. B
12. C 37. A 62. A 87. B 112. C
13. B 38. D 63. C 88. B 113. C
14. B 39. A 64. C 89. C 114. A
15. C 40. B 65. A 90. A 115. D
16. C 41. C 66. B 91. B 116. A
17. B 42. B 67. D 92. C 117. C
18. D 43. A 68. C 93. C 118. A
19. C 44. A 69. A 94. B 119. A
20. C 45. A 70. B 95. B 120. C
21. C 46. B 71. B 96. C 121. C
22. B 47. C 72. B 97. A 122. B
23. C 48. C 73. B 98. A 123. C
24. C 49. A 74. D 99. D 124. D
25. A 50. C 75. A 100. A 125. D
74

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LYMPHATIC ORGANS

Primary Lymphatic Organs : Thymus & bone marrow.

Splenic cords (Billroth cords) Blood sinusoids

- Lined with fenestrated endothelium.

PAROTID GLAND SUBMANDIBULAR GLAND

induces fat breakdown in fat androgens and

- Differences between Adrenal Cortex and Medulla:

THYROID AND PARATHYROID GLAND

Pneumocyte type I Pneumocyte type II

ADULT LUNG TRACHEA

UTERUS VAGINA LACTATING MAMMARY GLAND PROSTATE

PROPRIOCEPTION PATHWAY PAIN ,TEMPERATURE & SIMPLE TOUCH

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