Sink 1 Anglo ea tue wdh cle rebound iy together ‘actu nd ncaa sete abr ‘urethral tral ewe hee 1 Cal eptha cch hea apie side cig he set ee sacs ba sie fceg a seset membre one Inngconneine ve fp are sen spclued fr serps oe tamer, pocrossofmacl a he apa adeandexcyoss atte so. ‘The basement membrane all epi thin etclar ner feted pte sul having opts sala ‘auaad toe fron erating «+ Taeteatlomior natin meshwork ype collagen ana hin peered ye epita cte 4 The feel amin cman pe clipe ad schon Asa colon alse cls athe medal a 1 Tyger these componsae atch eptlato oanetne tins, ‘epute (her)subunts psig fom cone ne to “pilin proves ie or sel during tte eencration ‘herr an compartments epi cele om ter Intercltuletunctons Ines ations wll developed in ciel ad const tre maior pe wh aes eta + Tg rong nt ora y acing a ‘membrane retin sch saad and odin sree ‘ett nkedprotine sro heap er fhe (land prevent paracar pape uses men the Sete * fuleent oc ancoeng juntos aed ineracting pos {the adr any. ve ms oso athena {oye lof he eth, ‘i eat yh oon er tc ‘sich etal epic eatin + Hendemoone congo of armenian latin stich Morphological Types of pithelia ‘aletopracnr othe alanine 1 Gaporommnotating ncn pots of llconic where ‘ech plasm nonbrantrhae meres became comple of ‘antheairanectaneoas vc frminge ame svn pe Apical Structures of pith calle * Micon ae smal membrane rojectons wth oes of actin ‘laments tha generally acon onesie se fren fo sorption, 1 Shoes et eng eco wah ped chica fon cla ofthe ne ea an ar alc nero the maeepaacine a. 1 Gi ae inger poking strctres th a we-oaniad ore ‘mrt 9 2 arengemet ee the ene) ‘chro de ed ding of err nes {yew tha propel sterling amp ace ‘+ TWanstonl phim wroteon fandom he ining ‘Tawurnary em ised ae mundel sre sole retecive aun rie Epithet secreton/lan * Themajor funtion nmany eit el is ots and sce tin af pcan poac ogans composed rina fh “ple cldgade + Heine linda ep ac crying ects spe ‘lest tne dts ofp and urbane ang tof ‘emp lands ratchet 1 Themes tons erin nds ma frm odie ‘in (ao cel elo clngted ables oth tp ' dAneptun in which te bisenem mente hase cel oer ‘simple the cl of dew spe ths range wide a Tigh om very thin squamous ou eabeldal to ey ‘il clumose 1 Fins wth or moreno reed sn ato allah pts ar stated eamons tn whch he oe el Iayesare ths and need = Cale ot art gunman epitha move grad fom the testo the sce yr, changing shape and becoming ied ‘rb erate nemo fat f Sete guns epi sch the eer caer the tb uric preetingudering tise rm ess te os {oyna mb son = Trendouratied opti aretbckand appear tone ver ayers ae ata thes ia bt hot ce othe Seqieial eee "+ Edctne glans Ick dis sere ssn ae boone ‘Sed threghow the Body the era and Be, ‘hsp predic the hormone aero rls 1 Ghnisane te base etary eh mean Wik ‘ses exojsi hlocrin whch realy deste cals ‘lt wit pd pedal were sd apace n hich (at produc a wreasof ed re oxradel + Bowie gs producing caso sar nia es ‘le pblet ell, are aed macaw lands lish omponen macs sian poor wih rutin desu st wel SaaS 1 Bowie gan profaing ly espe gece ll ‘serous natn ry ws HES eal te (FRE and secrete grams,Pea CM oy ‘Connective sue is specialized to physically support and connect ‘other tissues and maintain the water required for metabolite diff ‘Son wand rom eal Connective tues all consist primarily of extracellular material rather than cll Within most organs connective tissue proper forms the supportive stroma, hich supports the organs unique functional components orparenchyma “The extracellular matrix (ECM) of connective tisue proper ust ally consist ofboth large protein fiber and nonsrovs areas of ‘unstained ground eubstance rich in various GAGs and water, All adult connective taaues are derived from an embryonic frm of ‘connective tisue called mesenchyme, which contain uniformly ‘undiferentated coll satered ina gel-like matrix. Cells of Connective Tissue |= Fibroblasts (fbrocte) the major cells of connective tse prope, ae elongated, irregularly shaped cll with val nicl that sym Size and seciete mest components ofthe ECM, ‘Adipocytes (at cell) are very large els speciazed for storage of iriglyeetdes they predominate ins specialized form of connective tisue called adipose ste, Macrophages are short-lived calle that ifereniate in connec- tive tatu fom precursor cel called monocytes cicultng in the ‘ood: they fonction in ECM turnover, phagocytosis of dead cells and debris, and