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PDQ* SERIES ACKERMANN PDQ PHYSIOLOGY BAKER, MURRAY PDQ BIOCHEMISTRY CORMACK PDQ HISTOLOGY DAVIDSON PDQ MEDICAL GENETICS JOHNSON PDQ PHARMACOLOGY, 2/e KERN PDQ HEMATOLOGY McKIBBON PDQ EVIDENCE-BASED PRINCIPLES AND PRACTICE NORMAN, STREINER PDQ STATISTICS, 3/e SCIUBBA, REGEZI, ROGERS PDQ ORAL DISEASE: DIAGNOSIS AND TREATMENT STREINER, NORMAN PDQ EPIDEMIOLOGY, 2/e * PDQ (Pretty Darned Quick) PDQ HISTOLOGY DAVID H. CORMACK, PHD Professor Emeritus Division of Anatomy, Department of Surgery University of Toronto Toronto, Ontario with illustrations by Monique Guilderson, BSc., MSc., BMC 2003 BC Decker Inc Hamilton • London Exit BC Decker Inc P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7 Tel: 905-522-7017; 800-568-7281 Fax: 905-522-7839; 888-311-4987 E-mail: [email protected] www.bcdecker.com © 2003 BC Decker Inc All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by an means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher. 02 03 04 05/ PC /9 8 7 6 5 4 3 2 1 ISBN 1-55009-187-5 Printed in Canada Sales and Distribution United States BC Decker Inc P.O. Box 785 Lewiston, NY 14092-0785 Tel: 905-522-7017; 800-568-7281 Fax: 905-522-7839; 888-311-4987 E-mail: [email protected] www.bcdecker.com Singapore, Malaysia,Thailand, Philippines, Indonesia, Vietnam, Pacific Rim, Korea Elsevier Science Asia 583 Orchard Road #09/01, Forum Singapore 238884 Tel: 65-737-3593 Fax: 65-753-2145 Canada BC Decker Inc 20 Hughson Street South P.O. 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Maurílio Biagi, 2850 City Ribeirão Preto – SP – CEP: 14021-000 Tel: 0800 992236 Fax: (16) 3993-9000 E-mail: [email protected] Notice: The authors and publisher have made every effort to ensure that the patient care recommended herein, including choice of drugs and drug dosages, is in accord with the accepted standard and practice at the time of publication. However, since research and regulation constantly change clinical standards, the reader is urged to check the product information sheet included in the package of each drug, which includes recommended doses, warnings, and contraindications. This is particularly important with new or infrequently used drugs. Any treatment regimen, particularly one involving medication, involves inherent risk that must be weighed on a case-by-case basis against the benefits anticipated. The reader is cautioned that the purpose of this book is to inform and enlighten; the information contained herein is not intended as, and should not be employed as, a substitute for individual diagnosis and treatment. Preface I t is my sincere hope that this short laboratory guide will turn out to be a handy study aid for those histology students who, because of inexperience, are nervous about becoming overwhelmed by too much histologic detail. In keeping with the approach taken by the other books in the PDQ series, it deals only with basics, which it presents in a reasonably rational manner. Because PDQ Histology focuses the reader’s attention on the main structural features found in standard sections taken from the student’s slide box and emphasizes the particular combination of histologic criteria that characterizes each section, it represents a minireview of the distinctive microscopic features that permit histologic preparations of the various tissues and organs of the body to be correctly identified. Included on the accompanying CD-ROM are representative selections of review questions, sample multiple-choice questions, and temporarily unidentified test sections available for private assessment of the reader’s comprehension and proficiency at appropriate stages in the course of study. Along with a good slide box, microscope, labeled relevant photomicrographs, and the timely assistance of expert slide interpreters, histology students generally appreciate being provided with a fairly nitty-gritty approach to slide identification. PDQ Histology is designed to help beginners to make a productive start and then to keep them firmly on the rails. To advance, students should, of course, endeavor to supplement their knowledge base with further relevant information that they are receiving from lectures, other textbooks, atlases, and recommended additional sources. Before long, diligent students will find that they are able to compile other reliable recognition features of their own. By learning how to rationalize test situation responses, they will soon be able to avoid flagrant guesswork and with sufficient practice will attain self-confidence in microscopic identification of tissues. David H. Cormack January 2003 Contents Preface, v 1 Introduction: Cells and Tissues, 1 2 Epithelial Tissue, 19 3 Connective Tissue, 35 4 Cartilage and Bone, 45 5 Blood and Myeloid and Lymphoid Tissues, 61 6 Nervous Tissue, 83 7 Muscle, 99 8 Circulatory System, 109 9 Integumentary System, 119 10 Digestive System, 129 11 Respiratory System, 145 Contents 12 Urinary System, 155 13 Endocrine System, 169 14 Female Reproductive System, 185 15 Male Reproductive System, 201 Index, 214 vii PDQ Histology 1 Introduction: Cells and Tissues A fundamental concept of body structure is that its interior represents an intricate assembly of distinct body tissues. The constituent cells of these tissues are so frail that they generally require the support of extracellular matrix (ECM), but certain tissues have a minimal amount of this component and others have an ECM that is represented by a fluid. The least conspicuous tissue component at a microscopic level is a body fluid, predominantly interstitial (tissue) fluid and, less commonly, blood plasma or lymph. A profusion of functional cell products passes into these body fluids from the tissues, ranging from secreted matrix constituents and plasma proteins to hormones and various other signaling molecules. Histology is essentially the study of the body tissues. Although there are only four basic tissues, some have variant and special subtypes, as shown in Table 1–1. Organs and body parts are all constructed from these four basic tissues and their subtypes. Histology also addresses the question of how tissue cells carry out body processes at the cellular level. By describing major body functions in terms of the relevant tissues and their distinctive cell structure, it serves as a structural foundation for allied and applied health sciences such as physiology, biochemistry, hematology, and pathology. 1 2 PDQ HISTOLOGY Table 1–1 Four Basic Tissues with Their Subtypes Epithelial tissue Epithelial membranes Epithelial glands Connective tissue Loose (areolar) tissue Nervous tissue Muscle tissue Skeletal muscle Cardiac muscle Smooth muscle Dense ordinary (fibrous) tissue Adipose (fat) Cartilage Bone Blood cells Myeloid tissue Lymphoid tissue MICROSCOPES The chief tool at the histologist’s disposal is the light microscope (LM). Providing two-staged magnification (Figure 1–1), the LM has as its basis (1) an objective lens assembly and (2) an ocular (eyepiece) lens assembly. For an eye unaided by any magnifying device, the minimal distance between two adjacent points in a specimen that is necessary for these to be distinguishable as separate entities (ie, retinal resolution) is 0.2 mm. Magnifications up to 1,000, obtainable with the LM, enable small details up to 0.2 µm apart to be discerned, but because 0.2 µm is the LM’s absolute limit of resolution, any further photographic enlargement exceeding 1,400 discloses no further details. Another limitation of the LM is that incident light must pass through the specimen viewed. Tissue slices (sections) or suitably thin alternative preparations are therefore necessary. Also, appropriate histologic stains (dyes) are required for most tissue components to be seen clearly, so the tissue is routinely fixed (killed and preserved with 4% aqueous formaldehyde or some other protein coagulant) and processed further to permit its sectioning and enhance its staining. The necessary harsh treatment can cause unintentional distortion that may complicate the interpretation of LM appearance. An atypical histologic appearance may indicate inadequate fixation or excessive shrinkage during tissue processing. Further information about the LM and some hints on how to get it to perform properly may be found in the accompanying CD-ROM. Chapter 1 Introduction: Cells and Tissues 3 Image on retina Eyepiece lenses Intermediate image in optical path Objective lenses Section on stage Condenser lenses Lamp Figure 1–1 Optical path of the light microscope. When higher magnifications and better resolution are required, an electron microscope (EM) is used instead. The transmission electron microscope (TEM) operates in a manner similar to the LM but uses a beam of electrons instead of incident light. The scanning electron microscope (SEM) is somewhat different in design. When its narrow electron beam tracks back and forth across a metallic or metal-coated surface, electrons secondarily emitted or reflected from the metal are collected. The resulting signal is processed to produce a three-dimensional-looking television image (scan) of the scanned surface. The usual kind of electron micrograph found in histology texts and atlases (see Figure 1–5) is obtained with a TEM, which can provide magnifications up to 50,000 and resolve details that are 1 nm apart. This greater resolution is achieved by using an electron beam instead of light. Resolution is proportional to wavelength, and the wavelength of an electron beam is over 1,000 times shorter than that of light. Resolution in scanning electron micrographs, which are encountered less commonly in histology courses, is generally limited to about 15 nm by the coating thickness, but SEM resolutions of 3 nm are technically possible. 4 PDQ HISTOLOGY When EM sections of a tissue are viewed with the TEM following fixation with glutaraldehyde and appropriate staining with heavy metals, electrons pass unimpeded through areas where tissue components remain unstained, whereas stained components scatter electrons out of the beam. Through photographic reversal of the image on the viewing screen, electrondense components of the tissue accordingly appear black and electron-lucent components appear white in the reversed prints (electron micrographs). Although three-dimensional imaging of biologic surfaces is possible with the SEM, routine photomicrographs and micrographs show tissues and organs in section, so it is important to try to visualize the three-dimensional structure of a living tissue or organ before it was fixed, distorted by tissue preparation, sectioned, and stained. INTERPRETING TISSUE SECTIONS When confronted with histologic sections, beginning students often ask what they are supposed to see. A generalized answer is either individual cells or aggregates of cells forming some characteristic arrangement with the ECM. Indeed, many organs and tissues are recognizable histologically by their distinctive arrangement of cells and ECM. Some detailed mental reconstruction is generally necessary before histologic sections can be visualized in three dimensions. An initial general impression to seek is whether the composition of the tissue or organ is predominantly cellular (Figure 1–2) or predominantly ECM (Figure 1–3). Another useful clue is whether the structure seems solid, perforated with spaces, or hollow. Preliminary observation under scanning power (30) or low power (100) generally provides helpful information before details are sought. Lower magnifications are often more informative than high ones, particularly for organ identification. Chapter 1 Introduction: Cells and Tissues Figure 1–2 Liver tissue made up chiefly of cells. Extracellular matrix Cells Figure 1–3 Elastic cartilage tissue made up chiefly of extracellular matrix. 5 6 PDQ HISTOLOGY CELLS The appearance of cells in LM sections of liver may be seen in Figure 1–4. The central spherical nucleus houses the cell’s complement of chromosomes that contain gene-bearing deoxyribonucleic acid (DNA). The darkly stained structure toward the nuclear center, the nucleolus, is the site of production of ribosomal RNA (rRNA). The other darkly stained material in the nucleus, heterochromatin (condensed chromatin), represents genetically inactive DNA that is not being transcribed, that is, copied from DNA to RNA for protein synthesis. The outer part of the cell, its cytoplasm, derives energy through cell metabolism and synthesizes proteins. Few details of its internal structure are seen in routine histologic sections because the cytoplasmic organelles are so small, so the EM, with its higher resolution, is generally employed instead. The perimeter of each cell is sometimes difficult to discern in LM sections (see Figure 1–4), generally because it lies at the wrong angle for good visibility. The cell membrane itself is not thick enough to be resolved in the LM. Nucleus Nucleolus Cell boundary Figure 1–4 Light microscopic appearance of hepatocytes. Cytoplasm Chapter 1 Introduction: Cells and Tissues 7 Figure 1–5 shows an example of cell and ECM appearance at the EM level. The chief cytoplasmic organelles and their functions are summarized in Table 1–2. For further information, see Web site links in the accompanying CD-ROM. Lysosome Extracellular matrix Rough-surfaced endoplasmic reticulum Nuclear envelope Heterochromatin Cell membrane Figure 1–5 Electron microscopic appearance of chondrocytes and their associated extracellular matrix. 8 PDQ HISTOLOGY Table 1–2 Main Components of Cytoplasm Component Cell membrane Cytosol Structure Chief Functions Fluid lipid bilayer with integral and peripheral proteins and cell coat on external surface Semifluid with minimal internal support Regulates molecular exchanges with tissue fluid, responds to signals Contains soluble molecules and cytoplasmic organelles and inclusions Synthesizes lipids and steroids, segregates calcium in muscle cells, metabolizes drugs and glycogen in hepatocytes Incorporates integral membrane proteins, segregates secretory and lysosomal proteins in its lumen Completes glycosylation of glycoproteins, modifies and sorts secretory products, distributes secretory proteins to secretory vesicles, sends acid hydrolases to lysosomes Convey secretory proteins from Golgi apparatus to cell surface Smooth-surfaced endoplasmic reticulum Branched tubular system of smooth intracellular membrane Rough-surfaced endoplasmic reticulum Parallel flat membranous cisternae with bound ribosomes Golgi apparatus Saucer-shaped stack of flat smooth membranous saccules Secretory vesicles Spherical smooth membranous saccules containing secretory proteins Lysosomes Small spherical smooth membranous saccules containing acid hydrolases Segregate destructive enzymes for general use in intracellular digestion Mitochondria Outer and inner limiting membranes, cristae, internal mitochondrial matrix Produce ATP through oxidative phosphorylation Ribosomes Electron-dense ribonucleoprotein particles present as subunits Provide sites where amino acids are assembled in the order specified in mRNA sequences Microtubules Unbranched tubular assemblies of tubulin subunits, 25 nm in diameter, single and assembled into centrioles, cilia, and flagella Provide support, guide intracellular transport, provide ciliary and flagellar motility Continued Chapter 1 Introduction: Cells and Tissues 9 Table 1–2 (Continued) Main Components of Cytoplasm Component Structure Chief Functions Microfilaments (equivalent to thin filaments) Actin-containing 7 nm rods Interact with thick filaments in contractions, support microvilli Thick filaments Myosin-containing 12–16 nm rods Interact with microfilaments or thin filaments in contractions Intermediate filaments Heterogeneous class of 10 nm rods Provide support, distribute stresses ATP = adenosine triphosphate; mRNA = messenger ribonucleic acid. STAINS A stain combination routinely used for histologic sections is hematoxylin and eosin (H&E). Unless otherwise stated, the photomicrographs in this book show sections that have been stained in this manner. Hematoxylin, a treederived dye combined with Al3+ ions, colors negatively charged components blue or purple. Eosin is a negatively charged stain that colors positively charged components pink or red. Basophilic components stain with hematoxylin (a basic stain); acidophilic components stain with eosin (an acid stain). When a blood stain is used, basophilic and acidophilic constituents stain equivalent blue and pink colors. Periodic acid–Schiff (PAS) staining generates aldehyde groups in glycoproteins and polysaccharides and discloses these as magenta or purple dye complexes. Tissue components staining blue in H&E sections • • • contain macromolecules having a net negative charge, for example, DNA, RNA (nucleic acids are rich in PO43– groups); have an affinity for hematoxylin because of its associated Al3+ ions; include nuclear chromatin, nucleoli, and cytoplasmic ribosomes. Tissue components staining pink in H&E sections • • • contain macromolecules having a net positive charge in the staining pH range of 5 to 6, for example, fixed proteins with amino groups ionized to –NH3+, take up eosin because it has a negative charge, and are in most cases proteins. Tissue components staining magenta in PAS sections • • may be secretory glycoproteins; may be glycogen, a stored polysaccharide. After H&E staining, why does the cell cytoplasm appear essentially pink in Figure 1–6 and comparatively blue in Figure 1–7 and have areas of each 10 PDQ HISTOLOGY Figure 1–6 Pink-stained cytoplasm in skeletal muscle fibers. Osteoblasts Figure 1–7 Blue-stained cytoplasm in osteoblasts. color in Figure 1–8? What does this staining reveal about the particular functions of each cell type? The cytoplasm of muscle fibers (see Figure 1–6) • has a high concentration of structural proteins (actin, myosin, etc) that are moderately acidophilic, and Chapter 1 • Introduction: Cells and Tissues 11 is functionally specialized for contraction. The cytoplasm of osteoblasts (see Figure 1–7) • • contains abundant ribosomes, and therefore basophilic RNA, bound to its rough-surfaced endoplasmic reticulum (rER); is functionally specialized for secretion (bone matrix constituents). The cytoplasm of pancreatic acinar cells (see Figure 1–8) • • • contains abundant ribosomes, and therefore basophilic RNA, bound to its rER; contains abundant secretory vesicles with acidophilic secretory protein content; is functionally specialized for the synthesis and release of stored acidophilic secretory proteins (digestive enzymes). Alternative staining can provide supplementary information. For example, the surface epithelium stained with H&E in Figure 1–9 exhibits round, virtually colorless gaps containing some constituent with negligible affinity for either stain. A PAS-stained section (Figure 1–10) discloses magentacolored mucus at these sites, indicating that the white gaps are goblet cells Figure 1–8 Pink- and blue-stained cytoplasmic components in pancreatic acinar cells. 12 PDQ HISTOLOGY Figure 1–9 Goblet cells in a hematoxylin and eosin–stained section of the small intestine. Figure 1–10 Goblet cells in a periodic acid–Schiff–stained section of the small intestine. Chapter 1 Introduction: Cells and Tissues 13 (glycoprotein-secreting surface epithelial cells). Special staining methods are occasionally preferable, notably silver impregnation for nervous tissue and immunohistochemical staining for specific proteins. NUCLEAR APPEARANCE Functional activity may be reflected in the appearance of the nucleus as well as the cytoplasm. Cells that are actively synthesizing proteins, for example, often exhibit a large nucleolus (see Figure 1–4) because they require an abundance of the rRNA exclusively transcribed there. It is equally important to be able to recognize mitotic (dividing) cells because the proportion and LM appearance of dividing cells can have diagnostic value. Mitotic figures may be spotted under low magnification (Figure 1–11). At higher magnification, the individual rod-shaped chromosomes may be discernible (Figure 1–12). Mitotic figures Figure 1–11 Mitotic figures present in crypt bases of the small intestine. 14 PDQ HISTOLOGY Anaphase Figure 1–12 Mitotic figure seen in more detail (crypt of small intestine). Chapter 1 Introduction: Cells and Tissues The process of mitosis is summarized in Figure 1–13. Polar microtubules form between centriole pairs Prophase Chromosomes become thread-like Nuclear envelope starts fragmenting Metaphase Kinetochore microtubules form in mitotic spindle Chromosomes (two chromatids in each) align in equatorial plane Anaphase Kinetochore microtubules shorten Spindle elongates due to sliding between opposed polar microtubules Chromatids separate, move toward poles Nuclear envelope re-forms Telophase Daughter chromosomes (formerly the chromatids) segregate Equatorial region constricts Residual microtubules form midbody Figure 1–13 The stages of mitosis. 15 16 PDQ HISTOLOGY Appropriate preparation and special staining of isolated mitotic cells allow specific identification of the chromosomes they contain (Figure 1–14). An assembled chromosome map obtained from a representative cell is called a person’s karyotype. Figure 1–14 Chromosomes isolated from a mitotic cell and stained to show their chromosome bands. Another important distinction that needs to be made is between mitotic cells and dying cells. Sometimes both are present in the same field of view. All stages of mitosis except early prophase are recognizable by the presence of dark-staining chromosomes and the absence of an intact nuclear envelope (Figure 1–15). Dying or dead cells, on the other hand, exhibit terminal disintegration of their nucleus (karyorrhexis), extreme condensation and heavy (heterochromatic) staining of its chromatin (pkynosis), or unusually pale heterochromatin staining (karolysis). Examples of these changes are shown in Figure 1–16. Chapter 1 Introduction: Cells and Tissues Anaphase Metaphase Figure 1–15 Mitotic figures in dividing hepatoma cells. Pyknosis Karyorrhexis Figure 1–16 Nuclear signs of cell death. Karyolysis 17 18 PDQ HISTOLOGY Finally, a few cell types, for example, osteoclasts (Figure 1–17) and skeletal muscle fibers (see Figure 1–6), possess more than one nucleus. In these cases, the multinucleate condition is a consequence of cell fusion. Human erythrocytes (red blood cells) possess no nucleus because it is discarded at a late precursor stage. Osteoclasts Figure 1–17 Multiple nuclei in osteoclasts. 2 Epithelial Tissue B ody cavities are lined with extensive cellular sheets known as epithelial membranes (epithelia). The body also has a protective epithelial covering termed the epidermis. Epithelia are invaginated at certain sites, extending into adjacent connective tissue as epithelial glands. Epithelial tissue accordingly consists of epithelial membranes and glands. EPITHELIAL MEMBRANES The constituent cells of epithelial membranes are clearly polarized in structure. Their free (luminal or apical) surface borders on the lumen of a body compartment or the exterior of the body. A well-defined extracellular matrix layer known as a basement membrane (basal lamina) attaches their basal surface to adjacent connective tissue. This special matrix layer is described in Chapter 3, “Connective Tissue.” The diverse functional roles of epithelia include protection, absorption, secretion, transcellular transport, restriction of diffusion, and provision of sensory function. Progressive cell renewal through mitosis in basal layers of epithelia is their chief means of maintaining structural integrity. Because epithelial tissue is entirely avascular, its cells typically obtain oxygen and nutrients by diffusion from capillaries of adjacent loose connective tissue. Subtypes Epithelial membranes are characterized by the number of constituent cell layers and cell shape at their free surface (Table 2–1). Typical examples of simple epithelia as they appear in hematoxylin and eosin (H&E) sections are shown in Figures 2–1, 2–2, and 2–3. 