Sanad Issam Al-Dwairi Lecture 1 Medical Club

Cartilage.
 Cartilage tissue is a specialized, semi-solid derivative of C.T that functions mainly to
provide support.
 Just like epithelial, cartilage is an avascular tissue with no vessels or nerves in the tissue.

 Cartilage is nourished by a special layer of C.T called the perichondrium, which

surrounds cartilage and is considered to be a reservoir of chondroblasts.

 Cartilage are found in areas of bone articulation, weight bearing, and areas of elasticity.

 Cartilage is very important for the process of development, as it is considered to be the

origin of bones.

 Cartilage help in the process of fracture healing, as it forms in the early steps of healing.

Components of Cartilage

 Since it is a type of C.T, they share the same components:

I. Cells
 The main cells that form cartilage are chondroblasts, which originate from
multipotent mesenchymal cells.
 Chondroblasts mature and grow up to chondrocytes to lay down fibers &
ECM and form the tissue.
 One main difference is that chondroblast after secreting the ECM of the
tissue, they start secreting an ECM around themselves and this space is
called lacunae
 Note: Chondrocytes CAN'T divide

II. ECM
 It is also made up of a ground substance that has same components:
A. GAGS
B. Proteoglycans.

III. Fibers
 Variation of fibers among cartilage is a main reason behind its diversity.

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Growth of Cartilage.
 Cartilage can grow by 2 ways:

Interstitial Growth Appositional Growth

Takes place in immature cartilage. Takes place in mature cartilage.
Here, the cartilage grows from the inside. Here, the cartilage grows from the edges.
Here the chondroblasts present within the Here, the tissue is mature, and has
cartilage, start dividing and forming these chondrocytes.
groups of cells and start secreting matrix so, the layer of perichondrium surrounding
and fibers, so the tissue grows… the tissue, start secreting chondroblasts
that divide and mature to give
chondrocytes and lay down matrix and
fibers, so the tissue grows from the edges

Regeneration & Degeneration Process.

 Cartilage sometime have poor nutrition so, when an injury takes place in the cartilage
this will lead to the atrophy of the tissue.
 The tissue will respond to this atrophy by more secretion of fibers to form what is called
fibrosis.
 Fibrosis is then followed by calcification, which will induce more death for chondrocytes,
eventually this cartilage is transformed to bone.

Types of cartilage
 Cartilage has 3 main types:

i. Hyaline Cartilage.

ii. Elastic Cartilage.

iii. Fibrocartilage.

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Hyaline Cartilage.
 Hyaline cartilage begins developing from about the fifth fetal week as the mesenchymal
cells become rounded and form densely packed cellular masses known as centers of
chondrification

 Hyaline cartilage is the most common type of cartilage, and it is found in many places
such as:
i. Places of articulations between two
bones.
ii. Trachea.
iii. Larynx.

 Hyaline Cartilage is made up from

chondrocytes that sit in an extracellular space
called lacunae.
 Each Lacunae may endure 1 or 2 or 3 or even 4 chondrocytes.

 In hyaline cartilage, the cells in their lacunae, form a nest-like fashion, as the appear to
be very close from each other, this is called isogenous groups.

 In Hyaline cartilage, fibers are not well seen under Light Microscope, because both
ground substance and fibers share the same refractive index.

 The main type of fibers in hyaline cartilage is COLLAGEN TYPE II.

 Histological Features:
i. A homogenous, basophilic ground substance.

ii. Chondrocytes have:

a. single nucleus.
b. granular cytoplasm.
c. Basophilic chromatin.
d. Lipid droplets, with a size that correspond to
the maturity (age) of the chondrocyte.

iii. Has a perichondrium layer around it.

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Articular Cartilage.
 Articular Cartilage is a specialized form of hyaline cartilage.
 The main function of articular cartilage is to transform the articulating ends of the bones
into lubricated, wear-proof, slightly compressible surfaces, which exhibit very little
friction.
 Articular Cartilage is not surrounded by a perichondrium and it is partly vascularized & is
nourished by synovial fluid.

 Depending on the arrangement of chondrocytes and collagenous fibres, Articular

cartilage is divided into several zones :
i. Tangential layer
 Chondrocytes are small, flattened & parallel to the surface.Collagen fibres in
the matrix of the tangential layer are very fine & run parallel to the surface of
the cartilage.

ii. Transitional zone

 The chondrocytes are slightly larger, round and occur both singly and in
isogenous groups. Collagen fibres take an oblique course through the matrix
of the transitional zone.

iii. Radial zone

 Fairly large chondrocytes form radial columns, i.e. the stacks of cells are
oriented perpendicular to the articulating surface.
 The course of the collagen fibres follows the orientation of the chondrocyte
columns.

iv. Calcified cartilage layer

 It rests on the underlying cortex of the bone. The matrix of the calcified
cartilage layer stains slightly darker (H&E) than the matrix of the other layers

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Elastic Cartilage.
 Elastic Cartilage is very similar to hyaline cartilage,
but it has a dense delicate network of branching
elastin fibers.

