OLFU College of Medicine

Section A, Batch 2021

I. The Cell and Tissues Peroxisomes – membranous sacs of oxidase enzymes

II. Muscle Tissue - small spherical organelles containing enzymes for
III. Circulatory System various metabolic reactions, for oxidation and
IV. Respiratory System detoxification
V. Digestive System - also contain the enzyme catalase, which eliminates
VI. Blood, Lymphatics, and Immune System excess hydrogen peroxide by breaking it down into
VII. Endocrine and Integumentary System water and oxygen molecules
VIII. Genitourinary System
Mitochondria – also known as the “powerhouse of the cell”
I. The Cell and Tissues - major site of ATP synthesis
(dra. Araga) - abundant in cells or cytoplasmic regions where large
amounts of energy are expended
Cells are the building blocks of all living things; the basic structural and - with two membranes: a porous outer membrane
functional units, the smallest living parts of the body encloses the intermembrane space and an inner
membrane with many folds (cristae) enclosing a gel-
Tissues are groups of cells that are similar in structure and function. like matrix.

Cytoskeleton – microfilaments (axonemes), intermediate

Anatomy of the Cell filaments, microtubules
- consists of a network of tiny protein filaments and
• Nucleus – the control center of the cell; contains genetic tubules that extend throughout the cytoplasm
material or DNA. - microtubules – important in maintaining cell shape and
o nucleolus – site of ribosome synthesis as tracks for transport of vesicles and organelles by the
o nucleosome – the smallest chromatin subunit motor proteins kinesin and dynein.

• Plasma Membrane – barrier for cell proteins; trilaminar Centriole – retains the greatest energy during cell division
o double phospholipid layer, with hydrophilic heads and - direct formation of mitotic spindle during cell division
hydrophobic tails
o other materials in the plasma membrane: proteins,
glycoproteins, cholesterol Filaments – provides elastic support to the cell membrane
o plasma membrane specializations: microvilli, striated Cilia – for locomotion
border, brush border, stereocilia
o Membrane Junctions:
✓ Tight junctions
✓ Gap junctions
✓ Desmosomes • Parenchyma – structural and functional characteristic cells
of a tissue or organ
• Cytoplasm – material outside the nucleus and inside the
• Stroma – supporting tissue of the organ, usually are forms
plasma membrane
of connective tissue
o cytosol – fluid that suspends other elements
o organelles – metabolic machinery of the cells
o inclusions – non-functioning units; deposits of
carbohydrates, lipids, or pigments
Types of Tissues
Cytoplasmic Organelles:
✓ Epithelium
✓ Connective Tissue
Ribosomes
✓ Muscle Tissue
- made of protein and RNA ✓ Nervous
- site of protein synthesis
- Ergastoplasm in glands
1. Epithelial Tissues – continuous sheet of closely adherent cells
- Nissl’s bodies in neurons
covering body surfaces; forms boundary layer that controls
movement of substances between external and internal
Endoplasmic Reticulum – largest cytoplasmic organelle;
environment or between internal compartments
Rough ER Smooth ER
Characteristics:
+ ribosomes on the surface - ribosomes
✓ cells fit closely together
Protein synthesis Steroid synthesis
Storage of calcium ✓ may or may not be specialized for absorption, secretion,
Site of detoxification or ion transport
process ✓ cells are arranged in layers or sheets
✓ tissue layer always has one free surface
✓ the lower surface is bound by a basement membrane
Golgi Apparatus – packaging system of the cell ✓ avascular or no blood supply
- found largest in secretory cell types ✓ regenerates easily if well nourished
- in fibroblasts, for production of GAGs
- causes the intense basophilia in the matrix of hyaline Types of Epithelial Tissue
cartilage
A. Simple Squamous Epithelium
Lysosomes – digestive system of the cell - single layer of flat or squamous cells, includes mesothelium and
- formed from the Golgi complex endothelium
- contains hydrolytic enzymes - usually forms membranes
- functions in filtration, diffusion, transport, secretion, and
reduction of friction

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 OLFU College of Medicine
Section A, Batch 2021

B. Simple Cuboidal Epithelium b. Zonula Adherens – intermediate junction, fascia

- layer of round cells adherens; encircles apical portion below the occludens;
- protects ducts; transports and absorbs filtered material in kidney cross links are made possible by myosin, alpha actinin, and
tubules vinculin. It stabilizes the epithelium by connecting the
terminal webs of adjoining cells (cell-to-cell adherence)
C. Simple Columnar Epithelium
- single layer of tall cells c. Macula Adherens – desmosome; small, round
- often includes goblet cells, which produces mucus specializations on sides of the adjoining cells; trans-
- secretes protective mucus for stomach lining membrane linkers bind membranes and dense plaques
together (cell-to-cell attachment); it contributes to the
D. Pseudostratified Columnar Epithelium, with Cilia or stability of the epithelium by linking the cytoskeleton of
Stereocilia adjoining the cells
- single layer, but often looks like a double layer
- all cells reach basement membrane, but not all reach the surface d. Nexus – gap junction; cell-to-cell communication; low
- ciliated cells interspersed among mucus-secreting goblet cells resistance pathways insuring simultaneous contractions.
- stereocilia – non-motile apical modifications of the cell, contains Membranes on each side contain circular patches called
actin filaments connexons
- respiratory tract
Hemidesmosomes – anchor basal cells to the basal lamina
E. Stratified Epithelium Basement membrane – extracellular layer found beneath the epithelia
o lamina lucida – transparent, collagen type IV
- formed by multiple layers of cells, the superficial cell layer
o lamina densa – meshwork, collagen type VII
determining epithelial type
- cells at the free end are flattened
- found as a protective covering where friction is common
- skin, mouth, esophagus
2. Connective Tissue – most diverse and abundant tissue;
encloses organs as a capsule, separates organs into layers,
F. Transitional Epithelium
provides support for bones, storage and insulation for fats,
- changes shape in response to stretching caused by fluid transports blood.
accumulation
- during extension or contraction, cell contact unbroken
Main Classes:
- forms protective barriers
• Connective tissue proper
- lines the organs of the urinary system
• Cartilage
G. Glandular Epithelium • Bone tissue
• Blood
According to number of cells
- unicellular – made up of a single cell Characteristics:
- multicellular – many cells make up the gland ✓ Mesenchyme is the common tissue of origin
✓ Varying degrees of vascularity
According to type of secretion ✓ Nonliving extracellular matrix, consisting of ground substance
- purely serous and fibers
- purely mucous ✓ Cells are not as abundant nor as tightly packed together as in
- mucoserous (mixed) epithelium
- cytogenic
Extracellular Matrix has 3 major components:
According to how they pour their secretions ✓ Protein fibers
- exocrine – pour their secretions through duct systems ✓ Ground substance
- endocrine – directly pour their secretions in the blood (ductless ✓ Cells
glands)
• Protein Fibers
According to mode of secretion
- merocrine – secretory products exit the glands by exocytosis Collagen Fibers – composed of the protein collagen. Strong, flexible,
without loss of cytoplasm or membrane inelastic, great tensile strength, perfect for tendons and ligaments.
- apocrine – secretory products exit the cell with some cytoplasm
and membrane, hence, with partial destruction of the cell Elastic Fibers – contain molecules of protein elastin that resemble
- holocrine – exocytosis of the secretory products by lysis of the coiled springs. Returns to its original shape after stretching or
cell (total destruction) compression. Perfect for lungs and large blood vessels.

According to structure of multicellular exocrine glands
- tubular
- alveolar/acinar/saccular
- tubulo-acinar/mixed/racemose
Cell Cohesion – dependent on cell adhesion molecules such as
cadherins; in addition to cadherins, cells are attached by local
specializations called junctional complexes.
a. Zonula Occludens – tight junction, occluding junction;
belt-like specializations that encircle columnar cells below
the free surface of the epithelium; constitute selective
permeable barrier, barrier between apical and basolateral
plasma membrane
Reticular Fibers – formed from fine collagenous fibers; form branching
networks or stroma, fill spaces between tissues and organs
Components of Connective Tissue
✓ Connective Tissue Cells
✓ Connective Tissue Fibers
✓ Ground Substance – highly hydrated transparent, complex
mixture of macromolecules; major components are GAGs
which are in the form of chondroitin SO4, heparan SO4, and
hyaluronic acid.