19 20 PDQ HISTOLOGY Table 2–1 Epithelial Membranes Simple—a monolayer of cells Squamous—flat shape Cuboidal—short, roughly square in sections Columnar—tall and narrow Pseudostratified—all cells are attached to the basement membrane but some do not reach the free surface, giving a false impression of stratification Columnar Ciliated columnar—commonly with goblet cells Stratified—more than one layer of cells Squamous—cuboidal basal cells, flat surface cells Keratinized—flat keratinized cells on free surface Nonkeratinized—flat nonkeratinized cells on free surface Cuboidal—usually 2 layers, lines small ducts Columnar—usually 2 layers, lines larger ducts Transitional—bulging surface cells become flat if epithelium is stretched Simple squamous epithelium Figure 2–1 Simple squamous epithelium. Simple cuboidal epithelium Figure 2–2 Simple cuboidal epithelium. Chapter 2 Epithelial Tissue 21 Simple columnar epithelium Figure 2–3 Simple columnar epithelium. The pseudostratified epithelium lining the main airways (Figure 2–4) possesses goblet cells and cilia that act together to trap and clear away any inhaled suspended particles that settle. Cilia are hair-like motile cytoplasmic processes that project from the luminal surface of the epithelium. Using the energy that they release from adenosine triphosphate, they continuously sweep a thin coating of mucus across the luminal surface. Cilia are characterized by nine peripheral pairs of microtubules (doublets that can actively slide past each other) and two central single microtubules (Figure 2–5). The mucus coating that is swept along by the cilia is produced by goblet cells (Figure 2–6) and underlying mixed (seromucous) glands. 22 PDQ HISTOLOGY Cilia Goblet cell Figure 2–4 Ciliated pseudostratified columnar epithelium with goblet cells. Figure 2–5 Electron micrograph of cilia. Chapter 2 Epithelial Tissue 23 Figure 2–6 Electron micrograph of a goblet cell. The chief stratified epithelia are shown in Figures 2–7, 2–8, and 2–9. Cells approaching the surface of stratified squamous keratinizing epithelium become a layer of evaporation-resistant soft keratin termed the stratum corneum (Figure 2–7), whereas those of stratified squamous nonkeratinizing epithelium (Figure 2–8) remain nonkeratinized but still fairly resistant to abrasion. 24 PDQ HISTOLOGY Stratum corneum Basal layer of epithelium Figure 2–7 Stratified squamous keratinizing epithelium. Figure 2–8 Stratified squamous nonkeratinizing epithelium. Chapter 2 Epithelial Tissue 25 Transitional epithelium (see Figure 2–9), confined to the urinary tract, is unique in that, for unknown reasons, some of the large football-shaped cells on its luminal border are multinucleated and a few are polyploid, that is, they contain more than one diploid set of chromosomes. Multinucleated cell Figure 2–9 Transitional epithelium. Cell Junctions Specialized sites known as cell junctions lie on the lateral and basal parts of the epithelial cell membrane (Figure 2–10). Table 2–2 details their various electron microscopic appearances and functions—essentially, cell-to-cell sealing, cell attachment, and direct cell-to-cell communication. 26 PDQ HISTOLOGY Continuous tight junction Adhesion belt A Desmosome Gap junction Hemidesmosome Basement membrane B C Continuous tight Adhesion belt Desmosome Gap Figure 2–10 Epithelial cell junctions. A, Belt-shaped junctions on lateral surfaces. B, Circular junctions on lateral and basal surfaces. C, Detailed structure of cell junctions. Chapter 2 Epithelial Tissue 27 Table 2–2 Principal Cell Junctions Junction Structural Features Function Continuous tight junction (zonula occludens) Circumferential band where aligned integral membrane proteins interlock and form anastomosing ridges By obstructing lateral intercellular spaces, these ridges limit paracellular diffusion at lateral cell borders Adhesion belt (zonula adherens) Circumferential band where linker glycoproteins extend into the intercellular gap, strongly bonding contiguous cell membranes; anchors the marginal band of microfilaments This junction maintains strong cell-to-cell adherence at the site where the attached marginal band contracts Desmosome Circular area where strongly bonding linker glycoproteins form an electron-dense line along midline of the gap; electron-dense plaques along desmosome’s lateral borders anchor intermediate (keratin) filaments Tension in the attached intermediate filaments is resisted by the rivet-like site of strong cell-to-cell adherence Hemidesmosome Circular area on basal surface, Tension in the attached resembling half a desmosome, intermediate filaments where cell membrane, plaque, is resisted by the and anchored intermediate rivet-like site of strong filaments lie apposed to anchorage to the ECM basement membrane Gap junction Circular area containing tiny spool-like assemblies (connexons) of aligned interlocking integral membrane proteins; connexons bridge the intercellular gap and in their open configuration constitute walls of aqueous channels ECM = extracellular matrix. By providing a route for small molecules and ions to diffuse directly from one cell to another, these channels permit metabolic coupling and direct cell-to-cell communication 28 PDQ HISTOLOGY EPITHELIAL GLANDS Glands that release their secretion through a duct are classified as exocrine; those that deliver it directly to the bloodstream are termed endocrine (see Chapter 13, “Endocrine System”). The epithelial components of a gland (its secretory units and ducts) are called its parenchyma; the connective tissue components (loose connective tissue and fibrous capsule) are known as its stroma. Exocrine gland classification is broadly based on the general structure and function of glands (Table 2–3). Table 2–3 Exocrine Epithelial Glands Structural Classification Simple—unbranched duct system Tubular —secretory unit is tubular and in some cases coiled Acinar/alveolar—secretory unit is spherical/flask-shaped Compound—branched duct system Tubular Acinar/alveolar Functional Classification Serous—produces a watery secretion that generally contains some protein Mucous—produces mucus Seromucous (mixed)—possesses separate serous and mucus-secreting cells Other—eg, sebaceous glands producing an oily secretion (sebum) from disintegrated lipid-laden cells Chapter 2 Epithelial Tissue 29 In simple glands, the secretory portion is generally distinguishable from the duct. In the example shown in Figure 2–11, a coiled simple tubular sweat gland, • • • the pale-staining, low columnar epithelial cells are serous secretory cells, the flat nuclei closely apposed to their basal border are those of contractile myoepithelial cells, and the double layer of cuboidal epithelial cells with dark-staining nuclei are duct cells. Secretory portion Duct Figure 2–11 Simple tubular gland (eccrine sweat gland). 30 PDQ HISTOLOGY In compound glands (Figure 2–12), stromal elements such as intralobular loose connective tissue, fibrous interlobular septa, and the fibrous capsule are also recognizable. Intralobular ducts (see Figure 2–14) are the narrow duct branches lying within lobules. Interlobular ducts are the slightly wider branches extending along fibrous septa that delineate lobules. These ducts collect the secretion from intralobular ducts. Hence, the parenchymal organization of a compound gland may be likened to a dormant bush-like tree: • • • • rounded buds = secretory units small twigs = intralobular ducts branches = interlobular ducts trunk = main duct Building on this analogy, a heavy fall of snow covering the tree and filling all its crevices = stromal connective tissue. Secretory unit Interlobular duct Fibrous interlobular septum Intralobular duct Intralobular loose connective tissue Fibrous capsule Figure 2–12 Organization of a compound gland. Chapter 2 Epithelial Tissue 31 Serous secretory units (Figures 2–13 and 2–14) are readily distinguishable from mucous secretory units (Figures 2–13 and 2–15) by the following criteria: Serous cells • • • large spherical nucleus basophilic cytoplasm at base acidophilic secretory granules Mucus-secreting cells • • small flat dark-staining nucleus at base essentially colorless in H&E sections because of their stored mucus Mucous secretory units Serous secretory units Figure 2–13 Mixed (seromucous) gland showing mucous and serous secretory units. 32 PDQ HISTOLOGY Both types of secretory unit may be found in the same gland (see Figures 2–13 and 2–15). The serous and mucous secretory cells of these mixed (seromucous) glands can lie in separate lobules (see Figure 2–13), a common lobule (see Figure 2–15), or a common mixed secretory unit (Figure 2–16). Serous secretory units Intralobular duct Figure 2–14 Serous gland showing serous secretory units and duct. Mucous secretory unit Serous secretory unit Serous cell in mixed secretory unit Figure 2–15 Mixed (seromucous) gland showing mucous, serous, and mixed secretory units. Chapter 2 Epithelial Tissue 33 The serous and mucous cells of a mixed secretory unit release their secretions independently into the same central lumen. Arranged as a cap on one side of the mucous unit, the serous cells in such a unit appear in sections as a serous demilune. Whether this is apparent as a crescent-shaped area depends on the plane of section. Intralobular duct Serous demilune Figure 2–16 Mixed (seromucous) gland showing serous demilunes. 3 Connective Tissue T he three subtypes of connective tissue being considered in this chapter are loose (areolar), dense ordinary (fibrous), and body fat (adipose). In contrast to the extracellular matrix (ECM) that represents the principal constituent of the first two subtypes, the functionally important constituent of adipose tissue is stored lipid. INTERSTITIAL MATRIX The ECM complex of connective tissue, known as the interstitial matrix, contains collagen fibers, elastic fibers, and an amorphous component known as ground substance. Hard to distinguish in hematoxylin and eosin (H&E)stained sections, these intercellular fibers are recognizable in specially stained tissue spreads (Figure 3–1). Representing strong bundles of nonbranching collagen fibrils, collagen fibers can be fairly acidophilic, for example, at sites where they are abundant. They provide substantial tensile strength. Branched, comparatively narrow, straight elastic fibers provide elasticity. Incorporating the protein elastin within a framework of unbranched microfibrils made of glycoproteins called fibrillins, elastic fibers have little affinity for eosin and require special stains (eg, orcein) for their presence to be evident. The finest bundles of collagen fibrils (found, for example, in the liver and myeloid and lymphoid tissues) branch owing to longitudinal bundle splitting. Demonstrable with silver stains, these bundles are called reticular fibers because they constitute an intimate supporting network for cells. Whereas the coarse collagen fibers of connective tissue are assemblies of type I collagen, representing ~ 90% of the total collagen, reticular fibers are assemblies of type III collagen. Both collagen and elastic fibers become assembled interstitially from their respective secreted precursor proteins, procollagen and tropoelastin. The ground substance of connective tissue, essentially colorless in H&E sections, is a hydrated gel containing proteoglycans, the glycosaminoglycan hyaluronic acid, and glycoproteins. This gel plays a key role in nutrient and waste diffusion because it sequesters tissue fluid in its aqueous channels. 35 36 PDQ HISTOLOGY LOOSE CONNECTIVE TISSUE In suitably stained loose connective tissue prepared as a flat spread (see Figure 3–1), it is possible to distinguish • • • • • capillaries (because it is a highly vascular tissue), nuclei of the fibroblasts that secreted ECM macromolecules, conspicuous mast cells full of histamine-containing secretory granules wavy wide collagen fibers made up of fibrils, and straight narrow elastic fibers. It is important to realize that in such preparations, the entire thickness of cells and fibers is seen. Capillary Fibroblast nucleus Mast cell Elastic fiber Figure 3–1 Loose connective tissue spread (special stains). Collagen fiber Chapter 3 Connective Tissue 37 The H&E-stained loose connective tissue shown adjacent to stratified epithelium in Figure 3–2 looks dissimilar from that in Figure 3–1 because it has been sectioned. This is how it is usually seen. Its recognizable characteristics include the following: • • abundant pink collagen fibers numerous capillaries extending into projecting papillae that supply the thick epithelium with nutrients Epithelium Loose connective tissue Figure 3–2 Loose connective tissue in section (lamina propria of the esophagus). 38 PDQ HISTOLOGY Along the interface between loose connective tissue and other tissues such as epithelium, the ECM is organized into a thin sheet of binding matrix called a basement membrane. At this site, laminin, an adhesive glycoprotein with a binding receptor in the cell membrane, is intimately associated with an interstitially assembled meshwork of type IV collagen. Other interstitial glycoproteins and proteoglycans participate in binding the adjacent cells to the interstitial matrix. Basement membrane sites are periodic acid–Schiff positive because of this high glycoprotein content (Figure 3–3). At the electron microscopic level, a cross-section of the basement membrane appears as a thin fuzzy extracellular line of low electron density (lamina densa) situated parallel and adjacent to the basal surface of the attached cells. Basement membrane Figure 3–3 Basement membranes of renal tubules. CONNECTIVE TISSUE CELLS Table 3–1 lists the main characteristics of the cell types found in loose connective tissue. Because this tissue is involved in certain types of immune and inflammatory responses, lymphocytes and neutrophils may also be encountered (see Chapter 5, “Blood and Myeloid and Lymphoid Tissues”). Chapter 3 Connective Tissue 39 Table 3–1 Connective Tissue Cells Cell Type Structural Features Chief Functions Fibroblast Spindle-shaped, basophilic cytoplasm in secretory state Plasma cell Round with basophilic cytoplasm, pale Golgi region, eccentric nucleus with condensed peripheral chromatin Ovoid, eccentric kidney-shaped nucleus sometimes hidden by phagocytosed particles or hemosiderin (hemoglobin breakdown pigment) Secretes fibrous and amorphous interstitial matrix constituents Secretes immunoglobulin Macrophage Mast cell Endothelial cell Pericyte Adipocyte (fat cell) Phagocytoses microorganisms, foreign particles, and cell debris; processes antigens; secretes complement proteins and growth factors Ovoid, central ovoid nucleus Releases histamine and sometimes hidden by granule other inflammatory content, large metachromatic mediators when triggered secretory granules by local trauma or antigen cross-linking of surfacebound immunoglobulin E Squamous epithelial lining cell Regulates production of of blood vessels and lymphatics tissue fluid and fluid exudate, regulates bloodtissue molecular exchanges, releases vasoactive mediators (nitric oxide radical and endothelin 1) Irregularly shaped with long Incompletely differentiated cytoplasmic processes cell persisting as a wrapped around capillaries potential source of new and small venules fibroblasts and smooth muscle cells Large and round, with small Stores and mobilizes lipid flat nucleus at periphery of (long-term energy reserve) large central lipid droplet (which is extracted in tissue processing) 40 PDQ HISTOLOGY Fibroblasts are most readily recognizable at connective tissue sites where they are actively secreting ECM macromolecules (Figure 3–4). Plasma cells, derived from antigen-activated B lymphocytes, are recognizable by their round shape, characteristic eccentric “clock-face” nucleus, cytoplasmic basophilia, and pale negative Golgi region (Figures 3–4 and 3–5). Plasma cells Fibroblasts Figure 3–4 Fibroblasts and plasma cells in loose connective tissue. “Clock-face” nucleus Golgi region Figure 3–5 Plasma cells seen in more detail. Chapter 3 Connective Tissue 41 Macrophages are readily identifiable if they contain phagocytosed particles, for example, a marker dye (Figure 3–6) or inhaled smoke-derived carbon particles. They are further characterized by having a kidney-shaped nucleus. Macrophages Figure 3–6 Macrophages in loose connective tissue. DENSE ORDINARY CONNECTIVE TISSUE Compared with loose connective tissue, dense ordinary (fibrous) connective tissue is substantially less vascular and its collagen bundles are much coarser (Figures 3–7 and 3–8). Scattered between the type I collagen bundles are nuclei of inactive fibroblasts (fibrocytes). Because the form of dense ordinary (fibrous) connective tissue shown here is an interweaving arrangement of wavy collagen bundles extending in almost every direction, it is described as irregular. Tendons and ligaments are characterized by the regular form of this tissue, where orderly arrays of essentially parallel collagen bundles are oriented like cable wires along the direction of tension. 42 PDQ HISTOLOGY Loose ordinary connective tissue Dense ordinary connective tissue Figure 3–7 Irregular dense ordinary connective tissue (reticular layer of dermis of thin skin). Figure 3–8 Collagen bundles of irregular dense ordinary connective tissue. Chapter 3 Connective Tissue 43 ADIPOSE TISSUE In loose connective tissue, adipocytes (fat cells) may be found singly or in small groups. In adipose (fat) tissue, adipocytes represent the predominant cell type (Figure 3–9). The white spaces created by lipid extraction give this tissue a distinctive “chicken wire” appearance. Besides storing lipid for potential energy production, adipose tissue pads parts of the body and fills some crevices. The widely distributed kind of adipose tissue shown in Figure 3–9, called white fat, is the principal site of lipid metabolism. The less extensive kind, called brown fat because it contains an even greater abundance of mitochondrial cytochromes and blood capillaries, stores lipid as multiple droplets and provides essential body heat, which is important in newborn babies. Figure 3–9 Adipocytes of white fat. 4 Cartilage and Bone E ach of the structurally specialized skeletal tissues cartilage and bone is derived from mesenchyme, as are the other forms of connective tissue. Although both tissues are made up of extracellular matrix and cells, cartilage is totally avascular, whereas bone tissue is highly vascular. Another key difference is that cartilage can grow from within (interstitial growth) through internal production of more matrix as well as grow externally by adding more matrix to its outer surface (appositional growth), whereas bone grows entirely through apposition to its surface. Functionally relevant differences also exist in the composition of the matrix. CARTILAGE Essentially, hyaline cartilage (Figure 4–1) is designed to resist compression. Approximately 75% of its wet weight is tissue fluid that provides a longdistance diffusion route for nutrients and oxygen to reach the chondrocytes embedded in its avascular matrix. Other functionally important constituents of hyaline cartilage matrix are proteoglycan (chiefly present as aggregates) and reinforcing fibrils composed of type II collagen. Chondrocytes occupy tiny spaces in the matrix (lacunae) that become visible because the fixed cells shrink. When the chondrocytes of growing cartilages divide, some lacunae remain closely associated as cell nests. The common type of cartilage is more fully described as hyaline (glasslike). Articulating surfaces of bones are covered with a specialized form of hyaline cartilage called articular cartilage (Figure 4–2). Besides hyaline cartilage, there are two other forms of cartilage, also avascular, known as elastic cartilage (Figures 4–3 and 4–4) and fibrocartilage (Figure 4–5). The distribution of these reinforced forms of cartilage is more limited. 45 46 PDQ HISTOLOGY Perichondrium Matrix Cell nests Figure 4–1 Hyaline cartilage. Articular cartilage Subchondral bone Figure 4–2 Articular cartilage. Chapter 4 Cartilage and Bone 47 Typical features of hyaline cartilage (see Figure 4–1) include the following: • • • • • • matrix slightly blue (or slightly pink) peripheral fibrous perichondrium (irregular dense ordinary connective tissue) lacunae large and round, with shrunken chondrocytes, particularly in its midregion lacunae flatter near its periphery some lacunae associated as cell nests blood vessels absent Articular cartilage (see Figure 4–2) has the following characteristics: • • • • • • matrix pink, reflecting extent of type II collagen packing no peripheral perichondrium (hence postnatal growth is entirely interstitial) lacunae near the articular surface are parallel and flat (sandwiched between horizontal collagen fibrils) in the midregion, some lacunae are arranged in longitudinal columns (a feature in growing articular cartilages indicating chondrocyte proliferation) vascular subchondral bone supporting it appears more acidophilic because it contains relatively more collagen avascular 48 PDQ HISTOLOGY The characteristics of elastic cartilage (see Figures 4–3 and 4–4; see also Figure 1–3) are as follows: • • • matrix contains supplementary acidophilic elastic fibers that give the matrix additional elastic properties (these fibers are more conspicuous with an elastin stain, eg, in Figure 4–4) resembles hyaline cartilage in other respects found in the epiglottis and external ear Figure 4–3 Elastic cartilage (hematoxylin and eosin stain). Figure 4–4 Elastic cartilage (special elastin stain). Chapter 4 Cartilage and Bone 49 Distinctive features of fibrocartilage (see Figure 4–5) are as follows: • • • • matrix contains reinforcing pink-staining bundles of type I collagen fibers that give the matrix extra tensile strength round lacunae, containing round chondrocytes, are typically arranged in straight rows matrix is slightly blue between lacunae found in tendon insertions, intervertebral disks, menisci, and pubic symphysis Figure 4–5 Fibrocartilage. BONE Bone matrix is heavily calcified (hydroxyapatite constitutes 70% of its wet weight), and type I collagen constitutes approximately 90% of its organic content, making it highly resistant to compression, tension, bending, and twisting. In contrast, cartilage matrix stays largely uncalcified except during long bone development and growth. Other important constituents of bone matrix are (1) proteins that induce bone formation and promote matrix calcification and (2) tissue fluid representing roughly 25% of its wet weight. Because bone matrix is heavily calcified and has a comparatively low water content, bone tissue requires short-range diffusion from blood capillaries; hence, it is highly vascular. Numerous fine communicating channels called canaliculi interconnect its lacunae (see Figures 4–16 and 4–17), conveying tissue fluid that facilitates such diffusion. 