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Tissue and Membranes ST110 Concorde Career College. INTRODUCTION. Tissue : group of similar cells that perform a common function Matrix : nonliving intercellular material Histology: The study of the structure, composition and functions of tissues. Four Major Types of Human Tissue.

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Tissue and MembranesST110Concorde Career College


INTRODUCTION

  • Tissue: group of similar cells that perform a common function

  • Matrix: nonliving intercellular material

  • Histology: The study of the structure, composition and functions of tissues


Four Major Types of Human Tissue

  • Epithelial

  • Connective

  • Muscle

  • Nervous


EPITHELIAL TISSUE

  • Types

    • Epithelium is divided into two types:

      • Membranous (covering or lining) epithelium

      • Glandular epithelium


Epithelial tissue

  • Locations

    • Membranous epithelium: covers the body and some of its parts and lines the serous cavities; blood and lymphatic vessels; and respiratory, digestive, and genitourinary tracts

    • Glandular epithelium: secretory units of endocrine and exocrine glands

    • Along with connective are bound together by a basement membrane.


Epithelial Tissues

  • Functions include:

    • Protection

      • Skin

    • Excretion and Secretion

      • endocrine glands

      • Mucous glands

      • Kidneys

      • Sweat glands

    • Diffusion

      • Alveolar wall

    • Cleaning

      • Intestinal tract (Ciliated)

    • Absorption

      • Intestinal tract

      • Kidneys

    • Sensation

      • Skin

      • Tongue


EPITHELIAL TISSUE (cont.)

  • Generalizations about epithelial tissue

    • Limited amount of matrix material

    • Membranous type attached to a basement membrane

    • Avascular

    • Cells are in closely packed together, with many desmosomes and tight junctions

    • Capable of reproduction


EPITHELIAL TISSUE: MEMBRANOUS

  • Classification of epithelial tissue

    • Membranous (covering or lining) epithelium

      • Classification based on cell shape

        • Squamous

        • Cuboidal

        • Columnar

        • Transitional

        • Pseudostratified columnar


EPITHELIAL TISSUE: MEMBRANOUS

  • Epithelial and Connective tissue are bound together by basement membrane


EPITHELIAL TISSUE

Classification based on layers of cells:

Simple epithelium

  • Simple squamous epithelium

    • One-cell layer of flat cells

    • Permeable to many substances

    • Examples: Alveoli of the lungs and lining of blood vessels

  • Simple cuboidal epithelium

    • One-cell layer of cells that are as tall as they are wide

    • Found in many glands and ducts (secretion & absorption)


Simple squamous

  • Found in the lining of the heart, blood and lymphatic vessels, body cavities, and alveoli of the lungs.


Simple cuboidal


EPITHELIAL TISSUE (cont.)

  • Classifications based on layers of cells (cont.)

    • Simple columnar epithelium

      • Single layer of tall, column-shaped cells

      • Cells often modified for certain functions such as goblet cells (secretion), cilia (movement), microvilli (absorption)

      • Often lines hollow visceral structures

    • Pseudostratified columnar epithelium

      • Columnar cells of differing heights

      • All cells rest on basement membrane but may not reach the free surface above

      • Cell nuclei at odd and irregular levels

      • Found lining air passages and segments of male reproductive system

      • Motile cilia and mucus are important modifications


Simple columnar


Pseudostratified columnar


Cilia

  • Hair-like extensions of cells in the respiratory tract and female reproductive system.


EPITHELIAL TISSUE (cont.)

Classifications based on layers of cells (cont.)

  • Stratified epithelium

    • Keratinized stratified squamous epithelium

      • Multiple layers of flat, squamous cells

      • Cells filled with keratin

      • Covering outer skin on body surface

    • Nonkeratinized stratified squamous epithelium

      • Lining vagina, mouth, and esophagus

      • Free surface is moist

      • Primary function is protection

    • Stratified cuboidal epithelium

      • Two or more rows of cells are typical

      • Basement membrane is indistinct

      • Located in sweat gland ducts and pharynx


Keratinized stratified squamous

  • Found in covering outer skin on body surface.


Nonkeratinized stratified squamous

  • Found in lining of vagina, mouth and esophagus.


Stratified cuboidal


EPITHELIAL TISSUE (cont.)