antigen presentation to ymphosyes. ‘Mast ell alo originate from blood cell precursors and are ied ‘with granules for the release of vareus vasoactive agents and other substances during nammatory and allergic reactions Plasma cells are shored cells that differentiate from B Irapho- pte end are epee for the eben eeretion of speci sl bodies immunaglobains) 120. HAPTER = Connective Tae Ground Substance "© Ground substance 56 the watery largely unstained extracelilar ‘trial hat s more abundant thon fibers in some types of connec tive sue proper 1 Ground sbstance i ich in hydrated glycosaminoglycans (GAGS), proteoglycans, and maltiadhesve glycoproteins. ‘= Themajor pes of GAGE ae hyaluronan (hyslovonc acd), which ‘sa veryong polymer ofthe isaecharde glocosamine-glucuronate, tnd various shorter chains of sulfated GAG composed of other ‘isccharde polymers. 1 Sulfite GAGs sich as chondroitin sulfate snd keratan sulfate have various sizes and compositions, but they ae all bound tothe core proteins of proteoglycans and are prodaced inthe Gogh apparatus before secretion, 1 Proteoglycan tach to polymers of HA via ink proteins o form huge complexes in ground aubstance that bind water and ater sub stance, incising cetsn polypeptide growth factors that hp ep Late fibroblast polation 1 Maltiadhesive glycoproteins such a Sbronectin and laminin have binding ses for ellagens and fr integrin proteins incall mem. branes, thus allowing temporary attachments between cells andthe ECM required for call migration and positioning ‘+ Besides macrophages and plasma coll, other leukocytes normally ‘wander through all types of connective tse proper provi ing sorveilanceagaiont bacterial invaders and stimulating Hesue repel, Fibers of Connective Tissue “The most important and abundant fibers of connective tsue ate composed othe protcin collagen of which theese some 20 elated ‘ype Synthesis of collagen by Sbroblasts and certain othor cls aveles postransational modifications inthe RER, notably hydroxyatlon ‘the numerous proline: and lysines, and formation of heli tr rere subunis of procollagen, {Upon exacyose, the noni ends ofthe procollagen subunits te removed. forming, trimeric collagen molecules that aggregate snd ‘become covalently bound together in lrg collagen fibrils “The highly regular assembly of collagens inthe fbsis produces a «characteristic pattern of eossbanding visible ultrastructural along, the is somecllagen pes. Fs ype collagen are bndled together by other forms cf nan- Sila, inking collagens to produce large collagen bundles. Collagen fibrils are degraded by collagenase enzymes clasifed 45 matrix metalloproteinases (MMPS), produced primary by macrophages "Type IM collagen produces a network of delicate reticular fibers, ‘which stein very dale ver tang and ae abundant in immne 2nd Iymphold tues, ‘Basic bers, sects called lastc lamellae, are composed of the proteins elastin and ibrlin, which ext ina stretchable conforma- tion that provides elastic properties to connective isu ich inthis material “Types of ConnectiveTiesue * Connective tissue proper is usually cassfied as lose or dense according to the amount of cllagen and ground substance present, ' Loose connective tissue (or areolar tissue) has relatively more (ground substance chan collagen, and i typically surrounds small bod vessels and occupies areas adjacent to other types of epithelia, ‘Dense irregular connective asue filed primary with randomly disributed bundles of type 1 collagen, with some elastic fer proving resistance to tearing fom all directions a well ae some Sati. = Dense regular connective tissue, prominent in tendons and lig rents, tures bundles of sentially paral ype T collagen, provi Ing grea strength but ite stretch) in binding together components ofthe musculoskeletal sytem. 