 Elastic Cartilage is present in places that need

elasticity and stretch, such as:
i. epiglottic cartilage
ii. the corniculate
iii. cuneiform cartilage of the larynx.
iv. the cartilage of the external ear
v. auditory tube

 Histological Features:
i. Cells are paired and present in lacunae.
ii. It has a layer of perichondrium surrounding it.
iii. A Dense network of black elastin fibers and has also TYPE II COLLAGEN.

Fibrocartilage
 It is a transitional form between Dense C.T & Hyaline
Cartilage.
 The main Remark here is that the main type of fibers is
COLLAGEN TYPE I.

 Histological Features:
i. Chondrocytes may lie singly or in pairs, but most
often they form short rows between dense
bundles of collagen.
ii. Type I collagen is the dominant form of collagen fibers.
iii. It does not have a perichondrium.

Location of fibrocartilage Functions of fibrocartilage

Labrum of shoulder Shock absorbent .
Intra-articular discs. Provide stability to joints.
Menisci of Knee Joint & Intervertebral
Discs

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 How does fibrocartilage act as a shock absorbent ?

 This is due to 2 factors :
i. Abundant amounts of collagen bundles, to provide strength.
ii. Central nucleus with a jell-like material called nucleus pulposus.

Prolapse of Intervertebral discs

 Happens because of increased pressure and weight on the intervertebral disks.
 As a result, the disk (annulus fibrosus) ruptures, and the nucleus fluid is released,
causing pressure on the nerves of that disk.
 The pain is felt along the whole nerve, not only in the ruptured disk’s region.

SANAD ISSAM AL-DWAIRI – Medical

Club

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Bone Tissue
 Bone tissue is a special derivative of CT, and it has similar components (Cells, ECM,
Fibers).
 Mesenchymal Cells Differentiate into Osteoblasts which laydown bone tissue then
become osteocytes.
 Bone tissue is similar to cartilage in architecture, as Osteoblasts are present in lacunae).
 Bone tissue is surrounded by 2 layers of C.T called the periosteum & Endosteum and
these are full of mesenchymal cells that give rise to blast cells that help in the formation
of bones

Features of Bone Tissue

i. Bone tissue has perforating channels that help Blood vessels and nerves to pass
into the bone, because it is highly vascularized and with very good nerve supply.

ii. Bone tissue has a very high capacity of regeneration which will help in Fracture
Healing.

iii. Dead tissue in the bone undergoes a continuous process of remodeling.

Functions of Bones
i. Solid Support.

ii. Storage of Minerals, like Calcium Bones from outside are always compact
and from inside are spongy
iii. Blood Cells Production.
iv. Leverage of Motion
v. Protection

Structure of long bones

 Long bones are divided into 3 main regions:
Epiphysis (Articulation) Metaphysis Diaphysis
It is the expanded ends of long It is the middle area between It is the tubular shaft that forms
bones, in which outer surface is epiphysis & diaphysis which the axis of long bones and it is
compact & inner surface is connects them. composed of compact bone that
spongy bone. surrounds the medullary cavity
which contains yellow bone
Epiphyseal line separates the marrow.
diaphysis from the epiphyses

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Cells in Bone tissue (Histologically)

 There are 3 MAIN types of cells in bone tissue:

Osteoprogenitor Cells Osteoblasts Osteocytes

These are mesenchymal stem Osteoblasts may form a low These have little RER and are
cells located in the inner cellular columnar "epitheloid layer" at smaller
layer of periosteum that divide sites of bone deposition.
to produce osteoblasts
They may have transverse
These function in fracture repair process and contain plenty of
and remodeling. RER for collagen synthesis and a
large Golgi apparatus.
These are different to
distinguish from other C.T cells.

Cells in bone tissue (Physiologically) Notes

ECM is made of two Units:
 Lets speak about the cells function and physiology: 1. Organic Matrix (Osteoid)
2. Inorganic Matrix (Osteon
Mineralized bone)

i. Osteoblasts:
 Immature Bone Cells that secrete matrix compounds (osteogenesis)
 Osteoblasts actually secrete what is know as osteoid, which is the organic
material, that is not calcified yet to form mature bones

ii. Osteocytes:
 Osteocytes are mature bone cells that live in lacunae and they maintain
the bone matrix (protein and mineral content)
 They are between layers (lamellae) of matrix and connected to each
other by the canaliculi of the lamellae (Gap Junctions)
 Osteocytes don’t divide but they help in the recruitment of osteoblasts
and this done by secreting cAMP, Osteocalcin and growth factors as a
response to tension.
 A specific space between osteocyte membrane and the wall of the
lacunae is called as periosteocytic space which contains a bony fluid
(1.3L) which functions as route for the calcium circulation during bone
formation & transmit stress between Osteoblasts and ostecytes.
 They are present in lacunae

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iii. Osteoclasts(5-10 under LM, but actually 50 in the cell):