50 PDQ HISTOLOGY Bone Cells Bone tissue forming in connective tissue membranes incorporates developing loose connective tissue that brings with it a capillary blood supply. In this vascular environment, mesenchymal cells differentiate into osteoblasts that start secreting the macromolecular constituents of bone matrix. In intramembranously developing flat bones (Figure 4–6), basophilic osteoblasts cover the surface of acidophilic bony trabeculae (beams), laying down new matrix on the surface (appositional growth). Bone consisting of anastomosing trabeculae like this is called cancellous bone. Bony trabecula Osteoblasts Capillary Figure 4–6 Cancellous bone developing in an intramembranous environment. Osteoblasts show the cytoplasmic basophilia and pale negative Golgi region characteristic of active protein secretion (Figure 4–7). Spindleshaped osteoprogenitor (osteogenic) cells are also present on the surface. These progenitor cells persist as bipotential stem cells that give rise to osteoblasts at well-vascularized sites but produce chondrocytes at avascular sites. Osteocytes appear smaller and less rounded than osteoblasts and lie within lacunae (see Figure 4–7). Chapter 4 Cartilage and Bone 51 Osteoprogenitor cell Endothelial cell of blood vessel Osteoblasts Osteocyte Figure 4–7 Osteoblasts and osteocytes of cancellous bone. In addition to this bone-forming cell family, bone tissue contains large multinucleated cells called osteoclasts that resorb bone matrix (Figures 4–8 and 4–9; see also Figure 1–17). Derived from blood monocytes, osteoclasts are recognizable by their multiple nuclei, relative size, acidophilic cytoplasm, and resorptive ruffled border applied to a ragged matrix surface or resorption bay (Howship’s lacuna). They decalcify and then partly digest the adjacent matrix locally by secreting H+ ions and lysosomal hydrolases into a sealed compartment of extracellular space under this border. 52 PDQ HISTOLOGY Osteoclasts Figure 4–8 Osteoclasts resorbing bone matrix. Figure 4–9 Osteoclast seen in more detail. Chapter 4 Cartilage and Bone 53 Bone matrix is subject to lifelong internal remodeling in which old or weakened bone resorbed through osteoclast activity is immediately replaced by new bone through osteoblast activity. Osteoporosis (ie, a decrease in the body’s total bone mass) is a manifestation of inadequate compensation of bone resorption by bone formation. Growth of Long Bones Development and postnatal growth of a long bone involves the progressive bony replacement of a temporary cartilage model. This indirect process, known as endochondral ossification, is more complicated than the intramembranous ossification occurring directly in connective tissue membranes (see Figure 4–6). It is a consequence of vascularization of the model and progressive encroachment into the cartilage by bone cells that lay down layers of bone matrix by apposition on cartilage remnants. The following zones may be recognized in the cartilaginous growth plate (epiphyseal plate) present at either end of a child’s typical growing long bone (Figure 4–10): • • • • resting (reserve) cartilage—anchors epiphyseal plate to bony epiphysis; chondrocytes randomly distributed proliferating cartilage—replaces chondrocytes lost during ossification; chondrocytes arranged as longitudinal stacks maturing cartilage—hypertrophying (enlarging) chondrocytes initiate calcification; chondrocytes large and pale staining calcifying cartilage—calcium phosphate becomes deposited in matrix; chondrocytes along diaphyseal border die; transverse partitions of lacunae disintegrate Bone becomes deposited by apposition on the longitudinal partitions of calcified cartilage extending as remnants from the diaphyseal border. 54 PDQ HISTOLOGY Zones: resting proliferating maturing calcifying Figure 4–10 Zones of an epiphyseal plate. Bone Subtypes Cancellous bone forming in the metaphysis under the epiphyseal plate (Figure 4–11) shows the following features: • • • light-staining wide vascular soft tissue spaces representing > 50% of its volume lamellae (layers) of dark pink bone matrix deposited on pale blue remnants of calcified cartilage osteoblasts and osteoprogenitor cells on the bone surface Adult cancellous bone (from iliac crest) is shown in Figure 4–12. The pale tissue between the trabeculae is fat-storing (yellow) bone marrow. Cancellous bone (upper border of Figure 4–13) can give rise to dense (compact) bone (lower third of Figure 4–13) through appositional thickening of its trabeculae. The additional new lamellae diminish the former soft tissue spaces to narrow haversian canals. Persisting cancellous bone nevertheless provides necessary internal support in medullary cavities (see Figure 4–12). Chapter 4 Figure 4–11 Cancellous bone developing endochondrally. Figure 4–12 Cancellous bone (iliac crest). Cartilage and Bone 55 56 PDQ HISTOLOGY Figure 4–13 Dense bone forming from cancellous bone. Dense (compact) bone (Figures 4–14 and 4–15) is characterized by the following features: • • • • • • filled-in soft tissue spaces representing only a small proportion of its volume cylindrical haversian systems (osteons), each having lamellae and osteocytes arranged concentrically around a central haversian canal blood vessels in longitudinal haversian canals and radial Volkmann’s canals smooth inner and outer circumferential lamellae external periosteum made up of an outer vascular dense ordinary connective tissue and a deeper population of osteoprogenitor cells internal endosteum represented by a single layer of osteoprogenitor cells that lines the medullary cavity and haversian canals Chapter 4 Cartilage and Bone 57 Cancellous bone in medullary cavity Inner circumferential lamellae Haversian vessel in a haversian canal Blood vessel in a Volkmann's canal Periosteum Interstitial lamellae Haversian system (osteon) Outer circumferential lamellae Figure 4–14 Organization of dense bone. Figure 4–15 Dense bone. 58 PDQ HISTOLOGY Several histologic features of dense bone, for example, haversian systems, bone canaliculi, and interstitial lamellae, are more recognizable in ground sections (silver-stained transparent thin slices of undecalcified bone matrix). Figure 4–16 shows some details of a haversian system. After parts of a haversian system have been dismantled by osteoclasts during the course of internal remodeling, the parts that are left behind constitute interstitial lamellae (Figure 4–17). Haversian canal Osteocyte lacunae interconnected by canaliculi Figure 4–16 Haversian system of dense bone (ground section, silver stain). Lamellae of haversian system Interstitial lamellae Figure 4–17 Interstitial lamellae of dense bone (ground section, silver stain). Chapter 4 Cartilage and Bone 59 JOINT TISSUES In sections of articulating synovial joints, it is possible to find articular cartilage (see Figure 4–2), fibrocartilage at tendon or ligament insertions into cartilage (see Figure 4–5), epiphyseal plates if the bones are still growing (see Figure 4–10), and the lining synovial membrane of the joint. The synovial membrane (synovium), not regarded as an epithelial membrane because it is made up of connective tissue cells trapped between abundant interstitial fibers (both collagen and elastin), has three characteristic appearances. The vascular area shown at left in Figure 4–18 is typical of an areolar region. Secretory cells (synovocytes) near its surface produce the viscous glycoprotein and hyaluronic acid present in synovial fluid, the lubricating fluid of the joint. The dense ordinary connective tissue shown at the right in Figure 4–18 is a fibrous region with coarse collagen bundles that are highly resistant to friction. The central fold of tissue in Figure 4–19 is an adipose region with synovocytes near its surface and underlying grouped adipocytes that collectively serve as a cushion. Areolar region Fibrous region Figure 4–18 Areolar and fibrous regions of synovium. 60 PDQ HISTOLOGY Articular cartilage Adipose region of synovium Figure 4–19 Adipose region of synovium. 5 Blood and Myeloid and Lymphoid Tissues P eripheral blood consists of plasma (ie, serum along with fibrinogen and clotting factors) and formed elements, which are commonly known as blood cells even though erythrocytes have no nucleus and platelets are only cytoplasmic fragments. The total blood volume is about 5 L, with blood cells occupying roughly 45% of this volume. Blood cells are produced by myeloid tissue and lymphoid tissue, the two hematopoietic (hemopoietic) tissues. BLOOD CELLS The chief characteristics of the various kinds of circulating blood cells are outlined in Table 5–1. In addition to erythrocytes (red blood cells) and platelets, five different types of leukocytes (white blood cells) exist, each having a characteristic appearance and distinctive functions. Erythrocytes are more abundant than leukocytes in peripheral blood. The neutrophil is the predominant type of leukocyte. Individual blood cells are routinely observed in peripheral blood films stained with suitable blood stains. 61 62 PDQ HISTOLOGY Table 5–1 Blood Cells Cell Morphology and Staining (Blood Stain) Erythrocyte Pink disk, without nucleus Transports oxygen as oxyhemoglobin Platelet Small blue fragment with central purple granules and no nuclear component Platelet aggregates stop blood loss from damaged blood vessels Chief Functions Leukocytes Neutrophil Pale with small mauve granules; nucleus segmented (2–5 lobes) Phagocytoses and destroys bacteria Eosinophil Large red granules; nucleus bilobed Destroys parasitic worms, regulates local allergic inflammation Basophil Large blue granules; nucleus bilobed or segmented Releases histamine and other inflammatory mediators when triggered by antigen cross-linking of surfacebound immunoglobulin E (systemic allergic response) Lymphocyte Diameter small or large; cytoplasm blue, without granules; nucleus spherical B and T cells mediating immune responses Monocyte Phagocytoses debris; circulating precursor of macrophages and osteoclasts Diameter large; cytoplasm pale blue, without granules; nucleus shaped like a kidney or horseshoe Chapter 5 Blood and Myeloid and Lymphoid Tissues 63 Erythrocytes and Platelets Distinctive features of erythrocytes (Figure 5–1) are as follows: • • • • biconcave disks, diameter 7 µm middle third thinner and therefore paler contain the oxygen-transporting protein hemoglobin worn out and destroyed after 4 months in the circulation Platelets (Figure 5–2) have the following characteristics: • • • • biconvex disks, diameter 3 µm, dispersed or aggregated in blood films irregular mass of purple granules at the center derived through fragmentation of megakaryocytes contain the vasoconstrictor serotonin and a potent growth factor Figure 5–1 Erythrocytes. Figure 5–2 Platelets. 64 PDQ HISTOLOGY Granulocytes Figure 5–3 Neutrophil. Figure 5–4 Eosinophil. Chapter 5 Blood and Myeloid and Lymphoid Tissues 65 Key features of neutrophils (Figure 5–3) include the following: • • • • mauve granules, smaller and paler than those of eosinophils or basophils distinctive segmented nucleus presence at acutely inflamed sites short life span (~ 3 days) In sections, mature neutrophils are easily recognizable by their characteristic segmented nucleus with two to five lobes. Tissue sites where significant numbers of neutrophils lie external to blood vessels are sites of acute inflammation. Eosinophils (Figure 5–4) have the following characteristics: • • • conspicuous red granules and relatively large diameter distinctive bilobed nucleus found in loose connective tissue in local allergic responses Distinctive features of basophils (Figure 5–5) are as follows: • • large blue granules commonly obscuring bilobed or segmented nucleus rarely encountered in blood films (~ 1% of the total leukocyte count) 66 PDQ HISTOLOGY Figure 5–5 Basophil. Nongranular Leukocytes Small lymphocytes (Figure 5–6) are characterized by the following: • • • • • • • diameter close to that of erythrocytes dark-staining spherical or slightly indented nucleus occupying most of the cell’s volume thin rim of blue cytoplasm more T cells than B cells in peripheral blood majority are long-lived T cells recirculate from blood to lymph to blood, etc found in (1) loose connective tissue at sites where antigen has entered and (2) lymphoid tissues Large lymphocytes (Figure 5–7) may be recognized by the following: • • diameter approaching that of monocytes similar in nuclear morphology and cytoplasmic color to the small lymphocyte but relatively more cytoplasm Chapter 5 Figure 5–6 Small lymphocyte. Figure 5–7 Large lymphocyte. Blood and Myeloid and Lymphoid Tissues 67 68 PDQ HISTOLOGY Typical monocytes (Figure 5–8) have the following: • • • a large diameter a relatively large amount of pale blue cytoplasm a large kidney-shaped nucleus Figure 5–8 Monocyte. MYELOID TISSUE All types of blood cells except T lymphocytes are produced in myeloid tissue (red bone marrow). The intricate process of blood cell formation is known as hematopoiesis. Hematopoietic cell populations include pluripotential self-renewing hematopoietic stem cells, hematopoietic progenitor cells, and blood cell precursors. Respective properties, potentialities, and acronyms have been assigned to these stem cells and progenitors, based in large part on the types of blood cells they produce in tissue culture. In each lineage, precursor stages can nevertheless be recognized directly with a light microscope. Erythroid precursors, granulocytic precursors, and megakaryocytes (precursor cells of platelets) are examples of hematopoietic precursors that histology students may be asked to identify in myeloid tissue. Chapter 5 Blood and Myeloid and Lymphoid Tissues 69 Erythroid Series The erythroid precursors, with their various alternative names, are listed in Table 5–2 following the sequence in which they are formed. Table 5–2 Precursor Stages of Erythropoiesis Proerythroblast (pronormoblast) Basophilic erythroblast (basophilic normoblast) Polychromatophilic erythroblast (early normoblast) Normoblast (late normoblast; orthochromatophilic erythroblast) Polychromatophilic erythrocyte (reticulocyte) Erythrocyte (normocyte) The erythroid precursors shown in Figures 5–9 to 5–13 are individually identifiable in stained films of red bone marrow. 70 PDQ HISTOLOGY Figure 5–9 Proerythroblast. Figure 5–10 Basophilic erythroblast. Figure 5–11 Polychromatophilic erythroblast. Figure 5–12 Normoblast showing extrusion of its nucleus. Chapter 5 Blood and Myeloid and Lymphoid Tissues 71 Proerythroblasts (see Figure 5–9) are recognizable by the following: • • • large diameter large spherical nucleus, sometimes with large nucleoli visible abundant blue cytoplasm Basophilic erythroblasts (see Figure 5–10) have the following characteristics: • • • • diameter almost as large as that of proerythroblasts spherical nucleus; chromatin now more condensed blue cytoplasm relatively abundant Polychromatophilic erythroblasts (see Figure 5–11) are characterized by the following: • • • • slightly smaller diameter spherical nucleus proportionately smaller; chromatin more condensed and dark staining bluish-pink cytoplasm (cytoplasmic ribonucleic acid [RNA] along with newly synthesized hemoglobin) final dividing stage in the erythroid series Normoblasts (see Figure 5–12) have the following characteristics: • • • small diameter dark-staining spherical nucleus, highly condensed and pyknotic, becomes extruded from the cell bluish-pink cytoplasm (becoming increasingly pink) 72 PDQ HISTOLOGY At the polychromatophilic erythrocyte stage (see Figure 5–13), • • • • the diameter is slightly larger than that of a mature erythrocyte; the nucleus has been extruded; compared with the color of mature erythrocytes, the cytoplasm still looks a slightly bluish pink; and the cell enters the circulation and after 2 days stains as a mature erythrocyte. The blue component of the characteristic cytoplasmic staining of erythroid precursors is the RNA involved in globin synthesis. Its recognition is facilitated by the use of special stains (new methylene blue or cresyl blue) that aggregate and stain it, generally as a wreath-like network (Figure 5–14). Polychromatophilic erythrocytes stained this way are called reticulocytes. Cells lacking such blue-stained particles represent mature erythrocytes (see Figure 5–14). Mature erythrocyte Polychromatophilic erythrocyte Figure 5–13 Polychromatophilic erythrocyte Figure 5–14 Reticulocytes and mature and mature erythrocyte. erythrocyte. Chapter 5 Blood and Myeloid and Lymphoid Tissues 73 Granulocytic Series Table 5–3 lists the granulocytic precursors in the order of their formation. Table 5–3 Precursor Stages of Granulopoiesis (Neutrophil Series) Myeloblast Promyelocyte Myelocyte Metamyelocyte Band neutrophil Neutrophil The granulocytic precursors that are most readily identified in marrow films are those with recognizable specific granules that are mauve, red, or blue. Neutrophil precursors, characterized by mauve granules, predominate. The earliest precursors, myeloblasts and promyelocytes, are large cells with spherical nuclei, sometimes with discernible large nucleoli. Promyelocytes also contain inconspicuous azurophilic (primary) granules. However, because these two stages can have quite an ambiguous appearance, histology students are not often required to recognize them. 74 PDQ HISTOLOGY Figure 5–15 Myelocyte (neutrophilic). Figure 5–16 Metamyelocyte (neutrophilic). Figure 5–17 Band neutrophil. Chapter 5 Blood and Myeloid and Lymphoid Tissues 75 The neutrophilic myelocyte (Figure 5–15), the last dividing cell in the neutrophilic series, may be recognized by the following: • • • diameter similar to that of the basophilic erythroblast spherical or slightly indented nucleus with rather condensed chromatin mauve specific (secondary) granules in addition to preexisting fine azurophilic (primary) granules The nucleus becomes more kidney shaped and condensed at the metamyelocyte stage (Figure 5–16). The band neutrophil (Figure 5–17) is a slightly immature neutrophil that is nevertheless able to enter the peripheral blood. The highly condensed nucleus is shaped like a band or horseshoe before it begins to segment. Changes in the proportion of immature neutrophils to mature neutrophils in the peripheral blood can be diagnostically indicative. 76 PDQ HISTOLOGY Erythroid precursors Granulocytic precursors Figure 5–18 Bone marrow film. Sinusoid Megakaryocyte Figure 5–19 Section of red bone marrow. Megakaryocyte Lipid droplet Figure 5–20 Megakaryocyte in red bone marrow. Chapter 5 Blood and Myeloid and Lymphoid Tissues 77 In bone marrow films (Figure 5–18), it is often possible to find erythroid precursors by looking for spherical nuclei and to find granulocytic precursors (which are more numerous) by spotting their content of granules and/or elongating nucleus. Histologic organization of the tissue, however, is totally disrupted. Sections of myeloid tissue (Figures 5–19 and 5–20) reveal further structural details in the tissue: • • • • wide blood channels termed sinusoids white empty-looking spaces representing lipid droplets in large fatstoring stromal cells large megakaryocytes, some adjacent to sinusoids an assortment of dividing and differentiating hematopoietic cells held in a reticular fiber meshwork Megakaryocytes (see Figure 5–19) have the following characteristics: • • • massive size large multilobed nucleus that becomes increasingly polyploid as the cell matures copious cytoplasm that fragments into platelets at maturity LYMPHOID TISSUE Lymphoid tissue is characterized by an abundance of lymphocytes. Diffusely distributed below wet epithelial membranes and aggregated in the tonsils, Peyer’s patches, and the appendix, it also constitutes a key component of the lymphoid organs, which are the thymus, lymph nodes, and spleen. Because all of these locations except the thymus represent sites where immune responses to antigen occur, they are often described as the secondary lymphoid organs and tissues. The thymus is considered one of the primary lymphoid organs because it is the site where T cells differentiate. The other primary lymphoid organ is bone marrow, the site where mammalian B cells differentiate. 78 PDQ HISTOLOGY Crypt Lymphoid follicle Mucous glands Figure 5–21 Lingual tonsil. Crypt Lymphoid follicles Figure 5–22 Palatine tonsil. Chapter 5 Blood and Myeloid and Lymphoid Tissues 79 Tonsils are substantial aggregates of lymphoid follicles situated in the pharynx (palatine tonsils), nasopharynx (pharyngeal tonsil), and tongue (lingual tonsil). The lingual tonsil (Figure 5–21) is recognized by the following: • • • • conspicuous lymphoid follicles overlying stratified squamous nonkeratinizing epithelium underlying mucous glands crypts kept clear of debris by secretion The palatine tonsils (Figure 5–22) have the following characteristics: • • • • • large aggregates of lymphoid follicles overlying stratified squamous nonkeratinizing epithelium no underlying glands deep crypts that commonly contain debris more susceptible to infection The palatine tonsils are the ones that are removed if they become chronically infected. 80 PDQ HISTOLOGY Capsule Subcapsular sinus Medullary sinus Cortical lymphoid follicle Figure 5–23 Lymph node. Cortex Medulla Figure 5–24 Thymus. Chapter 5 Blood and Myeloid and Lymphoid Tissues 81 Distinctive recognizable histologic features of lymph nodes (Figure 5–23) are the following: • • • • • afferent and efferent lymphatics connective tissue capsule with subcapsular sinus blue-staining cortex with lymphoid follicles and paracortical high endothelial venules antibody-secreting plasma cells present in medullary cords pale lymph-containing medullary sinuses The thymus (Figure 5–24) has the following characteristics: • • • • incompletely lobulated appearance dark blue-staining cortex packed with small lymphocytes (proliferating and differentiating T cell progenitors) cortical network of pale-staining thymic epithelial reticular cells (source of thymic cytokines and hormones) medullary pink spherical thymic (Hassall’s) corpuscles 82 PDQ HISTOLOGY The spleen (Figure 5–25) has the following distinctive features: • • • • connective tissue capsule with substantial inward projections (trabeculae) blue areas (white pulp) containing abundant lymphocytes close association between white pulp and splenic arterial blood vessels (eg, the follicular arterioles found in its lymphoid follicles) pink structural component (red pulp) with characteristic wide sinusoids and closely associated active macrophages Capsule Trabecula Sinusoid Red pulp Figure 5–25 Spleen. Lymphoid follicle with central arteriole 6 Nervous Tissue T he nervous system is made up of nervous tissue with a certain amount of associated connective tissue. The neurons (nerve cells) of the central nervous system (CNS) are chiefly supported by neuroglial cells (glia), an ancillary population of heterogeneous cells that, in common with neurons, are derived from neuroectoderm. Extending from the CNS is the peripheral nervous system (PNS), consisting of the peripheral nerves, ganglia, and afferent and efferent nerve endings. A characteristic of the PNS is that its nerve fibers, neuronal cell bodies, and associated glia are intimately supported and strengthened by substantial wrappings of connective tissue. Three concentric external connective tissue membranes collectively known as the meninges similarly invest and protect the brain and spinal cord. CENTRAL NERVOUS SYSTEM The brain and spinal cord are both made up of two dissimilar arrangements of nervous tissue termed gray matter and white matter. Gray matter is an intimate assortment of neuronal and glial cell bodies embedded in an entwined mass of nerve fibers (many without a myelin sheath) termed the neuropil (see Figure 6–3). White matter is a more structured arrangement of nerve fibers, many with myelin sheaths, along with their associated glia. Neuronal cell bodies, on the other hand, are absent from white matter. The two different arrangements are more easily recognized in sections of spinal cord and cerebellum than in sections of cerebral cortex. Myelin sheaths invest and insulate fast-conducting axons. The axon is generally the neuron’s longest nerve fiber, and, in most cases, it propagates nerve impulses away from the cell body (afferent neurons being an exception). Compared with the axon, the dendrites are typically shorter, more branched, and tapered, and their role is to receive nerve impulses. In hematoxylin and eosin (H&E)-stained sections, it is rarely evident whether representative unmyelinated nerve fibers are axons or dendrites. 