Primal Pictures Ltd.

2014

Anal canal cancer

Pramana, a 76-year-old Indonesian man, had swelling around his anal canal. His doctor diagnosed anal canal cancer.
The tumor was removed surgically, along with the internal and external anal sphincters. Subsequent examination of the
excised tissue, via light microscopy, showed that the tumor had spread through the internal (involuntary muscle)
sphincter, but not through the external (voluntary muscle) sphincter. During microscopic examination of the tissue
sample, it was possible to distinguish between the internal and external anal sphincters without knowing the orientation
of the slide.
1. What type of muscle tissue will form the external
1. The external sphincter will be formed from voluntary
(voluntary) sphincter?
skeletal muscle fibers.
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2. What type of muscle tissue will form the internal
2. The internal sphincter will be formed from involuntary
(involuntary) sphincter?
smooth muscle fibers.
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3. How would you distinguish between the internal and
3. There are various ways to distinguish between the
external sphincter muscle tissues when viewed with a light internal and external sphincter muscle tissues. The
microscope? What should each muscle type look like?
skeletal muscle fibers of the external sphincter, when cut
longitudinally, will appear as long, thin, cylindrical fibers,
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with many peripheral nuclei. In longitudinal section, the
fibers will have striations with alternating light and dark
bands, due to the presence of regularly arranged
contractile proteins. The smooth muscle fibers of the
internal sphincter are smaller than skeletal muscle fibers,
are spindle-shaped (they taper at each end), and have a
single, centrally located nucleus. Smooth muscle does not
appear to be striated. Both arrangements will be clearly
visible on light microscopy.
Epithelia of the gastrointestinal tract
Julia, a 57-year-old restaurant owner, has a history of stomach pain and indigestion. She underwent an endoscopy to
allow doctors to view her esophagus and duodenum, and to take biopsy samples of the epithelial lining of each.
Microscopic examination showed that the esophageal biopsy had stratified squamous epithelium and that the duodenal
biopsy had non-ciliated simple columnar epithelium. In one sample of esophageal epithelium, a number of small blood
vessels were seen passing through the epithelial cell layers.
1. What is epithelium?
1. Epithelium is a cellular covering or lining of a body
surface. Epithelium is made up from one, or multiple,
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layers of cells that are held closely together by specialized
junctions between the cells and the basement membrane.
2. What are the roles of epithelium?
2. Epithelium has several roles. It can serve as a protective
barrier, a selectively absorptive barrier, and as a secretory
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membrane.
3. Explain what you would expect to see when looking at 3. When looking through a microscope, stratified
stratified squamous epithelium using a microscope.
squamous epithelium would be seen to consist of multiple
layers of cells, with only the bottom layer of cells anchored
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to the basement membrane. The cells near to the
basement membrane would be relatively cuboidal in shape,
with the cells getting flatter and more squamous when
moving toward the free edge of the epithelium.
4. What are the functional properties of stratified squamous 4. Stratified squamous epithelium is often found in areas of
epithelium?
abrasion and wear and tear, as the multiple layers of cells
act as a protective barrier, providing good protection to the
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underlying basement membrane. Wear and tear may
damage the superficial cell layers but the underlying cell
layers remain intact. In addition, squamous cells are

relatively flat and therefore present low mechanical

resistance to objects moving across their surface.
5. Based on your answer to question 4, do you think that 5. Yes, stratified squamous epithelium would normally be
stratified squamous epithelium should normally be seen in found in the esophagus as it is an area of high abrasion
the esophagus?
and wear and tear, due to the passage of foodstuffs through
its lumen.
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6. Explain what you would expect to see when looking at a 6. Seen through a microscope, non-ciliated simple
sample of non-ciliated simple columnar epithelium using a columnar epithelium would consist of a single layer of
microscope.
columnar (rectangular) shaped cells, each of which would
be attached to the underlying basement membrane. The
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free edge of the epithelium would not possess cilia (small
extensions), but would likely possess small folds in the
plasma membrane, known as microvilli.
7. What are the functional properties of non-ciliated simple 7. Non-ciliated simple columnar epithelium is found in
columnar epithelium?
areas of absorption. The single cell layer provides a simple
path for the diffusion, osmosis, filtration, secretion, and
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absorption of substances from the apical side of the
epithelium into the body. The lack of cilia mean that the
epithelium is not able propel to things across its surface.
8. Based on your answer to question 7, do you think that 8. Yes, non-ciliated simple columnar epithelium is the
non-ciliated simple columnar epithelium should normally be normal epithelium of the duodenum, since this area of the
seen in the duodenum?
gut is concerned with the absorption of nutrients,
molecules, and water from food.
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9. Blood vessels were seen in the epithelium of Julia's
9. No, blood vessels should not normally be seen in an
esophagus. Is it normal to see blood vessels passing
epithelial cell layer. Epithelia are normally avascular, with
through epithelium?
the blood vessels only occupying the region below the
basement membrane.
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Fibrolipoma
Saul, a 56-year-old male, noticed a firm lump under the skin of his thigh. A biopsy revealed that the lump contained
fibroblasts and adipocytes. Saul was diagnosed with a benign connective tissue tumor known as a fibrolipoma.
1. What is connective tissue?
1. Connective tissue is a term used to describe support
cells and the extracellular matrix that they secrete.
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2. What are the normal roles of connective tissue?
2. Connective tissue is found throughout the body. It has
many roles including structural support, strength,
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protection, insulation, and storage.
3. What are support cells? What do they do?
3. Support cells are found within connective tissues. They
produce the majority of the extracellular matrix.
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4. Name the five main types of support cells.
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5. What is the extracellular matrix?
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6. Name three types of fiber that are often found in the

