HISTOLOGY Study of microscopic parts of plant & animal bodies, and the morphologic evidence of their functions.

PATHOLOGY Study of structure & function of body in disease

HISTO-PATHOLOGY

Combined study of histology + pathology, and its relationship

HISTOCHEMISTRY Chemistry of tissue components and its relation to tissue morphology

CYTOLOGY Study of cell

Cell Smallest functional unit of living material. Capable of maintaining its: Integrity Responsiveness Chemical composition

Tissue Communities of specialized cells united for performance of common function

NORMAL CELL STRUCTURE

Cell membrane (plasma lemma)

-semi permeable -lipoprotein bilayer -selective entrance & exit -protection -cell interaction -impart size & shape -phagocytosis -pinocytosis

Cytoplasm -surrounds nucleus -contains organelles & inclusion bodies

Mitochondria -powerhouse of the cell -ATP production -ion transport -steroid synthesis -double-layered membrane -inner : extensively folded (produce cristae)

Golgi Apparatus

-located b/w nucleus & cell surface -connected to ER -synthesize glycoprotein -package secretory materials -form lysosomes -transport & release secretory materials to cells -has flattened tubular membranes (cisternae) -has dilated terminal areas (vacuoles)

ER -has parallel arrays of creating canals & vesicles -channel between inner & outer membrane -ROUGH ER & SMOOTH ER -intracellular transport, synthesis, release of proteins

Lysosomes -suicide bags -membrane bound -dense appearing structures -has hydrolytic enzymes (acid hydrolases/ lysozyme) -breakdown intracellular molecules -digest foreign materials entering cell

Peroxisomes -membrane bound sacs w/ enzyme -produce H2O2 to water -destroy H2O2 to water -purine catabolism -breakdown of NA -conversion of fat to glucose

Centrosome & centrioles (cell center)

-Lie close to nucleus -has a pair of centrioles -centrioles : cell division, forms cilia

Microfilaments & microtubules

-maintenance of shape of cell -movement of organelles & inclusions

Nuclear envelope

-double layered membrane -enclosed to nucleus -has openings/ pores, control passage of materials -site of nuclear division

Nucleus -center of all activities of cell -has hereditary info (genes) -directs cell division -control ribosome synthesis

Nucleoplasm/ nuclear sap

-ground substance -makes up nucleus -suspends nucleolus, chromatin, chromosome

Nucleolus -dense, round -located at the center of nucleus -single/multiple -synthesis of ribosomes

TISSUES 徐智慧/

DIFFERENT TYPES OF TISSUE

Epithelium -cells are arranged in sheets, cords, tubules, follicles -former: form protective sheath or limiting membrane -latter: secretion, absorption, excretion -cells are compactly arranged, no intercellular substance

Connective -cells lie more, less scattered -has more intracellular substance -often found in an irregular branching form (stellate)

Muscle -for body movements -cells has contractile protein -muscle cells = muscle fibers -muscular tissues = myoblasts (from embryonal muscle elements -cytoplasm = sarcoplasm -cell membrane = sarcolemma -contractility = myofibrils/ sarcostyles

Nervous --CNS = Brain, spinal cord -PNS = Nerves, ganglia -neuron/neurocyte = unit structure -1 neuron has 1 cell body/cyton -1 neuron has 2 processes = axon & dendrites

ARRANGEMENT OF EPITHELIAL TISSUE

Simple -1 cell layer -cells rest on basal lamina -cells reach the apical surface

Stratified -multi-layered cells -some cells rest at basal lamina/ reach apical surface

Pseudostratified -appear stratified = nuclei lie at different levels -all cells rest on basal lamina -some cells reach apical surface

SPECIFIC CLASSIFICATION OF EPITHELIAL TISSUE

Squamous -flat cells -abundant flattened cytoplasm -elongated, darkly stained nucleus

Cuboidal -cells equal in height and width -nucleus is spherical centrally located