83 84 PDQ HISTOLOGY Anterior horn of gray matter White matter Posterior horn of gray matter Subarachnoid space Dura Figure 6–1 Spinal cord. Neuropil Multipolar neurons in gray matter Myelinated nerve fibers in white matter Pia Figure 6–2 Gray matter and white matter of spinal cord. Chapter 6 Nervous Tissue 85 Spinal Cord The spinal cord (Figure 6–1) can be recognized by a combination of distinctive features: • • • • • central H-shaped area of gray matter (anterior and posterior horns with interconnecting gray commissures) surrounding white matter (funiculi containing descending and ascending longitudinal tracts) anterior median fissure and posterior median sulcus spinal nerve roots in the subarachnoid space surrounding meninges (dura mater, arachnoid membrane, and pia mater) At higher magnification (Figure 6–2), it may be seen that • • • • multipolar neurons are present in the gray matter, delicate ingrowths of the pia mater (innermost meningeal membrane) bring a blood supply, shrinkage artifact is common (particularly between neuronal cell bodies and the surrounding neuropil), and white matter contains pale-looking myelin sheaths (myelin lipids are extracted during processing) but lacks neuronal cell bodies. 86 PDQ HISTOLOGY Dendrite Neuropil Nucleolus in nucleus Glial cell nuclei Axon hillock Capillaries Figure 6–3 Multipolar neuron. Synaptic vesicles in axon Dendrite Figure 6–4 Electron micrograph of a chemical synapse. Postsynaptic thickening Chapter 6 Nervous Tissue 87 Typical neurons (Figure 6–3) are characterized by the following features: • • • • • • large diameter asymmetric multipolar, pseudounipolar, or bipolar shape (multipolar in this case) intense cytoplasmic basophilia, typically patchy and indicative of patches of rough-surfaced endoplasmic reticulum (Nissl bodies), reflecting active protein synthesis for maintenance of long axon axon hillock (site where axon is attached) is generally not basophilic dendrites with basophilic cytoplasm as in cell body pale-staining central nucleus with central large nucleolus (“owl’s eye” nucleus) that also reflects active protein synthesis Neuropil and blood capillaries may also be seen to advantage in this photomicrograph. The special sites on neurons where nerve impulses can be transmitted from one cell to another are known as synapses. Chemical synapses (the common type) release neurotransmitter into their synaptic cleft; electrical synapses (uncommon) possess gap junctions that conduct impulses directly. Typical features of an axodendritic directed chemical synapse seen in the electron microscope (Figure 6–4) include synaptic vesicles containing neurotransmitter and electron-dense material (variable in amount) on the cytoplasmic surface of the postsynaptic membrane (postsynaptic thickening). In addition to chemical synapses, there are electrical synapses. These are essentially gap junctions (see Figure 2–10, C) that permit direct conduction of nerve impulses. 88 PDQ HISTOLOGY Pia Neuronal cell body Figure 6–5 Cerebral cortex (hematoxylin and eosin stain). Neuroglial cell Figure 6–6 Cerebral cortex (silver impregnation). Capillary Chapter 6 Nervous Tissue 89 Brain In H&E sections of cerebral cortex (Figure 6–5), the following may be found: • • • • superficial gray matter with neurons arranged as a series of indistinct laminae (layers) neuronal cell bodies, the largest of which are pyramid shaped (pyramidal cells) widely scattered nuclei of neuroglia and surrounding neuropil blood capillaries supplying the necessary oxygen and nutrients Silver or gold impregnation methods (Golgi preparations) selectively reveal representative neurons and neuroglia (Figure 6–6). With special staining, the extensively interlacing long cytoplasmic processes of astrocytes, the predominant type of glial cell, may be seen (Figure 6–7). Figure 6–7 Fibrous astrocytes (special stain). 90 PDQ HISTOLOGY Molecular layer Granular layer White matter Figure 6–8 Cerebellum. Granular layer Purkinje cell Figure 6–9 Purkinje cell of the cerebellum. Molecular layer Chapter 6 Nervous Tissue 91 The cerebellar cortex (Figure 6–8) may be recognized by the following characteristics: • • • • • deeply folded appearance (fissures and sulci) pink outer cortical layer of gray matter (molecular layer) blue inner cortical layer of gray matter (granular layer) flask-shaped neuronal cell bodies (Purkinje cells) scattered along the interface between the outer and inner cortical layers pink central medullary core of white matter Characteristic features of Purkinje cells (Figure 6–9) include the following: • • • large diameter cytoplasmic basophilia (Nissl bodies) and nuclear morphology both typical of neurons extensively branching dendritic tree extending far into the molecular layer PERIPHERAL NERVOUS SYSTEM The PNS is more strongly reinforced by abundant connective tissue. Furthermore, under the right conditions, peripheral nerves show considerable potential for nerve fiber regeneration when they become damaged. Small peripheral nerves may often be found in adventitial connective tissue of organs or structures. Sensory cranial ganglia and spinal ganglia (see Figure 6–13) have a slightly different histologic appearance from autonomic ganglia (see Figure 6–14), but the difference is subtle. 92 PDQ HISTOLOGY Epineurium Fascicle Endoneurium Perineurium Schwann cell and myelin sheath Axon Figure 6–10 Organization of a peripheral nerve. Perineurium surrounding fascicle Myelinated nerve fibers Figure 6–11 Peripheral nerve (cross-section). Chapter 6 Nervous Tissue 93 Peripheral Nerves A moderate-sized peripheral nerve has the structural organization shown in Figure 6–10. Its outermost fibrous connective tissue covering, not represented in small nerves, is termed its epineurium. Internal to this, fibrous perineurium fills the crevices between nerve fiber bundles and surrounds each bundle as a sheath. Inside the bundle, loose connective tissue known as endoneurium lies between the individual nerve fibers. Typical features of peripheral nerves cut in cross-section (Figure 6–11) or longitudinal section (Figure 6–12) are as follows: • • • • • nerve fiber bundles (fascicles), each bundle surrounded with perineurium nerve fibers, with or without white myelin sheaths (compare Figures 6–11 and 6–12) endoneurium often difficult to discern epineurium not represented except in large nerves nuclei of Schwann cells, occasionally with nuclei of endoneurial fibroblasts Perineurium surrounding fascicle Schwann cell nuclei Figure 6–12 Fascicle of peripheral nerve (longitudinal section). 94 PDQ HISTOLOGY Cell body of ganglion cell Nuclei of capsule cells Figure 6–13 Spinal ganglion. Nuclei of capsule cells Cell body of ganglion cell Unmyelinated nerve fibers Figure 6–14 Autonomic ganglion (parasympathetic ganglion in pancreas). Chapter 6 Nervous Tissue 95 Spinal Ganglia A section of spinal (posterior root or dorsal root) ganglion (Figure 6–13) is recognizable by the following: • • • pseudounipolar ganglion cells with large spherical cell bodies ganglion cell nucleus central to the cell body, conspicuous large nucleolus and cytoplasmic basophilia (Nissl bodies) indicative of active protein synthesis each ganglion cell body enclosed by a layer of comparatively small capsule cells (neuroglial cells) AUTONOMIC NERVOUS SYSTEM Viscera, exocrine glands, blood vessels, and smooth muscles have their functional activities regulated automatically by way of their autonomic innervation. Sympathetic and parasympathetic ganglia of the autonomic nervous system (Figure 6–14) are both characterized by the following features: • • • large multipolar ganglion cells, cell bodies more irregular in shape because of multiple dendrites but otherwise resembling spinal ganglion cells ganglion cell nucleus more commonly eccentric in position the population of small capsule cells associated with each ganglion cell appears discontinuous rather than as a layer because of the neuron’s multipolar shape 96 PDQ HISTOLOGY Neural retina Retinal pigment epithelium Figure 6–15 Position of the retina. Box indicates the site and orientation of Figures 6–16 and 6–17. Neuroglial cells Inner nuclear layer Outer plexiform layer Nuclei and cell bodies of photoreceptors External limiting membrane Outer and inner segments of photoreceptors Retinal pigment epithelium (simple cuboidal; outermost) Figure 6–16 Photoreceptive part of the retina. Cone Rod Chapter 6 Nervous Tissue 97 OPTIC RETINA The functional importance of the retina (Figures 6–15, 6–16, and 6–17—a toluidine blue–stained semithin section) is that it is uniquely provided with photoreceptors. Some essential features by which retinal sections may be identified are as follows: • • • • • • • inner multilayered neural retina (photoreceptors, other retinal neurons, optic nerve fibers) outer single-layered retinal pigment epithelium (RPE) (a simple cuboidal melanin-containing epithelium) outer and inner segments of photoreceptors (rods and cones) adjacent to RPE a band of photoreceptor nuclei adjacent to the layer containing the inner segments a wide band containing nuclei of other retinal neurons and tall columnar supporting neuroglia inner layers (not shown) containing fewer nuclei and more nerve fibers optic nerve fibers forming the superficial retinal layer that lines most of the vitreous cavity of the eye Figure 6–17 Outer part of the retina. 7 Muscle M uscles are described histologically as consisting of muscle cells associated with moderate to large amounts of connective tissue. Each of the three muscle types—skeletal, cardiac, and smooth—has distinctive features. When seen with a microscope, skeletal muscle (responsible for voluntary movements) and cardiac muscle (involuntary heart muscle) show striations. Smooth muscle (involuntary muscle of viscera and contractile vessels) lacks striations. Detailed descriptions of muscle cells commonly use terms that would benefit from some initial explanation. In the case of skeletal or smooth muscle, the term muscle fiber is often used as a synonym for muscle cell. In cardiac muscle, however, it means a row of individual cells joined end to end. Myofibrils, present in skeletal and cardiac muscle but not smooth muscle, are thread-like organized arrangements of thick and thin filaments. Filaments of all three classes (thick, thin, and intermediate) are present in all three types of muscle cells. The underlying structural basis for all terminology is summarized in Figure 7–1. SKELETAL MUSCLE As in peripheral nerves, skeletal muscle fibers are arranged in bundles (fascicles), with fibrous perimysium surrounding each bundle (see Figures 7–1 and 7–2). The muscle is enclosed as a whole by fibrous epimysium, and delicate endomysium lies between the muscle fibers. 99 100 PDQ HISTOLOGY Epimysium Perimysium Fascicle Endomysium Endomysium Skeletal muscle fiber Myofibril Thin and thick filaments Figure 7–1 Organization of a skeletal muscle. Chapter 7 Skeletal muscle fibers in fascicle Perimysium Figure 7–2 Skeletal muscle at low magnification. Endomysium Muscle 101 102 PDQ HISTOLOGY Nucleus of capillary endothelial cell Nuclei of muscle fibers Capillary endothelial cell Figure 7–3 Skeletal muscle fibers in cross-section. Myofibrils Skeletal muscle fiber containing myofibrils Chapter 7 Muscle 103 The robust perimysial sheaths of skeletal muscle fascicles are recognizable in cross-sections of skeletal muscle, particularly at very low magnifications (see Figure 7–2). With more magnification, it is evident that skeletal muscle fibers are multinucleated (as a result of fusion of myoblasts, their precursor cells), and their nuclei lie in the peripheral cytoplasm (Figure 7–3). The interior portion of the muscle fibers appears closely packed with myofibrils (the “breaks” between them are fixation artifact). The distinctive multinucleated appearance of skeletal muscle fibers becomes more apparent in longitudinal sections (Figure 7–4). Striations Under optimal viewing conditions (or after special staining), transverse striations may also be seen on the myofibrils: dark-staining A bands and light-staining I bands. These bands seem to extend across the entire muscle fiber because striations of myofibrils are aligned transversely across the fiber. Scattered fibroblast nuclei or capillary endothelial nuclei (see Figure 7–3) can sometimes be found in the pale-staining endomysium separating the muscle fibers. Nuclei of a skeletal muscle fiber Striations Figure 7–4 Skeletal muscle fibers in longitudinal section, showing striations. 104 PDQ HISTOLOGY Sarcomeres A distinctive arrangement of thick and thin filaments known as the sarcomere (Figure 7–5) is repeated along myofibrils in the form of an extended linear series. The sarcomere is considered the basic contractile module of skeletal and cardiac muscle. The thin filaments, which contain actin, troponin, and tropomyosin, are anchored to Z lines made of α-actinin. The thick filaments, which contain myosin, are centrally interconnected in the transverse plane by a narrow M line containing myomesin. A bands contain both thick and thin filaments. I bands do not include any thick filaments. H bands do not include any thin filaments. During contraction, the H band disappears and the I bands shorten because the thin filaments are pulled farther into the A band, and this decreases the distance between the Z lines at the ends of the sarcomere. I A I Z H Z M Relaxed Contracted Figure 7–5 Sarcomere, showing its bands and the arrangement of thin and thick filaments. CARDIAC MUSCLE Although cardiac muscle resembles skeletal muscle in certain respects, cardiac muscle is involuntary and has fibers made up of individual cardiac muscle cells, each with one or two central nuclei. Distinctive structures called intercalated disks attach these muscle cells to each other, forming fibers that show a certain amount of branching. Hence, two key histologic features of cardiac muscle fibers are their limited anastomosis and their distinctive assembly pattern incorporating separate cardiac muscle cells with intercalated disks between them (Figure 7–6). A delicate endomysium occupies the spaces between cardiac muscle fibers, but epimysium and perimysium, characteristic of skeletal muscle, are unrepresented. Unlike skeletal muscle, which can regenerate new muscle fibers from satellite (myosatellite) cells situated at the periphery of its muscle fibers, cardiac muscle is characterized by a negligible inherent potential for regeneration. If it dies, it is replaced by fibrous scar tissue. Chapter 7 Muscle 105 Intercalated disks (see Figure 7–6) are not evident at the light microscopic level unless special stains are used. Electron microscopy reveals that they are specialized for attachment and electrical conduction. They traverse the muscle fiber in a step-like manner at the level of Z lines. Their distinctive features are as follows: • • • extensive interdigitation of cell borders exclusive site of gap junctions that allow free ion movement (direct electrical conduction) transverse adhering junctions (two types) that anchor (1) thin filaments and (2) intermediate filaments Fascia adherens junction Desmosome-like junction Intermediate filaments Gap junction Thick filament Thin filament Z line Figure 7–6 Part of an intercalated disk, showing the component junctions and associated filaments. 106 PDQ HISTOLOGY Central nuclei Peripheral myofibrils in muscle fibers Endomysial capillary Figure 7–7 Cardiac muscle in cross-section. Branched muscle fibers Endomysial capillaries Central nuclei of muscle fibers Figure 7–8 Cardiac muscle in longitudinal section. Chapter 7 Muscle 107 Cross-sections of cardiac muscle fibers (Figure 7–7) have these characteristics: • • • • a large diameter a central nucleus peripheral myofibrils highly vascular associated endomysium In longitudinal sections (Figure 7–8), muscle fiber branching may also be seen, together with striations at higher magnifications. Intercalated disks are not usually identifiable at this magnification in hematoxylin and eosin–stained sections. SMOOTH MUSCLE The appearance of smooth muscle fibers cut in cross- and longitudinal section may be seen in Figure 7–9. Smooth muscle fibers (commonly called smooth muscle cells) may be recognized by the following: • • • • • • small diameter compared with other types of muscle fiber arranged as muscle coats, layers, or bundles surrounding sheaths of loose connective tissue central nucleus absence of the discrete myofibrils and aligned striations that characterize skeletal and cardiac muscle distinctive pleating of the nucleus in contracted and partly contracted muscle fibers (compare Figures 7–10 and 7–11) Other features of smooth muscle include gap junctional coupling (basis of excitation spread through direct conduction, as in cardiac muscle) and postnatal potential for mitosis and supplemental derivation from pericytes. Figure 7–9 Smooth muscle in cross-section (left) and longitudinal section (right). 108 PDQ HISTOLOGY Figure 7–10 Smooth muscle fibers in the relaxed state. Pleated nuclei Figure 7–11 Smooth muscle fibers in the contracted state. 8 Circulatory System C irculatory system is a broadly inclusive term for (1) the heart and the various types of blood vessels characterizing the blood circulatory system and (2) the lymph-collecting vessels of the lymphatic system. Components of the circulatory system are conventionally described as being made up of three concentric layers known as tunicae—the tunica intima, tunica media, and tunica adventitia—but the borders between these layers are hard to distinguish in certain cases. In general, the tunica intima is a loose connective tissue layer with endothelium, a characteristic simple squamous lining epithelium, anchored to it by underlying basement membrane. The intimal lining layer of the heart is known as the endocardium, and heart valves are sheet-like inward extensions of this layer. Deep in the endocardium lie specialized impulse-conducting cardiac muscle fibers (Purkinje fibers) belonging to the impulse-conducting system of the heart. In arterial vessels, the intima is characterized by an additional substantial layer of fenestrated elastin called the internal elastic lamina. The tunica media of vessels and myocardium of the heart, the middle layer of their walls, consist primarily of muscle cells—smooth muscle in most vessels and cardiac muscle in the heart. The total amount of muscle present, however, is consistent with the component’s function: abundant in the heart, meager in venules, and unrepresented in capillaries. The outermost region of the wall, the tunica adventitia, is a layer of loose connective tissue that in the great veins also contains substantial bundles of smooth muscle. The tunica adventitia—particularly that of veins—and also the outer region of the media of some vessels are nourished by vasa vasorum (small nutritive vessels). The equivalent cardiac layer is the epicardium, consisting of fibrous connective tissue and the overlying visceral layer of serous pericardium. Lymphatic vessels share this wall structure, but the layers of the wall are harder to distinguish. The component vessels of the blood circulatory and lymphatic systems are listed in Table 8–1. In light microscopic sections, metarterioles resemble arterioles and lymphatic capillaries may be difficult to recognize and distinguish with confidence from blood capillaries. The main features of blood vessel wall structure are shown in Figure 8–1. 109 110 PDQ HISTOLOGY Table 8–1 Blood Circulatory and Lymphatic Vessels Blood circulatory system Elastic arteries (aorta) Distributing (muscular) arteries Arterioles and metarterioles Capillaries Venules Small- and medium-sized veins Large collecting veins (vena cava) Lymphatic system Lymphatics and lymphatic ducts Lymphatic capillaries Subendothelial layer (intima) Elastin (laminae, fibers) Internal elastic lamina Smooth muscle (media) Smooth muscle (media) Aorta Smooth muscle in adventitia Vena cava External elastic lamina Distributing artery Smooth muscle (media) Vein Arteriole Smooth muscle (media) Venule (large) Figure 8–1 Comparative composition of the walls of blood vessels. Chapter 8 111 Circulatory System ELASTIC ARTERIES Distinctive wall features of the aorta, which is an elastic artery (Figure 8–2; see also Figure 8–1), are as follows: • • • • • • • • marked overall thickness substantial content of elastin (maintains diastolic blood pressure) uniformly laminated appearance of the very wide media (rows of dark pink smooth muscle cells separated by pale pink elastic laminae) relatively thick intima compared with intima of a muscular artery (endothelium with substantial subendothelial layer containing elastin, smooth muscle cells, and some fibroblasts) somewhat indistinct border between intima and media even more indistinct internal and external laminae vasa vasorum in adventitia, penetrating outer part of media together with muscular (distributing) arteries, a site of development of atherosclerotic plaques Intima Media Figure 8–2 Aorta. Adventitia 112 PDQ HISTOLOGY Artery Vein Figure 8–3 Distributing artery and vein (hematoxylin and eosin stain). Endothelium Internal elastic lamina Figure 8–4 Distributing artery (toluidine blue stain). Smooth muscle cells Chapter 8 Circulatory System 113 DISTRIBUTING ARTERIES Also known as muscular arteries, distributing arteries (Figures 8–3 and 8–4; see also Figure 8–1) may be recognized by the following: • • • • • substantial wall thickness compared with vein but thinner than aortic wall very thin intima compared with aorta (endothelium and underlying internal elastic lamina) wavy pale-staining internal elastic lamina (demonstrated to advantage by toluidine blue staining; see Figure 8–4) wide media containing dark pink smooth muscle cells circularly arranged (regulates blood flow) distinct border between muscular media and substantial connective tissue adventitia VEINS Features of the accompanying veins (see Figures 8–1 and 8–3) include the following: • • • • • • relatively thin walls (lower venous pressure) media generally thinner, less distinct, and less muscular (except in superficial leg veins) adventitia fairly thick relative to other layers internal elastic lamina unrecognizable intimal flap valves, rarely seen in sections degenerative changes in their wall components can lead to dilatation (varicose veins) The inferior vena cava (see Figure 8–1) has some additional characteristics: • • • wide lumen fairly thin media compared with adventitia thick contractile adventitia containing longitudinal bundles of smooth muscle 114 PDQ HISTOLOGY Endothelium Smooth muscle cells Figure 8–5 Arteriole. Arteriole Venules Figure 8–6 Arteriole, venules, and capillaries. Capillaries Chapter 8 Circulatory System 115 SMALL BLOOD VESSELS The features by which arterioles (Figures 8–5 and 8–6; see also Figure 8–1) may be recognized include the following: • • • • • small overall diameter (< 100 µm) thick walled relative to lumen (ie, wall thickness almost comparable with luminal diameter) distinct media made up of only one or two layers of circularly arranged smooth muscle cells internal elastic lamina generally discernible except in the smallest arterioles (see Figure 8–6) indistinct border between media and adjacent thin adventitia Venules may often be found in the vicinity of their companion arterioles (see Figure 8–6). They are characterized by the following: • • • • small diameter generally between that of arterioles and capillaries very thin walls barely recognizable smooth muscle cells in media (unrepresented in small venules) allowing leukocytes and fluid exudate to escape at sites of acute inflammation Blood capillaries are distinguishable from arterioles and venules by their small luminal diameter (see Figure 8–6). However, few details are discernible without the electron microscope. 