extracellular matrix.
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7. What are fibroblasts? What do they do?
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8. What are adipocytes? What do they do?

4. The five types of support cells are fibroblasts,

adipocytes, chondroblasts, osteoblasts, and
myofibroblasts.
5. The extracellular matrix refers to the substance found
outside of the support cells of a connective tissue. The
extracellular matrix is made up from fibers and ground
substance. The composition of the extracellular matrix
determines the unique properties of each connective
tissue.
6. Collagen, elastic, and reticular fibers are often found in
the extracellular matrix.
7. Fibroblasts are large, flat, branching cells that are found
in most connective tissues. They secrete collagen and
some of the ground substance components of the
extracellular matrix.
8. Adipocytes are specialized support cells that can store

lipids (triglycerides). Adipocytes serve as an energy store

and provide protective padding in certain areas of the body.
9. Given the support cells types that were found in Sauls 9. The presence of fibroblasts means that Sauls tumor
tumor, what extracellular matrix fibers might be seen in the could contain collagen fibers or reticular fibers. Reticular
biopsy sample?
fibers are often found in adipose tissue.
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Meniscus injury
Sophia, a 23-year-old runner, went to see her doctor with pain in her right knee. Examination revealed damage to her
medial meniscus and a small tear in her medial collateral ligament. The medial meniscus is made from fibrocartilage.
1. What is cartilage?
1. Cartilage is a connective tissue made from a dense
network of collagen or elastic fibers and chondroitin sulfate,
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a glycosaminoglycan.
2. What is fibrocartilage and what are its general
2. Fibrocartilage consists of thick bundles of collagen
properties?
fibers, interspersed with chondrocytes, and is the strongest
cartilage in the body. It has relatively high tensile strength,
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is relatively rigid, and resists deformation.
3. What is the purpose of the collagen fibers found within 3. Collagen fibers within cartilage provide it with tensile
cartilage?
strength.
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4. What type of connective tissue are ligaments formed
4. Ligaments are formed from dense regular connective
from?
tissue, which consists of a regular arrangement of thick
and tightly packed parallel bundles of collagen fibers, with
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very few supporting cells (such as fibroblasts).
5. What type of support cell(s) will be involved in the repair 5. Fibroblasts are the main support cells found in
of Sophia's damaged meniscus and ligament? Explain
ligaments, and fibroblasts and chondrocytes are the main
what the support cell(s) normally do(es).
support cells found in fibrocartilage. Both of these support
cell types secrete fibers, including collagen, and
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components of the extracellular matrix, therefore, they will
both be involved in the repair of Sophia's meniscus and
ligament.
6. Based on the blood supply to ligaments and cartilage, 6. A good blood circulation with its supply of nutrients,
relatively how long will it take for Sophia's injuries to heal, such as protein and vitamins, is vital for the effective repair
as compared to a skin wound?
of body tissues. Ligaments have a relatively poor blood
supply, and cartilage is avascular. Therefore, the
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poor/absent blood supply of these tissues would result in a
much longer healing time of Sophia's injuries when
compared to the healing time of a skin wound.
Neural cells
Chun-Po, a 72-year-old man, went to see his doctor as he had been suffering with a headache for 3 weeks, and was
suffering from a collection of other symptoms. Investigations revealed that Chun-Po had a neuroglial cell tumor in the
frontal lobe of his brain. The tumor was compressing neurons and neuron synapses in the brain.
1. What is a neuroglial cell? Name one type of neuroglial 1. A neuroglial cell is a non-neuronal cell of the brain.
cell.
Astrocytes are a type of neuroglial cell, as are
oligodendrocytes and microglial cells.
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2. Describe the structure of a neuroglial cell.
2. Neuroglial cells have a small cell body containing a
nucleus, and have branching cytoplasmic processes of
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variable number and size.
3. What is the role of neuroglial cells?
3. Neuroglial cells provide support, nourishment, and
protection to the neurons of the central nervous system.
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Certain neuroglial cells form myelin sheaths around the
axons of neurons, which helps enhance the transmission
of action potentials.
4. What is a neuron?
4. A neuron is a nerve cell, the functional unit of the
nervous system.
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5. Describe the structure of a neuron.