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Section A, Batch 2021

Proteoglycans which act as Adhesion Proteins (Multiadhesive Subtypes of Connective Tissues

Glycoproteins) a. Fibrous Connective Tissue

✓ Fibronectins – interconnect the three components of Collagenous Tissue:

connective tissue
✓ Integrins – bind collagen fibers directly
✓ Laminins – binding sites for the cell membrane, collagen fibers
and heparan SO4.
Connective Tissue Fibers
1. Collagen – most abundant, in unstained preparations, appear
as colorless strands; made up of tropocollagen which consists of
3 polypeptide chains in triple helix configuration.
o loose collagenous tissue – also called areolar tissue;
occurs in areas where less resistance is required.
Collagen fibers are small, moderately abundant and
loosely interwoven.
o dense irregular tissue – fibers are coarse and very
abundant with random orientation
o dense regular tissue – closely packed in parallel bundles
Elastic Tissue
Reticular Tissue

b. Adipose Tissue – reserve energy

Type I Fibroblasts Skin, bones, tendons, capsules of o White adipose tissue – insulators
Osteoblasts organs o Brown adipose tissue – energy reserve
Type II Chondrocytes Cartilages, nucleus pulposus of IV
c. Undifferentiated Mesenchymal Cells
disc, vitreous body of the eye
d. Mucous Connective Tissue
e. Lymphatic Tissue
Type III Fibroblasts Fibers that are arranged in loose f. Myeloid Tissue
Smooth muscle networks g. Blood
cells
h. Bones
Hepatocytes
Type IV Epithelial cells Copolymerizes with entactin and
i. Cartilages
laminin

Type V Forms fibers Fetal tissues, skin, bone, placenta, II. Muscle Tissue
together with most interstitial tissues (dr. Samonte)
Type I
- composed of elongated cells with the property of contractility
• Collagen fibers types I-III are sometimes referred to as - can convert chemical energy into mechanical work through
interstitial collagen fibers. contraction
• Collagen fibers types V-X have restricted distributions.
• Collagen fiber type VII forms anchoring fibrils in the basal sarcoplasm – cytoplasm of muscle cells
lamina of epithelial tissues sarcolemma – cell membrane

2. Reticular Fibers – support parenchyma of many organs;
composed of fibrils of type III collagen and some glycoproteins;
seen on silver stain, hence, the term agyrophilic. It is most
abundant in hemopoietic, lymphoid tissues, and hollow organs.
3. Elastic Fibers – composed of elastin; synthesized by fibroblasts
and smooth muscles of large arteries.
- within the cytoplasm are sarcomeres which are membrane-
bound structures containing granules and sarcoplasmic
reticulum
sarcoplasmic reticulum – the SER in muscle cells, which is
responsible for release and uptake of calcium ions during contraction
and relaxation of the muscle

Skeletal Cardiac Smooth

Connective Tissue Cells Striated Striated Non-striated

Voluntary Involuntary Involuntary

a. Fibroblasts – principal cells of connective tissue, for synthesis
of collagen, elastin, and proteoglycans of ground substance.
Usually fusiform, tapering on both sides, may be flat or stellate.
b. Adipose Cells or Fat Cells – arise from mesenchymal cells;
take up and store triglycerides, “signet ring” in appearance.
c. Mesenchymal Cells – round or stellate; smaller than fibroblasts.
d. Reticular Cells – support parenchyma of many organs; produce
reticular fibers; stellate with long, thin cytoplasmic process. Some
can phagocytose antigenic materials and cellular debris, others
can present antigens.
Free Wandering Cells:
• Macrophages – motile phagocytic cells; sometimes referred to as
histiocytes; highly important for up-take, processing and
presentation of antigens for lymphocyte activation
• Leukocytes or WBC
• Plasma Cells – produces immunoglobulins or antibodies
• Mast Cells – with intensely basophilic granules in the cytoplasm;
associated with IgE in hypersensitivity reactions
1. Skeletal Muscle
- skeletal muscle fibers are long, cylindrical, multi-nucleated
syncytia formed by fusion of multiple individual cells called
myoblasts
- fibers are not branched, and the nuclei are peripherally located
- the muscle as a whole is surrounded by a thin layer of dense
connective tissue called the epimysium
- this epimysium then extends inwards, enveloping each of the
bundles of muscle fibers forming septa, called perimysium
- a delicate reticular fiber around the individual muscle fibers is
called endomysium
- the outer surface of the sarcolemma is coated with a thin
external lamina that resembles the basal lamina of epithelia.
- the inner surface of the sarcolemma is coated by a very thin layer
of protein called dystrophin, which reinforces the membrane,
enabling it to resist stresses developed in muscle contraction,
relaxation, and stretching.
- in the sarcoplasm, there are thousands of myofibrils that are
cross-banded which account for the cross-striations of the fiber
as a whole

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Section A, Batch 2021

- the sarcoplasm also contains an oxygen-binding protein, 3. Smooth Muscle

myoglobulin, which is responsible for the brown color of the - widely distributed in the body
muscle. - situated in the wider central portion
- two parallel cisternae and a T-tubule form a complex called a - cells are organized into bundles or layers
triad - each smooth muscle is enveloped by a thin external lamina
resembling the basal lamina of epithelia
Dark Bands – anisotrophic, designated as A-band - cells are in contact only at gap junctions which provide cell-to-
Light Bands – isotrophic, designated as I-band cell communication necessary for integrated contraction
throughout the layer
A-band I-band - ratio of actin to myosin filaments is about 12:1
Length is constant Length is very short - contraction is relatively slow but it can be sustained for longer
during contraction, and periods
longer when the muscle is - contraction is initiated by an influx of calcium which binds to
relaxed, calcium-binding protein calmodulin
Presence of H-band in Each I-band is bisected
the middle of A-bands, by a darker narrow
bisected by a thin M-line transverse line, the Z disc
at its midpoint or Z line Muscle dystrophy – hereditary disease, sex-linked affecting males
Major constituent: myosin Dominant component: only; there is a defect in the gene for dystrophin. Muscle weakness is
filaments actin filaments evident by the age of 5 years and by 13 years of age, the patient will
be confined in a wheelchair.

Myasthenia Gravis – an autoimmune disease characterized by

2. Cardiac Muscle muscular weakness and fatigability; antibodies are formed for
- consists of fibers that are not a syncytium but are made up of unknown reason against the acetylcholine receptors in the
separate cellular units – cardiac myocytes sarcolemma at the myoneural junction. It may be life-threatening if
- cells are joined end-to-end at junctional complexes called the muscles of respiration are seriously involved; more common in
intercalated disks women between 20-40 years of age.
- intercalated disks represent junctional complexes between
adjacent cardiac myocytes

• Fascia adherens or fascia junctions – most prominent Skeletal Cardiac Smooth

membrane specialization in transverse portion of the disc; Hypertrophy ✓ ✓ ✓
serves as anchoring fibers for actin filaments of the
terminal sarcomeres
Atrophy ✓ ✓ ✓
Hyperplasia x x ✓
• Desmosomes or macula adherens – bind the cardiac
muscles together to prevent their pulling apart under
constant contractile property
Skeletal Cardiac Smooth
Red fibers Cardiac myocytes Single-unit
• Gap junctions – found on the lateral portion of the disks, Intermediate fibers Purkinje fibers Multi-unit
portion has iconic continuity between adjacent cells White fibers Endocrine cells Mixed
A, I, H band A, I, H band Dense bodies
- pattern of cross-striations of cardiac muscle is similar to that of Z disc Z disc (absence of
skeletal muscle sarcomeres)
- contractile substance is composed of actin and myosin filaments T-tubules T-tubules Caveolae
Muscle spindles Synapse Dense plaque
in the same inter-digiting relationship as that of skeletal muscle
Neuromuscular No mitosis Synapse
- tubules from the sarcoplasmic reticulum are less numerous than junctions
those in skeletal muscle Undergoes mitosis
- tubules form the sarcolemmal network called the corbular No mitosis
reticulum that extends into deep clefts in the columns of Capable of Capable of self-
myofilaments regeneration after regeneration after
injury through satellite injury
cells
Myocardial Endocrine Cells
- specialized myocytes in the right and left atrial appendages
secrete peptide hormones III. The Circulatory System
- involved in the regulation of blood volume and electrolyte (dr. Samonte)
composition of the extracellular fluid
- most distinctive feature is the presence of many membrane- - the circulatory system is responsible for the transport and
bound secretory granules in the core sarcoplasm that extends in homeostatic distribution of oxygen, nutrients, wastes, body fluids,
either direction from the poles of the nucleus and solutes, body heat, and immune system components
- these granules contain cardiodilatin, or atrial natriuretic - two subsystems:
peptides (ANP), which are released into the blood and cause
peripheral vasodilation and consequent lowering of blood Cardiovascular System – a closed system of tubes through which the
pressure blood circulates with the aid of an in-line pump; has 4 components:
o Heart – muscular pump
o Arteries – carry blood from the heart to the tissues
Corbular Reticulum – larger calibers than the T-tubules of the o Veins – return the blood from the tissues to the heart
skeletal muscles, tend to occur at the level of the Z-band between o Capillaries – intervene between the blood and other tissues
successive sarcomeres; not flanked by long terminal cisternae,
therefore, triads are lacking in cardiac muscle Lymphatic Vascular System – comprises another set of vessels in
which lymph moves in only one direction; lacks a pump and includes
functional counterparts of the terminal cisternae are small saccular
dilatations of certain longitudinal tubules of the reticulum that is in three vessel types: lymphatic capillaries, lymphatic vessels, and
close contact with the T-tubules referred to as the diads. lymphatic ducts.