116 PDQ HISTOLOGY Pericyte Erythrocyte Endothelial cell Figure 8–7 Electron micrograph of a capillary. Figure 8–8 Lymphatic. Chapter 8 Circulatory System 117 Typical blood capillaries (Figure 8–7) have the following characteristics: • • • • small diameter (8–10 µm, only slightly larger than an erythrocyte; see Figure 8–7) very thin endothelial lining (continuous or fenestrated) associated pericytes no media LYMPHATIC VESSELS Lymphatics (Figure 8–8) may be recognized through any combination of the following: • • • • • • uniform pink staining of the lymph protein in their lumen presence of lymphocytes (without other blood cells) in their lumen relatively wide lumen (appropriately scaled down in lymphatic capillaries) very thin walls, occasionally showing recognizable smooth muscle cells in larger lymphatics poorly organized or skimpy appearance of walls proximity to lymphoid organs (eg, lymph nodes) Lymphatic capillaries differ from blood capillaries in the following respects: • • • • • slightly wider lumen blind ending incomplete endothelial basement membrane basal border of endothelium anchored to adjacent collagen fibers pericytes absent 9 Integumentary System T he integumentary system consists of the skin and various types of skin appendages (Table 9–1). Each kind of skin is constructed from two tissue components: epidermis, a stratified squamous keratinizing epithelium derived from ectoderm, and dermis, its connective tissue layer derived from mesoderm. The term hypodermis denotes the subcutaneous adipose layer found immediately under the dermis. The skin-associated glands, hairs, and nails (ie, all skin appendages) are entirely epidermal derivatives. In thick skin, which covers the palms of the hands, soles of the feet, and the flexor surface of digits, epidermis is almost half as thick as the dermis, whereas in the thin skin covering the remainder of the body, epidermal thickness is only about one-fifth of the dermal thickness (Figures 9–1 and 9–2). The terminology is based on the thickness of the epidermis, not the total thickness of the skin. Unless understood, this can be quite confusing because thin skin has a greater total thickness than thick skin! One reason Table 9–1 Integumentary System Skin Epidermis Dermis Epidermal skin appendages Hairs Nails Sebaceous glands Sweat glands Eccrine type Apocrine type 119 120 PDQ HISTOLOGY B A Stratum corneum Stratum lucidum Stratum granulosum Stratum spinosum Stratum germinativum Papillary layer of dermis Reticular layer of dermis Blood vessel Sweat gland Pacinian corpuscle Subcutaneous fat Figure 9–1 A, Organization of thick skin. B, Details of the epidermis. Hair Papillary layer of dermis Sebaceous gland Arrector pili muscle Sweat gland Reticular layer of dermis Root sheath of hair follicle Connective tissue papilla Subcutaneous fat Figure 9–2 Organization of thin skin. Chapter 9 Integumentary System 121 for making a distinction between two types of skin is that certain structural differences exist, notably the presence of friction ridges and protective thickened stratum corneum in thick skin and the presence of hair follicles and sebaceous glands in thin skin. Because epidermis is an avascular epithelium, it must receive nutrients from capillaries in the underlying papillary layer of dermis. Progressive displacement of its keratinocytes toward the surface isolates them from this source, so they die and flake off. The turnover time for keratinocytes to reach the skin surface from the stratum germinativum is almost 1 month. The deep parts of certain skin appendages (namely, the growing region of hair follicles and the secretory portion of most sweat glands) extend down from the dermis into the subcutaneous tissue (see Figures 9–2 and 9–7). Encapsulated pressure-sensitive sensory nerve endings resembling onions (pacinian corpuscles) may also be found in this adipose layer, particularly in sections of thick skin (Figure 9–3). THICK SKIN AND THIN SKIN CHARACTERISTICS The following generalizations apply to thick skin (see Figure 9–1): • • • • • five distinguishable epidermal layers (germinativum, spinosum, granulosum, lucidum, corneum) thick stratum corneum dermal papillae arranged on double (secondary) dermal ridges under friction ridges no hair follicles or sebaceous glands eccrine sweat glands opening onto friction ridges General features of thin skin (see Figure 9-2) include the following: • • • • • • four distinguishable epidermal layers (germinativum, spinosum, granulosum, corneum) thin stratum corneum dermal papillae randomly arranged hair follicles with associated flask-shaped sebaceous glands eccrine and apocrine sweat glands (apocrine glands, limited to pubic, perineal, and axillary areas and breasts, open into hair follicles) nail plates in nail grooves 122 PDQ HISTOLOGY Corneum Sweat gland Adipose tissue Pacinian corpuscle Figure 9–3 Thick skin at low magnification. Corneum Granulosum Spinosum Papillary layer of dermis Duct of sweat gland Reticular layer of dermis Sweat gland Figure 9–4 Thick skin seen in more detail. Chapter 9 Integumentary System 123 Seen under low power, sections of thick skin (see Figure 9–3) are recognizable by the following: • • • • thick stratum corneum total depth (epidermis + dermis down as far as subcutaneous fat) smaller than in thin skin hair follicles and sebaceous glands absent (note that thorough lowpower searching of the entire section is mandatory for certainty about this) pacinian corpuscles also present in this particular case (compatible with its being thick skin but does not rule out thin skin) Increased magnifications of thick skin (Figure 9–4) disclose the following: • • • • epidermal layers (notably, spinosum, granulosum, and thick corneum) vascular dermal papillae (part of the papillary layer of dermis) comparatively coarse collagen bundles indicative of the reticular layer of dermis (beneath the papillary layer) eccrine sweat glands, with their duct portion extending up through the dermis and their secretory portion situated in the subcutaneous adipose tissue 124 PDQ HISTOLOGY Corneum Granulosum Spinosum Papillary layer of dermis Reticular layer of dermis Figure 9–5 Thin skin at low magnification. Stratum granulosum Melanin in stratum germinativum Figure 9–6 Epidermis of thin skin seen in more detail. Chapter 9 Integumentary System 125 Sections of thin skin (Figures 9–5 and 9–6) typically show the following: • • • • relatively thin epidermis recognizable germinativum, spinosum, and corneum; granulosum usually somewhat indistinct, and lucidum is not represented relatively thin stratum corneum melanin mostly confined to deep layers of the epidermis in lightskinned races (variable in amount; synthesized by neural crest–derived epidermal melanocytes and acquired by keratinocytes through phagocytosis) In histology tests, students are generally expected to state whether the skin being identified is thick or thin. HAIR FOLLICLES Although sections of thin skin may happen to include isolated small portions of hair follicles and/or their associated sebaceous glands, this is often not the case. These particular skin appendages are more easily observed in sections of the scalp, where the hair follicles are more tightly packed and there are numerous oblique or longitudinal cuts to look at. 126 PDQ HISTOLOGY The scalp is an area of thin skin uniquely characterized by a dense population of hair follicles (Figure 9–7). Readily identifiable features include the following: • • • • hair follicles containing growing hairs, extending down into subcutaneous tissue follicle-associated, flask-shaped sebaceous glands (produce sebum through disintegration of their lipid-laden cells) arrector pili muscles (smooth muscles that give sebaceous glands a squeeze and make hairs “stand up on end”) representative parts of hairs and hair follicles, composite drawings of which are shown in Figure 9–8 It is seldom expected that students will memorize every microscopic detail of these structures. Recognition of the following components could be considered challenging enough: • • • • • connective tissue papilla (nourishes the growth zone) matrix region of the hair (the growth zone) cortex and medulla of hair (medulla unrepresented in some types of hair) internal and external root sheaths connective tissue sheath (external to root sheath) Arrector pili muscles Sebaceous glands Adipose tissue Papilla of hair follicle Blood vessel Figure 9–7 Scalp. Chapter 9 Integumentary System 127 Sebaceous gland Cortex of hair Medulla of hair Connective tissue sheath External root sheath Internal root sheath Stratum germinativum Trichohyalin granules B. Arrector pili muscle Hair matrix Connective tissue papilla A. Figure 9–8 Organization of a hair follicle. A, Longitudinal section. B, Cross-section at the level indicated in A. 128 PDQ HISTOLOGY SWEAT GLANDS Two types of sweat gland exist, termed eccrine and apocrine. Eccrine Type The widely distributed, ordinary kind of sweat gland (eccrine sweat gland; Figure 9–9), represented in both thick and thin types of skin, shows the following features: • • • • • • simple tubular gland irregularly coiled secretory portion helically winding straighter duct portion embedded in loose connective tissue secretory portion with single layer of pale-staining low columnar serous secretory cells duct portion with double layer of cuboidal epithelial cells, characterized by dark-staining nuclei Apocrine Type Largely resembling eccrine sweat glands in their histologic appearance, apocrine sweat glands open into hair follicles instead of opening directly onto the skin surface. Also, their secretory portion is rather large in comparison with their duct portion. The postpubertal secretory product of apocrine sweat glands can undergo bacterial degradation, giving rise to body odors. Sweat glands of the apocrine type are found chiefly in the armpits and the pubic and perineal areas. Duct Figure 9–9 Eccrine sweat gland. Secretory portion 10 Digestive System The digestive system, represented by the tubular gastrointestinal tract (gut) and its various accessory digestive glands (Table 10–1), is endoderm derived. The duct portions of its many accessory glands open directly into the gut lumen. An obvious general histologic feature of the tract is its regional specialization for nutrient processing, digestion, and absorption. Even though constituent regions share a common wall structure based on four concentric layers (Figure 10–1), additional features indicating specific functions allow each part to be recognized individually. Thus, absorptive villi (finger-like projections) are found in the small intestine but not elsewhere. Lymphoid tissue is more conspicuous in the ileum (Peyer’s patches) and appendix than it is elsewhere. A mixed population of simple columnar absorptive epithelial cells and mucus-secreting goblet cells characterizes the intestine but not the esophagus or stomach. Special arrangements are needed for continuous renewal of the lining epithelial cells because they are subject to abrasion and exposure to acid or damaging enzymes. In the intestine, the epithelial stem cells are protected by being situated deep in crypts extending below the luminal surface. Gastric epithelial cells are renewed every 4 to 6 days and villous epithelial cells are renewed every 5 to 6 days. Rapid epithelial turnover and secretion of protective mucus by gastric epithelium, goblet cells, and mucous glands are key mechanisms in maintaining an uninterrupted epithelial barrier between gut contents and the internal environment of the body. Table 10–1 Digestive System Oral cavity Esophagus Stomach Fundus Pylorus Duodenum Jejunum Ileum Appendix Colon Accessory glands Salivary glands Pancreas Liver 129 130 PDQ HISTOLOGY Serosa or adventitia Outer layer (longitudinal) Inner layer (circular) Muscularis externa Submucosa with submucosal glands Muscularis mucosae (circular) Mucosa Lamina propria Epithelium Figure 10–1 Layers of the gastrointestinal tract. Epithelium Muscularis mucosae Lamina propria Submucosa Muscularis externa Figure 10–2 Esophagus. Chapter 10 Digestive System 131 WALL ORGANIZATION The four layers of the gut wall (see Figure 10–1) are as follows: • • • • mucosa made up of epithelium (lining and glandular invaginations, eg, gastric pits, crypts of Lieberkühn), lamina propria (loose connective tissue extending into villi), and muscularis mucosae (smooth muscle regulating size and independent movement of luminal folds) submucosa (loose connective tissue extending into rugae and plicae; contains medium-sized blood vessels and submucosal autonomic nerve plexus; site of mucous glands in the duodenum and esophagus) muscularis externa (major smooth muscle layers involved in peristalsis; inner circular and outer longitudinal layers; contains myenteric autonomic nerve plexus) serosa or adventitia (covering of simple squamous visceral peritoneum = serosa; connective tissue attachment, eg, to abdominal wall = adventitia) ESOPHAGUS Sections of esophagus (Figure 10–2) may be identified by the following criteria: • • • • • four wall layers evident stratified squamous nonkeratinizing epithelial lining, resistant to abrasion muscularis mucosae comparatively substantial in the lower part thick muscularis externa made of skeletal muscle in the upper third, smooth muscle in the lower third, and both types of muscle in the middle third adventitia instead of a serosa 132 PDQ HISTOLOGY Gastric pit Mucus-secreting simple columnar epithelium Chief cells Parietal cells Figure 10–3 Fundic region of the stomach. Mucus-secreting simple columnar epithelium Pyloric gland Gastric pit Lamina propria Figure 10–4 Pyloric region of the stomach. Muscularis mucosae Chapter 10 Digestive System 133 STOMACH Two representative parts of the stomach are shown here: the body of the stomach (designated the fundic region) and the pyloric region. The fundic region (Figure 10–3) may be recognized by the following: • • • • • pale-staining mucus-secreting simple columnar surface epithelium (without goblet cells) the same epithelium dipping down into the lamina propria as gastric pits (foveolae) long fundic glands extending down through the lamina propria from the pits, their bases reaching down to the substantial muscularis mucosae fundic glands containing pink parietal cells (which produce hydrochloric acid and secrete intrinsic factor, a glycoprotein required for vitamin B 12 absorption), purple chief cells (which secrete pepsinogen and lipase), enteroendocrine cells (which secrete hormones), and mucussecreting cells large mucosal folds with submucosal cores (rugae) Some additional features by which the pyloric region (Figure 10–4) may be identified: • • mucus-secreting pyloric glands, resembling mucus-secreting surface epithelium (demonstrated here to advantage by periodic acid–Schiff staining, which colors glycoproteins magenta) muscularis externa thickened at the pyloric sphincter 134 PDQ HISTOLOGY Villus Surface epithelium Crypt Lamina propria Muscularis mucosae Crypt Figure 10–5 Organization of a villus and crypts. Goblet cells Absorptive cells Enteroendocrine cell Paneth cells Figure 10–6 Crypt of the small intestine. Chapter 10 Digestive System 135 SMALL INTESTINE In the small intestine, the total absorptive area is increased by folds, villi, and microvilli on the absorptive luminal surface of epithelial cells. Situated between villi projecting into the lumen are crypts, straight simple tubular mucosal glands invaginated into the lamina propria (Figure 10–5). Without a clear understanding that in contrast to villi, which are tissue extensions surrounded by luminal space, crypts are invaginations with a central space and surrounding tissue, it can be difficult to tell which is which in sections. In general, isolated profiles surrounded by space (the “tissue islands” seen on the luminal border in Figure 10–7) are villi, and those extending into solid tissue are crypts. In the lower part of crypts (Figure 10–6) it is possible to find the following: • • • • • basal epithelial stem cells called crypt base columnar cells undifferentiated dividing epithelial cells mucus-secreting goblet cells Paneth cells, characterized by large acidophilic secretory granules that contain an antibacterial enzyme (lysozyme) enteroendocrine cells of many kinds that secrete a variety of gastrointestinal hormones 136 PDQ HISTOLOGY Villi Muscularis mucosae Submucosal mucous glands Muscularis externa Figure 10–7 Duodenum. Villi Crypts Submucosal lymphoid follices Muscularis externa Figure 10–8 Ileum. Chapter 10 Digestive System 137 Distinctive features of the duodenum (Figure 10–7) are the following: • • relatively wide villi (seen in various planes of section) with crypts in the lamina propria conspicuous large mucus-secreting (Brunner’s) glands in submucosa, generally extending through muscularis mucosae into lamina propria (major source of protective alkaline mucus) The ileum (Figure 10–8) is recognizable by the following: • • • narrower villi compared with duodenum absence of large submucosal glands conspicuous large aggregates of confluent lymphoid follicles (Peyer’s patches) in submucosa, extending through muscularis mucosae into lamina propria and raising surface epithelium between villi The jejunum has the villi, crypts, and basic wall structure typical of the small intestine but lacks conspicuous submucosal glands and lymphoid follicles. 138 PDQ HISTOLOGY Crypt Lamina propria Muscularis mucosae Figure 10–9 Large intestine. Crypts Submucosal lymphoid follices Figure 10–10 Appendix. Muscularis mucosae Muscularis externa Chapter 10 Digestive System 139 LARGE INTESTINE Distinguishing characteristics of the large intestine in general (Figure 10–9) include the following: • • • absence of villi (often difficult to establish firmly unless a large area can be searched for evidence of the “tissue islands” that would indicate villi) higher proportion of goblet cells relative to columnar absorptive epithelial cells relatively long straight crypts containing numerous goblet cells along with a few enteroendocrine cells Sections of the appendix (Figure 10–10) are additionally characterized by the following: • • relatively small irregularly shaped lumen conspicuous confluent masses of lymphoid follicles in submucosa, extending into lamina propria (enlarged appearance in children) SEROUS ACCESSORY GLANDS A few microscopic similarities exist between the parotid (a salivary gland of the serous type) and the pancreas (another example of a compound serous accessory digestive gland). 140 PDQ HISTOLOGY Serous secretory units Intralobular ducts Figure 10–11 Parotid. Intralobular duct Islet Centro-acinar cell Figure 10–12 Pancreas. Chapter 10 Digestive System 141 The parotid (Figure 10–11) shows the following features: • • • thick fibrous capsule, substantial septa, and obvious lobular organization relatively numerous intralobular ducts, lined with simple cuboidal or simple columnar epithelium typical serous secretory units (acini) In contrast, the pancreas (Figures 10–12 and 10–13) has the following: • • • • • • a flimsy investing sheath of loose connective tissue relatively thin and delicate septa large main and accessory ducts, both supported by substantial amounts of fibrous connective tissue relatively few intralobular ducts (mostly with simple cuboidal or even lower epithelium; see Figure 10–13) central pale-staining centroacinar cells (proximal duct cells) included in some of its serous acini, depending on their plane of section irregularly shaped islets of Langerhans (pancreatic islets, the diffuse endocrine component of this gland) Acinus Figure 10–13 Intralobular duct of the pancreas. Intralobular duct 142 PDQ HISTOLOGY Portal area Central vein Figure 10–14 Liver. Central vein Hepatocytes Sinusoids Figure 10–15 Central part of a liver lobule. Chapter 10 Digestive System 143 LIVER Histologic sections of the liver, the largest compound gland of all, appear characteristically sponge-like. At low magnification (Figure 10–14), it is possible to distinguish the following: • • • • portal areas containing a wide portal vein, hepatic artery or arteriole, bile duct (with characteristic simple cuboidal epithelium), and commonly also a lymphatic wide central veins roughly hexagonal liver lobules, with portal areas indicating their periphery and central veins indicating their middle irregularly anastomosing rows of hepatocytes arranged in a radial pattern that converges on the central vein Further details seen with additional magnification (Figure 10–15) include the following: • • • anastomosing radiating rows of hepatocytes (representing cross-sections of widely perforated plates having a thickness of a single hepatocyte) thin-walled venous sinusoids (ie, pale-looking blood channels between these rows that convey the blood delivered by the hepatic artery and portal vein of a portal area toward a central vein) cytologic details of hepatocytes 144 PDQ HISTOLOGY The liver acinus, an essentially functional concept, is not strictly recognizable in routine histologic sections. However, its central axis is represented by an arteriolar branch of the hepatic artery, along with an accompanying venular branch of the portal vein, extending along a border of a lobule from a portal area (Figure 10–16). Its periphery is partly indicated by the central veins on either side of this axis. Visualized in three dimensions, the liver acinus resembles a hard-boiled egg lying on its side. Pursuing this analogy, the highest concentrations of blood-borne nutrients and oxygen reach the yolk area (termed zone 1). The lowest nutrient and oxygen levels are found in the outer part of the egg white (termed zone 3). 