Columnar -elongated cell -basal nucleus -low or high columnar cells

Simple Squamous Endothelium of BV

Simple Cuboidal PCT

Simple Columnar Small intestines

Stratified Squamous Vagina (keratinized) Epidermis

Stratified Cuboidal Sweat glands

Stratified Columnar Prostatic urethra

Pseudostratified columnar (w/cilia) Trachea (w/o cilia) epididymis

Transitional = Urinary bladder

TYPES OF CONNECTIVE TISSUE FIBERS

Collagen/white -most abundant -wavy bundles -pale pink (H&E) -blue (Mallory Azan) -widely scattered (loose areolar) -densely packed (tendons)

Reticular -collagen molecules -smaller than collagen -form network supporting cellular elements of liver & lymph node

Elastic -highly refractile -single/sheets -thinner than collagen

PROPER CONNECTIVE TISSUE

Mucus -in embryo (mesenchyme) -spindle-shaped/branching -dominant feature: matrix Ex: vitreous humor of eye, umbilical cord of infants

Fibrous LOOSE/AREOLAR -many collagen fibers + some elastic fibers -rich in cells -not very fibrous

-found in mesenteries, subcutaneous skin, omenta DENSE REGULAR -fibers, great lengths, overlapping layers -found in ligaments, tendons, cornea DENSE IRREGULAR -many fibers -found in dermis, periosteum, perichondrium -no intercellular fluid

SPECIAL CONNECTIVE TISSUE

Adipose -no intercellular fibers/matrix -store fats -large vacuolated cytoplasm -thin nucleus

Reticular -lacelike reticulum of collagen fibers -rich coat of glycoproteins -found in vascular channel of liver, spleen, lymph nodes, bone marrow

Cartilage -made of polygonal chondrocytes in lacuna -hyaline, fibrous, matrix

Bones -dense compact (cortex of long bones) -cancellous/spongy (medulla of long bones) -mature = osteocytes (small dense round to elongated nuclei, ill defined cytoplasm) -spaces = lacunae -fine channels interconnector = canaliculi

TYPES OF MUSCULAR TISSUE

Smooth -controlled by ANS -found in walls of alimentary, respiratory, genitourinary tract -no cross striations in sarcoplasm -has longitudinal myofibrils -cells are cigar shaped, tapered poles -nuclei = single, centrally placed

Skeletal -controlled by CNS (main motor) -striated cells -nuclei = multiple, peripherally located -has voluntary contractions n relaxations

Cardiac -has cross striations -has longitudinal myofibrils -nuclei : single, central -has intercalated discs in Z band region

CELLULAR PROPERTIES

Respiration Take in O2, liberate energy

Excretion Eliminate waste material

Absorption, Assimilation

Absorb & utilize food

Secretion Synthesize useful substance from absorption

Irritability Respond to stimulus

Conductivity Transmit excitation wave

Contractility Be stimulated

Cell division Grow to a limited extend, produce other cells

Cellular Adaptation : A state which lies intermediate between normal, unstressed cell and overstressed, injured cell, allows cell to maintain an equilibrium between environment and its metabolic activity. 4 Most important adaptive changes in cells: -Atrophy -Hypertrophy -Hyperplasia -Metaplasia

Retrogressive Changes

Organ/tissues are smaller than normal

Developmental Defects Atrophy

Progressive Changes

Organ/tissues are larger than normal

Hypertrophy Hyperplasia

Degenerative Changes

Due to aberration of cellular growth patterns

Metaplasia Dysplasia Anaplasia Neoplasia/tumor

DEVELOPMENTAL DEFECTS

Aplasia -Incomplete/defective tissue/organ development -has a mass of fatty/fibrous tissue -no resemblance to adult structure -seen in one of paired structures (kidneys, gonads, adrenals)

Agenesia -Complete non-appearance of an organ -Ex: turner’s syndrome

Hypoplasia -Failure of organ to reach its full mature/adult size -incomplete development