Classifications based on layers of cells (cont.)

  • Stratified columnar epithelium

    • Multiple layers of columnar cells

    • Only most superficial cells are typical in shape

    • Rare

    • Located in segments of male urethra and near anus

  • Transitional epithelium

    • Located in lining of hollow viscera subjected to

      stress (e.g., urinary bladder)

    • Often 10 or more layers thick

    • Protects organ walls from tearing

    • Has varying shapes and is capable of stretching

      (found in urinary bladder)


  • EPITHELIAL TISSUE: GLANDULAR EPITHELIUM

    • Glandular epithelium

      • Glands are usually composed of simple cuboidal cells

      • Specialized for secretory activity

      • Exocrine glands: discharge secretions into ducts

        • Simple exocrine glands- only has one duct leading to the surface

        • Compound exocrine glands- only has two or more ducts leading to the surface

      • Endocrine glands: “ductless” glands; discharge secretions directly into blood or interstitial fluid

      • Goblet cells- glandular epithelial cells that secrete mucous to lubricate the intestinal wall


    EPITHELIAL TISSUE: GLANDULAR EPITHELIUM (cont.)

    • Structural classification of exocrine glands

      • Multicellular exocrine glands are classified by the shape of their ducts and the complexity of their duct system

      • Shapes include tubular and alveolar

      • Simple exocrine glands: only one duct leads to the surface

      • Compound exocrine glands: have two or more ducts


    EPITHELIAL TISSUE: GLANDULAR EPITHELIUM (cont.)

    • Functional classification of exocrine glands (Figure 5-12)

      • Apocrine glands

        • Secretory products collect near apex of cell and are secreted by pinching off the distended end

        • Secretion process results in some damage to cell wall and some loss of cytoplasm

        • Mammary glands are good examples

      • Holocrine glands

        • Secretion products, when released, cause rupture and death of the cell

        • Sebaceous glands are holocrine

      • Merocrine glands

        • Secrete directly through cell membrane

        • Secretion proceeds with no damage to cell wall and no loss of cytoplasm

        • Most numerous gland type

          Mast= cell that produces heparin and histamine


    CONNECTIVE TISSUE

    • Has large amounts of intracellular matrix

    • Most varied and abundant tissue in the body

    • Functions, characteristics, and types

      • General function:

        • Support – holds organ together

        • Bind together tissues

        • Mechanical framework (skeleton)

      • General characteristics

        • ECM predominates in most connective tissues and determines its physical characteristics

        • Consists of fluid, gel, or solid matrix, with or without extracellular fibers (collagenous, reticular, and elastic) and proteoglycans or other compounds that thicken and hold together the tissue


    CONNECTIVE TISSUE

    • Types

      • Three subgroups:

        • Loose connective Tissue

        • Dense Connective Tissue

        • Specialized Connective Tissue


    CONNECTIVE TISSUE (cont.)

    • Loose Connective Tissue

      • Areolar

      • Adipose

      • Reticular

  • Dense Connective Tissue

    • Fibrous

    • Elastic

  • Specialized Connective Tissue

    • Bone

    • Compact bone

    • Cancellous bone

    • Cartilage

    • Hyaline

    • Fibrocartilage

    • Elastic

    • Blood


  • Loose areolar connective tissue


    CONNECTION TISSUE cont.

    • Areolar connective tissue

      • One of the most widely distributed of all tissues

      • Intercellular substance is prominent and consists of collagenous and elastic fibers loosely interwoven and embedded in soft viscous ground substance

      • Several kinds of cells present, notably fibroblasts and macrophages, also mast cells, plasma cells, fat cells, and some white blood cells

      • Function: stretchy, flexible connection


    Areolar connective tissue


    CONNECTION TISSUE (cont.)