1 2 3 Central vein Hepatic artery Portal vein Portal area Figure 10–16 Organization of a liver acinus. 11 Respiratory System E xtending posteriorly from the nasal cavities and nasopharynx and descending into the thorax are the constituent parts of the respiratory system (Table 11–1). This system is conventionally subdivided into (1) its conducting portion, which extends as far as the terminal bronchioles, and (2) its respiratory portion, which continues to the alveoli. A dichotomously branching system of airways, the tracheobronchial tree, cleans and conducts the incoming air and also provides the exit route. Most of the lining layer is ciliated pseudostratified columnar epithelium with goblet cells, which is specialized to produce and propel a particle-trapping coating of mucus. The respiratory portion of the system lying distal to this represents the essential site of gas exchange. Beyond respiratory bronchioles, its structural components (alveolar ducts, alveolar sacs, and alveoli) represent air spaces separated by intervening walls. A functionally important component of the tracheobronchial tree, visceral pleura, and interalveolar walls is elastin, the passive recoil of which is the chief factor expelling air in expiration. Besides providing a simple squamous mesothelial (serosal) gliding surface with underlying (subserosal) dense fibroelastic tissue, the visceral pleura contains a plexus of pulmonary lymphatics draining, by way of interlobular septal lymphatics, toward the hilum of the lung. Another functionally important constituent of the respiratory portion is its extensive population of alveolar macrophages. When these phagocytes engulf inhaled particles settling beyond the mucus coating of the airways, they subsequently become trapped in the mucus layer and are swept along with it toward the pharynx. Table 11–1 Respiratory System Nasal cavities and nasopharynx Bronchioles Larynx and epiglottis Alveolar ducts and alveoli Trachea Pleura Bronchi 145 146 PDQ HISTOLOGY Pseudostratified epithelium Mixed submucosal glands Cartilage Fibrous perichondrium Figure 11–1 Trachea. Cartilage Mixed submucosal gland Figure 11–2 Bronchus. Chapter 11 Respiratory System 147 TRACHEA AND BRONCHI Sections of the trachea (Figure 11–1) may be recognized by the following: • • • • • C-shaped hyaline cartilages (keeping this major airway open when the neck is bent) ciliated pseudostratified columnar epithelium with goblet cells (responsible for maintaining ascending mucus coating) mixed submucosal glands (providing supplementary watery mucus) smooth (trachealis) muscle (interconnecting posterior ends of C-shaped cartilages) dense fibroelastic perichondrium (extending as cartilage interconnections) Sections of the intrapulmonary bronchi (Figure 11–2) appear fairly similar to those of the trachea, except that their • • • • lumen is smaller than that of the trachea, supporting cartilages are more irregular in shape, mixed submucosal glands are smaller than those of the trachea, and adventitia is attached to the surrounding lung tissue. Crisscrossing smooth muscle bundles lie in the submucosal connective tissue between the epithelium and the cartilage, but because they follow helical courses, they are not always easy to recognize. 148 PDQ HISTOLOGY Smooth muscle Ciliated pseudostratified columnar epithelium Figure 11–3 Large bronchiole. Simple cuboidal epithelium Figure 11–4 Small bronchiole. Chapter 11 Respiratory System 149 BRONCHIOLES Larger bronchioles such as a preterminal bronchiole (Figure 11–3) have the following characteristics: • • • • • • luminal diameter < 1 mm smooth muscle arranged as helical bundles crisscrossing deep to the elastic lamina propria (excessive tonus of this muscle can lead to expiratory difficulties in asthmatic patients) ciliated pseudostratified columnar epithelium with goblet cells (continuation of the “mucociliary escalator”) adventitia attached to surrounding lung tissue (bronchiolar walls pulled outward by tension in interalveolar walls when alveoli inflate) flexible walls unsupported by cartilages submucosal glands are absent Additional features of the smaller bronchioles (Figure 11–4) are as follows: • • • • decreased total wall thickness and smaller luminal diameter smooth muscle even less conspicuous simple cuboidal epithelium, with some cells nonciliated no goblet cells 150 PDQ HISTOLOGY Alveolar duct Alveolar sac Respiratory bronchiole Figure 11–5 Respiratory bronchiole. Alveolar sac Respiratory bronchiole Alveoli Alveolar ducts Figure 11–6 Respiratory bronchiole leading into alveolar ducts. Chapter 11 Respiratory System 151 RESPIRATORY BRONCHIOLES AND ALVEOLAR AIR SPACES Respiratory bronchioles represent the last few orders of branching of the tracheobronchial tree. It is usually easier to recognize them from their distal position in the dichotomously branching air passages (Figure 11–5) than from the small numbers of alveoli extending from their walls. Alveolar ducts (Figure 11–6; see also Figure 11–5) are essentially cylindrical air spaces extending distally from the ends of the final order of respiratory bronchioles. The more distal alveolar sacs represent compound air spaces that are smaller than alveolar ducts yet larger than alveoli. Their perimeters consist of bubble-like alveoli that bulge out from the sac (see Figures 11–5 and 11–6). The ultimate structural and functional unit of gas exchange, the alveolus, is recognizable in lung sections as the smallest white-looking intrapulmonary air space. Most of the very cellular tissue lying between air spaces in this section represents juxtaposed walls of collapsed alveoli because it is a section of collapsed lung. 152 PDQ HISTOLOGY Alveolar sac Alveolus Capillary in interalveolar wall Figure 11–7 Alveolar sacs. Alveolar macrophage Type II Type I pneumocyte pneumocyte Figure 11–8 Cell types in the interalveolar wall. Erythrocytes in alveolar capillary Chapter 11 Respiratory System 153 Additional histologic features of the respiratory portion appearing to advantage in sections of expanded lung (Figures 11–7 and 11–8) include the following: • • • • • • thin interalveolar walls (septa) pulmonary blood capillaries (lymphatics present in the bronchovascular connective tissue but not the interalveolar walls) flat squamous epithelial cells (type I pneumocytes) lining the alveoli, recognizable by their flat nuclei rounded secretory epithelial cells (type II pneumocytes) secreting pulmonary surfactant, recognizable by their slightly foamy-looking cytoplasm rounded alveolar macrophages, recognizable by their content of phagocytosed particles (particularly in smokers’ lungs) but generally hard to distinguish from type II pneumocytes in light microscopic sections unless their position is superficial elastic fibers (demonstrable in interalveolar walls when a special elastin stain is used) 154 PDQ HISTOLOGY Interalveolar walls are essentially sandwich-like in construction (Figure 11–9): • • • • • type I pneumocytes, with occasional interposed type II pneumocytes, constitute the slices of bread; a continuous basement membrane underlying these two types of epithelial cells represents the butter; a flat plexus of anastomosing pulmonary capillaries (ie, rolled-up endothelial cells with their surrounding basement membrane) represents a major part of the filling; an extensible supportive framework of interstitial fibers (elastic and reticular) represents another part of the filling; motile alveolar macrophages, scattered over the alveolar surfaces, correspond to crumbs adhering to the flat outer surfaces of the sandwich. Alveolar macrophage Basement membrane Type I pneumocyte Type II pneumocyte Endothelial lining cell of capillary Figure 11–9 Organization of the interalveolar wall. Interstitial fibers 12 Urinary System R epresented by the kidneys, ureters, urinary bladder, and urethra, the urinary system is responsible for producing and storing urine. Internal organization is most complex in the kidneys; the other components are all characterized by a central lumen and an appropriate wall structure. KIDNEYS The kidneys are largely composed of structural and functional units termed nephrons that form urinary filtrate continuously from circulating blood plasma and then concentrate, process, and deliver it to the collecting duct system. The histologic basis for distinguishing the renal cortex from the renal medulla is the route taken by the various parts of the nephron and the collecting tubules and ducts into which it empties. The renal cortex represents the unique site of the renal corpuscle (the proximal filtration unit), convoluted segments of the nephron (its proximal and distal convoluted tubules), and medullary rays (ray-like cortical areas containing straight segments of several nephrons along with cortical collecting tubules). The renal medulla is characterized by its content of straight segments of nephrons (thick- and thin-walled parts of loops of Henle) and associated straight medullary collecting tubules that merge and drain into main collecting ducts opening onto the renal papillae at the hilum of the kidney. Each conical medullary pyramid, with its covering cap of cortex, represents a kidney lobe. The human kidney is regarded as multilobar because it contains up to 18 lobes. Between kidney lobes, renal cortex extends down into the renal medulla as renal columns. A convenient way to substantiate the position of the corticomedullary boundary is to look for arcuate vessels fanning out distally from the interlobar blood vessels at this level like the ribs of an umbrella. 155 156 PDQ HISTOLOGY Interlobular blood vessels Cortical labyrinth Renal corpuscles Figure 12–1 Renal cortex. Interlobular blood vessels Medullary ray Figure 12–2 Lobule of renal cortex. Chapter 12 Urinary System 157 Some distinctive histologic features of the renal cortex (Figure 12–1) are as follows: • • • • • renal corpuscles scattered throughout the cortex cortical labyrinth (multiple cuts through proximal and distal convoluted tubules) interlobular blood vessels, afferent and efferent arterioles medullary rays (predominantly longitudinal cuts through straight tubules resembling the medullary tubules) fibrous external capsule may be included in the section, immediately adjacent to outer cortex (not shown) The following additional features characterize the cortical lobule (Figure 12–2): • • the lateral borders of the lobule are indicated by the positions of the interlobular blood vessels (interlobular arteries or veins); the central core of the lobule is made up of longitudinal or oblique cuts through parallel straight tubules, that is, it is a medullary ray. Although cortical lobules are recognizable in favorable planes of section, they are not always easy to discern. 158 PDQ HISTOLOGY Figure 12–3 Renal medulla. Proximal convoluted tubule Renal corpuscle Glomerulus Site of juxtaglomerular apparatus Afferent arteriole Distal convoluted tubule Collecting duct Loop of Henle Figure 12–4 Parts of the nephron with associated collecting tubules. Chapter 12 Urinary System 159 Sections of the renal medulla (Figure 12–3) typically contain longitudinal or oblique cuts of • • • • thick- and thin-walled parts of loops of Henle, medullary collecting tubules and papillary ducts (main collecting ducts), long straight capillaries known as vasa recta, and traces of loose connective tissue (comprising the site of an interstitial osmotic gradient). Each nephron is made up of a renal corpuscle, proximal convoluted tubule, loop of Henle, and distal convoluted tubule (Figure 12–4). The component segments of the nephron have distinctive histologic appearances and are readily distinguishable where they have been cut in cross-section (see Figure 12–9). 160 PDQ HISTOLOGY Renal corpuscle Arterioles Figure 12–5 Renal corpuscles. Vascular pole Capsular space Podocyte Glomerular capillary Glomerular basement membrane Proximal convoluted tubule (tubular pole) Parietal (capsular) epithelium Figure 12–6 Renal corpuscle seen in more detail. Chapter 12 Urinary System 161 Renal Corpuscle The blood being filtered by renal corpuscles comes from their afferent arteriole and leaves by way of their efferent arteriole (Figure 12–5). It is seldom possible to tell whether a given arteriole lying in close association with a renal corpuscle is afferent or efferent. Even though the glomerulusassociated end of the afferent arteriole is characterized by the presence of juxtaglomerular (JG) cells in its media (see Figure 12–7), these periodic acid–Schiff (PAS)-positive secretory cells are present in small numbers and therefore difficult to find. Distinctive features by which renal corpuscles (Figure 12–6) may be recognized are as follows: • • • • • • • parietal (capsular) epithelium—a simple squamous epithelium with a supporting basement membrane that appears to advantage in PASstained sections visceral (glomerular) epithelium—represented by scattered cell bodies and nuclei of podocytes (the pedicels or foot processes of which are attached to the glomerular basement membrane) central tuft of glomerular capillaries glomerular basement membrane (the renal filtration barrier component that minimizes exit of plasma macromolecules), also appearing to advantage in PAS-stained sections capsular space into which urinary filtrate passes vascular pole (representing the joint attachment site of the afferent and efferent arterioles) tubular pole (representing the proximal end of the proximal convoluted tubule) 162 PDQ HISTOLOGY Efferent arteriole Blood from glomerulus Afferent arteriole Blood to glomerulus JG cells Lacis cells Distal convoluted tubule Macula densa Urinary filtrate to collecting tubule Figure 12–7 Organization of the juxtaglomerular apparatus (see Figure 12–4 for its orientation). Medullary ray Figure 12–8 Medullary ray. Chapter 12 Urinary System 163 Juxtaglomerular Apparatus JG cells are the principal effector component of the juxtaglomerular apparatus (Figure 12–7), the major features of which are as follows: • • • • its juxtaglomerular position—located where the distal convoluted tubule lies in apposition to the afferent and efferent arterioles at the vascular pole of the renal corpuscle granule-containing JG cells (modified smooth muscle cells) in media of afferent arteriole, which respond to decreased stretch of the vessel wall by releasing renin, the enzyme that produces angiotensin from its precursor; angiotensin raises blood pressure apposed macula densa (densely nucleated spot in the epithelial wall of the distal convoluted tubule), which detects falls in the sodium and chloride contents of urinary filtrate and triggers renin release by JG cells lacis (extraglomerular mesangial) cells, interposed between macula densa cells and JG cells and presumed to be involved in cell-to-cell signaling Renal Tubules The following are readily recognizable characteristics of a medullary ray (Figure 12–8): • • • flanked by a combination of cortical labyrinth and renal corpuscles (indicative of renal cortex) straight thick-walled parts of loops of Henle (segments of superficial nephrons) straight cortical collecting tubules (recognizable by the fact that the lateral margins of their cuboidal epithelial lining cells are relatively distinct) 164 PDQ HISTOLOGY Proximal convoluted Distal convoluted Thin-walled loop of Henle Collecting tubule Figure 12–9 Renal tubules in cross-section. Proximal convoluted tubule Distal convoluted tubule Figure 12–10 Proximal and distal convoluted tubules. Chapter 12 Urinary System 165 In routine histologic sections, the straight tubules characterizing medullary rays and the medulla are seldom totally represented as longitudinal sections. The various kidney tubules, however, are also individually recognizable in cross- or oblique section (Figure 12–9). Cortical proximal and distal convoluted tubules are commonly cut in these two planes. Proximal and distal convoluted tubules (Figure 12–10) are typically distinguishable by the following criteria: • • • proximal convoluted tubule longer than distal convoluted tubule (therefore seen with greater frequency in sections) epithelial lining cells of the proximal convoluted tubule larger, pinker, and wider than those of the distal convoluted tubule epithelial lining cells of the proximal convoluted tubule characterized by a distinct striated luminal border (abundant absorptive microvilli with an associated thick PAS-positive cell coat), whereas those of the distal convoluted tubule lack such a border 166 PDQ HISTOLOGY Smooth muscle Lamina propria Transitional epithelium Figure 12–11 Ureter. Lamina propria Transitional epithelium Smooth muscle bundles Figure 12–12 Urinary bladder. Chapter 12 Urinary System 167 URETERS Sections of a ureter (Figure 12–11) typically show the following features: • • • • • tubular organization distinctive stellate lumen deeply folded transitional epithelial lining (exclusive to the urinary tract) fibroelastic lamina propria and adventitia (with resulting luminal folding) muscular coat made up of inner longitudinal and outer circular layers of smooth muscle (reverse arrangement of that found in the digestive tract) URINARY BLADDER The urinary bladder (Figure 12–12) may generally be recognized by the following: • • • • • wall structure less distinctly organized (sac-like, not tubular) transitional lining epithelium (indicative of urinary tract) comparatively shallow mucosal folds fibroelastic lamina propria and adventitia smooth muscle layers, the respective orientations of which are hard to distinguish 13 Endocrine System T he glands generally included in histology courses as representative of the endocrine system are listed in Table 13–1 (the ovaries are described in Chapter 14, “Female Reproductive System,” and the testes in Chapter 15, “Male Reproductive System”). In contrast to epithelial glands of the exocrine type, the endocrine glands are not provided with any ducts. Instead, their target cell-specific secretory products (hormones) pass directly into capillaries, enabling these products to reach their target cells by way of the bloodstream. Each hormone (or its precursor) is synthesized continuously. Many hormones then become stored in the cytoplasm until their release is suitably triggered. Thyroid and steroid hormones, however, are lipid soluble; hence, they diffuse out of secretory cells as soon as they are made. Whereas the water-soluble hormones bind to specific hormone receptors on the surface of their target cells, thyroid and steroid hormones diffuse into cells and bind to specific intracellular receptor proteins in their target cells. The complexes thus formed specifically promote the transcription of appropriate genes. The secretory cells of most endocrine glands are arranged as anastomosing cords, columns, or clumps lying adjacent to wide fenestrated capillaries and supported by a fibrous capsule and connective tissue trabeculae. Table 13–1 Endocrine Organs Pituitary Anterior lobe Posterior lobe Adrenal Cortex Thyroid Parathyroids Pancreatic islets Ovaries Testes Medulla 169 170 PDQ HISTOLOGY Infundibular stalk Anterior lobe Pars intermedia Posterior lobe Figure 13–1 Parts of the pituitary. Anterior lobe Posterior lobe Figure 13–2 Pituitary seen under scanning power. Chapter 13 Endocrine System 171 PITUITARY The pituitary (hypophysis) is a relatively small endocrine gland, roughly ovoid in shape, that is connected to the hypothalamus by its infundibular stalk (Figure 13–1). Functionally and histologically, the anterior and posterior lobes of the pituitary are dissimilar. Situated between these lobes is the pars intermedia, poorly represented in the human pituitary and hard to recognize except for a few colloid-filled cysts with negligible functional significance. The anterior and posterior lobes may both be represented in vertical or horizontal planes of section. Secretory epithelial cells of the anterior lobe, a derivative of the oral ectoderm, secrete the hormones listed in Table 13–2. Hypothalamic hormones regulating the release of these hormones are included in this table. The posterior lobe (pars nervosa), derived from a downgrowth of the brain (the floor of the third ventricle), is entirely composed of nervous tissue. It is the exclusive site of release of two hypothalamic peptide hormones: oxytocin and vasopressin (antidiuretic hormone [ADH]). In a horizontal section of the pituitary (Figure 13–2), the anterior larger lobe, with its brightly stained secretory epithelial cells, is readily distinguishable from the pale-staining nervous tissue that characterizes the posterior lobe. Table 13–2 Anterior Pituitary Hormones Hormones Release-Regulating Hormones (Hypothalamic) Adrenocorticotropic Corticotropin releasing Follicle stimulating Gonadotropin releasing Growth Growth hormone releasing Growth hormone inhibiting (somatostatin) Luteinizing Gonadotropin releasing Melanocyte stimulating None established Prolactin Prolactin releasing Prolactin inhibiting (dopamine) Thyroid stimulating Thyrotropin releasing 172 PDQ HISTOLOGY Posterior lobe Anterior lobe Figure 13–3 Anterior and posterior pituitary. Acidophils Basophils Figure 13–4 Anterior pituitary. Fenestrated capillary Chromophobes Chapter 13 Endocrine System 173 Juxtaposition of a mass of nervous tissue (representing the posterior lobe) and a large mixed population of brightly stained secretory epithelial cells, somewhat haphazard in arrangement and without ducts (representing the anterior lobe), is reliably indicative of the pituitary gland (Figure 13–3). The pars intermedia may or may not be discernible, depending mainly on the plane of section. The posterior lobe contains the following: • • • hypothalamohypophyseal tracts of pale-staining unmyelinated axons belonging to neurosecretory neurons situated in the supraoptic and paraventricular nuclei of the hypothalamus (the major respective sources of ADH and oxytocin) small pale-staining neuroglia (pituicytes) represented by their darkstaining nuclei capillaries of the fenestrated type, into which ADH and oxytocin are released from axon terminals of the neurosecretory neurons Characteristic features of the anterior pituitary, suitably stained (eg, with Gomori’s stain) to show its acidophils and basophils and viewed at higher magnification (Figure 13–4), are as follows: • • • • groups of chromophils of two main kinds—red-staining acidophils and blue-staining basophils groups of chromophobes—unstained, smaller, quiescent, or degranulated secretory cells no ducts abundant wide capillaries of the fenestrated type The various pituitary acidophils and basophils, together with the hormones they secrete, are listed in Table 13–3. Table 13–3 Anterior Pituitary Hormone Sources Cells and Cytoplasmic Staining Secreted Hormones Somatotrophs (acidophil) Mammotrophs (acidophil) Mammosomatotrophs (acidophil) Corticotrophs (basophil) Growth hormone Prolactin Prolaction and growth hormone Adrenocorticotropic hormone (and putative source of melanocytestimulating hormone) Adrenocorticotropic hormone and thyroid-stimulating hormone Adrenocorticotropic hormone, follicle-stimulating hormone, and luteinizing hormone Thyroid-stimulating hormone Follicle-stimulating hormone and luteinizing hormone Corticothyrotrophs (basophil) Corticogonadotrophs (basophil) Thyrotrophs (basophil) Gonadotrophs (basophil) 174 PDQ HISTOLOGY Capsule Zona glomerulosa Zona fasciculata Fenestrated capillary Zona reticularis Medullary chromaffin cells Figure 13–5 Organization of an adrenal