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Section A, Batch 2021

- Walls of blood vessels:

o Tunica Intima – innermost layer and borders the lumen, Annuli Fibrosa Dense connective tissue rings that surround and
consists of endothelium and subendothelial connective reinforce the valve openings in the AV canals and at
tissue the origins of the aorta and pulmonary artery
Trigona Fibrosa Two triangular dense connective tissue masses,
o Tunica Media – consists mainly of circumferential vascular
occasionally containing some cartilage that lie
smooth muscle fibers; arteries generally have a thicker between the two groups of annuli fibrosae
media than do veins Septum A dense fibrous plate forming the top of the otherwise
o Tunica Adventitia – outermost layer; consists chiefly of Membranaceum muscular interventricular septum
type I collagen and elastic fibers that anchor the vessel in
the surrounding tissues;
Cardiac Valves – control the direction of blood flow through the heart;
In veins – the thickest layer is the adventitia
each valve is a fold of epicardium enclosing a plate-like core of dense
connective tissue that is anchored in, and continuous with the annuli
In large vessels, the adventitia contains smaller vessels or
fibrosa
vasa vasorum that supply oxygen and nutrients to cells in
the vessel wall too far from the lumen to be nourished by
1. Tricuspid Valve – between the right atrium and ventricle, has
diffusion
three cusps or flaps. The free edge of each cusp is anchored to
papillary muscles in the floor of each ventricle by fibrous cords
The Cardiovascular System
called chordae tendinae.
A. Heart – has four chambers:
2. Bicuspid Valve or Mitral Valve – between the left atrium and
ventricle; has only two cusps, each anchored by chordae
• two atria – thinner-walled chambers located at the base
tendinae to papillary muscles in the ventricle floor
(top) of the heart, collects returning blood
3. Semilunar Valves – has three semilunar cusps which are not
• two ventricles – thicker-walled chambers located in the attached to the chordae tendinae; the two semilunar valves are
body and the apex of the heart; re-distribute the collected the aortic and pulmonary valve which has a characteristic
blood thickening at the center of its free edge.
3 layers of the walls or tunics of the heart:
Impulse Generating and Conducting System
1) Endocardium – inner layer which is homologous to the intima of
vessels, with three components: 1. Sinoatrial (SA) Node – pacemaker node
a. endothelium – underlain by a thin, continuous basal lamina - a small cell mass in the right atrium’s median wall, near the
b. subendothelial connective tissue – with elastic fibers and opening of the superior vena cava
some smooth muscles - because the SA node’s cells have the fastest intrinsic rhythm,
c. subendocardium – a layer of areolar tissue with small they set the pace for the rest of the heart
blood vessels, nerves, and in the ventricles, branches of the - impulses generated in the SA node travel slowly through ordinary
impulse conducting system atrial cardiac muscle to the atrioventricular node – the slow
conduction allows the atria to complete their contraction before
the ventricles begin theirs.
2) Myocardium – consists mainly of cardiac muscle fibers that
carries out the forceful contractions that allow the heart to serve 2. Atrioventricular (AV) Node – a cell cluster on the right side of
as a pump; contains the impulse conducting system and the the interatrial septum
parts of the cardiac skeleton - as an impulse leaves the AV node, it passes rapidly along the
a. atrial cardiac muscle – arranged in overlapping atrioventricular bundle
network giving the inner surface of the atria a
woven appearance. 3. AV Bundle (of His) – a bundle of specialized cardiac muscle
fibers passing from the interatrial septum to the interventricular
Atrial Cardiac Muscle Ventricular Cardiac Muscle
septum
Overlapping network, giving the inner Complex layers of cells wound
surface of the atria a woven helically around the ventricular cavity
- gives off a smaller bundle (bundle branch) to each ventricle
appearance
- Somewhat smaller - arrangement aids in “wringing Right and Left bundle branches – travel a short distance before
- (+) granules containing atrial out” the heart during branching to form Purkinje fibers.
natriuretic factor contraction which maximize the
- Have less extensive T-tubule percentage of blood in the 4. Purkinje Fibers – cardiac muscle cells specialized to conduct
system cavity that is expelled during
electrochemical impulses
- More gap junctions contraction
- Conduct impulses at a higher - wider than typical cardiac muscle cells with sparse myofilaments
rate concentrated at the cell periphery
- Contract more rhythmically - generally wider than bundle branch cells and, like typical cardiac
than the ventricular muscles muscle cells, are connected by intercalated disks and may have
one or two central nuclei

3) Pericardium or Visceral Pericardium – outermost layer,
consists of a single layer of squamous mesothelial cells, a thin
basal lamina, and a layer of sub-epicardial connective tissue that
binds the epicardium to the myocardium
Cardiac Skeleton – also known as the fibrous skeleton of the heart;
made up of a dense fibrous connective tissue scaffolding into which
the cardiac muscle fibers insert.
5. Ventricular Cardiac Muscle Cells – last link in the impulse
conducting chain
- they not only contract in response to the impulse but also
propagate the impulses they receive from the Purkinje fibers and
pass them onto their neighbors
- cardiac musculature functions effectively as a syncytium, its cells
contacting as one in a synchronous coordinated manner.

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 OLFU College of Medicine
Section A, Batch 2021

B. Blood Vessels 3) Veins

- have thinner walls than arteries
1) Arteries - may contain erythrocytes in sectioned tissue
- thicker tunica media - have a thicker, more prominent adventitia which in larger veins
- distinguishable by refractile, eosinophilic internal and external may contain longitudinal muscle
elastic laminae - contain valves that help maintain the unidirectional flow of blood
- valves are extensions of the intima into the lumen consisting of a
Intima Media Adventitia fibroelastic tissue core covered on both sides by endothelial
Elastic or Very thick Contains Thin, related to vessel
Large abundant elastin diameter contains Classifications of Veins
Arteries type I collagen and
(conducting) external elastic
lamina Intima Media Adventitia
Muscular or Contains typical Thick, contains Relatively thin and Well developed Contains Best developed layer in
Medium- endothelium and as many as 40 contains mostly Large Veins and includes a several layers large veins which
sized subendothelial layers of smooth collagen fibers thick layer of of smooth contains abundant
Arteries connective tissue muscle subendothelial muscle cells collagen and
(distributing) connective and abundant longitudinal bundles of
tissue reticular and smooth muscle that
Small Lined by Thinner but Discernible
collagen fibers. strengthen the vessel
arteries endothelial cells predominantly
wall to prevent
smooth muscle
excessive dilatation
Comprises 1-5
Small and Typical Thin, relative to Relatively thick, contains
Arterioles Contains typical layers of smooth Very thin and
Medium- endothelium vessel diameter little, if any muscle;
(resistance) endothelium muscle encircling composed of collagen
sized Veins made up mainly of
the vascular fibers
collagen fibers
lumen
Typical Very thin Very thin and contains
Incomplete single
Venules endothelium but collagen
Meta- Contains typical layer of smooth Indistinguishable
lack valves
arterioles endothelium muscle

Small and medium-size veins contain no internal elastic lamina

2) Capillaries
- smallest vascular channels
- walls consist of simple squamous epithelia (endothelial) cell
sheet rolled into a tube and surrounded by a thin basal lamina 4) Lymphatic Vessels and Ducts
- the cells attach to one another at their respective borders by - contain walls that resemble those of veins
junctional complexes, including tight (occluding) junctions and - the beaded appearance of lymphatic ducts and vessels reflect
gap junctions the presence of valves that control the unidirectional flow of
- some capillaries have fenestrations or pores in their endothelial lymph
linings - major lymphatic duct for each side of the body are:
- thoracic duct on the LEFT
Cells of Capillaries - right lymphatic duct on the RIGHT
a. endothelial cells – chief structural components of capillaries, - lymphatic ducts return lymph to the blood by emptying into the
lined by simple squamous epithelial cells; mesenchymal in origin, venous system at the junction of the jugular and subclavian veins
joined by intercellular junctions to form a tube. in the neck
- lymphatic capillaries are lined by simple squamous endothelial
key functions: tubes
✓ conversion of angiotensin I to angiotensin II - have a greater diameter and a thinner discontinuous basal
✓ inactivating bioactive compounds like bradykinin and lamina than capillaries
serotonin - lack fenestrations and have fewer tight junctions than blood
✓ breaking down of lipoproteins capillaries
✓ preventing clot formation
✓ participating in capillary transport
IV. Respiratory System
b. pericytes or adventitial cells – small mesenchymal cells (dr. Gironella)
scattered along capillaries; each is surrounded by its own basal
lamina and clings by long cytoplasmic processes to capillary The Nasal Cavity
surfaces - site of filtration, hydration, and temperature regulation of inspired
air; formed by paired chambers separated from each other by the
Continuous Capillaries Fenestrated Sinusoidal Capillaries nasal septum
Capillaries - lined by a ciliated pseudostratified columnar epithelium

Smooth, nonporous
endothelial lining
Cells attach lightly by
junctional complexes
Brain, muscles,
peripheral nerves
Endothelial cells
perforated by pores
that may be open or
covered by thin
diaphragms that limit
the size of
macromolecules able
to pass
Tissues where rapid
exchange between the
tissues and blood is
required
Kidneys, intestines,
endocrine glands
With wide lumens,
follow a tortuous path;
Gaps between
endothelial cells often
allowing cells to pass
Many fenestrations and
discontinuous basal
laminae
Functions of the Nasal Mucosa
✓ Air Hydration
- secretions of serous and mucous exocrine glands coat and
moisten the surface of the nasal cavity
- secretions add water vapor to the inspired air
- goblet cells in the epithelial lining and their secretions also
contribute to the fluid layer
✓ Air Filtration
- turbulent airflow is created in the nasal cavities by interruption of
the airstream by the conchae
- Turbulent precipitation – a mechanism for cleaning inspired air

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Section A, Batch 2021

✓ Temperature Regulation - localized immune reactions to antigen contained in inspired air is