 These are very large (up to 100 µm), Multi-nucleated, Bone-resorbing Cells.
 They arise by the fusion of Monocytes or macrophages.
 Osteoclasts attach themselves to the bone matrix through processes and form a
tight seal at the rim of the attachment site and form a ruffled border.
 Osteoclasts are stimulated by Parathyroid Hormone (parathyroid gland) and
inhibited by Calcitonin (thyroid gland).
 Osteoclasts are often seen within the indentations of the bone matrix that are
formed by their activity (resorption bays or Howship's lacunae).
 How do osteoclasts help do their function ?
- Osteoclasts Secrete (Acidphophotase, Proteinase & lysosomes) into the
extracellular space between the ruffled border and the bone matrix.
- The released enzymes Break Down The Collagen Fibres of the matrix.
- Another clarification: Pump Hydrogen Ions and Chloride so decrease the
PH, hence the environment becomes Acidic and this will digest the dying
bone matrix.

 The formation of osteoclast:

- It depends on 3 signals:
i. Macrophage colony-stimulating factor (M-CSF). It binds to a
receptor on Macrophage and it induces expression of receptor for
the activation of Nuclear Factor Kappa (RANK).

ii. RANKL(Ligand) Induces the expression of multinucleated Osteoclast.

iii. Osteoprotegerin (OPG) binds to macrophage and inhibiting its

transformation into an Osteoclast (Regulation). It Inhibits Osteoclast
Differentiation, Fusion, And Activation./////(regulate number)

Bone Membranes
1. Periosteum is a double-layered protective membrane in which the Outer fibrous
layer is dense regular connective tissue and the in inner osteogenic layer is composed
of osteoblasts and osteoclasts. Richly supplied with nerve fibers, blood, and
lymphatic vessels, which enter the bone via nutrient foramina Secured to underlying
bone by Sharpey’s fibers.
2. Endosteum delicate membrane covering internal surfaces of bone.

Functions of periosteoum
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i. Isolate bone from surrounding tissues

ii. Provide a route for circulatory and nervous supply

iii. Participate in bone Growth And Repair

Bone Matrix
 Bone matrix consists of collagen fibres (about 90% of the organic substance) and Ground
Substance.
 Collagen type I is the dominant collagen form in bone.
 The hardness of the matrix is due to its content of inorganic salts (hydroxyapatite; about
75% of the dry weight of bone), which become deposited between collagen fibers.
 Calcification begins a few days after the deposition of organic bone substance (or
osteoid) by the osteoblasts.

 Osteoblasts are capable of producing high local concentration of Calcium Phosphate in

the extracellular space, Which Precipitates On The
 Collagen Molecules. About 75% of the hydroxyapatite is deposited in the first few days
of the process, but complete calcification may take several months. Notes
Sialoprotein: Binding
Osteoblast to matrix
 It is made up from:
Notes
1. Organic Matrix:
Osteoclacin: Binds to
 Secreted initially while forming the primary bone Hydroxyapatite leading to
(Osteoid). Mineralization.

2. Inorganic part:
Notes
 Made of Minerals. Osteopontin: Binds to
 Initially, Osteoblasts lay down the organic matrix and Hydroxyapatite and
collagen in Irregular Fashion. integrins on
Osteoblasts and
 Later-on, collagen is arranged in lamellae (Layers around Osteoclasts (Sealing).
the central Haversian canal.

Bone Formation(Osteogenesis & Ossification)

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 Osteogenesis and ossification is a process of bone tissue formation which begins at the eighth week of
embryo development and it leads to The formation of the bony skeleton in embryos, bone growth
until early adulthood, bone thickness, remodeling, and repair.
 The process of bone formation can be divided into 2 types:
i. Intramembranous ossification:
 Here, bone develops from a fibrous membrane.
 All Flat Bones Develop via this method (skull and the clavicles)

ii. Endochondral Ossification:

 bone forms by replacing hyaline cartilage.
 All Long & Irregular Bones develop via this method

Intramembranous Ossification

 Occurs within a membranous, condensed plate of mesenchymal cells.

 At the initial site of ossification (ossification center) mesenchymal cells (osteoprogenitor cells)
differentiate into osteoblasts.
 The osteoblasts begin to deposit the organic bone matrix, the osteoid.
 The matrix separates osteoblasts, which, from now on, are located in lacunae within the matrix.
 The collagen fibers of the osteoid form a woven network without a preferred orientation, and lamellae
are not present at this stage.
 Because of the lack of a preferred orientation of the collagen fibers in the matrix, this type of bone is
also called woven bone.
 The osteoid calcifies leading to the formation of primitive trabecular bone.

Endochondral Ossification.

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Endochondral Ossification
 Most bones are formed by the transformation of cartilage "bone models", a process
called Endochondral Ossification.
 A periosteal bud invades the cartilage model and allows osteoprogenitor cells to enter
the cartilage.
 At these sites, the cartilage is in a state of hypertrophy (very large lacunae and
chondrocytes) and partial calcification, which eventually leads to the death of the
chondrocytes.
 Invading osteoprogenitor cells mature into osteoblasts, which use the framework of
calcified cartilage to deposit new bone.
 The bone deposited onto the cartilage scaffold is lamellar bone. The initial site of bone
deposition is called a primary ossification center.
 Secondary ossification centers occur in the future epiphyses of the bone.

