MBBS I Histology Revision Sheet For the practical identifications of tissues, the standard and style of the questions

will be similar to those set out all year as quizzes during class. The questions have, generally, two components; firstly, identifying the specimen correctly and giving identifying characteristics, and secondly, answering some question about the function of the tissue/organ. Here is a list of things to help you identify a specimen correctly and answer the questions. More detailed instructions follow. 1. Read the questions carefully. Know what is being asked. Correctly identify slides A and B and dont get them confused. 2. Pick the slide up and look at it with the unassisted eye. The majority of specimens can be correctly identified this way without even needing a microscope. Assess colour, shape and size, as these parameters can limit your choice for identification. Narrow your choices. 3. Scan the ENTIRE slide under low magnification. Ensure your condenser lens is open, your light is bright enough, and that you place the slide onto the stage the correct way up, coverslip on top. If there are two differently stained sections of the same specimen on the slide, examine both of them. Decide what it is. 4. Use higher magnification to confirm your choice if necessary. Using high magnification will not help you identify a tissue if you dont know what it is under low magnification. However, it can confirm your choice by showing you identifying characteristics more clearly eg Hassalls corpuscles in the thymus. 5. Answer the questions. Make sure you READ the questions, particularly the functional ones. If asked for cell types, give cell types. If asked for hormones, give hormones. Be as specific as possible. The question may ask for a specific stage or structure. If given the breast, say whether it is prepubertal, resting mature, pregnant or lactating. Similarly, say the stage for endometrium, and the specific region of the stomach/ small intestine. 6. Terminology: Try to use the current internationally accepted terminology for naming structures. Using eponyms means risking your marker not determining exactly what you mean, or not finding out whether it is an alternative term that is acceptable. (However, we do try, and similarly, we do try to work out spelling, and whether or not A and B have been accidently confused). Please write legibly (This really assists your marker, especially after they have marked several thousand questions and its 3.00am). Identifying Characteristics Not that hard. (a) Pick features that are found in that tissue alone. Examples: Hassalls corpuscles in the thymus, Brunners glands in the duodenum. Or, (b) Pick features that allow you to identify the system, Examples: wall structure in GIT (mucosa, muscularis mucosae, submucosa, muscularis propria, adventitia/serosa) And combine these with some description. Example: the stomach has a muscularis propria with three layers of muscle. (Just saying that the stomach has a muscularis propria isnt good enough for a single characteristic as many things have a muscularis propria,) So three good characteristics for the stomach would be: 1. Secretory type columnar epithelium 2. A muscularis propria with three layers of muscle 3. A distinct muscularis mucosae To further identify the portion of the stomach, look at the mucosa and decide whether it is the cardia, the fundus or the pylorus as the epithelium differs between the three.

(c)

Dont say has cells because everything has cells. Naming a specific type of cell is much better.