- nasal mucosa has an extensive superficial vascular bed that present in the tracheal mucosa as diffuse lymphatic tissue and
warms or cools inspired air nodules with germinal centers

• Ciliated columnar cells

The Olfactory Mucosa • Basal cells
- a localized sensory region in the dome of each nasal cavity that • Goblet cells
is thicker than the surrounding non-sensory mucosa of the nasal • Microvilli or brush cells
cavity • Small granule cells or Kulchitsky cells
- a specialized pseudostratified epithelium that is part of the
olfactory mucosa
The Bronchi
• Olfactory cells - extrapulmonary and intrapulmonary cartilage-supported airways
• Supporting or sustentacular cells
• Basal cells Extrapulmonary Bronchi Intrapulmonary Bronchi
• Microvilli “primary” bronchi Surrounded by the parenchyma of
the lung and divides repeatedly to
Serous exocrine glands or Bowman’s glands – found in the connective form the lobar or the “secondary”
bronchi, and the segmental or the
tissue deep to the olfactory epithelium; secretions are released into the “tertiary” bronchi
surface of the olfactory region; odoriferous substances are suspended Resemble the trachea but are Lobar – largest intrapulmonary
or dissolved in this fluid layer slightly smaller in diameter bronchi
Segmental – smaller in diameter

Paranasal Sinuses - lined by ciliated pseudostratified columnar epithelium similar to

- frontal, maxillary, ethmoidal, and sphenoidal sinuses the trachea
- air-filled spaces in the bones that form the wall of the nasal cavity - goblet cells occur in the epithelium and mucous and serous
- mucosal surface of the sinuses is a thin ciliated pseudostratified exocrine glands are present in the subepithelial connective tissue
columnar epithelium - all contain cartilage

Nasopharynx
- air-filled space posterior to the nasal cavity and superior to the
soft palate
- most of the nasopharyngeal mucosa is covered by a ciliated
pseudostratified columnar epithelium although patches of
stratified squamous non-keratinized epithelium may spill over
from the oropharynx
- the pharyngeal tonsil is a mass of lymphatic tissue in the
posterior wall of the nasopharynx; when enlarged, this tonsil is
called adenoids.
The Larynx
- an expanded hollow portion of the respiratory system located
between the nasopharynx and the trachea
- air passing through the larynx produces speech and other
vocalizations
- laryngeal muscles are skeletal muscles
a) areas subject to abrasion are characterized by a stratified
squamous epithelium
b) parts of the epiglottis which direct food into the esophagus
and prevent food from entering the larynx are also covered
by a stratified squamous epithelium
Bronchioles
- the smallest bronchi lead into the bronchioles
- lung bronchioles branch repeatedly until finally terminal
bronchioles and respiratory bronchioles are formed
- always smaller than the bronchi
- lined by ciliated columnar or cuboidal epithelium
- occasionally pseudostratified epithelium extends into a larger
bronchiole from a bronchus
- bronchiolar secretory or Clara cells are present in the
epithelium of bronchioles and are different from goblet cells; it
has a characteristic domed-apex that contain numerous
secretory granules containing surfactant-like material that is
secreted into the bronchiolar surface
Terminal bronchioles – smallest, most distal bronchioles that function
exclusively in air conduction; lined by simple columnar epithelium
Respiratory bronchioles – transitional structures partly devoted to air
conduction and partly devoted to gas exchange; a small (post terminal)
bronchiole with non-contagious (scattered) alveoli punctuating its wall
- air conduction occurs in non-alveolar regions which are lined by
cuboidal epithelial cells
- gas exchange occurs in alveolar regions which are lined by
squamous epithelial cells

c) pseudostratified ciliated columnar epithelium covers most Alveolar Unit

of the remaining laryngeal mucosa
d) stratified columnar epithelium may occur in transitional
zones
The Trachea
- carries air between the larynx and the bronchi
- supported by C-shaped rings of hyaline cartilage
- bifurcates at the level of the sternal angle of Louis to form the
primary (extra-pulmonary) bronchi
- the tracheal wall is formed by an inner mucosal epithelial layer,
a submucosal connective tissue layer, numerous glands,
cartilage rings, and an outer adventitial layer
- lined by a ciliated pseudostratified columnar epithelium
- blind, spheroidal compartments that are the terminal part of the
respiratory system
- functional unit of gas exchange in the respiratory system
Alveolar duct – resembles a respiratory bronchiole in which alveoli
become the predominant structure in the airway wall
Alveolar sac – alveolar ducts end in cul de sacs called alveolar sacs;
are clusters of alveoli that have a common central space into which
alveoli open
- smooth muscle is not present in alveolar sacs

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Alveoli - saliva dissolves water-soluble particles and contains enzymes

- lined by simple squamous epithelium that attack carbohydrates
- taste buds check for contaminants, toxins, and nutrients
Type I cells / Pneumocytes Type II cells / Pneumocytes - the tongue moves chewed food back into the oropharynx and
Thin squamous cells specialized for Cuboidal secretory cells that closes the epiglottis to protect the airway
gas exchange protrude into the alveolar space - skeletal muscle in the walls of the oropharynx and the upper third
Rest on a basal lamina Widely scattered in the alveolar of the esophagus aid the tongue in swallowing and moves food
lining
Predominant cell type of the alveolar Integral components of the alveolar
down the esophagus, where smooth muscles take over
lining lining
Small alveolar cells Secrete membrane-bound ✓ Absorption
multilamellar bodies which - occurs mainly in the intestines
accumulate in the apical cytoplasm - the small intestines absorb nutrients
and have been shown to contain - the large intestines absorb water
phospholipids rich in pulmonary - to maximize the absorptive surface, the small intestine’s lining
surfactant
has multiple permanent folds, including the plicae circulares
and villi.
Alveolar macrophages – sites of phagocytic activity and are part of the
- intestines are lined by absorptive cells or enterocytes, whose
mononuclear phagocytic system derived from blood monocytes; also
apical microvilli further increase the surface area
present in the interalveolar connective tissue
✓ Excretion
- metabolic wastes are excreted by the liver as bile and emptied
V. Digestive System
into the duodenal lumen
(dra. Araga)
- smooth muscles in the small intestine’s wall move undigested
materials and waste products to the large intestine
- the digestive tract is composed of organs that form a long
- in the large intestines, more mucous is added and most of the
muscular tube whose continuous lumen open to the exterior at
water is extracted
both ends
- the process concentrates and solidifies the intestinal contents,
forming feces
Each organ’s wall has four concentric layers:
- the material is further dehydrated, stored in the rectum, and
✓ mucosa
finally expelled through the anal canal
✓ submucosa
✓ muscularis externa
✓ Endocrine function
✓ serosa or adventitia
- the enteroendocrine cells were formerly called argentaffin,
argyrophilic, and enterochromaffin (EC) cells, owing to their
1. Mucosa
affinity for silver and chromium stains
- epithelium
- EC cells secrete hormones and amines (serotonin, secretin,
- lamina propria
gastrin, somatostatin, cholecystokinin, glucagon) that regulate
- muscularis mucosae
local GI functions as gut motility and the secretion of acid,
enzymes, and hormones by other cell types.
2. Submucosa
- layer of loose connective tissue which contains blood vessels
and the submucosal or Meissner’s plexus of nerves
The Oral Cavity
- some organs are characterized by glands and lymphoid nodules
in this layer
Wall structure:
- the mouth is lined by stratified squamous epithelium
3. Muscularis Externa
- the underlying mucosa contains salivary glands which secrete
- consists of two layers (inner circular and outer longitudinal) of
mixed or mucoserous fluids
smooth muscle throughout most of the tract
- skeletal muscle fibers in the deeper layers are responsible for
- between the smooth muscle layers lie the Myenteric or
altering the size and shape of the cavity and for moving the food
Auerbach’s plexus
- skeletal muscle fibers form the bulk of the tongue, and are also
- muscle around the oral cavity is skeletal, except in the hard
numerous and important in the cheek
palate and gingiva
- the muscularis mucosa of the stomach has three layers: inner
A. Lips
oblique, middle circular, and outer longitudinal
- a transition occurs from non-keratinized mucous membrane to
- the colon’s outer longitudinal layer is gathered in three bands
the keratinized stratified squamous epithelium of the skin – or the
and called the taenia coli.
vermillion border
- the thin keratinized layer covering the lips’ vermillion border
4. Serosa and/or Adventitia
allows the reddish color of the blood vessels of the lamina propria
- the tract’s outer covering differs according to location.
to show through
- intraperitoneal organs (stomach, jejunum, ileum, transverse and
- hair follicles, keratin, and additional pigment help distinguish the
sigmoid colon) are suspended in mesenteries and covered by a
outer lip surface from the inner lip surface in tissue sections.
serosa (mesothelium)
- occasional sebaceous glands or Fordyce’s spots are common
- retroperitoneal organs (duodenum, ascending and descending
at the angles of the mouth, which open directly into the mucosal
colon) are bound to the posterior abdominal wall by adventitia
surface rather than into the hair follicle as in the skin.
and are covered on their anterior surfaces by serosa.
- in the deeper parts of the lips, bundles of striated muscle fibers
(orbicularis oris) are arranged mainly in a concentric manner
around the oral orifice
General Functional Features of the Digestive System
B. Teeth
✓ Digestion
- main task of the oral cavity is fermentation of large food masses
- degradation of food is a pre-requisite for absorption
performed by the teeth
- enzymes act mainly at food surfaces, and chewing exposes more
- hard, heavily mineralized structures embedded in raised alveolar
surface area
ridges of the maxilla and the mandible
- lip, cheek, and tongue muscles position food between the teeth