    • Adipose tissue

      • Similar to loose connective tissue but contains mainly fat cells

      • Functions: protection, insulation, support, and food reserve

    • Reticular tissue

      • Forms framework of spleen, lymph nodes, and bone marrow

      • Consists of network of branching reticular fibers with reticular cells overlying them

      • Functions: defense against microorganisms and other injurious substances; reticular meshwork filters out injurious particles and reticular cells phagocytose them


    Adipose tissue


    Reticular tissue


    Dense CONNECTIVE TISSUE

    • Dense Connective Tissue

      • Matrix consists mainly of densely packed fibers and relatively few fibroblast cells

        • Irregular: fibers intertwine irregularly to form a thick mat

        • Regular: bundles of fibers are arranged in regular parallel rows

          • Fibrous(Collagenous): mostly collagenous fibers in ECM

          • Elastic: mostly elastic fibers in ECM


    Dense connective tissue


    Dense fibrous connective tissue


    Fibrous elastic dense connective tissue


    Dense CONNeCTIVETISSUE (cont.)

    • Locations: structures that need great tensile strength, such as tendons and ligaments; also dermis and the outer capsule of the kidney and spleen

    • Function: furnishes flexible connections that are strong or stretchy


    DAY 2

    Membranes and Wound Healing


    Specialized CONNECTIVE TISSUE: BONE TISSUE

    • Bone tissue

      • Uniquely hard and strong connective tissue type

        • Cells (osteocytes) embedded in a calcified matrix

        • Inorganic component of matrix accounts for 65% of total bone tissue

      • Functions

        • Support

        • Protection

        • Point of attachment for muscles

        • Reservoir for minerals

        • Supports blood-forming tissue

        • Provide movement


    Specialized CONNECTIVE TISSUE:BONE TISSUE (cont.)

    • Compact bone

      • Osteon (Haversian system)

        • Structural unity of bone

        • Spaces for osteocytes called lacunae

        • Matrix present in concentric rings called lamellae

        • Canaliculi are canals that join lacunae with the central Haversiancanal (communication passageway)

      • Cell types

        • Osteocyte: mature, inactive bone cell

        • Osteoblast: active bone-forming cell

        • Osteoclast: bone-destroying cell


    Compact bone tissue


    Specialized CONNECTIVE TISSUE: BONE TISSUE (cont.)

    • Cancellous bone made up of trabeculae

      • Trabeculae: thin beams of bone

      • Supports red bone marrow

        • Myeloid tissue: a type of reticular tissue

        • Produces blood cells

      • Called spongy bone because of its spongelikeappearance

      • Endochondrial ossification- the conversion of cartilage to bone

      • Periosteum- membrane that surrounds bone


    Specialized CONNECTIVE TISSUE: CARTILAGE

    • Cartilage

      • Chondrocyte is the only cell type present

      • Lacunae house cells as in bone

      • Avascular: nutrition of cells depends on diffusion of nutrients through matrix

      • Heals slowly after injury because of slow nutrient transfer to cells

      • Perichondrium is membrane that surrounds cartilage

      • Endochondrial ossification- the conversion of cartilage to bone


    Specialized CONNECTIVE TISSUE: CARTILAGE (cont.)

    • Types

      • Hyaline

        • Appearance is shiny and translucent

        • Most prevalent type of cartilage

        • Located on ends of articulating bones

      • Fibrocartilage

        • Strongest and most durable type of cartilage

        • Matrix is semirigid and filled with strong white fibers

        • Found in intervertebral disks and pubic symphysis

        • Serves as shock-absorbing material between bones at the knee (menisci)

      • Elastic

        • Contains many fine elastic fibers

        • Provides strength and flexibility

        • Located in external ear and larynx


    Fibrocartilage


    Elastic cartilage


    Specialized CONNECTIVE TISSUE: BLOOD

    • Blood

      • A liquid tissue

      • Contains neither ground substance nor fibers

      • Composition of whole blood

        • Liquid fraction (plasma) is the matrix; 55% of total blood volume

        • Formed elements contribute 45% of total blood volume

          • Red blood cells (erythrocytes)

          • White blood cells (leukocytes)

          • Platelets (thrombocytes)


    blood


    Specialized CONNECTIVE TISSUE: BLOOD (cont.)