(d) Dont say has blood vessels as virtually everything does. Is highly vascular is ok as some tissues (cardiac muscle for example) are characteristically highly vascular, and is avascular is even better, as only cartilage and cornea are basically avascular. (e) Dont just give the layers of the wall. Has lamina propria is no good as lots of things have lamina propria. Has lamina propria containing Peyers patches/Brunners glands/ other feature is fantastic. Similarly, virtually every blood vessel has three layers to its wall, but saying that the media has lots of elastin identifies the vessel as an elastic artery, which is good. Similarly, for epithelium, be specific about what type it is. At the very least say simple or stratified, squamous, cuboidal, columnar, and then mention any surface modifications (keratin, cilia, microvilli, stereocilia etc). Basically, whatever you see that allows you to identify the structure is ok as a characteristic. (f) And, read the question carefully. If the questions asks what is this tissue? then it is asking is it muscle (and what type), connective tissue (and what type), epithelia (and what type) or nervous (and, again, what type). So an appropriate answer might be, muscle smooth/involuntary. If the question asks what organ is this, then give the name of the organ. Now more detailed instructions for identification Assessing Colour: Most specimens are stained with H&E (exceptions are some blood vessels, nervous tissue, and blood and bone marrow aspirate smears). Therefore, acidic structures are blue (eg DNA in nuclei) and basic structures are pink/orange (eg cytoplasm). Because nuclei are generally small when compared to the remainder of the tissue, most tissues appear pinkish to the unassisted eye. Exceptions generally are tissues with large accumulations of lymphocytes (and other WBCs) where the nuclei are closely packed together and prominent. Hence, parts of the immune system with lots of lymphocytes are blue in colour. A slide that looks blue in part or in whole to the unassisted eye should immediately make you think of the lymphoid organs (thymus, lymph node, (spleen), or, if the blue is patchy, then Mucosal Associated Lymphoid Tissue (GIT, respiratory, potentially reproductive). A bright pink slide should suggest muscle or connective tissue in some variety. (Note that this hold true in pathology as well, where a tissue in inflammation is bluer than normal, or a tissue with fewer nuclei (necrotic) or more collagen (fibrous) is pinker than normal). Looking at Shape: You basically have four choices here solid chunk, hollow circle/oval, a strip, or a smear. The smears are easy, they are blood or bone marrow aspirates. The hollow circle/ovals are an organ with a lumen, eg GIT, respiratory, circulatory system or ureter, urethra, uterine tube, ductus deferens. In these cases, examine the epithelium lining the lumen and the structure of the wall. Each system has unique features. The strip can either be a hollow thing opened out and laid flat or something naturally flattened, eg opened aorta or stretched bladder. Use the type of epithelium and the layers of the wall to help you. Check for sandwich organs eg palate, epiglottis with a central core of tissue lined by epithelium on both sides. Solid chunk is from a solid organ, eg liver, kidney, pancreas, brain, heart (yeah, ok, not totally solid, but with very thick walls). Looking at Size: Remember that some of these specimens come from foetal material or from animals, so matching the size with that of an adult human is not necessarily a good idea. Use proportions more to guide you.

Tissues that can be confused and hints for alleviating confusion: 1. Prostate and breast Check for sperm and corpora amylacea in the prostate, the breast has neither. The breast has adipose, the prostate doesnt. The prostatic epithelium can also be confused with seminal vesicles and ampulla of the uterine tube. 2. Various parts of the GIT Examine the epithelium initially. Then look for things like Brunners glands, Peyers patches, three layers in the muscularis propria, or taenia coli to confirm your choice. 3. Seminal vesicles and ampulla of uterine tube Check the epithelial lining and remember that the walls of the uterine tube are highly vascular. Look with the unassisted eye, and remember that the seminal vesicle is a single, highly coiled tube, (therefore, the section looks like it has compartments) whereas the ampulla is a single, uncoiled tube, with finger-like fimbriae. 4. Various blood vessels, the ureter, urethra and ductus deferens Examine the shape of the lumen. Is it open or folded? Examine the epithelium endothelium, transitional, stratified squamous, cuboidal etc etc. Examine the wall structure compared to the basic plans for each system. 5. Anterior Tongue and tonsil Check for taste buds, the presence of lots of striated muscle and salivary glands in the tongue. The epithelium is the same on both tissues. Remember the posterior tongue IS lingual tonsil. A tonsil will have lymphoid aggregates under epithelium that is highly crypted. 6. Vagina/oesophagus/skin Check for keratinisation. Unless pathology is present, keratin is not normally found in the oesophagus or the vagina. Check for a muscularis propria. Skin doesnt have one. Check for a cervix. The oesophagus has glands in the lamina propria, the vagina does not. The vagina has large numbers of lymphocytes in the lamina propria. 7. Cardiac muscle and testis. I have no explanation for this one. There are several other tissues that can be confused, but these are examples that have been commonly seen in exams. The written exams should be approached in a similar manner, but on those photographs, there is likely to be more emphasis on correctly identifying various constituents or structures within an organ. The best approach is to have a system and be methodical. Remember to examine the whole slide/photograph with the naked eye and with low magnification and answer the questions that are asked. About the functional parts of the question, well, youll have to learn what the organ does. Good Luck!