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o Incisors – located directly behind the lips
o Canines – or cuspids; lie lateral to the incisors
o Premolars – or bicuspids; lie posterolateral to the canines
o Molars – or tricuspids; lie behind the premolars
C. Oropharynx
- lies below the level of the soft palate
- lined by non-keratinized stratified squamous epithelium
- contains the palatine and pharyngeal tonsils, many small
subepithelial mucous glands, and skeletal muscle arranged as
circular pharyngeal constrictors and longitudinal pharyngeal
muscles
- communicates with the oral cavity, the esophagus, and the larynx
D. Cheeks
- outermost layer is made up of skin lined by stratified squamous
keratinized epithelium
- next is a layer of dense irregular connective tissue superficial
fascia
- at the middle is a bundle of skeletal muscles (buccinator) salivary
glands called buccal glands
- innermost layer is lined by stratified squamous non-keratinized
epithelium called mucosa
E. Gums or Gingiva
- covers the mandibular and maxillary arches in which teeth are
anchored or embedded
- consists of stratified squamous keratinized epithelium
- includes an underlying lamina propria, whose long papillae
interdigitate with epithelial ridges
- epithelium forms a cuff around the crown’s base and is separated
from the tooth by a narrow gingival cervica
- at the base of the cervica, gingiva forms a basal lamina-like
thickening called cuticle, which encircles the tooth and attached
to the enamel forming the epithelial attachment of Gottlieb.
F. Tongue
- muscle is arranged in bundles of many sized which are separated
by connective tissue and cross each other in three planes, giving
the tongue the flexibility required for speech, positioning of food,
chewing, and swallowing
- mucosa differs in the ventral and dorsal surface
Salivary Glands
- secretion is called saliva, which moistens food, lubricates the
digestive tract, and begins the enzymatic digestion of
carbohydrates
- also secrete salts and protect against bacterial invasion by
releasing lysozyme and IgA into the saliva
• Parotid Gland
- largest salivary gland, enclosed in a fibrous capsule, subdivided
into lobules, situated below and in front of the pinna on each side
of the face
- branched acinar gland that contains almost exclusively serous
secretory cells
- main duct is called the Stensen’s duct, which opens into the oral
vestibule opposite the upper second molar tooth
- secretion is about 25% of the total salivary volume
- secretion contains amylase, maltase, sialomucin, and enzyme-
resistant secretory IgA.
• Submandibular or Submaxillary Gland
- branched tubulo-acinar glands that produce about 70% of the
salivary volume
- contains both serous and mucous, but predominantly serous
adenomeres
- serous secretions contain sialomucin and have weak amylase
activity
- mucous adenomeres may be capped by serous demilunes
(serous crescent or demilunes of Gianuzzi) composed of several
lysozyme-secreting serous cells
- main duct is called the Wharton’s duct, which opens at the
summit of the sublingual papillae.
• Sublingual Gland
- an aggregation of small salivary glands that lie in the submucosa
of the floor of the mouth
- considered the smallest among the three large salivary glands
- also a mixed gland, but predominantly mucous with no fibrous
capsule
- major duct of Bartholin opens alongside the Wharton’s duct
- minor duct of Rivinus opens along the sublingual fold

Ventral surface Dorsal surface The Esophagus

Thin, non-keratinized stratified Partly keratinized; - lies between the pharynx and the stomach
squamous epithelium underlain with Anterior 2/3 is separated from the
a lamina propria posterior 1/3 by a V-shaped groove
- transports food in an undigested but fragmented form to the
stomach
- originating from the pharynx at the level of the cricoid cartilage,
Four types of papillae: and extending to the posterior mediastinum in the midline to the
level of the diaphragm
Filiform MOST NUMEROUS but LACK TASTE BUDS; partly
- penetrates the left crus before opening into the stomach at the
keratinized epithelium, with conical projections
esophago-gastric junction
Fungiform Resemble mushrooms; each papilla has taste buds on its
expanded surface but not on its narrow stalk
Layers of the Esophagus
Foliate Occurs in rows separated by furrows into which serous
glands in the lamina propria drain; the furrow walls harbor A. Mucosa
many taste buds
Vallate LARGEST but LEAST NUMEROUS; surrounded by a • Lining Epithelium – stratified squamous non-keratinized
ring-like mucosal ridge from which it is separated by the epithelium; scattered in this layer are occasional melanocytes
circular furrow; walls contain taste buds on both sides, only
7-12 occur near the V-shaped groove at the back of the
and neuroendocrine cells
tongue
• Lamina Propria – consists of loosely arranged collagen fibers
and fibroblast embedded in an acellular glycosaminoglycan
G. Soft and Hard Palate matrix, with scattered lymphocytes and eosinophils, as well as
occasional mast cells and plasma cells
Soft Hard
Stratified squamous non- Stratified squamous • Muscularis Mucosa – thick at the lower end near the
keratinized epithelium with keratinized epithelium with esophagogastric junction
underlying loose connective underlying loose connective
tissue tissue firmly bound to the
periosteum

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B. Submucosa – broad and contains mucus glands which secrete - collection of nerves and ganglions between the circular and the
acid mucins; each gland has 2-5 lobes, which drains into a short longitudinal muscle is the Myenteric or the Auerbach’s plexus.
duct lined by stratified columnar epithelium;
4) Serosa
• Tunica Muscularis – the muscularis proper; upper third is made - composed of loose collagenous tissue and lined by mesothelial
up entirely of striated muscle, middle third with both skeletal and cells
smooth muscle, lower third is entirely smooth muscle

• Serosa or Tunica Adventitia – made up of mesothelial cells and
small amount of loose collagenous tissue
The Stomach
- dilated portion of the digestive tract, temporarily holds ingested
food, adding mucous, acid, and the enzyme pepsin
- contractions blend these components into a viscous mixture
called chyme, which is subsequently divided into parcels for
further digestion and absorption by the intestine
The Small Intestines
- includes the duodenum, jejunum, and the ileum
- receives chyme from the stomach, bile from the liver, and
digestive enzymes from the pancreas
- they hydrolyze the nutrients to be absorbed and transferred to
the blood and lymphatic capillaries
- undigested material is moved to the large intestine by peristalsis
- longest portion of the alimentary tract
- continues the digestion of food
- absorbs the nutrient products of digestion

General Structure • Duodenum – 12-15cm, firmly fixed to the posterior abdominal

- the complex mucosa contains numerous gastric glands wall, has C-shaped course around the head of the pancreas
- a two or three-layered muscularis mucosa helps empty the
glands • Jejunum – suspended from the posterior wall on a mesentery,
- when empty and contracted, the mucosa and the underlying comprises 2/5 of the total length of the small intestine
submucosa are thrown into irregular, temporary folds called
rugae, that flatten when it is full. • Ileum – makes up the distal 3/5 of the small intestine
- four major regions: cardia, fundus, corpus/body, and pylorus

Layers of the Small Intestine

Layers of the Gastric Wall
1) Mucosa
1) Mucosa
A. Intestinal Epithelium – intestinal epithelial cells are short
A. Lining Epithelium – simple columnar epithelium, perforated lived and must be continuously replaced
by many small holes called foveolae gastricae
absorptive cells – tall columnar cells with prominent brush
foveolae – openings of the epithelial invaginations, gastric pit; borders
serves as ducts for the branched tubular gastric glands
goblet cells – mucous secreting cells scattered among
Epithelial Cell Types of the Mucosa absorptive cells; lubricates the surface of the intestinal
mucosa, protection from abrasion, and for the prevention
Surface Mucous Cells Neutral mucous secretion that protects of adherence and invasion by numerous bacteria.
the stomach’s cell surface from acidic
gastric fluid
stem cells – found in the neck of intestinal glands
Mucous Neck Cells Secrete acidic mucous
Parietal or Oxyntic Cells Secrete HCl and Intrinsic Factor enteroendocrine cells – small cells that are usually located
Chief or Zymogenic Cells Secrete pepsinogen and some lipase at the base of the epithelium; also scattered among
Enteroendocrine Cells Produce various endocrine and paracrine
absorptive cells
amines
Cells Secretion Location
A cells Glucagon Upper third of the stomach
B. Lamina Propria – is made up of loose collagenous tissue
with some lymphocytes; gastric glands extend up to this EC cells Serotonin Most numerous; found
throughout the intestinal
layer tract
G cells Gastrin Numerous in the duodenum,
C. Muscularis Mucosa – made up of two or three layers of absent in ileum
smooth muscles
S cells Secretin
2) Submucosa I cells Cholecystokinin Duodenum and jejunum
- consists of loose lymphatic tissue as well as loose collagenous
tissue D cells Somatostatin Rare in ileum
- occasional eosinophils and plasma cells may be found MO cells Motilin
- contains the submucosal plexus of Meissner, a collection of L cells Enteroglucagon Small and large intestines
nerves and ganglions