    • Functions

      • Transportation

      • Regulation of body temperature

      • Regulation of body pH

      • White blood cells destroy bacteria

    • Circulating blood tissue is formed in the red bone marrow by a process called hematopoiesis; the blood-forming tissue is sometimes called hematopoietic tissue


    Hematopoietic Tissues

    • Tissues that form RBC’s or WBC’s

      • Lymphoid organs

        • WBC’s

      • Red bone Marrow

        • RBC’s


    MUSCLE TISSUE

    • Types

      • Skeletal, or striated voluntary

      • Smooth, also known as nonstriated involuntary or visceral

      • Cardiac, or striated involuntary

    • Microscopic characteristics

      • Skeletal muscle: threadlike cells with many cross-striations and many nuclei per cell

      • Smooth muscle: elongated narrow cells, no cross-striations, one nucleus per cell

      • Cardiac muscle: branching cells with intercalated disks (formed by abutment of plasma membranes of two cells)

      • Works with connective tissue to provide movement


    Skeletal muscle


    Smooth muscle

    • Located in walls of hollow organs, bladder, and uterus


    Location of smooth muscle


    Cardiac muscle


    NERVOUS TISSUE

    • Functions: rapid regulation and integration of body activities

    • Special characteristics

      • Excitability

      • Conductivity

    • Organs

      • Brain

      • Spinal cord

      • Nerves


    NERVOUS TISSUE (cont.)

    • Cell types

      • Neuron: conducting unit of system. Composed of axon, dendrites, myelin sheath, and cell body (soma)

        • Cell body, or soma

        • Processes

          • Axon (single process): transmits nerve impulse away from the cell body

          • Dendrite (one or more): transmits nerve impulse toward the cell body and axon

      • Neuroglia: special connecting, supporting, coordinating cells that surround neurons

      • Epineurium- the connective membrane that surrounds entire nerve


    Nervous tissue


    BODY MEMBRANES

    • Thin, “sheet like” tissue layers that cover surfaces, line cavities, and divide spaces or organs

    • Four major types:

      • Cutaneous

      • Serous

      • Mucous

      • Synovial (connective tissue)


    Serous Membranes

    • Line body cavities that are not open to the outside of the body

    • Secrete a thin watery fluid called Serous Fluid

      • Lubricates the surface of the membrane and reduces friction between structures

    • Visceral layer: covers the organs within the cavity

    • Parietal layer: the inner linings of those cavities

      • Visceral peritenium- covers the organs within the abdominal cavity

      • Parietal peritoneum- inner lining of the abdominal cavity


    Serous Membranes

    • Pleura: serous membranes in the thoracic cavity

    • Peritoneum: serous membranes in the abdominal cavity


    Cutaneous membranes

    • Epithelial membranes are most common type

      • Cutaneous membrane (skin)

        • Primary organ of integumentary system

        • One of the most important organs

        • Approximately 16% of body weight


    Mucous Membranes

    Epithelial Tissue Membranes Cont.

    • Mucous membrane (mucosa)

      • Lines and protects organs that open outside the body

      • Found lining ducts and passageways of the respiratory, digestive, and other tracts

      • Lamina propria: fibrous connective tissue underlying mucous epithelium

      • Mucus is made of mostly of water and mucins—proteoglycans that form a double-layer protection against environmental microbes


    BODY MEMBRANES (cont.)

    • Connective tissue membrane:

      • Synovial membranes line the spaces between bone in joints (classified as connective tissue membrane)

        • Do not contain epithelial components

        • Have smooth and slick membranes that secrete synovial fluid

        • Help reduce friction between opposing surfaces in a movable joint

        • Synovial membranes also line bursae


    THE BIG PICTURE: TISSUES, MEMBRANES, AND THE WHOLE BODY

    • Tissues and membranes maintain homeostasis

      • Epithelial tissues

        • Form membranes that contain and protect the internal fluid environment

        • Absorb nutrients

        • Secrete products that regulate functions involved in homeostasis

      • Connective tissues

        • Hold organs and systems together

        • Form structures that support the body and permit movement


    THE BIG PICTURE: TISSUES, MEMBRANES, AND THE WHOLE BODY (cont.)