gland. Zona reticularis Capsule Medulla Figure 13–6 Adrenal seen under scanning power. Chapter 13 Endocrine System 175 ADRENALS The adrenals (suprarenals) are distinctively shaped endocrine glands attached to the superomedial borders of the kidneys. Each adrenal gland has a mesoderm-derived cortex with a neural crest–derived medulla that is functionally separate. Compared with the medulla, the cortex is more elaborate in organization (Figure 13–5). The following steroid hormones are produced by the adrenal cortex (adrenocorticosteroids): • • aldosterone, secreted by the cells in the glomerulosa (outermost zone of the adrenal cortex) cortisol and weak androgens, secreted jointly by the cells in the fasciculata and reticularis (middle and innermost zones of the adrenal cortex) The following catecholamine hormones are produced by the adrenal medulla: • • epinephrine, secreted by many of the medullary chromaffin cells norepinephrine, secreted by the remainder of the medullary chromaffin cells Features generally permitting sections of the adrenals to be recognized under scanning power (Figure 13–6) include the following: • • • • characteristically folded, essentially triangular outline (indicating the overall shape of the capsule) bright-staining zona reticularis, demarcating the border between the cortex and the medulla paler-staining zona fasciculata, external to zona reticularis relatively uniform-looking pale pink medulla with large medullary veins that commonly have the appearance of wide empty spaces 176 PDQ HISTOLOGY Capsule Zona glomerulosa Zona fasciculata Zona reticularis Medulla Figure 13–7 Adrenal cortex. Capsule Glomerulosa Fasciculata Reticularis Medulla Figure 13–8 Adrenal cortex seen in more detail. Chapter 13 Endocrine System 177 Working inward, further features of adrenal sections that may be distinguished at higher magnification (Figures 13–7 and 13–8) are as follows: • • • • • fibroelastic thick external capsule narrow outer zone containing spherical clusters of small purple secretory cells, with closely associated fenestrated capillaries—the zona glomerulosa of the adrenal cortex wide middle zone containing radial columns, approximately one cell thick, of larger pink secretory cells, with closely associated long straight fenestrated capillaries—the zona fasciculata of the adrenal cortex narrow inner zone containing anastomosing cords of small, pale purple secretory cells arranged as a network, with closely associated fenestrated capillaries—the zona reticularis of the adrenal cortex central mass of slightly larger, relatively pale-staining, round cells that include chromaffin cells of two types (either epinephrine secreting or norepinephrine secreting) and occasional basophilic sympathetic ganglion cells, together with wide branches of the medullary vein and fenestrated capillaries—the adrenal medulla 178 PDQ HISTOLOGY Figure 13–9 Thyroid (hematoxylin and eosin stain). Figure 13–10 Thyroid (periodic acid–Schiff stain). Chapter 13 Endocrine System 179 THYROID The bilobed thyroid gland, lying anterior and lateral to the trachea just inferior to the larynx, incorporates two independent populations of hormonesecreting cells. The thyroid follicular epithelial cells, derived from endoderm, produce thyroid hormone (thyroxine plus triiodothyronine). The parafollicular (C) cells, derived from neural crest, produce calcitonin. A characteristic histologic feature of the thyroid gland is the thyroid follicle, a cyst-like spherical structure lined by simple cuboidal thyroid follicular epithelial cells and filled with extracellular thyroglobulin, the macromolecular stored precursor of thyroid hormone (Figure 13–9). Thyroglobulin is demonstrated to advantage by periodic acid–Schiff staining (Figure 13–10) because it is a glycoprotein. On release through exocytosis from the epithelial lining cells of the follicle, the secreted thyroglobulin becomes iodinated extracellularly. It is subsequently ingested by these cells and submitted to intracellular proteolysis, releasing thyroid hormone. An outer fascial sheath surrounds the external connective tissue capsule of the thyroid. The minimal connective tissue stroma is profusely supplied with fenestrated capillaries. 180 PDQ HISTOLOGY Follicular epithelial cell Figure 13–11 Thyroid follicle. Parafollicular cell Follicular epithelial cell Figure 13–12 Parafollicular cells of the thyroid. Chapter 13 Endocrine System 181 Seen here at higher magnification, thyroid follicular epithelial cells constitute a simple cuboidal epithelium bordering on the stored thyroglobulin (Figure 13–11). In a less active thyroid, these cells can appear low columnar (Figure 13–12). In the course of tissue processing, the thyroid tends to undergo uneven shrinkage, accounting for the wide split extending from the bottom left to the upper right in Figure 13–11 and the majority of empty-looking “spaces” and thyroglobulin “bubbles” commonly seen in thyroid sections. The slightly larger round cells with central nuclei that lie between follicles (see Figure 13–12) are parafollicular (C) cells. These cells lie internal to the follicular basement membrane but do not border on the thyroglobulin (Figure 13–13). They release calcitonin into adjacent fenestrated capillaries. Parafollicular cells Basement membrane Thyroid follicle Figure 13–13 Position of parafollicular cells in the thyroid. 182 PDQ HISTOLOGY Oxyphil cells Chief cells Figure 13–14 Parathyroid. Acinus Figure 13–15 Pancreatic islet. Islet Chapter 13 Endocrine System 183 PARATHYROIDS Distinctive features of the parathyroids (Figure 13–14), the small endoderm-derived endocrine glands lying on the posterior surface of the thyroid that secrete parathyroid hormone, are as follows: • • • • large areas of relatively small round chief cells with an intensely stained small central nucleus, representing the cells that secrete parathyroid hormone smaller groups of larger, pinker cells with a fairly similar nucleus (oxyphil cells) that first appear at puberty and are assumed to represent retired or nonsecreting chief cells numerous fenestrated capillaries no ducts PANCREATIC ISLETS Pancreatic islets (islets of Langerhans), representing the diffuse endodermderived endocrine component of the pancreas (Figure 13–15), may be recognized by the following: • • • proximity to serous acini (a readily recognizable pancreatic exocrine component) relatively pale staining of the cytoplasm of their constituent cells in hematoxylin and eosin–stained sections irregular shape, size, and distribution of the islets A (α) cells producing glucagon can be distinguished from B (β) cells producing insulin by specially devised staining methods (eg, Gomori). Also present are D (δ) cells secreting somatostatin, F cells secreting pancreatic polypeptide, and fenestrated capillaries. 14 Female Reproductive System T his chapter deals with the parts of the female reproductive system listed in Table 14–1 and describes how the histologic appearance of some of them is affected by physiologic variation in the ovarian steroid hormone levels. From the age of puberty until menopause, the ovaries constitute the exclusive site of cyclic maturation of ovarian follicles, monthly release of the secondary oocyte formed at the time of ovulation, and phasic secretion of ovarian hormones. The secondary oocyte liberated in the course of ovulation enters a uterine tube, where it may become fertilized. Peristaltic waves of contraction, produced by smooth muscle of the tubal wall, convey the liberated germ cell to the uterine body. The blastocyst developing from a fertilized ovum generally implants in the endometrium (uterine mucosa) at some posterior site. Estrogen and progesterone, the ovarian steroid hormones, are essential for appropriate growth and functional activity of the endometrium, myometrium (uterine smooth muscle), cervical mucous glands, and breast and also affect the cytologic appearance of the vagina. OVARIES The ovarian cortex is characterized by its distinctive content of ovarian follicles representing various stages of maturation, embedded in a swirlylooking stroma. Just under the simple cuboidal covering epithelium lies a relatively fibrous layer termed the tunica albuginea. The ovarian medulla contains similar fibroblast-like stromal cells and is the site of substantial ovarian blood vessels, some of which are fairly convoluted. Table 14–1 Female Reproductive System Ovaries Vagina Uterus Breast Uterine tubes (fallopian tubes) 185 186 PDQ HISTOLOGY Early secondary follicle Corpus albicans Primordial follicle Primary follicle Corpus luteum Cortex Atretic follicle Secondary follicle Medulla Simple cuboidal epithelium Theca Mature follicle Figure 14–1 Maturation stages of ovarian follicles. Figure 14–2 Primary ovarian follicles. Chapter 14 Female Reproductive System 187 The histologic appearance of the ovaries depends on both the species represented and the current menstrual phase at the time of fixation. Composite drawings showing the maturation stages of ovarian follicles (Figure 14–1) are based on all of their possible histologic appearances. Only a representative selection is found in any given section. Furthermore, mature follicles may appear surprisingly large after they accumulate follicular fluid, and several follicles may be found to be approaching full maturity if, as is often the case, the ovary was obtained from some animal that produces litters rather than single offspring. All stages except the corpus luteum are generally present during the proliferative (estrogenic, follicular) phase. The corpus luteum appears as an added feature in the secretory (progestational, progravid) phase and, in particular, in the first trimester of a pregnancy, when it becomes very large. Follicles may degenerate (undergo atresia) at any stage in their maturation. Atretic and ruptured (ovulated) follicles become replaced by a long-lasting fibrous scar called a corpus albicans. The early stages of ovarian follicular maturation resulting from ovarian stimulation by follicle-stimulating hormone (FSH) (Figure 14–2) are classified according to the histologic appearance of the ovarian follicular (granulosa) cells surrounding the primary oocyte: • • • • primordial follicles—single layer of low cuboidal (almost squamous) unstimulated follicular cells primary follicles—two or more layers of cuboidal to columnar follicular cells but no antrum secondary follicles—many layers of columnar follicular cells with antrum containing follicular fluid mature (tertiary, graafian) follicle—cyst-like structure with primary oocyte attached to follicular wall at cumulus oophorus; surrounding stroma constitutes theca 188 PDQ HISTOLOGY Figure 14–3 Atretic ovarian follicles. Theca Cumulus oophorus Figure 14–4 Mature ovarian follicles. Antrum Zona pellucida Chapter 14 Female Reproductive System 189 Microscopic signs of follicular atresia (Figure 14–3) include the following: • • • loss, disorganized arrangement, or morphologic deterioration of the follicular cells degenerative changes of the primary oocyte, for example, loss of its zona pellucida (external glycoprotein covering), loss of nuclear staining, indications of nuclear disruption, invasion of the follicle by leukocytes, such as neutrophils presence of fibroblasts but not scar tissue inside the follicle Mature follicles (Figure 14–4) show the following features: • • • • • • • substantial size and spherical shape sizable antrum filled with follicular fluid numerous follicular epithelial (granulosa) cells (producing estrogen) vascular theca interna (releases the androgen substrate used in estrogen production) fibrous theca externa cumulus oophorus containing primary oocyte substantial pink zona pellucida present on oocyte surface 190 PDQ HISTOLOGY Corpus albicans Figure 14–5 Corpus albicans. Theca lutein cells Granulosa lutein cells Figure 14–6 Corpus luteum. Chapter 14 Female Reproductive System 191 A corpus albicans (Figure 14–5) may generally be recognized by its • • • essentially round to ovoid shape and rather irregular periphery merging with the stroma, pink hyalinized collagen content, and residual fibroblast nuclei (also showing that scarring has occurred). Histologic features of a corpus luteum (Figure 14–6) include the following: • • • • • • during the first part of the secretory phase of a menstrual cycle: a diameter similar to or smaller than that of a ripening ovarian follicle during the first trimester of a pregnancy: a large diameter (generally peaking at about half the ovarian volume) relatively pale-staining granulosa lutein cells (producing both estrogen and progesterone) slightly smaller and pinker theca lutein cells (producing additional progesterone and the androgen substrate used in estrogen production) connective tissue septa, extending into its interior from the theca and giving it a somewhat “lobular” appearance persisting remnants of the intrafollicular blood clot formed at ovulation 192 PDQ HISTOLOGY Endometrial glands Spiral arteries Early proliferative Late proliferative Late secretory Figure 14–7 Endometrium at representative phases of the menstrual cycle. Endometrium Myometrium Figure 14–8 Uterine body. Chapter 14 Female Reproductive System 193 UTERUS, ENDOMETRIUM, AND MENSTRUAL CYCLE The histologic appearance of the endometrium reflects cyclical variation in the circulating levels of estrogen and progesterone (Figure 14–7). Following 4 to 5 days of partial endometrial loss (the menstrual phase of the cycle), rising estrogen levels from FSH-stimulated follicular granulosa cells promote mitosis and endometrial regeneration (proliferative, estrogenic, or follicular phase). After ovulation, rising progesterone and estrogen levels from luteinizing hormone– and FSH-stimulated granulosa lutein cells promote hypertrophy and secretory activity of endometrial glands in preparation for implantation (secretory, progestational, or progravid phase). Subsequent fall of the progesterone and estrogen levels leads to ischemic necrosis of the endometrium (ischemic phase). Sections of the uterine body (Figure 14–8) may be recognized by the following: • • • • “hollow pear” shape, with wide central lumen substantial mucosa termed the endometrium, characterized by simple tubular glands that appear straight at this menstrual phase thick multilayered muscular wall termed the myometrium (uterine smooth muscle) thin external serosa 194 PDQ HISTOLOGY Straight endometrial glands Figure 14–9 Proliferative endometrium. Sacculated endometrial glands Figure 14–10 Secretory endometrium. Chapter 14 Female Reproductive System 195 Endometrium observed fairly late in the proliferative phase (Figure 14–9) may be recognized by the following: • • • • simple columnar lining epithelium predominantly straight or slightly tortuous long endometrial glands deeply invaginated into a relatively cellular lamina propria a few mitotic figures in the glandular epithelium or lamina propria underlying smooth muscle (myometrium) Endometrium that is approaching the end of the secretory phase (Figure 14–10) typically shows the following additional features: • • • • hypertrophy and sacculation of the endometrial glands (giving grazing sections a “ladder-like” appearance) pale-stained glandular secretory cells with a “ragged” luminal border indicative of glycogen secretion empty-looking spaces in the lamina propria, representing sites of intercellular accumulation of tissue fluid (edema spaces) elongated spiral arteries in the lamina propria 196 PDQ HISTOLOGY Lamina propria Smooth muscle Ciliated simple columnar epithelium Figure 14–11 Uterine tube. Stratified squamous nonkeratinizing epithelium Lamina propria Figure 14–12 Vagina. Chapter 14 Female Reproductive System 197 UTERINE TUBE Sections through the ampullary region of a uterine tube (Figure 14–11) may be recognized by the following: • • • • • elaborately folded mucosa characterized by substantial primary, secondary, and tertiary folds loose ordinary connective tissue (lamina propria) extending into each fold simple columnar lining epithelium, predominantly ciliated, with scattered groups of nonciliated secretory cells fairly substantial muscular wall consisting of an inner circular layer and an outer longitudinal layer of smooth muscle external serosal covering Care should be taken not to misidentify a section of this part of a uterine tube as a section of seminal vesicle bearing a superficial resemblance to it (see Figure 15–9). VAGINA Histologic features of the vagina (Figure 14–12) are as follows: • • • • substantial stratified squamous nonkeratinizing lining epithelium characterized by pale staining owing to its content of stored glycogen and lipid (estrogen effect) thick, vascular fibroelastic lamina propria containing numerous small veins and venules smooth muscle coat consisting of inner circular and outer longitudinal bundles fibrous adventitia 198 PDQ HISTOLOGY Intralobular connective tissue Intralobular ducts Interlobular connective tissue Figure 14–13 Resting breast. Interlobular connective tissue Intralobular connective tissue Figure 14–14 Lobule of resting breast. Chapter 14 Female Reproductive System 199 BREAST Breast tissue that is not currently lactating is commonly described as resting breast. At low magnification (Figure 14–13), resting breast is recognizable by the following criteria: • • small groups of ducts showing a somewhat scattered distribution indicative of spherical lobules (permitting their distinction from sweat glands) a relatively fibrous kind of connective tissue around the lobules that has a variable content of adipocytes (not shown) Additional features confirmed at higher magnification (Figure 14–14) are as follows: • • • epithelial lining of some larger ducts consists of two layers of cuboidal cells; smaller ducts lined with a single layer no secretory component (unlike sweat glands or lactating breast) intralobular connective tissue—relatively cellular; interlobular connective tissue—relatively fibrous 200 PDQ HISTOLOGY Distinctive histologic features are acquired by the lactating breast (Figure 14–15) in the second half of a pregnancy and lasting until the end of breast-feeding: • • distended, rounded lobules separated by septa of fibrous interlobular connective tissue numerous pale-staining secretory alveoli variably filled with extracellular secretion (colostrum until about the end of the first postnatal week and then milk) In the first half of a pregnancy, high estrogen levels induce a proliferative response in the ductal epithelium, bringing about further development of the ducts and formation of the secretory alveoli. In the second half, rising additional levels of progesterone, acting in concert with prolactin and a number of other hormones, ensure full breast differentiation and elicit secretory activity of the alveoli. Intralobular duct Secretory alveoli Fibrous interlobular connective tissue Figure 14–15 Lactating breast. 15 Male Reproductive System T he parts of the male reproductive system considered in this chapter are listed in Table 15–1. Beginning at the age of puberty, spermatozoa are produced from spermatogonial stem cells on an ongoing basis as synchronously developing clones. This process of spermatogenesis occurs in the seminiferous epithelium of the seminiferous tubules of each testis. The other important function of the testis is testosterone secretion by its interstitial (Leydig) cells. From the seminiferous tubules, spermatozoa pass into a ductus epididymis, a storage compartment where spermatozoa begin to mature and become motile. On each side, a long muscular-walled tube, the ductus deferens, conveys motile spermatozoa through the inguinal canal and pelvic cavity to its site of junction with the proximal end of a seminal vesicle, an accessory gland that contributes nutritive fluid secretion to semen. The prostate, the other major accessory gland, similarly contributes prostatic fluid to semen. The anatomic position of the prostate, surrounding the urethra at the base of the urinary bladder, is potentially of clinical importance because constrictive prostatic enlargement (benign or malignant) is a common condition in aging men. On each side, the ejaculatory duct leading from the junction between a ductus deferens and a seminal vesicle traverses the prostate inferiorly and opens into the prostatic urethra. Distally, the spongy part of the urethra terminates at the glans penis. Table 15–1 Male Reproductive System Testes Epididymides Ducti deferentes Seminal vesicles Prostate Penis 201 202 PDQ HISTOLOGY Ductus deferens Rete testis Tunica albuginea Ductuli efferentes Ductus epididymis Seminiferous tubule Figure 15–1 Organization of the testis and epididymis. Mesothelium Tunica albuginea Seminiferous tubules Figure 15–2 Testis. Chapter 15 Male Reproductive System 203 TESTES Each testis (Figure 15–1) is an ovoid structure enclosed by a capsule-like tunica albuginea. Fibrous septa extend inward and subdivide the interior incompletely into lobules, each of which contains up to four tightly packed seminiferous tubules. The two ends of each looped seminiferous tubule open through the rete testis and ductuli efferentes of the mediastinum testis into the long convoluted ductus epididymis extending from the head of the epididymis to its tail. In sections of testis observed at low magnification, the thick tunica albuginea and numerous component seminiferous tubules are readily identifiable (Figure 15–2). The external surface is covered with squamous peritoneal mesothelium (tunica vaginalis testis). Scattered small groups of interstitial (Leydig) cells may be discerned in the connective tissue stroma lying between the tubules. 