 Close to the zone of ossification, the cartilage can usually be divided into a number of
distinct zones :
i. Reserve Cartilage, furthest away from the zone of ossification, looks like immature
hyaline cartilage.

ii. A zone of Chondrocyte Proliferation contains longitudinal columns of mitotically

active chondrocytes, which grow in size

iii. The zone of Cartilage Maturation And Hypertrophy.

iv. A zone of Cartilage Calcification forms the border between cartilage and the zone of
bone deposition (Osteogenic Zone).

 Stages of Endochondral Ossification

1. Formation Of Bone Collar
2. Cavitation Of The Hyaline Cartilage
3. Invasion Of Internal Cavities By The Periosteal Bud,And Spongy Bone Formation
4. Formation Of The Medullary Cavity;
5. Appearance Of Secondary Ossification Centers In The Epiphyses
6. Ossification Of The Epiphyses, With Hyaline Cartilage Remaining Only In The
Epiphyseal Plates

Types Of Bone Tissue

i. Compact Bone/Cortical Bone
ii. Cancellous Bone/Trabecular/Spongy

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Compact Bone
 Compact bone consists mainly of ECM,
which is deposited in form of sheet called
lamellae(microscopic structure)
 Collagen fibers within each lamella has
collagen fibers that run parallel to each
other.
 Collagen fibers which belong to adjacent
lamellae run at oblique angles to each other.
 Bone which is composed by lamellae when viewed under the microscope is also called
Lamellar Bone.
 Microscopically, compact bone is made up from its structural unit known as the
Haversian system/Osteon which is
composed from:
i. Lamella – weight-bearing, column-
like matrix tubes composed mainly
of collagen

ii. Haversian, or central canal: central

axis channel containing blood
vessels and nerves

iii. Volkmann’s canals – channels lying at right angles to the central canal, connecting
blood and nerve supply of the periosteum to that of the Haversian canal
( Connects 2 Haversian together)

 Osteocytes have several thin processes called Canaliculi.

 They extend from the lacunae into small channels within the bone matrix , the Canaliculi
arising from one lacuna may Anastomose with those of other lacunae and, eventually,
with larger, vessel-containing canals within the bone.
 Canaliculi help osteocytes to communicate with each other and to exchange
substances by diffusion.

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Notes
 Restorative activity continues in aged humans (about 2%of the Haversian systems seen
in an 84 year old individual contained lamellae that had been formed within 2 weeks
prior to death!).
 However, the Haversian systems tend to be smaller in older individuals and the canals
are larger because of slower bone deposition. If these age-related changes in the
appearance of the Haversian systems are pronounced they are termed osteopenia or
senile osteoporosis.
 The reduced strength of bone affected by osteoporosis will increase the likelihood of
fractures.

Hormonal Mechanism
 Rising blood Ca2+ levels trigger the thyroid to Release Calcitonin
 Calcitonin stimulates calcium salt deposit in bone
 Falling blood Ca2+ levels signal the parathyroid glands to release PTH
 PTH signals osteoclasts to degrade bone matrix and release Ca2+ into the blood

Big note: Main difference between compact and spongy, is that collagen is not arrangen
in lamellae, in spongy bones

Big Big Big Note: In both endochondral & Intermembranous ossification, the type of bone
is woven bone.

The End
SANAD ISSAM AL-DWAIRI-medical club

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Muscular tissue (Special Thanks to Obada Al-Nasser)

 These are mesodermal origin specialized type of cells that produce motion, either
movements in skeletal muscles or motility as in smooth muscles of visceral Organs which
depends on ATP.
 Terminology: we use the suffix “Sarc” in describing the muscular tissue, so Cytoplasm and
endoplasmic reticulum of muscle cells are often referred to as Sarcolemma, Sarcoplasm,
and Sarcoplasmatic Reticulum

Skeletal muscle (50% of body Weight)

 These are voluntary multinucleated (Peripheral) long tubular cells/fibers with a diameter
10 to 100 µm (sartorius muscle in thigh up to 30 cm, stapedius muscle in middle ear only
about 1 mm).
 Skeletal muscle is striated due to the presence of functional and anatomical units called
sarcomeres.
 Development of SKM:
i. These originate from stem cells called myoblast that fuse together to form elongated
growing myotube containing several nuclei.
ii. The second stage is the lay down of contractile proteins (actin and myosin mainly).
iii. During the synthesis of the contractile proteins, the nuclei are gradually displaced to
the periphery of the cell.

Structure of SKM
 Muscle fibers (Cells) occur in bundles,
fascicles, which make up the muscle.

 Each fiber is surrounded by a layer of

connective tissue (Endomysium).

 Each fascicle is surrounded by a layer of

connective tissue (Perimysium).

 Then All fascicles are surrounded by a layer of connective tissue (Epimysium).