    • Muscle tissues

      • Work with connective tissues to permit movement

    • Nervous tissues

      • Work with glandular epithelial tissue to regulate body function


    TISSUE REPAIR

    • Tissues have a varying capacity to repair themselves; damaged tissue regenerates or is replaced by scar tissue

    • Regeneration: growth of new tissue

    • Scar: dense, fibrous mass; unusually thick scar is a keloid

    • Epithelial and connective tissues have the greatest ability to regenerate

    • Muscle and nervous tissues have limited capacity to regenerate


    Classification of Surgical Wounds

    • Two types of surgical wounds:

      • Incisional: intentional cut through intact tissue for the purpose of exposing underlying structures

      • Excisional: Removal of tissue

    • Four Classes of surgical wounds:

      Classified by degree of microbial intrusion

      • Class I (clean)

      • Class II (Clean-contaminated)

      • Class III (Contaminated)

      • Class IV (dirty-infected)


    Classification of Surgical Wound(Cont.)

    • Wound classes

      • Class I- Clean occurs when an incision is made

      • Class II- Clean-Contaminated occurs after a primary closure- drain placed minor break in aseptic technique

      • Class III- Contaminated occurs when an open traumatic wound is encountered, aerodigestive tract, biliary, or genitourinary tract was entered with spillage, or major break in aseptic technique.

      • Class IV- Dirty-Infected occurs in open traumatic wounds in which microbial contamination had previously occured


    Classification of Surgical Wound(Cont.)

    • Infection rate

      • Class I – 1%-5%

      • Class II - 8%- 11%

      • Class III - 15%- 20%

      • Class IV - 27%- 40%


    Wound Healing

    • First Intention– Primary Union

    • Second Intention-- Granulation

    • Third Intention– Delayed primary Closure


    First Intention Healing

    • Primary union

    • Ideal

    • Wound heals side to side w/o infection

    • Inflammatory Response aka Lag Phase:

      3-5 days

      • Inflammation

      • Swelling

      • Heat

      • Redness

      • Loss of function

      • Scab forms


    First Intention Continued

    • Proliferation Phase: begins around the 3rd or 4th day and lasts for 20 days

      • Collagen fibers provide some tensile strength

      • New capillary network is established

        (day 5-6)

    • Maturation aka Differentiation Phase: Day 14 – healed

      • Tensile strength increases

      • Wound contraction complete (day 21)

      • Mature scar formed *Cicatrix


    Second intention Healing

    • Granulation

    • Occurs when a wound fails to heal by 1st intention

    • Wound left open to heal from the bottom up

    • Wound closure occurs by contraction

    • Weak (herniation common) and forms a large scar

    • Examples:

      • When wound can not be reapproximated

      • Infected wounds


    Third Intention Healing

    • Delayed primary closure

    • Used for dirty wounds

    • Wound is treated by debridment of dead tissue………then left open to heal by second intention (4-6 days)

    • once the wound is infection free, it is closed with suture or staples to finish healing by first intention


    Third Intention Healing


    Complications of Wound Healing

    • Dehiscence: partial or total separation of a layer (or layers) of tissue after closure

      • Most frequently between the 5th and 10thPostop day

      • Causes:

        • Abdominal distention

        • Coughing or Vomiting

        • Improper suture

        • Improper suturing technique

    • Dead Space (pg. 55): can occur when subcutaneous tissues are not approximated with suture


    Dehiscence


    Complications of Wound Healing Cont.

    • Evisceration

    • Hemorrhage

    • Adhesions

    • Herniation

    • Fistula

    • Keloid Scaring

    • Sinus Tract


    Evisceration


    Adhesions


    Herniation


    Keloid Scaring


    Tissue Typing

    • We have genetic markers on the surface of our WBC’s

      • Ex. HLA: Human leukocyte antigen

        • An antigen is something that when introduced into the body triggers an immune response.

    • Donor WBC’s and Recipient WBC’s are mixed

      • If an immune response occurs (ex. Proliferation of WBC’s) the tissue will likely be rejected

  • DNA Tissue Typing

    • MHC: major histocompatibility complex

      • Particular genes unique to each individual


  • Surgical Specimens

    • Permanent section:

      • 10% formalin

      • May remain on sterile field until the end of case

    • Fresh or Frozen section:

      • Sent immediately after removal

      • Pathologist will phone OR with results

    • Surgical Techs Responsibilities

      • Must be able to Identity the specimen

      • Identify the origin

      • Must properly communicate information to circulator

      • Properly identify and explain markers (suture)

    • Specimens should be placed in/on:

      • Sterile specimen cup

      • Sterile Telfa pad

      • Sterile towel

      • Sterile basin

      • *a counted sterile sponge should never be used


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