3) Tunica Muscularis
- three layers of smooth muscle: inner oblique, middle circular, and
outer longitudinal
- when contracted, they decrease the stomach capacity and the
mucosa is thrown into folds called rugae, which are most
prominent on the convexity of the stomach or the greater curve
- at the pyloro-duodenal junction, the middle circular layer forms
the pyloric sphincter
Paneth cells – found at the base of intestinal crypts;
specialized for defense against bacterial invasion; contain
lysozymes, phospholipase A2, and defensins that are
capable of digesting bacterial cell walls and kills bacteria
by membrane disruption

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between bases of vili, epithelium is invaginated to form Ascending and Descending Colon – fixed to the posterior abdominal
short intestinal glands or crypts of Lieberkuhn, secreting wall
intestinal juice that acts as:
(1) solvent for nutrients released in digestion Transverse and Sigmoid Colon – suspended on a short mesentery
(2) vehicle for cytokines, a paracrine secretion of cells
that influence the functions of neighboring cell types Layers

B. Lamina Propria – areolar tissue that surrounds the 1) Mucosa – no folds and no villi; contains straight glands
intestinal glands; forms the core of intestinal villi
- contains fibroblasts, lymphocytes, macrophages, and Absorptive cells Present in the upper third
plasma cells Goblet cells Present in the upper and mainly in
- in the ileum, groups of nodules coalesce into aggregated the lower third of the gland
lymphoid nodules or Peyer’s patches that may extend Enteroendocrine
into the submucosa cells
Stem Cells
M cells – specialized epithelial cells overlaying the
lymphoid nodules; broad cells with dome-like apices, with - mucous secreted by the goblet cells coats the surface of the
limited short microvilli; has deep invaginations at the base mucosa and facilitates onward movements of its contents while
of membrane-forming “pockets” occupied by one or two protecting the surface from abrasion
macrophages and numerous lymphocytes; antigen - lamina propria contains mainly lymphocytes and macrophages
transporting cell - at the distal third of the rectum, mucosa and lamina propria
form longitudinal folds called the columns of Morgagni
C. Muscularis Mucosa – a thin layer of circumferentially
oriented smooth muscle; its contraction contributes to the 2) Submucosa – contains hemorrhoidal plexuses that
movements of the villi; absent or thin wherein aggregated extends to the lamina propria
lymphoid nodules underlie the mucosa of the jejunum and
ileum 3) Muscularis Externa – outer longitudinal layer is
incomplete and they become aggregated into three
longitudinal bands called taenia coli.
2) Submucosa
- mostly consists of loose connective tissue containing more 4) Tunica Adventitia/Serosa – cecum, transverse colon, and
collagen and elastic fibers sigmoid colon all have tunica serosa; ascending and
- contains fibroblasts and clusters of adipose cells descending colon have tunica adventitia.
- in the duodenum, conspicuous components are submucosal
glands of Brunner that secrete a clear alkaline mucin (pH 8.2-
9.3) which protects the duodenal mucosa against the potentially The Appendix
damaging effects of the strongly acidic chyme from the stomach - an appendage of the blind end of the cecum
and it raises the pH into optimal range for activity of the - a vestigial portion of the intestinal tract of no functional
pancreatic enzymes significance
- contains a network of ganglia forming the submucosal or the - all layers are present but obscured by the presence of many
Meissner’s plexus that receives information from chemo and lymphoid nodules
mechanoreceptors

VI. Blood, Lymph, and the Immune System

3) Muscularis Externa
- consists of outer longitudinal and inner circular layers of smooth
muscle responsible for peristalsis, an intermittent wave-like Blood (dr. Gironella)
contractions that travel along the intestine advancing the - the only fluid tissue in the body
intestinal contents - 7-9% of the total body weight in adults
- also responsible for the segmental movement consisting of - 5-6 L in males
alternate constriction and relaxation of short segments that tend - 4-5 L in females
to agitate and mix the intestinal contents - liquid + fibrinogen = plasma
- at the terminal portion of the ileum, it becomes thickened, forming - liquid + no fibrinogen = serum
the ileocecal sphincters - “buffy coat” = WBC + platelets
- the myenteric or Auerbach’s plexus are found between the two
muscle layers, which are responsible for the peristaltic
movements of the intestine Blood Plasma
- 90% water, includes many dissolved substances like nutrients,
salts (metal ions), electrolytes, and proteins
4) Tunica Adventitia/Serosa
- generally covered by peritoneum except the duodenum, hence Plasma Proteins
outermost layer is serosa - 7% of the total plasma volume

• Albumin (60%) – controls the osmotic pressure of the cells

The Large Intestine
- also called the colon
- concentrate the indigestible residues of food by absorbing water
and electrolytes and to move them to the anus for elimination
- shorter and less convoluted
Cecum – blind-ending pouch in the lower quadrant of the pelvis and
continuous above with the ascending colon; joined on its medial side
by the ileum
• Globulins (35%) – carriers;
o Alpha & Beta: transports hormone-binding proteins,
metalloproteins, and steroid-binding proteins
o Gamma: antibodies
• Fibrinogen (4%) – molecules that form clots and produce long,
insoluble strands of fibrin; largest; blood clotting

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Plasma Nutrients 2. Leukocytes

• Amino acids
• Monosaccharides – stored as glycogen in the liver or converted Granulocytes
to fat 1) Neutrophils – 60-70%
- Barr body – inactive X chromosome
Lipoproteins - most numerous leukocyte
• Chylomicrons – carry fat to muscle and adipose cells - cytoplasmic granules are neither intensely acidophilic or
• VLDL intensely basophilic
• LDL - act as phagocytes
• HDL – carries chylomicron remnants to the liver and disposes of - decrease in circulatory compartment stimulates production
cholesterol by secreting it in bile
2) Basophils – stain deep blue
Plasma Gases - are less than 1% of the circulating WBCs
• Oxygen – needed for cellular respiration - may not be seen in the circulation
- may leave the bloodstream and develop into mast cells
• Carbon dioxide – byproduct of cell respiration
- release histamine, which dilates blood vessels
• Nitrogen – use unknown
- also release heparin, which prevents blood clotting

3) Eosinophils
1. Erythrocytes
- second most numerous
- also known as red blood cells
- acidophilic
- anucleated, biconcave, hemoglobin-containing disks
- quantity increases in peripheral blood during parasitic
- shape is maintained in the mature RBC by spectrin, a
infestations and allergic reactions
filamentous protein that is attached to the cytoplasmic side of the
- phagocytize antigen-antibody complexes
plasma membrane
- carry oxygen
Agranulocytes
- life span: about 120 days or 4 months
1) Lymphocytes – 20-25%
- sometimes form rouleaux, which is a precise stack of RBCs that
- capable of mitosis
resemble a stack of coins
- can re-enter the circulation
- microcytes – RBCs that are 5 um or less
- has a significant role in the immune response
- macrocytes – RBCs that are larger than 10 um
- increase in biopsy of graft tissue is a sign of rejection
- reticulocytes – immature RBCs released from the bone marrow
- may be classified as T cells, B cells, and NK cells
into the circulation before erythropoiesis is completed; comprises - T cells – divide and differentiate into cytolytic killer cells in the cell
1-2% of the RBCs in peripheral blood mediated immune response
- B cells – divide and differentiate into immunoglobulin (antibody)
secreting plasma cells in the humoral immune response
A hypotonic environment causes the RBC to swell, producing a spheroidal pale
structure called a ghost cell; this process is called hemolysis. 2) Monocytes
- largest cell type present in normal peripheral blood
A hypertonic environment causes the RBC to collapse, producing a crenated
cell.
- slightly more numerous than eosinophils
- serve as precursor cells of most phagocytic cells, such as Kupffer
cells (liver), dust cells (lungs), osteoclasts (bone), and connective
Control of Erythrocyte Production tissue macrophages
- rate is controlled by a hormone (erythropoietin)
- kidneys produce erythropoietin as a response to reduced oxygen
levels in the blood Differential Counts
- detects changes in WBC populations
- also indicates infections, inflammation, and allergic reactions
Hematocrit - average WBC count = 5,000 – 10,000/mm3 of blood
- percentage of volume of blood sample occupied by red cells
Leukocytosis WBCs are over 10,000 Appendicitis
- if a sample of blood is allowed to settle or if it is centrifuged, three
layers may be discerned; supernatant plasma, buffy coat, and Leukopenia WBCs are less than 5,000 Typhoid fever, flu, measles,
packed RBCs chicken pox, AIDS, polio
Leukemia Abnormal production of
immature leukocytes
Blood Types
- A, B, AB, O
- Carbohydrate – found on the surface of the RBC; is responsible 3. Platelets
for determining the blood type - anucleated, derived from ruptured multinucleate cells
(megakaryocytes)
- usually described as having biconvex discoidal shape
- circulate for 9-12 days
Hemolytic Disease - normal platelet count = 150,000 – 400,000/mm3 of blood
• Rh blood group - prevent loss of blood by clotting
- people whose RBCs have the Rh antigen are Rh+ - react to abnormal surfaces such as might be encountered in a
- people who lack the Rh antigen are Rh- bleeding wound; such platelets are activated
- normally, blood plasma does not contain anti-Rh antibodies - mass of platelet aggregate is called a thrombus.
- hemolytic disease of the newborn or HDN – if blood from
Rh+ fetus contacts Rh- mother during birth, anti-Rh
- release factors that participate in the clotting cascade and in fibrin
antibodies are made formation
▪ effect is on the second Rh+ baby - fibrin is the main fibrous component of blood clots