204 PDQ HISTOLOGY Spermatid Spermatozoon Primary spermatocyte Sertoli cell Loose connective tissue Myoid cell Basement membrane Spermatogonium Figure 15–3 Seminiferous tubule. Sertoli cell Spermatozoa Figure 15–4 Seminiferous tubule. Spermatid Spermatogonium Chapter 15 Male Reproductive System 205 Seminiferous Tubules The wall of a seminiferous tubule (Figure 15–3) is made up of (1) a single layer of tall columnar epithelial cells called Sertoli cells and (2) a diverse population of quiescent, dividing, and differentiating germ cell progenitors representing the various stages of spermatogenesis. Occupying pockets in the sides of Sertoli cells, the progenitor cells are so abundant that the Sertoli cells appear to be widely separated from each other in sections. At some level, however, all of these constitutive epithelial cells stay laterally interconnected by continuous tight junctions that seal off the adluminal differentiation compartment from the basal stem cell compartment. Adjacent to the basement membrane at the basal end of the Sertoli cells is an investing layer of loose connective tissue containing contractile flat myoid cells. Seminiferous tubules observed at an appropriate magnification (Figure 15–4) commonly show various combinations of the following characteristics: • • • • • • smooth, round perimeter (basement membrane with associated connective tissue and myoid cells) fairly large nuclei, with an ovoid or almost pyramidal shape and radial orientation, representing Sertoli cells (which respond to folliclestimulating hormone by secreting androgen-binding protein) fairly substantial rounded cells, with a spherical-to-ovoid central nucleus, that lie in the basal stem cell compartment immediately internal to the basement membrane of the seminiferous tubule (spermatogonia = spermatogenic stem cells) round dividing cells containing condensed chromosomes (predominantly spermatogonia and primary spermatocytes) spermatids that are transforming into spermatozoa as they approach the luminal border formed spermatozoa awaiting release from the luminal border of Sertoli cells 206 PDQ HISTOLOGY Mitochondrion Golgi apparatus 1. Centriole 2. Forming flagellum 3. Residual cytoplasm (discarded) Forming acrosome Head cap 4. Flagellum Mitochondrial sheath Figure 15–5 Principal stages of spermiogenesis. Interstitial (Leydig) cells Figure 15–6 Interstitial (Leydig) cells of testis. Chapter 15 Male Reproductive System 207 Spermiogenesis Based on electron microscopic observations, key stages in spermiogenesis (spermatozoal production from the preceding stage, spermatids) are as follows: • • • • • • • morphologic transformation of haploid spermatids with no further cell division (Figure 15–5) approximation of the Golgi apparatus to the anterior pole of the nucleus spreading of the acrosomal vesicle (a Golgi saccule) over the anterior pole of the nucleus, formation of the acrosome and head cap (site of penetration enzymes) caudal migration of the centriole pair nuclear elongation and further chromatin condensation flagellar growth from the distal centriole (which then disappears) mitochondrial aggregation and helical rearrangement in proximal axoneme as the mitochondrial sheath (middle piece) Interstitial (Leydig) Cells Testicular interstitial (Leydig) cells (Figure 15–6) possess the following characteristics: • • • • • interstitial position (small groups in stroma between seminiferous tubules) relatively large diameter and central round-to-ovoid, pale-staining nucleus pale cytoplasmic staining reflecting cholesterol content (stored steroid precursor) proximity to blood capillaries and lymphatic capillaries respond to luteinizing hormone by secreting testosterone 208 PDQ HISTOLOGY Figure 15–7 Ductus epididymis. Lamina propria Pseudostratified columnar epithelium Figure 15–8 Ductus deferens. Smooth muscle Chapter 15 Male Reproductive System 209 EFFERENT TESTICULAR DUCTS Distinctive features of the ductus epididymis (Figure 15–7) are as follows: • • • • stored spermatozoa in lumen pseudostratified columnar epithelium with stereocilia (immotile groups of long microvilli) surrounding thin circular layer of smooth muscle supportive connective tissue stroma A section of a ductus deferens, also widely known as a vas deferens (Figure 15–8), is recognizable by the following: • • • • • small corrugated lumen with low longitudinal mucosal folds pseudostratified columnar epithelium with stereocilia fibroelastic lamina propria remarkably substantial muscular wall consisting of a longitudinal inner layer, circular middle layer, and longitudinal outer layer of smooth muscle (propels through peristalsis during emission) connective tissue adventitia 210 PDQ HISTOLOGY Figure 15–9 Seminal vesicle. Fibromuscular stroma Figure 15–10 Prostate. Chapter 15 Male Reproductive System 211 SEMINAL VESICLES The histologic characteristics of a seminal vesicle (Figure 15–9) are as follows: • • • • • multiple cuts through a single tortuous tubular secretory diverticulum that is folded into a fairly compact mass wide, fluid-filled lumen containing an elaborate arrangement of thin folds of fibroelastic lamina propria covered with secretory epithelium (different in appearance from the folds found in the ampulla of a uterine tube; see Figure 14–11) dark-staining pseudostratified columnar or simple columnar secretory epithelium thick muscular wall consisting of inner circular and outer longitudinal smooth muscle connective tissue adventitia binding tubular convolutions together PROSTATE Distinctive histologic features of the prostate (Figure 15–10) are as follows: • • • • many lobules (compound tubuloalveolar gland) characteristic extensive folding of the secretory epithelium purple-staining tall columnar secretory epithelium (pseudostratified or simple) fibroelastic lamina propria 212 PDQ HISTOLOGY Secretory unit Calcified concretion Secretory epithelium Stromal smooth muscle cells Figure 15–11 Secretory unit of prostate. Corpora cavernosa Spongy urethra Figure 15–12 Penis. Tunica albuginea Corpus spongiosum Chapter 15 • • Male Reproductive System 213 distinctive fibromuscular capsule and stroma: smooth muscle cells— deep pink, collagen fibers—lighter pink (Figure 15–11) calcified concretions found in the lumen of some secretory units (variable in occurrence and more common in the prostate of aging men) PENIS Sections of the shaft of the penis (Figure 15–12) may be readily recognized by the following criteria: • • • essentially ovoid outline, thin skin at periphery paired corpora cavernosa, each enclosed by its fibrous sheath (tunica albuginea) ventral spongy urethra, lined with stratified (or pseudostratified) columnar epithelium and surrounded by the corpus spongiosum with its enclosing tunica albuginea Index Entries with f following a page number indicate figures; entries with t following a page number indicate tables. A bands, 103, 104, 104f A cells, of pancreatic islets, 183 Acidophilic staining, 9, 10f Acidophils, of pituitary, 172f, 173, 173t Acinus, of liver, 144, 144f Acrosome, 206f, 207 Adhesion belt, 26f, 27t Adipocytes, 39t Adipose tissue, 43, 43f Adrenals, 174f, 175, 176f, 177 Adrenocorticosteroids, 175 Adrenocorticotropic hormone, 171t, 173t Adventitia of blood vessels, 109, 110f of gut, 130f, 131 Afferent arteriole, of renal corpuscle, 158f, 161, 162f, 163 Aldosterone, 175 Alveolar ducts, 150f, 151 Alveolar macrophages, 145, 152f, 153, 154f Alveolar sacs, 150f, 151, 152f Alveoli, of lungs, 150f, 151, 152f Anaphase, 14f, 15f, 17f Androgen-binding protein, 205 Angiotensin, 163 Antidiuretic hormone, 171 Aorta, 110f, 111, 111f 214 Apocrine sweat glands, 121, 128 Appendix, 138f, 139 Appositional growth, of cartilage and bone, 45, 50 Arachnoid membrane, 85 Arector pili muscle, 126, 126f, 127f Arteries distributing, 110f, 112f, 113 elastic, 110, 111, 111f muscular, 113 Arterioles, 110f, 114f, 115 afferent, of renal corpuscles, 158f, 161, 162f, 163 efferent, of renal corpuscles, 161, 162f Articular cartilage, 45, 46f, 47, 60f Astrocytes, 89, 89f Atherosclerotic plaques, 111 Atresia, of ovarian follicles, 187, 188f, 189 Autonomic ganglia, 94f, 95 Autonomic nervous system, 95 Axon, 83, 92f Band neutrophil, 73t, 74f Basement membrane, 38, 38f glomerular, 160f, 161 Basic tissues, 1, 2t Basophilic erythroblasts, 69t, 70f, 71 Basophilic normoblast, 69t Basophilic staining, 9, 10f Basophils Index of blood, 62t, 65, 66f of pituitary, 172f, 173, 173t B cells, 66, 77 of pancreatic islets, 183 Bladder, urinary, 166f, 167 Blood cells, 61-68. See also under individual types B lymphocytes, 66, 77 Bone cancellous, 50, 50f, 51f, 54, 55f dense (compact), 56-58, 56f-58f growth of, 53 Bone marrow, 68, 76f, 77 Bone matrix, 49 Brain, 89 Breast lactating, 200, 200f resting, 198f, 199 Bronchi, 146f, 147 Bronchioles, 148f, 149, 150f, 151 Brown fat, 43 Brunner’s glands, 137 Calcitonin, 179, 181 Canal, haversian, 56, 57f, 58f Canaliculi, 49, 58, 58f Cancellous bone, 50, 50f, 51f, 54, 55f Capillaries, 114f, 116f, 117 Capsule cells, of ganglia, 94f, 95 Cardiac muscle, 104-107, 106f Cartilage, 45-49, 46f articular, 45, 46f, 47, 60f elastic, 5f, 48, 48f fibro-, 49, 49f hyaline, 45-47, 46f Cartilage matrix, 45, 46f, 47 Catecholamine hormones, 175 C cells, 181 Cell, microscopic appearance of, 6, 6f Cell junctions, 25, 26f, 27t Cell nests, 45, 46f 215 Cells. See under individual names Central nervous system, 83-91 Central veins, 142f, 143, 144f Centroacinar cells, 140f, 141 Cerebellar cortex, 90f, 91 Cerebral cortex, 88f, 89 Chief cells of fundic glands, 132f, 133 of parathyroid, 182f, 183 Chondrocytes, 7f, 45 Chromatids, 15f Chromophils, 173 Chromophobes, 173 Chromosomes, 15f, 16, 16f Cilia, 21, 22f Circulatory system, 109-117 Collagen fibers, 35, 36, 36f types, 35, 38, 45 Collecting ducts, of kidney, 158f, 159, 164f Compact bone. See Dense bone Compound glands, 28t, 30, 30f Cones, retinal, 96f, 97 Connective tissue, 35-42, 36f, 37f, 42f dense ordinary, 41, 42f loose, 36-41, 36f, 37f Convoluted tubules, of kidney, 158f, 164f, 165 Corneum, of epidermis, 24f, 120f, 122f, 124f Corpus albicans, 186f, 187, 190f, 191 Corpus luteum, 186f, 190f, 191 Corpuscles Hassall’s (thymic), 81 renal, 155, 156f, 158f, 160f, 161 Corticogonadotrophs, 173t Corticothyrotrophs, 173t Corticotrophs, 173t Cortisol, 175 216 PDQ HISTOLOGY Crypts, intestinal, 134f, 135, 136f, 138f Cytoplasm, main components of, 8t-9t. See also Table 1-3 on CD-ROM Cytosol, 8t D cells, of pancreatic islets, 183 Demilune, serous, 33, 33f Dendrites, 83, 86f, 87 Dense bone, 56-58, 56f-58f Dense ordinary connective tissue, 41, 42f Dermal papillae, 121 Dermis, 119, 120f, 122f, 124f Desmosome, 26f, 27t Digestive system, 129-144 Distal convoluted tubule, 158f, 164f, 165 Distributing arteries, 110f, 112f, 113 Dorsal root ganglia, 95 Ducts alveolar, 150f, 151 collecting of kidney, 158f, 159, 164f intralobular and interlobular, 30, 30f papillary, 159 Ductus deferens, 208f, 209 Ductus epididymis, 208f, 209 Duodenum, 136f, 137 Dura mater, 84f, 85 Eccrine sweat glands, 121, 128, 128f Efferent arteriole, of renal corpuscle, 161, 162f Elastic arteries, 110, 111, 111f Elastic cartilage, 5f, 48, 48f Elastic fibers, 35, 36f Elastin, in lungs, 145, 153 Electron micrographs, 3, 4. See also 7f, 22f, 23f, 116f Electron microscope, 3 Endocardium, 109 Endochondral ossification, 53, 55f Endocrine glands, 169-183, 169t. See also under individual names Endocrine system, 169-183 Endometrium, 192f, 193, 194f, 195 Endomysium, 99, 100f, 101f Endoneurium, 92f, 93 Endoplasmic reticulum, 8t, 11 Endosteum, 56 Endothelial cells, 39t, 116f Endothelium, 109, 112f, 114f Enteroendocrine cells, 134f, 135 Eosin, 9 Eosinophils, 62t, 64f, 65 Epicardium, 109 Epidermis, 119, 120f, 121, 124f Epididymis, 202f Epimysium, 99, 100f Epinephrine, 175, 177 Epineurium, 92f, 93 Epiphyseal plate, 53, 54f Epithelial glands, 28-33, 28t, 29f-33f Epithelial membranes, 19-25, 20t. See also under individual types Epithelium pseudostratified, 20t, 21, 22f retinal pigment, 96f, 97 simple, 20t, 20f, 21f stratified, 20t, 23, 24f, 25f stratified squamous, 23, 24f transitional, 25, 25f Erythroblasts basophilic, 69t, 70f, 71 polychromatophilic, 69t, 70f, 71 Erythrocytes, 62t, 63, 63f polychromatophilic, 69t, 72, 72f Index Erythroid (erythropoietic) precursors, 69-72, 9t, 70f, 72f, 76f Esophagus, 130f, 131 Estrogen, 185, 189, 191, 193, 200 Estrogenic phase, of menstrual cycle, 192f, 193, 194f, 195 Exocrine glands, 28, 28t, 29f-33f Extracellular matrix, 35, 38 Fallopian tubes. See Uterine tubes Fasciculata, of adrenal cortex, 174f, 175, 176f, 177 Fat cell, 39t Fat tissue, brown and white, 43 F cells, of pancreatic islets, 183 Female reproductive system, 185-200 Fibers collagen, 35, 36, 36f elastic, 35, 36f Purkinje, 109 reticular, 35, 77 Fibrillins, 35 Fibroblasts, 39t, 40, 40f Fibrocartilage, 49, 49f Filaments cytoplasmic, 9t of muscle cells, 99, 100f, 104, 104f Fixation, 2 Follicle-stimulating hormone, 187, 205 Follicles hair, 125, 126, 126f, 127f ovarian, 186f, 187, 188f, 189 primary, secondary, and tertiary, 187 primordial, 186f, 187 Follicular atresia, 187, 188f, 189 Follicular epithelial cells, of thyroid, 179, 180f, 181 217 Follicular phase, of menstrual cycle, 192f, 193, 194f, 195 Foveolae, 133 Fundic region, of stomach, 132f, 133 Ganglia autonomic, 94f, 95 spinal or posterior (dorsal) root, 94f, 95 Ganglion cells, 94f, 95 Gap junction, 26f, 27t, 87, 105, 105f Gastric pits, 132f, 133 Gastrointestinal tract, 129-139 Germinativum, of epidermis, 120f, 121, 124f Gland(s) adrenal, 174f, 175, 176f, 177 Brunner’s, 137 compound, 28t, 30, 30f digestive accessory, 129t, 139 endocrine, 169-183, 169t. See also under individual names epithelial, 28-33, 28t, 29f-33f exocrine, 28, 28t, 29f-33f fundic, 132f, 133 mixed (seromucous), 32-33, 32f, 33f parathyroid, 182f, 183 parotid, 140f, 141 pituitary, 170f, 171, 172f, 173 pyloric, 132f, 133 sebaceous, 126, 126f, 127 simple, 28t, 29, 29f sweat, 121, 128, 128f thyroid, 178f, 179, 180f, 181 Glia, 83, 86f, 88f Glomerular basement membrane, 160f, 161 Glomerulosa, of adrenal cortex, 174f, 175, 176f, 177 218 PDQ HISTOLOGY Glucagon, 183 Goblet cells, 21, 22f, 23f Golgi apparatus, 8t, 40f Gonadotrophs, 173t Graafian follicles, 187 Granulocytes, 64. See also under individual types Granulocytic (granulopoietic) precursors, 73, 73t, 76f Granulosa cells, 189 Granulosa lutein cells, 190f, 191 Granulosum, of epidermis, 120f, 121, 122f, 124f Gray matter, 83, 84f Ground substance, of connective tissue, 35 Growth hormone, 171t, 173t Gut, 129-139 Hair follicles, 125, 126, 126f, 127f Hassall’s corpuscles, 81 Haversian canal, 56, 57f, 58f Haversian system, 56-58, 57f, 58f H bands, 104, 104f Head cap, 206f, 207 Hematopoiesis, 68 Hematoxylin, 9 Hemidesmosome, 26f, 27t Henle, loop of, 158f, 159, 163, 164f Histamine, 36, 39t Hormone adrenocorticotropic, 171t, 173t antidiuretic, 171 follicle-stimulating, 187, 205 gastrointestinal, 133, 135 growth, 171t, 173t luteinizing, 193, 207 parathyroid, 183 release-regulating (hypothalamic), 171, 171t thyroid, 179 thyroid-stimulating, 171t, 173t Hormone receptors, 169 Howship’s lacunae, 51 Hyaline cartilage, 45-47, 46f Hydrochloric acid, 133 Hydroxyapatite, 49 Hypodermis, 119 Hypophysis. See Pituitary Hypothalamic release-regulating hormones, 171, 171t Hypothalamohypophysial tracts, 173 Hypothalamus, 173 I bands, 103, 104, 104f Ileum, 136f, 137 Inferior vena cava, 110f, 113 Insulin, 183 Integumentary system, 119-128 Interalveolar walls, 152f, 153-154, 154f Intercalated disks, 104, 105, 105f Interlobular ducts, 30, 30f Intermediate filaments, 9t, 27t, 105, 105f Internal elastic lamina, 109, 110f, 112f Interstitial cells, of testis, 203, 206f, 207 Interstitial growth, of cartilage, 45 Interstitial lamellae, 57f, 58, 58f Interstitial matrix, 35 Intestine large, 138f, 139 small, 135-137 Intima, of blood vessels, 109, 110f Intralobular ducts, 30, 30f, 32f Intramembranous ossification, 50, 50f Intrinsic factor, 133 Index Iodination, of thyroglobulin, 179 Ischemic phase, of menstrual cycle, 193 Islets, pancreatic (of Langerhans), 140f, 141, 182f, 183 Jejunum, 137 JG cells, 161, 162f, 163 Junctions cell, 25, 26f, 27t gap, 26f, 27t tight, 26f, 27t Juxtaglomerular apparatus, 158f, 162f, 163 Juxtaglomerular cells, 161, 162f, 163 Karyolysis, 16, 17f Karyorrhexis, 16, 17f Karyotype, 16 Keratin, 23 Keratinocytes, 121 Kidneys, 155-165 lobule of, 156f, 157 Lacis cells, 163 Lactation. See Breast, lactating Lacunae, 45, 49 Howship’s, 51 Lamina densa, 38 Lamina propria, of gut, 130f, 131 Laminin, 38 Langerhans, islets of, 140f, 141, 182f, 183 Large intestine, 138f, 139 Leukocytes, 62t. See also under individual types Leydig cells, 203, 206f, 207 Ligaments, 41 Light microscope, 2. See also in Appendix on CD-ROM Lingual tonsil, 78f, 79 219 Liver, 142f, 143, 144 acinus, 144, 144f lobules of, 142f, 143 Loop of Henle, 158f, 159, 163, 164f Loose connective tissue, 36-41, 36f, 37f Lucidum, of epidermis, 120f, 121 Luteinizing hormone, 193, 207 Lymph nodes, 80f, 81 Lymphatic capillaries, 117 Lymphatics, 116f, 117 Lymphocytes, 62t, 66, 67f Lymphoid organs, primary and secondary, 77 Lymphoid tissue, 77-82 Lysosomes, 8t Lysozyme, 135 Macrophages, 39t, 41, 41f alveolar, 145, 152f, 153, 154f Macula densa, 162f, 163 Male reproductive system, 201-213 Mammosomatotrophs, 173t Mammotrophs, 173t Mast cells, 36f, 39t Matrix of bone, 49 of cartilage, 45, 46f, 47 extracellular, 35, 38 interstitial, 35 Media, of blood vessels, 109, 110f Medullary rays, 155, 156f, 157, 162f, 163 Megakaryocytes, 76f, 77 Melanin, 124f, 125 Melanocytes, 125 Membrane arachnoid, 85 basement, 38, 38f epithelial, 19-25, 20t. See also under individual types 220 PDQ HISTOLOGY synovial, 59, 59f, 60f Meninges, 83, 85 Menstrual phase, 193 Mesangial cells, 163 Metamyelocytes, 73t, 74f Metaphase, 15f Microfilaments, 9t Microscope electron, 3 light, 2. See also in Appendix on CD-ROM Microtubules, 8t, 15f Mitochondria, 8t Mitosis, 15f Mitotic figures, 13, 13f, 14f, 17f Mixed glands, 32-33, 32f, 33f M line, 104, 104f Monocytes, 62t, 68, 68f Mucosa, of gut, 130f, 131 Mucous secretory units, 31, 31f, 32f Muscle cardiac, 104-107, 106f skeletal, 99-104, 100f-103f smooth, 107, 107f, 108f Muscular arteries, 113. See also Distributing arteries Muscularis externa, 130f, 131 Muscularis mucosae, 130f, 131 Myelin sheath, 83, 85, 92f, 93 Myeloblasts, 73t Myelocytes, 73t, 74f Myeloid tissue, 68-77, 76f Myofibrils, 99, 100f, 102f, 103 Myoid cells, 204f, 205 Myosatellite cells, 104 Nephrons, 155, 158f, 159 Nerves, 91, 92f, 93, 93f Nervous tissue, 83-95 Neuroglial cells, 83, 86f, 88f Neurons, 83, 86f, 87 Neuropil, 83, 86f Neutrophilic myelocytes, 74f, 75 Neutrophils, 62t, 64f, 65 band, 73t, 74f Nissl bodies, 87, 91, 95 Norepinephrine, 175, 177 Normoblasts, 69t, 70f, 71 types of, 69t Normocyte, 69t Nucleolus, 6, 6f, 13 Nucleus, 13 Oocyte primary, 187, 189 secondary, 185 Ossification endochondral, 53, 55f intramembranous, 50, 50f Osteoblasts, 10f, 50, 51f Osteoclasts, 18, 18f, 51, 52f Osteocytes, 50, 51f Osteon, 56, 57f Osteoporosis, 53 Osteoprogenitor (osteogenic) cells, 50, 51f Ovarian follicles, 186f, 187, 188f, 189 Ovaries, 185-191 Oviduct. See Uterine tube Oxyphil cells, 182f, 183 Oxytocin, 171 Pacinian corpuscles, 120f, 121, 122f Palatine tonsils, 78f, 79 Pancreas, 140f, 141, 182f, 183 Pancreatic islets, 140f, 141, 182f, 183 Pancreatic polypeptide, 183 Paneth cells, 134f, 135 Papilla dermal, 121 of hair, 126, 126f, 127f Papillary ducts, 159 Index Parafollicular cells, 179, 180f, 181 Parathyroid hormone, 183 Parathyroids, 182f, 183 Parenchyma, 30 Parietal cells, 132f, 133 Parotid gland, 140f, 141 Pars intermedia and pars nervosa, of pituitary, 171 Pedicels, 161 Penis, 212f, 213 Pepsinogen, 133 Pericytes, 39t, 117 Perimysium, 99, 100f, 101f, 103 Perineurium, 92f, 93 Periodic acid-Schiff staining, 9, 12f Periosteum, 56, 57f Peripheral nerves, 91, 92f, 93, 93f Peripheral nervous system, 83, 91-95 Peyer’s patches, 137 Photoreceptors, 96f, 97 Pia mater, 84f, 85 Pituicytes, 173 Pituitary, 170f, 171, 172f, 173 Pituitary hormones, 171t, 173, 173t Plasma, 61 Plasma cells, 39t, 40, 40f Platelets, 62t, 63, 63f Pleura, 145 Pneumocytes, 152f, 153, 154, 154f Podocytes, 161 Polychromatophilic erythroblasts, 69t, 70f, 71 Polychromatophilic erythrocytes, 69t, 72, 72f Portal areas, 142f, 143, 144f Posterior root ganglia, 95 Primary follicles, 186f, 187 Primary oocyte, 187, 189 Primordial follicles, 186f, 187 Proerythroblasts, 69t, 70f, 71 221 Progestational (progravid) phase, of menstrual cycle, 187, 193 Progesterone, 185, 191, 193, 200 Prolactin, 171t, 173t, 200 Proliferative phase, of menstrual cycle, 192f, 193, 194f, 195 Promyelocytes, 73t Pronormoblast, 69t Prophase, 15f Prostate, 210f, 211, 212f, 213 Proximal convoluted tubule, 158f, 164f, 165 Pseudostratified epithelium, 20t, 21, 22f Purkinje cells, 90f, 91 Purkinje fibers, 109 Pyknosis, 16, 17f Pyloric region, of stomach, 132f, 133 Red pulp, of spleen, 82, 82f Remodeling, of bone, 53 Renal columns, 155 Renal corpuscles, 155, 156f, 158f, 160f, 161 Renal cortex, 155, 156f, 157 Renal medulla, 155, 158f, 159, 165 Renin, 163 Resolution, 2, 3 Resorption, of bone, 51-53, 52f Resorption bays, 51 Respiratory bronchioles, 150f, 151 Respiratory system, 145-154 Rete testis, 202f, 203 Reticular fibers, 35, 77 Reticularis, of adrenal cortex, 174f, 175, 176f, 177 Reticulocytes, 72, 72f Retina, 96f, 97 Retinal pigment epithelium, 96f, 97 222 PDQ HISTOLOGY Ribosomes, 8t, 11 Rods, retinal, 96f, 97 Root sheath, 126, 127f Rugae, 133 Sarcomeres, 104, 104f Satellite cells, 104 Scalp, 126, 126f Scanning electron microscope, 3 Schwann cells, 92f, 93 Sebaceous glands, 126, 126f, 127f Secondary follicles, 186f, 187 Secondary oocyte, 185 Secretory phase, of menstrual cycle, 187, 192f, 193, 194f Secretory units mucous, 31, 31f, 32f serous, 31, 31f, 32f types of, 31-33, 31f-33f Seminal vesicles, 210f, 211 Seminiferous tubules, 204f, 205 Seromucous glands, 32, 32f, 33f Serosa, of gut, 130f, 131 Serotonin, 63 Serous demilune, 33, 33f Serous secretory units, 31, 31f, 32f Sertoli cells, 204f, 205 Serum, 61 Sheath(s) of hair follicle, 126, 127f mitochondrial, 206f, 207 myelin, 83, 85, 92f, 93 Simple epithelium, 20t, 20f, 21f Simple glands, 28t, 29, 29f Sinusoids of bone marrow, 76f, 77 Sinusoids of liver, 142f, 143 of spleen, 82, 82f Skeletal muscle, 99-104, 100f-103f Skin appendages, 119t thick, 119, 120f, 121, 122f, 123 thin, 119, 120f, 124f, 125 Small intestine, 135-137 Smooth muscle, 107, 107f, 108f Somatostatin, 171t, 183 Somatotrophs, 173t Spermatids, 204f, 205, 207 Spermatocytes, 204f, 205 Spermatogonia, 204f, 205 Spermatozoa, 204f, 205, 206f, 207 Spermiogenesis, 207 Spinal cord, 84f, 85 Spinal ganglia, 94f, 95 Spinosum, of epidermis, 120f, 121, 122f, 124f Spleen, 82, 82f Staining acidophilic, 9, 10f basophilic, 9, 10f periodic acid-Schiff, 9, 12f Stains, 9 Stereocilia, 209 Stomach, 132f, 133 Strata, of epidermis, 120f, 121 Stratified epithelium, 20t, 23, 24f, 25f Stratified squamous epithelium, 23, 24f Striations, of muscle fibers, 103, 103f Stroma, 30 Subarachnoid space, 84f, 85 Submucosa, of gut, 130f, 131 Suprarenals. See Adrenals Sweat glands, 121, 128, 128f Synapses, 86f, 87 Synovial joints, 59 Synovial membrane (synovium), 59, 59f, 60f Synovocytes, 59 System circulatory, 109-117 digestive, 129-144 Index endocrine, 169-183 female reproductive, 185-200 haversian, 56-58, 57f, 58f integumentary, 119-128 male reproductive, 201-213 respiratory, 145-154 urinary, 155-167 T cells, 66, 77 Telophase, 15f Tendons, 41 Tertiary follicles, 187 Testes, 202f, 203 Testosterone, 207 Theca interna and externa, 188f, 189 Theca lutein cells, 190f, 191 Thick filaments, 104, 104f, 105f Thick skin, 119, 120f, 121, 122f, 123 Thin filaments, 104, 104f, 105f Thin skin, 119, 120f, 124f, 125 Thymus, 80f, 81 Thyroglobulin, 179, 181 Thyroid gland, 178f, 179, 180f, 181 Thyroid hormone, 179 Thyroid-stimulating hormone, 171t, 173t Thyrotrophs, 173t Thyroxine, 179 Tight junction, 26f, 27t Tissue adipose (fat), 43, 43f basic, 1, 2t connective, 35-42, 36f, 37f, 42f dense ordinary connective, 41, 42f epithelial, 19-33 joint, 59 loose connective, 36-41, 36f, 37f lymphoid, 77-82 223 myeloid, 68-77, 76f nervous, 83-95 T lymphocytes, 66, 77 Tonsils, 78f, 79 Trabeculae, of bone, 50, 50f Trachea, 146f, 147 Tracheobronchial tree, 145 Transitional epithelium, 25, 25f Transmission electron microscope, 3 Tubular pole, of renal corpuscle, 160f, 161 Tubules cortical collecting, 163, 164f proximal and distal convoluted, 158f, 164f, 165 renal, 163, 164f seminiferous, 204f, 205 Tunica adventitia, 109, 110f Tunica albuginea of ovary, 185 of testis, 202f, 203 Tunica intima, 109, 110f Tunica media, 109, 110f Ureters, 166f, 167 Urinary bladder, 166f, 167 Urinary system, 155-167 Uterine tube, 196f, 197 Uterus, 192f, 193 Vagina, 196f, 197 Varicose veins, 113 Vas deferens, 209 Vasa recta, 159 Vasa vasorum, 109 Vascular pole, of renal corpuscle, 160f, 161 Vasopressin, 171 Veins, 110f, 112f, 113 central, 142f, 143, 144f Vena cava, 110f, 113 Venules, 110f, 114f, 115 Villi, 129, 134f, 135, 136f 224 PDQ HISTOLOGY White fat, 43 White matter, 83, 84f White pulp, of spleen, 82 Z line, 104, 104f, 105f Zona pellucida, 188f, 189 Zones, of adrenal cortex, 174f, 175, 176f, 177 Zonula adherens, 26f, 27t Zonula occludens, 26f, 27t