 All CT is continuous with the muscle fascia to form the tendon which is dense regular type
of connective tissue.
Sanad Issam Al-Dwairi Lecture 3 Medical Club

Contractile Apparatus of Skeletal Muscle

 Myosin(Thick) & Actin(Thin) are arranged in-register within each fiber & furthermore fibers
are also in-register with each other forming striations. (Sarcomere)
 Sarcomere bands & lines:
A. I-band: actin filaments,
B. A-band: myosin filaments which may
overlap with actin filaments,
C. H-band: zone of myosin filaments only (no
overlap with actin filaments) within the A-
band.
D. Z-line: zone of apposition of actin filaments
belonging to two neighboring sarcomeres
(mediated by a protein called alpha-
actinin).
E. M-line: band of connections between myosin filaments (mediated by proteins, e.g.
myomesin, M-protein).

 The average length of a sarcomere is about 2.5 µm (contracted ~1.5 µm, stretched ~3 µm).
 Myofibrils are held In-register with each other by Intermediate filaments Desmin &
Vimentin anchor to Z-Lines.
 These bundles are attached to the inner side of Sarcolemma (Cytoplasmic) by Dystrophin
Complex (Muscular Dystrophy)
 The Structural Integrity of the Myofibril is maintained by 5-Proteins:
Titin Alfa-actinin Cap-Z Nebulin Tropomodulin
keeps the filaments keeps Filaments In- prevents addition or wraps around thin cap on minus end of
(actin & myosin) within Register by binding to removal of Actin thus filaments and binds to thin filament also
the sarcomere Z-Line. maintain the length. Z-line. Acts as a Ruler maintain length.
to maintain the length. Prevents deletion.
Contraction of Skeletal Muscle
 Sites of interaction between actin and myosin are in resting muscle cells "hidden" by
Tropomyosin.

 Tropomyosin is kept in place by a complex of proteins collectively called Troponin. The

binding of calcium to troponin-C induces a conformational change in the troponin-
tropomyosin complex which permits the interaction between myosin and actin and, as a
consequence of this interaction, contraction.
Sanad Issam Al-Dwairi Lecture 3 Medical Club

 Mechanism:
I. The action potential will transfer from nerve button to muscle by exocytosis of
acetylcholine from presynaptic membrane.

II. Acetylcholine will bind to receptors on muscle membrane and this will lead to opening
of ion channels and influx of sodium ions Na + to result an action potential inside the
muscle Notes
All or
III. Action potential then travels from muscle plasma membrane (sarcolemma) by none
what is called t-tubule system which surrounds each muscle fiber, finally end up in a sac-
like structure called sarcoplasmic reticulum.

I. sarcoplasmic reticulum contain the store of calcium so action potential will lead to
release of calcium which bind to tropomyosin leads it to move from actin active site
then binding of myosin globular heads and pull the actin toward the center. And this is
of course with consumption of energy.
Notes
Types of skeletal muscle fibers Fiber type is Determined
By The Pattern Of
Stimulation Of The Fiber
Type I Fibers (Red Fibers) Type II Fibers (White Fibers)
mainly (but not exclusively) red muscle cells. White fibers
Thin and contain large amounts of myoglobin and thicker and contain less myoglobin & fewer mitochondria
mitochondria.
low ATPase activity High ATPase activity
Used to sustain production of force fast type of muscle contraction
Type IIA fibers (red) contain and are available for both Type IIB/IIX fibers (white) contain only few mitochondria. They
sustained activity and short-lasting, intense contractions are recruited in the case of rapid accelerations and short-
lasting maximal contraction. Type IIB/IIX fibers rely on
anaerobic glycolysis to generate the ATP needed for
contraction
Tonicity of Skeletal Muscle
 Tone within skeletal muscle is controlled via a receptor called the MUSCLE SPINDLE. The
Hardness of Muscle Consistency Due to Continuous Contraction of Few Sarcomeres

 MUSCLE SPINDLE is a specified type of nerve supply that is connected to central nervous
system the function of it is to check muscle contraction if it is enough or not then send their
nerval senses to CNS and supplying neurons.

 Therefore, to understand the control of tone it is imperative to understand function of the

muscle spindle.
Sanad Issam Al-Dwairi Lecture 3 Medical Club

Muscle Spindle
 Whenever skeletal muscle is stretched the muscle spindles are stimulated.
 They detect:
I. changes in the length of muscle fibers.
II. the rate of change at which the muscles are lengthen stretched.