-less severe than aplasia

Atresia/Clausiuria -Failure of organ to form an opening -Ex: anal, aortic, aural

ATROPHY Acquired disease in the size of a mature tissue/organ. Caused by decrease in cell number. Have diminished function, but not dead

Pathogenesis -decreased workload -loss of innervation -diminished blood supply -inadequate nutrition -loss of endocrine stimulation >>proteolytic enzyme >>metabolic activity <<blood & lymphatic circulation Accumulation of CO2 & organic acids in cells Loss of cell substance << mitochondria, ER, myofilaments Atrophic cells replaced by connective & adipose tissue = Stromal fatty infiltration

Pathogenic changes

-organs : smaller, firmer >>conn.tissue >>vessels -cells : smaller -atrophic parenchymal cells @ heart, liver = contain yellow granular lipid containing pigments (lipochrome pigment/ lipofuscin) brownish discoloration on gross inspection

TYPES OF ATROPHY

Physiologic -natural consequence of maturation (during puberty) -Senile atrophy = at old age

Pathologic -decrease in tissue/organ size -consequence of disease

Vascular -lack of nutrition -reduced blood supply -vascular narrowing (arteriosclerosis)

Pressure -persistent pressure on the organ, injure the cells -promote disminution of blood supply, vascular atrophy

Starvation/ hunger

-general wasting of tissue -lack of nutritional supply necessary for normal growth

Disuse Inactivity/ diminished function of tissue/organ -long standing, chronic illness, muscle fibers inactivity -BW narrowing, loss of nutrition

Exhaustion -prolonged overwork of endocrine organ -initial enlargement with slow progressive loss of parenchymal elements -iform acid metabolites, increase catabolic enzymes

Endocrine -diminished or absent endocrine stimulation -produce functional atrophy of organs -dependent on endocrine supply

HYPERTROPHY -increase in size of tissue/organ -increase in size of individual cells -no new cells, just larger cells -due to increase intake of water (cellular swelling, edema)

True -skeletal muscle, heart, kidneys, endocrine organs, smooth muscle of holly viscera -due to increased workload and endocrine stimulation Ex: pregnancy, exercise

False -due to edema fluid & conn.tissue proliferation Ex : chronic hypertrophic salpingitis, appendicitis, cirrhosis

Compensatory -1 of paired organs when other opposite organ has been removed or suffered from functional sufficiency

HYPERPLASIA -increase in organ/tissue size -increase in number of cells -growth of new cells (Profound hyperplasia) white skin epidermis, intestinal ept, hepatocytes, fibroblasts, bone marrow cells (intermediate) bone, cartilage, smooth muscles (no capacity) nerve cells, skeletal muscle cells

Physiologic Hormonal -enlargement of glandular epithelium (puberty, pregnancy) -physiologic hyperplasia of pregnant uterus Compensatory -occurs when a portion of liver is removed (partial hepatectomy) -occurs in epidermis after skin abrasion

Pathologic -by disease of lymphoid follicles, payer’s patches

METAPLASIA -reversible, adult cell is replaced by other type -may represent adaptive substitution of cells more sensitive to stress Examples: (1) Squamous metaplasia = RT in chronic irritation Normal columnar ciliated ept cells in trachea & bronchi = Stratified squamous ept (2) Chronic infection of bronchi and bronchioles (3) stones in excretory ducts of salivary glands, pancreas, bile ducts Columnar ept = nonfunctioning Stratified squamous ept (4) Vit A deficiency induces squamous metaplasia in respiratory epithelium

DYSPLASIA -Reversible, regressive alteration in adult cells -adult cells, variation in size, shape, orientation -chronic inflammation, protracted irritation on epithelial cells -changes in structural component of cell (irregularity in size) -loss/ increase in nucleus size -presence of mitotic figures -disruption of the normal architectural pattern -don’t lead to tumor formation