1 Retcularisue consists of deieate networks of ype collagen and {s most abundant in certain lymphoid organs whee the fibers form attachment ites for hmphocyes and other immune el f¢ Mucold thaue isa gel-like connective tissue with few cells found ‘ost abundantly around blood vessel in the umbilical codeens 1 "The defining cls of adipose tse (ft) adipocytes are very large calls derived fom mesenchymeand specialized for energy storage in lip droplets) ith trighcerdes. Adipocytes store lipids fom thee sources: fom dietary fats pack- ged as Jn the imestine, from triglycerides pro- {ced in the lve and ctclating as very-low-density lipoproteins (VLDLs)and from faty acids sythestze local Lipids ae mobilized from adipocytes by hormone-sensitve lipase activated by norepinephrine released from the aenal gland and ‘tows peptide hormones. alls of alipose tsue are supported by reticular fibers, wih con- ectve tissue septa dividing the tissue int lobules of various sizes, “There are two types of adipose tissue white fat and browa fat White Adipose Tissue ‘White adipote sues found in many organs throughout the body, ‘typically forming about 20% ofthe body weight in adults 1 Adipocytes of white at are typeally very large eel, ranging in ‘iamcter from 5010 150 jm 136 cHaeTeR7 = cacage ‘= These cele cach contain primarily ane large lipid droplet (they are runilocular), causing the nucleus and remaining eytopasm to be ‘pushed agains the plasmalemma. ‘+ any acde are relesed from white adipocytes by pase activity ‘when nutrients are needed and carried throughout the body on plasma proteins sich albumin ‘= Leptin sa polypeptide hormone with target cells in the hypothal nie that stleased from white adipocytes an hele reglae esting ‘behavior. Brown Adipose Tiesue ‘+ Brown fat comprises up to of the newborn body weight bat smaller amounts in ads. |» Adipocytes ofthis tae are typically smaller than thot af white it and contain pray many small pid droplets (they ae multi ocular) i ctoplass containing many mutochondria abd acetal nucleus. ‘+ Fatty acids released in adipocytes of brown fat are metabolized in rulochondes ofthe ell for thermogenesis rather than ATP 58 thesis using uncoupling prteia- ‘© Cartage a tough, resent ype of connective sue hat stu tory sopportscetainsof tomes, noah the expat tet, and proves cushioned, lowfrtin suics in ot + Call of cartilage, chondroytes, makeup a small percentage of the tse mas which imal exible mas of extacllalar nati (FCM) 1 Chondroeytr are embedded within lacunae suround bythe Few + Cutlage EOM icy incades collagen as el av abundant proteoglycans, otably aggrecan, which bind s large amount of ' Cartage alvays acs Blood vessels Ipmphatis and nerves but it ‘sully surrounded by dense connective tise perichondriam ‘hate visculrie 1 There are three major forms of artilge(1) hyaline cartilage, (2) clastic cartilage, and (3) fibrocarilage Hyaline cartilage 1 The ECM of hyaline catiage is homogenous and glassy rch in brs of typeI collagen and aggrecan complexes With bound ‘= The ECM as les collagen and more proteoglycan immediately around the lacunae producing slight staining difrences in this territorial mate, "© Chondrocyts occur singly or in smal, it enous groups. 1 Perichondrium is wusly present, but ota the hyaline carage ‘ofarticular surfaces or the epiphyses of growing long bones. lly derived isog- Elastic Cartilage ' Hlatccartlage generally resembles hyaline cartilage ints chon ‘roeytes and major ECM components, but its matrix includes, ‘abundant elastic bers, vibe with special stains, which increase the tse felt. 1 Elastic carilage provides flexible support forthe external ear as well ascertain structures of the middle ear and lary ti aways surrounded by perichondrium, Fibrocartilage 'ibrocartilage contains varying combinations of hyaline cartilage jn small amount of dense connective issue. 1 Histologically consists of mal chondrocytesin hyaline matrix, ‘oually layered writ larger ares of bundled type T collagen with catered fibroblasts, f= Fibrocartlage proves very tough, strong support st tendon wertions and in intervertebral discs and certain ther joints Cartilage Formation, Growth, & Repair ‘All orm ofcarlage form fom embryonic mesenchyme. Cartlaginoussteuctures grow by mitosis of exiting chondrobasts sn Lacan (Unterstital growth) or formation af new conde ‘lasts peripherally from progenitor cells inthe perihondium (appesiions growth) 1 Repair or replacement of injred cartilage i ery slow ad ine fective, de in porto the tssich avascularty and low metabolic rateTC) 1 Hone ia type of connective tue with a callie extraclilar matrix (ECMD, specialized fo support the body, protect many ‘ternal organs, and act asthe bodys Ca reservoir [Major Cells & Matrix Components of Bone * Osteoblast diferetiate from (stem) osteoprogattr clls and secrete components ofthe inital mati, ealed osteoid that allow ‘matrix mineralization to occur "Important components of