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Lymph (dr. Gironella)
- a colorless fluid which is collected from the tissues and returned Summary of Unique Features of the Lymphoid Organs
into the blood stream
- composed of fluid plasma in which various cells are suspended Thymus Primary Hassall’s corpuscles
- cells are few, mostly the small lymphocytes derived from the No lymphatic nodules
lymphoid organs Lymph Secondary Paracortex and subcapsular sinus
- carries carbonic acid, but very little oxygen nodes
- content includes lymphocytes, lipids, occasionally some blood Spleen Secondary White pulp, PALS, red pulp, stave cells
cells, and abundance of lymph tissue fluid in the intercellular
space Tonsils Secondary Epithelial covering, partially encapsulated
- circulates only in one direction, towards larger vessels and
eventually into the thoracic duct and right lymphatic duct
All lymphoid organs are capable of producing lymphocytes

Primary Lymphoid Organs (Antigen independent)

The Immune System (dr. Gironella)
1) Thymus
- mesodermal and endodermal in origin (3rd and 4th pharyngeal Body Defenses
pouches) - the body is constantly in contact with bacteria, fungi, and viruses
- T-cell precursors (thymocytes) - the body has two defense systems for foreign materials
- Thymic epithelial cells – secrete cytokines and
compartmentalize the thymus into a cortex and a medulla ✓ Innate Defense System
- presence of Hassall’s corpuscles - release of cytokines
- no lymphoid nodules, no cords - activation of complement
- secretes thymopoietin and thymosin – for thymocyte - removal of foreign bodies
proliferation and T-cell differentiation - activation of adaptive immune system through antigen
presentation
2) Bone marrow - non-specific
- resistance not acquired through contact with antigen
- does not improve after exposure to antigen
Secondary Lymphoid Organs (Antigen-dependent) - includes host defenses such as barriers

1) Lymph node Surface Membrane Barriers – first line of defense (non-specific)

- smallest and most numerous; bean-shaped - skin
- for filtration of lymph, lymphopoiesis, immunoglobulin production - mucosa
- with a cortex, a medulla, a subcapsular sinus, and a paracortical - secretions – acid, sebum, saliva, mucous
zone (T-dependent region, CD8); with high endothelial venule
(cuboidal epithelium) Defensive Cells – second line of defense (non-specific)
- cortex contains mostly B cells - mononuclear phagocytes
- with antigen-presenting follicular dendritic cells - NK cells

2) Spleen Antimicrobial Chemicals

- largest; lacks a cortex and a medulla
- for lymphopoiesis (B & T), immunoglobulin production,
destruction of worn out RBC, extramedullary hematopoiesis, and
blood filtration
- White pulp – 20%; with periarteriolar lymphoid sheath or PALS,
a T-dependent region; and peripheral white pulp or PWP, mostly
B cells
- Red pulp – for blood filtration; contains cords of Billroth and
splenic sinusoids (lined by STAVE cells)
• Cytokines – cell-signaling; from lymphocytes, macrophages,
mast cells, fibroblasts, and endothelial cells
Interferons – interferes in the replication of viruses & cancer cells
(chemokines, lymphokines)
Interleukins – stimulate or suppress lymphocytic activity
IL 2 – stimulate cytotoxic T cells; raise CD4 counts
IL 4 – maturation and proliferation of T & B lymphocytes

3) Tonsils ✓ Adaptive Defense System

- Palatine – paired; 10-20 crypts, covered by SSNK - the specific immune system
- Pharyngeal – unpaired, no crypts, covered by pseudostratified - third line of defense
columnar ciliated epithelium; adenoids - improves upon repeated exposure
- Lingual – small and numerous, one crypt per tonsil, covered by - have long term memory for a specific antigen
SSNK - recognition of antigen
- generation of responses to maximally eliminate the antigen
4) Mucosa-associated Lymphatic Tissue (MALT) - development of immunological memory
- about 70% of all the body’s immune cells
- includes the tonsils, and other small accumulations of non- T-lymphocytes – long lived; gains immunocompetency and forms cluster of
encapsulated lymphoid tissue in the GIT, respiratory tract, and differentiation in the thymus
urinary tract
T-Helper or Cooperator (CD4+)
Cytotoxic or Killer (CD8+)
Suppressor (CD8+)
Memory

B-lymphocytes – gains immunocompetence in the bone marrow

Plasma cells – produce antibodies

Memory cells

Natural Killer Cells – non-specific

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Antibodies (immunoglobulins) Hypersensitivity Reactions

IgG 75% Transplacental; weak activation of complement system;

Type I Fast response Anaphylaxis, atopy, asthma IgE
IgA 15% Secretory (Anaphylactic)
IgM 7% Highly effective in complement activation; major
immunoglobulin in primary immune response Transfusion reaction
IgE Allergies and parasitism Type II Antibody- (erythroblastosis fetalis), IgM or
(Cytotoxic) dependent RHD, autoimmune hemolytic IgG
IgD Embryonal; found on the surface of B-lymphocytes anemia, receptor mediated
together with IgM (goodpastures’s syndrome
and myasthenia gravis)
SLE, AGN, Arthus Reaction
Types of Immunity Type III Immune (intradermal injection of IgG,
complex HPN tetanus and diptheria toxoid), neutro-
1) Humoral rheumatoid arthritis phils
- antibody-mediated immunity Type IV Delayed type Contact dermatitis, multiple T cells
- specific reaction evoked by an antigen acted upon by T-cells of HPN sclerosis, type I diabetes
(cell-mediated) mellitus, rheumatoid arthritis,
2) Cell-mediated chronic transplant rejection,
- specific reaction evoked by an antigen acted upon by antibodies tuberculin reaction
- needs the cooperation of macrophages, helper T cells, and B Autoimmune
Type V disease Graves’ disease, myasthenia IgM or
cells
(receptor- gravis IgG
mediated)

Diseases mediated by antibodies and immune complexes

Autoimmune Hemolytic Anemia IgG binds Fe receptor of phagocytic

VII. Endocrine and Integumentary System
cell; IgM activates complement
system
Myasthenia Gravis Antibodies block Ach receptors;
muscle weakness The Endocrine System (dra. Alonzo)
Graves’ Disease Ab to the receptor of TSH - contain secretory cells responding to signaling molecules
Goodpastures’ Syndrome Anti-GBM antibodies (kidney and - ductless
lungs) - secretion is in the form of hormones
Systemic Lupus Erythematosus Inability to screen new lymphocyte - epithelial at least in origin
for self-compatibility
- arrangement: aggregates of cords or clumps, clusters

Diseases mediated by T-cells Endocrine Cells

Type I Diabetes Mellitus
Multiple Sclerosis
Rheumatoid Arthritis
Systemic Sclerosis
✓ Paracrine – hormones produced would have its effect on nearby
Destruction of beta cells of the pancreas
target organs; diffuse into interstitial compartment and circulate
Insulating covers of nerve cells of the CNS are
damaged; loss of oligodendrocytes; may be through short loop blood vessels
immune mediated
Probably a defective MHC → abnormal B cell- ✓ Juxtacrine – secretions remain on the cell surface, or adjacent
T cell interaction extracellular matrix (interaction upon contact)
Connective tissue; T cells accumulate →
secrete cytokines → overproduction of ✓ Autocrine – secreted product acts on themselves
collagen

Endocrine Glands
Disorders of the Immune System 1. Pituitary Gland
1. Acquired Immunodeficiency Syndrome - also called the hypophysis
- retrovirus (HIV); RNA - location: below the brain, lodged in the sella turcica (body of the
- targets: immune system (CD4+, macrophages, and dendritic sphenoid bone)
cells), and the CNS
- loss of immature precursors of CD4+ T cell and apoptosis of
• Anterior Pituitary Gland or Adenohypophysis
uninfected CD4+; altered macrophage function
- arises as an epithelial outgrowth from the roof of the primitive oral
- leads to opportunistic infections; secondary neoplasm
cavity known as the Rathke’s pouch
- epidemiology: homosexuals or bisexuals (50%), intravenous
- secretory cells: chromophils and chromophobes
drug abuse (20%)
- routes: sexual contact (75%), parenteral; passage of virus from o Pars Distalis
infected mother to their newborn child - anterior lobe

mucosal dendritic cells are infected by the virus → transport to regional lymph o Pars Intermedia
node → virus is transmitted to the CD4+ T cell - zone between the pars distalis and the pars nervosa
- MSH (melanocytes-stimulating hormones)
CNS → microglia (carried by infected monocyte to the brain → neurons not - presence of Rathke’s cysts
affected/infected - hormone secreted: MSH (melanocyte-stimulating hormone)

o Pars Tuberalis
- smaller, highly vascular, funnel-shaped region surrounding the
2. Thymic Aplasia or Di George Syndrome
infundibulum
- defect of the 3rd and 4th pharyngeal pouches - most cells secrete gonadotrophs
- thymus (absence or defective T cells)
- parathyroid (tetany)

