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This course uses medical case studies as vehicles for students to learn collaboratively about the anatomy and physiology of the human body. Each student has the responsibility of researching aspects of the case study in question in order to create informative presentations that educate the entire class. Then, as a group, the class evaluates the information, much as detectives evaluate clues, in order to arrive at potential diagnoses which they must then defend.

Throughout the term, we will hold weekly virtual class meetings to discuss the case studies, review progress on research topics and discuss diagnoses and treatment plans. Students will occasionally connect with the teacher and other classmates through online discussions and virtual meetings to share presentations, receive and provide feedback and ask questions. In the undistended state, the epithelium is relaxed and the surface cells are rounded and project into the lumen. In the distended state, the epithelium is stretched and the surface cells become flattened.

The fusiform vesicles along with plaques merge into the surface plasma membrane providing a reserve membrane during stretching. It is widely distributed in the body. The impaired structure and function of the connective tissue result in some disorders of connective tissue. In inflammation of any organ it is the connective tissue that acts as a battle ground for the infecting agents and immune cells of the connective tissue. Basic Components The connective tissue consists of three basic components: i. Connective tissue cells both resident and wandering ii. Intercellular material or ground substance or matrix iii.

Fibers collagen, elastic and reticular. Resident Cells i. The fibroblasts are the most common type. They develop from embryonic mesenchymal cells. They are stellate or spindle-shaped cells with little cytoplasm. The fibroblasts are metabolically very active cells as they synthesize the three types of fibers and the ground substance. The electron microscopic appearance of fibroblasts reveals characteristics of protein secreting cells, like well- developed rough endoplasmic reticulum, one or more Golgi zones and abundant mitochondria.

The surfaces of active fibroblasts show characteristic scalloping coves.

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It is here that collagen fibrils are polymerized to form collagen fibers in the extracellular compartment. A special type of fibroblast known as myofibroblast shows properties of both fibroblast and smooth muscle cell.

The myofibroblasts play a significant role in wound contraction during healing. The macrophages are also known as histiocytes. These large cells have round nuclei and abundant acidophilic cytoplasm rich in lysosomes.

They show irregular contours or ruffles of plasma membrane. They develop from monocytes of the circulating blood. Their main function is phagocytosis by ingestion of foreign substances, cancer cells and organisms. The mast cells are usually found in close relation to the blood vessels. They are large in size. Their cytoplasm is filled with basophilic granules. The mast cell granules on staining show metachromasia, i. The granules contain histamine vasoactive agent , heparin anticoagulant and eosinophilic chemotactic factor of anaphylaxis ECF-A.

The mast cells increase their number in allergic or hypersensitivity reactions. The pigment cells or melanocytes of connective tissue are found in iris and choroid layer of eyeball. The adipocytes or lipocytes or fat cells are large in size average size 50 microns.

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They store neutral fat triglycerides in the form of a single lipid droplet in their cytoplasm. The lipid droplet is so large that it pushes the cytoplasm and the nucleus to the periphery of the cell. Thus, the cytoplasm is reduced to a rim containing cell organelles and flattened nucleus. On routine staining, the lipid droplet is dissolved. Therefore, the cell gives an empty appearance with a peripheral rim of stained cytoplasm containing a nucleus.

This appearance resembles a signet ring. The fat droplet stains orange on staining with Sudan III. Migrant Cells i. The plasma cells are derived from the B lymphocytes.

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They are characterized by well-developed rough endoplasmic reticulum accounting for basophilic cytoplasm. The Golgi complex is pale on regular staining, which is described as perinuclear halo negative image of Golgi or Golgi ghost. The eccentrically placed nucleus has characteristic cart wheel or clock face appearance due to distribution of the chromatin in the form of four or five clumps subjacent to nuclear envelope. The plasma cells produce antibodies, which maybe discharged locally or may enter circulation.

Sometimes, the antibodies are stored in the cytoplasm of the cell itself in the form of Russel bodies.

Clinical Anatomy (A Problem Solving Approach), 2nd Edition.pdf

The white blood cells that are found in connective tissue are the lymphocytes, neutrophils, basophils, eosinophils and monocytes. Ground Substance The connective tissue is composed of abundant ground substance. The connective tissue cells and fibres are embedded into it. The ground substance is amorphous and transparent having the properties of a viscous solution or a highly hydrated thin gel.

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On light microscopy, it is difficult to visualize the ground substance. Chemically the ground substance is mainly composed of glycosaminoglycans GAG , proteoglycans and multia dhesive glycoproteins e. The ground substance allows free exchange of nutrients and gases between the cells of tissues and the blood in the capillaries.

Water or tissue fluid might accumulate in the extracellular spaces in case of venous stasis or lymphatic stasis causing edema. Connective Tissue Fibers Collagen Fibers The collagen fibers are the white fibers of connective tissue. They are firm and do not stretch. They provide. Know More Biosynthesis and Secretion of Collagen The collagen is secreted by fibroblasts in connective tissue, by osteoblasts in bone, by chondroblasts in cartilage and by odontoblasts in tooth. The collagen is also secreted by non connective tissue cells like smooth muscle cells, Schwann cells and epithelial cells.

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Intracellular Synthesis of Procollagen Fig. The proline, glycine and lysine form the alpha polypeptide chains, which reach the rough endoplasmic reticulum. Here the lysine and proline are hydroxylated. The deficiency of vitamin C scurvy with resultant defective collagen leads to widespread effects like bleeding gums, loose teeth, weak bones and poor wound healing.

The polypeptide chains coil around each other to form a triple helix except at the terminals where th chain remains uncoiled. This forms the soluble procollagen molecules. The packaging of procollagen molecules takes place in Golgi apparatus for transportation out of the cells. Extracellular Synthesis of Collagen Fig. The soluble procollagen is converted into nonsoluble tropocollagen by cutting the uncoiled terminals. The tropocollagen molecules aggregate to form collagen fibrils, which are polymerized into collagen fibers on the surface coves.

Genetic Disorders of Collagen Synthesis Defective collagen encoding genes cause autoimmune disorders in which immune responses destroy the collagen fibers.