oseod inca type | collagen, the protein osteocalcin which binds Ca” and matrix vesicles with cnzymes generating PO, ‘© High concentrations of Ca and PO, ions cause formation of hydroxyapatite crystals, whose growth gradually calcies the = Onteocytes diferentise further from ostevblasts when they become enclosed thin matic lacunae and act t9 maitainthe ‘matric and detect mechanical stress on bone. ‘Woes orgntation of Bone Table 6-1) * Dense bone immediately beneath the periosteum i alled com- [pact bone, dep tothe conspact bone are small bony trabeculae oe ‘Spleuls of cancellous (r spongy) bone Ta ong bones of the Tbs these two types of mature bone tissue ‘ceur in both the knobby, bulbous ends, called epiphyses, and in the intervening shaft or diaphysis Immature bone, called woven bone, is formed during osteogenesis ‘repair and as climate with randomly aang cllage Firs. By the action of osteoclasts and osteoblasts, woven bone under- goes rapid turnover and is remodeled ico lamellar bone with new ‘matrix deposited in distint layers with pall collagen bundles ‘both compact and cancellous bone elmer bone. Most lamellar bone consists of lellae organized concenticaly around small central canals containing blood vessls and nerves, this organation i clled an osteon or Haverstan sytem, Within each osteon osteveytc lacunae oscur between the lame- Tse, sth eanalicul radiating through the lame, which allow all clit communicate with the central canal, Osteogenesis anes ofthe sll and js form intially by intramembranoas ‘ossification, with osteoblast diferentiting directly frm progen- tor eal in condensed “eacanbranes” of rcten hye All other bones form by endochondral ossification. in which ‘osteopragenitar cells surround and then invade hyaline cartilage ‘models of the sheletl elements in the embry. Primary ossification centers in diaphyses of etal long bones form ‘when chondrocytes die after enclosure ofthe carlage within a calla of woven bone, creating an intl cavity that entered by periosteal osteoblasts and vasculature. [ates secondary ossification centers develop smal within the pipes, with caraige of the epiphyseal growth plate berween the primary and secondary osiaton ses, “The growth pats are the ay to bone elongalon during childhood. and are organized aan interested serie of developing zones. Most distally isa “resting” or reserve zone of typical hyaline carage Inan adacent zone of proliferation, chondrocytes undergo mito sis and appear stacked within elongated lacunae ‘The most mature chondrocytes in these lacunae swell up, compress the matrix and undergo apoptosis in azone of hypertrophy closer to thelarge primary osifation center. ‘Spaces created in the matrix by these events characterize the rane of cartilage calcification when they ae invaded by osteobass, ‘osteoclasts and vasculature from the primary center Tn the zone of ossification woven bone is laid down initlly by ‘osteoblasts and remodeled int andi bone. Ococytes maintain communication with adjseat calls vis a network of long dendritic processes that extend through the tuatrixva narrow canalicl editing from each lacuna. 1 Onteocaste are very large cls, formed by fusion of several blood ‘monocytes, which locally erode bone matrix during osteogenesis and bone remodeling Periosteum & Endosteum ' Periosteum isa lyer of dense connective tisue on the outer sur face of bone, hound to bone matrix by bundles of type Tcllagen «alle perforating (or Sharpey) fiber Regions of periosteum adjacent to bone are rich in oxteopro- cnitor cells and osteoblast hat mete much bone growth and Femodsing 1 The endosteum is thin lyerof active and inactive estoobass ‘which line al he internal surface within bone; osteoblast here 2 alo required far bone growth. * -Appositional bone growth increases the circumference of a bone iy onecblastactiity atthe periosteum and le accompanied by ‘enlargement ofthe medllary marzo cavity ‘Bone Growth, Remodeling, & Repair * Growth of bones occurs throughout lf, with cells and matric turning over continuously through activities of esteoblas and ‘osteoclast 1 Lamellae and osteons are temporary structres anid ate replace and rebuilt continuously ina process of bone remodeling by which bones change ste and shape according to changes n mechanical * Bone repair afr fracture or other injury involves the activation of Peostea fibroblast o