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Chromophils – cells that have a high affinity to acid or basic dyes 2. Thyroid Gland
- a lobulated gland lying in front of the neck at the upper part of the
Acidophilic Basophilic trachea
Somatotrophs Corticotrophs - invested by two capsules:
Lactotrophs Gonadotrophs
Thyrotrophs False capsule – loose supporting tissue derived from pre-tracheal layer of
the deep cervical fascia; closely adherent to the gland

Somatotropin Stimulates growth in epiphyseal True capsule – formed from fibro-elastic tissue
Somatotrophs (GH) plates of long bones via insulin-
like growth factors - it is formed by various follicles of different sizes and shape lined
Lactotrophs or Prolactin Promotes milk secretion by simple cuboidal cells containing colloid material containing
Mammotrophs thyroglobulin
Promotes ovarian follicle
- secretes thyroid hormones: triiodothyronine (T3) and thyroxine
Gonadotrophs FSH development and estrogen
secretion, spermatogenesis, or tetraiodothyronine (T4)
- in a hyperactive thyroid gland, there is little amount of colloid in
LH Ovarian follicle maturation and the follicle and the lining epithelium is transformed into simple
interstitial cell secretion columnar cells
Thyrotrophs TSH Stimulates thyroid hormone - in a hypoactive thyroid gland, the follicles are filled with colloid
synthesis, storage, and liberation and the epithelium is transformed into simple squamous cells
Corticotrophs ACTH Stimulates secretion of adrenal
cortex hormones and helps
- also in the thyroid gland are parafollicular cells, also called C
regulate lipid metabolism cells or Chief cells, which are pale-staining cells found on both
the lining of the follicles and in the interfollicular spaces; secretes
calcitonin which decreases serum calcium by increasing
Chromophobes – the smallest cell type in the anterior pituitary gland; osteoblastic activity and decreasing osteoclastic activity
have little affinity to acid or basic dyes, and probably represent resting diminishing bone resorption
or degranulated chromophil cells
3. Parathyroid Glands
- small oval endocrine glands closely associated with the thyroid
Hypothalamic Hormones Regulating the Cells of the Anterior gland
Pituitary Gland - contains secretory cells of two types:

Chief or Principal Cells – small, round, or polyhedral in shape, the most

TRH Stimulates the release of TSH
abundant cells of the parathyroid; secretes the parathyroid hormone
GnRH Stimulates the release of FSH and LH
(PTH)
Somatostatin Inhibits the release of both somtotropin or GH and
TSH Oxyphil cells – larger and much less numerous
Dopamine Inhibits release of prolactin (PRL)
Corticotrophin-
releasing Hormone
- an intermediate type of cell may be found in this gland known as
the water clear cells in the hyperplasia of this organ

4. Adrenal (Suprarenal) Glands

• Posterior Pituitary Gland or Neurohypophysis
- small flattened endocrine glands closely applied to the upper
- derived from the down growth of nervous tissue from the
pole of the kidneys
hypothalamus to which it remains joined by the pituitary stalk, or
the “infundibulum”
Adrenal Cortex – outer and thicker portion, yellowish; forms 85-
- Pituicytes – modified neuroglial cells found in the pars nervosa;
90% of the gland and is mesodermal in origin;
is believed to store and release 2 hormones:
✓ zona glomerulosa – thin outermost zone of the adrenal cortex,
secrete mineralocorticoids
Oxytocin or Pitocin Antidiuretic Hormone (ADH) ✓ zona fasciulata – thickest layer formed of columns of relatively
Predominantly secreted by the Predominantly secreted by the larger slightly basophilic polyhedral cells; secrete glucocorticoids
supraoptic nuclei paraventricular nuclei ✓ zona reticularis – thin innermost zone of the adrenal cortex; secrete
androgens
Note: these hormones are secreted by both the supraoptic and
paraventricular nuclei of the hypothalamus, but the supraoptic
nuclei predominantly produces oxytocin and the Adrenal Medulla – reddish-brown, originates from the neural
paraventricular nuclei predominantly produces ADH. crest; has chromaffin cells which secrete catecholamines in the
form of norepinephrine and epinephrine
Neurophysin I Neurophysin II
Stimulates uterine contraction Increases water reabsorption at types of chromaffin cells:
Part of the milk let-down the DCT of the kidneys
mechanism ✓ epinephrine-storing cells
✓ norepinephrine-storing cells
* Neurophysins are carrier proteins chromaffin bodies:
✓ paraganglia
Neuroglial Cells ✓ aortic organ of Zuckerkandle
✓ chromaffin bodies at the back of the heart, testis, liver, and ovary
Herring Bodies – contains the neurohormones stored in the pars nervosa

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 OLFU College of Medicine
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Epidermal Cell Layers of the Skin

5. Pineal Gland
- also called the epiphysis cerebri or conarium Deepest cell layer, layer of intense mitotic activity;
- represents an evagination from the posterior part of the rood of attached by desmosomes/hemidesmosomes
the 3rd ventricle in the midline Stratum Basale
- cells are arranged in irregular clumps which consists of Cells serve as stem cells for the epidermis, with
pinealocytes and interstitial cells or neuroglial cells intermediate keratin filaments
- produces the hormone melatonin, which affects the modulation 4-6 rows of cells, keratin filaments – tonofilaments
of wake/sleep patterns
Stratum Layer where keratin filaments form bundles contributing
- also found in the gland are concretions of calcium carbonate and Spinosum to its microscopic characteristics.
calcium phosphate called brain sands or corpora amylacea or
psammoma bodies Presence of spines (site of desmosome attachment)
3-5 layers of flattened cells, keratohyalin granules, soft
Stratum keratin
Granulosum
6. Pancreas
Undergoes keratinization; lamellar granules dispose
- not only an exocrine gland but also an endocrine gland between lipid materials between the cells
- the endocrine portion is the islet of Langerhans Only found in thick skin, translucent, barely visible,
- pancreatic islets vary in size and is most numerous at the tail of Stratum hydrolytic enzymes disrupt cell contents and pack them
the pancreas Lucidum with keratin filaments
Most superficial cell layer, consists of flat, dead cells
Alpha cells or A cells – secrete glucagon (↑ blood sugar) filled with soft keratin.
Beta cells or B cells – secrete insulin (↓ blood sugar) Stratum
Delta cells or D cells – secrete somatostatin Corneum Keratinized cells continuously shed/desquamate from
PP cells – secrete pancreatic peptides the surface and are replaced by new cells

7. Testis Skin Cells

- the endocrine portion is the interstitial cells of Leydig, which 1) Melanocytes – arise from neural crest cells, located between the
produce testosterone. stratum basale and stratum spinosum
- These Leydig cells also contain elongated cytoplasmic crystals - synthesize from amino acid tyrosine a dark pigment called
of Reinke melanin, which darkens skin color and protects the skin from UV
radiation
8. Ovary 2) Langerhans cells – dendritic-type cells which originate from the
- the endocrine portion is the theca interna, which secrete bone marrow and migrate via the blood to the skin
estrogen and zona glomerulosa which secrete progesterone. - reside primarily in the stratum spinosum and are part of the
immune system of the skin
- antigen-presenting cells of the skin
9. Placenta
- the syncytiotrophoblast of the chorionic villi secrete the human 3) Merkel cells – present in the basal layer of the epidermis and
chorionic gonadotropin (HCG) function as mechanoreceptors for sensation

Skin Derivatives
The Integumentary System (dra. Alonzo) • Hair – hard, cylindrical structures that arise from hair follicles;
surrounded by external and internal root sheaths;
- the skin is the largest organ of the human body, which consists - grow from expanded hair bulb of hair follicles
of the superficial dermis and the deeper dermis - develop from surface epithelium of the epidermis and reside
deep in the dermis
Epidermis Dermis Hypodermis
- hair matrix – situated above the papilla; contains mitotic cells
Non-vascular Vascular Subcutaneous
and melanocytes
Stratified squamous Irregular connective Connective tissue,
keratinized epithelium tissue, blood vessels, fascia
nerves, glands
• Sebaceous glands – oil glands
- contraction of the erector pili muscle stands hair up and forces
sebum into the lumen of the hair follicle

Papillary layer • Sweat glands – widely distributed in the skin, assists in

- basement membrane separates the dermis from the epidermis
- superficial layer in the dermis and contains loose irregular
connective tissue
- sensory receptors: Meissner’s corpuscles present in the
dermal papillae
Reticular layer
- deeper and thicker layer of the dermis
- filled with dense irregular connective tissue
- type I collagen, blends inferiorly with the hypodermis
- sensory receptors: Pacinian corpuscles
- contains concentric lamellae of collagen fibers surrounding the
axons of the Pacinian corpuscles
- sweat glands, hair root follicles (erector pili muscle), blood
vessels, capillaries, nerves and elastic fibers are found here
temperature regulation and excretion of water, salts, and some
nitrogenous wastes
- are of two types:
Eccrine – simple coiled glands located deep in the dermis in
the skin of the palms and soles, consists of clear and dark
secretory cells and excretory ducts;
clear cells – secrete watery products
dark cells – secrete mucous
Apocrine – found coiled in the deep dermis of the skin of the
axilla, anus, and areolar regions of the breast; duct glands open
into the hair follicles; lumina are wide and dilated, becomes
functional at puberty when sex hormones are present.
* secretions have unpleasant odors d/t bacterial decomposition

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