Structure of the Muscle Spindle

 The MS consist of 2-10 specialized ((Modified))
muscle fibers enclosed in a connective tissue
capsule.
 These muscle fibers are called intrafusal muscle
fibers. (straited portion)
 Voluntary skeletal muscle fibers are called the
extrafusal muscle fibers. (non-straited portion).
 It is made form:
Nuclear bag fibers Nuclear Chain Fibers
approximately 1-3 fibers per spindle Approximately 3-7 fibers per spindle
the nuclei are found concentrated in a “bag type central” part nuclei are spread in a chain-like fashion in the center of the
of the fiber
the ends of these fibers (attached to extrafusal muscle) are the ends of these fibers (attached to bag muscle fibers) are
striated (contain actin and myosin filaments) and are striated (contain actin and myosin filaments) and are
contractile contractable
Innervation of the Muscle Spindle
i. The nerve fibers (axons) attached to the muscle spindle either conduct impulses from
the Muscle to the CNS (afferent/sensory fibers) or from the CNS towards the muscle
(efferent/motor fibers).
ii. Gamma fibers connect striated portion and the alpha fibers connect non-straited
portion.
iii. The sensory endings (Receive stimuli)
primary endings (annulospiral endings). secondary endings (flower spray endings)
Type 1A fibers: 17 microns in diameter that conduct impulses Type II Fibers: 8 Microns in diameter
at 100m/s.

iv. The motor fibers (from the CNS)

to the Muscle to the extrafusal muscle fibers
Gamma motor fibers Alpha type motor fibers (120 m/s)
innervates the striated portions of the intrafusal muscle
fibers.
Sanad Issam Al-Dwairi Lecture 3 Medical Club

Cardiac muscle
 It is found in the walls of atria and ventricles of the heart consisting of branching cardiac
myocytes (Central oval nuclei) that meet at intercalated discs (Gap Junctions).
 The heart start pumping almost from the 5th week of fetus till death.
 Cardiac muscle are involuntary stratied (Sarcomere) innervated by the ANS and they are
full of organelles and glycogen.

Structure of cardiac muscle

 These have the same contractile apparatus and the mechanism of contraction is similar
skeletal muscle cells with less distinct striations due to presence of mitochondria and
glycogen between fibrils.

 Cardiac muscle cells often branch at acute angles with Intercalated discs at the ends of
cardiac muscle cells in a region corresponding to the Z-line

 There is only one wider T-tubule set & One Sarcoplasmic Cisternae Hence Called DIADs for
each sarcomere, which is located close to the Z-line.

 The sarcoplasmic reticulum does not form continuous cisternae but instead an irregular
tubular network around the sarcomere with only small isolated dilations in association
with the T-tubules.

 Cardiac muscle cannot regenerate due to the absence of satellite cells.

Purkinje Fibers
 Purkinje fibers conduct stimuli faster than ordinary cardiac muscle cells (2-3 m/s vs. 0.6
m/s), and which ensure that the contraction of the atria and ventricles takes place in the
order that is most appropriate to the pumping function of the heart.

 Purkinje fibers contain fewer peripheral nonstratiretd myofibrils than ordinary cardiac
muscle cells.

 Purkinje fibers are Larger & Granular when compared to cardiac muscle cells and are
present sub-endocardial.
Sanad Issam Al-Dwairi Lecture 3 Medical Club

Smooth Muscle
 These muscles are fusiform, Non-striated, and that’s the reason for their name as they lack
sarcomeres.
 Involuntary under control of autonomic NS., Hormones, Metabolites.
 They are involuntary spindle like shape with one central oval Nucleus, connected with gap
junctions & Form Layers (Longitudinal & Circular to perform peristalsis)
 They undergo regeneration and hypertrophic changes such as in case of uterine during
pregnancy.

Functions of smooth muscle

I. Regulate the size of the lumen of hollow organs
II. Prestalsis of digestive tract
III. Vasodilation & Constriction of B.V.
IV. Synthesis of Nitric Oxide.

Structure of smooth muscle

 In the cytoplasm, Actin & filaments run in longitudinally oriented bundles in the cytoplasm
to get inserted into attachment plaques (on the cytoplasmic surface) .

 Actin filaments then get extend into the cytoplasm and interact with myosin filaments.

 The myosin filaments interact with a second set of actin filaments which insert into
intracytoplasmatic dense bodies. From these dense bodies further actin filaments extend to
interact with yet another set of myosin filaments. This sequence is repeated until the last
actin filaments of the bundle again insert into attachment plaques
Sanad Issam Al-Dwairi Lecture 3 Medical Club

Mechanics of Smooth Muscle Contraction

 They lack tubular system, but they have a caveolae for calcium storage.
 They are also Ca+ dependent, but mechanism is different than striated muscle:

i. Ca2+ ions released from caveolae/SER and complex with calmodulin and
this complex activates myosin light chain kinase which phosphorylate
myosin chain.
ii. Myosin unfolds & binds actin to start ATP-dependent contraction.
iii. Contraction continues as long as myosin is phosphorylated.
iv. When myosin head attached to actin is dephosphorylated this causes
decrease in ATPase activity .
v. Smooth muscle cells often electrically coupled via gap junctions
 Contraction is Triggered by:
i. Voltage-gated Ca+ channels activated by depolarization
 Mechanical stimuli
 Neural stimulation
ii. Ligand-gated Ca+ channels
 Smooth muscle cells can remain in a state of contraction for long periods. Contraction is
usually slow and may take minutes to develop.
Sanad Issam Al-Dwairi Lecture 4 Medical Club

Nervous Tissue (N.S)