produce an inital rot calls of bracar- Uage-like tissue The sot calist& gradually replaced by 2 hard callus of woven ‘bone that soon remodeled to produce stronger lamelar bane Metabolic Role of Bone Ca, a key ion forall calls stored in bone when dietary cal ‘lum is adequate and mobilized from bone when dietary calcium Isdeficient 1 Maintenance of proper blood calcium levels invaves activity ofall thre major bone cel and is largely regulated by subtle parectine Interaction among these and other coll * Hormones afetng calcium deposton and removal from bone include parathyroid hormone (PTH), which indirectly stimulates ‘osleclatie to elevate levels of calcium in blood, and ealetonin, which can inhibitestoclas activity. lowering blood cazium levels Joints * Joints ae places where ones meet or articulate, allowing at eas the potential for bending or mevement in that portion of the skeleton * Joims with very limited or no movement are assed collectively as smnathroses and frei mobil joint are called darthrones. Intervertebral diss are synarthross in the vertebral column which cushion adjacent vertebrae 1 Each intervercbral disc consists of a thick outer layer of fbrocar ‘lage forming a tough annulus brosus and a shock-absorbing inner gel-like core, he nucleus pulposus. = Diarthroses have joint envty led with ibricant gmovia uid, ‘enclosed within a tough, fibrous articular capeuler ends of the tones invobied are covered with balineaticolareatlge Specialized connective tisue ofthe synovial membrane ins the capsule, with olds extended into some ares ofthe joint vty 1 Macrophage lke synovial cells the synovial membrane remove vwcarand-tear debris rom synovial i 1 Fibroblast lie synovial ells fhe synovial membrane synthesize Inyalaronan which moves into the synovial Hid with water from Toca caplaries to lubricate and nourish the articular carlage1 The guid portion of ciculatng blood is plasma, while the cls and platelets compre the formed elements pon clotting, some pro- ‘eine are remove from plasma and ethers ate related from plate les forming a new guid termed serum. * Important protein components of plasma incude albumin, diverse fand (globulins, proteins of the complement systema, snd Abrinogen all of which ae secreted within the her, 38 wall the saline 1 Red blood cells or erythrocytes, which make up the hemato- «rit portion (~43)) of blood sample, are enucleated, biconcave diss 75 ym in diameter, led with hemoglobin forthe uptake, |= Neutrophils, the most abundant ype of Iso, have polymor- ‘hle, multilobed nude, and faint punk cytoplasmic granules that sontsin many factors for highly efficient phagolysosomal king and removal of bacteria ‘= Eosinophils hae bilobed nucle and eosinophilic specie granules containing fctors for destruction of heminthic parasites and for ‘modulating inflammation. | Basophils, the rarest type of circulating leukocyte, have irregular Iylobed nice and resemble mast cells with strongly basophilic spe lfc granules containing factors important in allies and chronic inflammatory conditions, including histamine, heparin, chemo- kines, and varios hyroaee, transport, and relesse of ©,,and with 3 norm 120 days. 1+ White blood cells or leukocytes are broadly grouped as granu cytes (neutrophils, eosinophils. basophils) or agranulocytes ymphoeyts, monocytes. ‘All leukocytes Bocome active ouside the circulation, specifically leaving the microvasculature in a process involving cytokines, selec tive adherion, changer sn the enothelam, and transendothelil migration or dapedesis: 1 Allgranilocytes have specialized lysosomes called szarophilic sramules and soullr specific granules with proteins for various ‘elhspecc functions, ife span of about Lymphocytes, granulocytes with many fanctons as T- and B-cell subtypes inthe immune system, ange widely in size, depending on their activation state and have roughly spherical mile with tle ‘cytoplasm and few organelles Monocytes are lager agranalacytes with distinctly indented or Coshaped nucle that crculte as precursors of macrophages and ‘ther cal of the mononuclear phagocyte systems Platte are smal (2-4 jum) ell fragments derived from megakary- ‘cytes in bone marow, wth a marginal bundle of actin laments, alpha granules and delta granules, and an open canalicular system ‘of membranous veils rapid degranulation on contact wth col lagen triggers bod cating