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6. What is the function of a neuron? What do networks of
neurons do?
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7. What is a synapse?
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8. Briefly explain how an action potential can be
transmitted across a synapse.
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9. What could be the consequence of compressing

neurons and synapses? Therefore, what other symptoms
might Chun-Po have been showing?
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5. A neuron has a cell body containing a nucleus and an

axon (a single thin projection from the cell body). The axon
ends in one or more axon terminals. The cell body has
several dendrites attached to it.
6. Neurons can respond to a stimulus. They convert the
stimulus into an action potential which is propagated down
the axon to the axon terminal. The activity of neuron
networks is responsible for the control of muscles, gland
secretions, sensations, and memory.
7. A synapse is a small gap between the axon terminal of
one neuron and the membrane of the cell body or dendrites
of another neuron. Synapses can transmit action
potentials.
8. When an action potential reaches the axon terminal at a
synapse, it triggers the release of a neurotransmitter into
the synapse. The neurotransmitter diffuses across the
synapse and binds to receptors in the postsynaptic cell
body or dendrites. This process can depolarize and initiate
an action potential in the postsynaptic neuron.
9. Compressing neurons and synapses prevents them from
working properly and prevents the transmission of neural
signals. Chun-Po might, therefore, show specific deficits
related to the area that is affected. For example, he might
show muscle weakness or paralysis, sensory loss,
memory loss, or another deficit in cerebral function.

Parotid gland infection

Svetlana, a 45-year-old mother of five children, went to see her doctor complaining of pain over the left side of her face
and a strange taste in her mouth. The doctor diagnosed an infection of Svetlana's parotid gland, a large salivary gland
located on the side of the face. He informed Svetlana that the taste in her mouth was due to the discharge of pus from
the gland into her mouth.
1. What is a gland?
1. A gland is a group of specialized cells that secrete
products onto a body surface or into the blood, either
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directly or via a duct.
2. What type of gland is a salivary gland?
2. A salivary gland is a multicellular exocrine gland.
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3. What type of secretion is used by a salivary gland?
3. Salivary glands are merocrine glands. Secretory vesicles
Explain how the products of a salivary gland are secreted. containing the cell product collect at the apical surface of
the secretory cell, to be released via exocytosis into the
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lumen of the gland.
4. Based on the route of drainage of most exocrine glands, 4. Most exocrine glands, such as the salivary glands, drain
how is it possible for a gland to become infected by a
via a duct that connects to the skin or to a hollow lumen of
bacterium from the outside world?
the body. The duct can therefore serve as a route for
infection spread from the outside world to the secretory
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epithelial lining of the gland.
5. Give examples of other glands that could become
5. Mammary glands connect via ducts to the nipple of the
infected and inflamed by bacteria from the skin.
breast and sebaceous and sweat glands connect via ducts
to the surface of the skin over most of the body.
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Prostate gland biopsy
Mark, a 67-year-old man, was having problems urinating. A lump was detected on his prostate gland. His doctor ordered
a biopsy (sample) of the lump to be taken for histological examination under a microscope, to determine if abnormal cells
were present. Thin sections of the biopsy were stained using hematoxylin and eosin.
1. What would you need to do to the tissue sample in order 1. For histological analysis, the tissue biopsy would need
to enable it to be thinly sectioned/sliced for histological
to be embedded in a suitable medium, such as paraffin
analysis? Explain why.
wax. Embedding ensures that the tissue is correctly
orientated and supported during sectioning.
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2. What would you need to do to a tissue sample in order

to enable it to be thinly sectioned/sliced and subsequently
analyzed for enzyme activity? Explain why.
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3. What would hematoxylin and eosin staining enable you
to see on the tissue section? What colors would the
structures be?
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4. Which type of microscopy would you use to examine
the stained section of Mark's prostate biopsy? Explain
why.
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2. The tissue biopsy would need to be rapidly frozen in

liquid nitrogen and then sectioned using a chilled
microtome (cryostat). Rapid freezing helps to preserve the
activity of enzymes in tissue samples.
3. Hematoxylin and eosin staining enables the
differentiation of nucleic acids from basic cytoplasmic
proteins. Hematoxylin stains acidic nucleic proteins a
blue/black color, and eosin stains basic cytoplasmic
proteins a red/pink color.
4. Light microscopy would be the most appropriate method
to view the cells present in Mark's biopsy. This is because
light microscopy allows the visualization of cells and larger
organelles in color, and therefore takes advantage of color
staining. Electron microscopy on the other hand is
expensive, requires special specimen preparation, and
provides only black and white images. It is therefore not the
best choice for the routine identification of the tissues and
cells in this section.