 Nervous tissue controls and integrates all body activities that maintain life.
 Three basic functions
i. sensing changes with sensory receptors
ii. interpreting and remembering those changes
iii. reacting to those changes with effectors

Structure of N.S
 The N.S is of ectodermal origin and it is made from cells with small ECM amount.
 Cells are closely packed to each other by clasping structures called synapses, which help
in the process of transferring AP in closed structures.
 NS is composed from:

CNS PNS
Brain which is present in the cranial cavity. Cranial Nerves & Spinal Nerves
Spinal Cord is in the spinal cavity. Ganglia which is the aggregation of nervous
cell bodies outside the CNS
Enteric Plexus these are specialized
network of nerves controlling the GI

Neurons
 Neurons are the functional unit of N.S that are in charge of changing their voltage to
generate AP (Electrical excitability) and spreading it to other neurons (Self Propagation).
 These are the longest cell in our human body and can reach 1.5 meter.
 They are mainly made of cell body and process .
 Neurons are classified based on their functions or structure.

Classification of neurons.
Neurons differ from one to other according to their function & Structure:

Structure (#of processes) Function

Unipolar(pseudounipolar), has 1 process functioning Sensory (afferent) neurons these, transport sensory
as sensory neurons and it develops from bipolar. information from skin, muscles, joints, sense organs &
viscera to CNS
These could be bipolar or unipolar.
Bipolar has one main axon and one main dendrite that Motor (efferent) neurons these send motor nerve
will divide to several dendrites. impulses to muscles & glands
found in retina, inner ear & olfactory These are multipolar.
Multipolar which is the most common type, has Interneurons (association) neurons connect sensory to
several dendrites & one axon. motor neurons & they make up 90% of neurons in the
body
These are multipolar and found in the CNS

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Structure of the neuron

Cell body (Perikaryon) Dendrites Axons
A trophic center that ranges Input portion of neuron which Axons (myelinated) are one per cell
from(4-5μm) to (150 μm) and Conducts impulses towards the cell and they are long, thin cylindrical
receives great number of nerve body (receiving part) & they form process of cell that conduct impulses
endings that convey excitatory or sharp branches with sharp ends away from cell body & it ends in fine
inhibitory stimuli. (Vital structure) processes called axon terminals.
It has a single, large, euchromatic A multiple short, highly branched Axon hillock cone like structure that
(pale-staining) nucleus with structure. gives initial segment. If voltage at
prominent nucleolus initial segment reaches threshold the
action potential triggered and spread
through the axon.
Nissl bodies which is RER & free It has irregular contour and spines Initial segment is where AP starts
ribosomes for protein synthesis (microvilli-like projections) for
communication with other neurons .
Has neurofilaments and when These are unmyelinated Side branches (collaterals) end in fine
stained they collect to form processes called Axon Terminals
Neurofibrils that can be seen under
LM after staining ; and this feature
can not be founded in other cells.
microtubules (22nm) move Nissil bodies are present & Swollen tips that form synapses with
material inside cell neurofibrils neurons, muscles or glands are called
synaptic end bulbs contain vesicles
filled with neurotransmitters.
lipofuscin granules (harmless - -
aging). They are residual lysosomal
products

Neuroglial Cells
 These smaller cells form half of the volume in the CNS and they surround neurons and
are numerous (50X) .
 They function in maintaining the appropriate environment around the neurons to
facilitate fast transmission of action potentials
 These cells have rapid mitotic activity so they are capable of dividing and this is seen in
gliomas.
 4 cell types in CNS: astrocytes, oligodendrocytes, microglia & ependymal
 2 cell types in PNS: Schwann and satellite cells

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Neuroglial cells of the CNS

Astrocytes Microglia Ependymal Cells oligodendrocytes
These are small glia cell Star- These are immune star These are the lining cerebral These cells under microscope
shaped cells with many, shaped small cells found cavities (Ventricles) & appear to have Round
short processes and they are near B.V in the CNS. central canal by forming a condensed nucleus & Clear
the most abundant type. cuboidal or low columnar or pale cytoplasm & they are
(Gap Junctions) epithelial membrane. mostly available in W.M .
Has two types: They are produced outside Have cilia for moving CSF to These are analogous to
Fibrous astrocytes in the the CNS from ectoderm, and outside the ventricles and Schwann cells of PNS but
W.M and these have longer then they migrate to CNS. microvilli to hep in the these can function on more
process with less process. secretion of the CSF than one axon as it wraps it
self around segments of
Protoplasmic astrocytes in several axons.
the G.M and these have
shorter process but wore in
number.
Functions: Functions: Functions: Functions:
They form networks and They have a phagocytic role Produce CSF, which moves Each forms myelin sheath
position structures to clear away dead cells as they from brain to the outside & around more than one axons
provide structural support are derived from cells that collect between meninges in CNS.
(Collagen). give rise to macrophages & that surrounds the CNS.
monocytes.
They form foot like structure
which increase in size and
bind with other astrocytes
and form a layer around
blood capillaries known as
BBB (‫(شوو هاظا ؟‬.

hemostasis of ions
(K+)around neurons.