ANAPLASIA/ DEDIFFEREN-TIATION

-change toward younger cell type -regressive change in adult cells toward more primitive/ embryonic cell type -malignancy -more marked, disorganized, irreversible

NEOPLASIA/ TUMOR

-continuous normal proliferation of cells without control -no useful purpose/function -increase in size and pigmentation, mitosis, number -metaplastic n anaplastic changes of cells -pathologic overgrowth -tumor formation

GENERAL PATHOLOGY Pathology = pathos (suffering) logos (reason) The science that deals with the study of diseases Purpose: to correlate manifestations of disease with underlying abnormalities and physiologic disturbance (pathophysiology) Different aspects of diseases: -Etiology (cause) -Pathogenesis (manner of development of disease) -Changes and final effects in the body

PATHOLOGIC ANATOMY : Deals with tissues and organs separated and removed from body for pathologic study purposes

Surgical -study tissue specimens excised surgically in major/minor operation BIOPSY = take pieces of tissue from a living patient

Autopsy -study tissue specimens from dead person on autopsy table AUTOPSY = take pieces of tissue (cut section) from dead person (cadaver)

Gross -study body structures because of disease (readily seen with unaided eye)

Microscopic -deals with changes in microscopic structure

CLINICAL PATHOLOGY : study of compositions and char of body secretions, excretions, fluids. For diagnosis of diseases, measurement of diseases course, and therapy evaluation.

Hematology -blood counts -microscopic test of blood cells -blood coagulation -Hb in blood

Microbiology -smears, cultures, animal inoculations -isolation and identification of pathogenic microorganisms -test susceptibility and antimicrobial drugs

Clinical Chemistry -chemical determinations -inorganic and organic constituents of blood, urine, etc

Serology and Immunohematology

-unknown serum tested against known antigen -identify unknown antibody -for testing or typing

Clinical Microscopy -diagnostic examination of urine, feces,

stomach contents, abnormal elements, disease producing factors

Parasitology -demonstration of protozoan, metazoan parasites, ova in the stool

RESEARCH/ EXPERIMENTAL PATHOLOGY = Study of diseases produced in animals to make significant correlation with comparable disease process in human to do further research and ultimate goal. GENERAL PATHOLOGY = surveys, disease processes as degenerative changes, circulation disturbance, inflammation, tumors, maladies that affect tissues and organs. SPECIAL PATHOLOGY = CLASSIFICATION OF DISEASES. -Neuropathology = pathology of nervous system -Urologic pathology = pathology of genitourinary system -Gynecologic and obstetric pathology = pathology of female rep system PATHOLOGIST = Person engaged in pathology practice. (surgical/clinical/autopsy) 3 Major Roles: 1. Service = practical application of knowledge for benefit of medical colleagues and patients 2. Teaching = disseminates/passes fund of knowledge to others 3. Research = engage in activities for their primary purposes, additions, and contributions to general store of knowledge of pathology. MED TECH OR HISTOLOGIC TECHNICIAN -prepare specimen -perform lab tests -prepare slides from surgical or autopsy material to be examined by pathologist for diagnosis. Role of Medtech: -technical ability -strong sense of responsibility toward patient -conscientious handling of tissue -care in producing best possible result PATHOLOGY LABORATORY (Start in operating room/ autopsy room)

FIRST STEP Remove organ/tissue of concern from the body By Attending surgeon

FIXATION Put tissue in a fluid to preserve cells as nearly as possible in the natural state

GROSS DESCRIPTION.

-Pathologist describes the tissue (char, size, shape, consistency, weight, color, special markings, appearance of outer and cut surfaces)

TISSUE PROCESSING

-Clearing/dehydration -Embedding -Sectioning -Staining -Mounting

MICROSCOPIC DESCRIPTION

-Pathologist examines and interprets microscopically -describe the fundamental unit, char, architectural relation to other cell (for study of disease)

WRITTEN MICROSCOPIC DESCRIPTION

FINAL REPORTING

徐智慧/