Recycling of
neurotransmitters released
at synapses.

Neuroglial cells in the PNS

Satellite cells Schwan cells
Star shaped flat cells surrounding neuronal cell bodies These are cells encircling PNS axons
in peripheral ganglia (PNS).
They form layers in the PNS which provides support & Each cell produces part of the myelin sheath
protection as they give insulation & nourishment. surrounding an axon in the PNS
They also regulate the transport of substances across
the cell body.

Myelination
Myelinated fibers Unmyelinated fibers
These are white jelly-roll like wrappings made of lipoprotein slow, small diameter fibers
where cytoplasm, nucleus & ends of plasma membrane are
covered.
act as electrical insulator to speed conduction of nerve only surrounded by neurilemma but no myelin sheath
impulses wrapping

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 Myelin sheath is a multilayered fatty layer (lipid & Notes

Nodes of Ranvier is the gap area
protein) covering surrounding the axons of most neurons between two myelinated
 The sheath electrically insulates the axon and increases segments where AP conduction
occurs across axon.
the speed of nerve impulse conduction.
 fused layers of membranes of Schwann cell is called Neurilemma.
 Types of myelination:
Myelination of PNS Myelination of CNS
Schwann cells myelinate axons in the PNS during Done by Oligodendrocytes trough Broad, flat cell
fetal development processes wrap about CNS axons.
Many Schwan Cells Myelinate One Peripheral Nerve One Oligo Can Myelinate Up to 50 Nerves.

Notes
Notes
in the spinal cord the grey
Presence of Neurolemms in PNS
matter is on the inside while
and not CNS is significant as it
white matter on the periphery
aids in process of regeneration;
while in the brain the
repairing of cut part of axon and
opposite.
guides regrowth of axon.
Ganglia
 It is the aggregation of cell bodies outside the nervous system, and it is subdived into:
i. Sensory ganglia
 These are unipolar cell bodies encapsulated with cuboidal cells.
 Ex, Spinal ganglia & Cranial ganglia

ii. Autonomic Ganglia:

 Multipolar cells enveloped by satellite cells.
 These are located within organs.

Repair & Regeneration

 N.S has limited ability for regeneration as PNS can repair damaged dendrites or axons
While CNS cant.
 Plasticity maintained throughout life sprouting of new dendrites synthesis of new
proteins changes in synaptic contacts with other neurons
Anesthetics
Prevent Opening Of Voltage-gated Na+ Channels thus nerve impulses cannot pass the anesthetized region
Examples of Anaesthetic Drugs: Novocaine and lidocaine

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Signal Transmission at Synapses

Electrical Chemical
ionic current spreads to next cell through gap one-way information transfer from a presynaptic
junctions neuron to a postsynaptic neuron
faster, two-way transmission & capable of axodendritic -- from axon to dendrite
synchronizing groups of neurons axosomatic -- from axon to cell body
axoaxonic -- from axon to axon
Multiple Sclerosis (MS)
 Autoimmune Disorder Causing Destruction Of Myelin Sheaths In CNS sheaths becomes
scars or plaques
 This disease is very common as there is 1/2 million people in the United States and
females acquire this more (twice) and it appears between ages 20 and 40.
 Symptoms include Progressive Muscular Weakness, abnormal sensations or double
vision
 Remissions & relapses result in progressive, cumulative loss of function

Epilepsy
 It is the second most common neurological disorder as it affects 1% of population
 Characterized by Involuntary Short, Recurrent Attacks Initiated By Electrical Discharges
In The Brain leading to involuntary SKM contraction and loos of consiouscness, with
sense may be lost.
 Epilepsy has many causes, including;
 Brain Damage At Birth, metabolic disturbances, infections, toxins, vascular
disturbances, Head Injuries, And Tumors

Strychnine Poisoning
 In spinal cord, Renshaw cells normally release an inhibitory neurotransmitter (glycine)
onto motor neurons preventing excessive muscle contraction
 Strychnine binds to and blocks glycine receptors in the spinal cord
 Massive tetanic contractions of all skeletal muscles are produced
 when the Diaphragm Contracts & Remains Contracted, Breathing Can Not Occur

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‫‪Sanad Issam Al-Dwairi‬‬ ‫‪Lecture 4‬‬ ‫‪Medical Club‬‬

‫هيك تفريغنا األخر خلص رسميا ً و خلصت حكاية الهستو من طرفي و بتمنى تكتبولها نهاية جميلة‬
‫بعالمات بترفع الراس ‪...‬‬

‫اسمحولي أشكركم على هالتجربة الجميلة ‪ ,‬صدقا درست مواد كثيرة و درست دفعات كثيرة و بجامعات‬
‫كثيرة ‪ ,‬بس ما بتذكر بيوم إني انبسطت هالقد ‪ ,‬شكرا إلكم ع ثقتكم ‪ ,‬على حبكم المستمر ‪ ,‬على الدعم‬
‫الالمتناهي ‪ ,‬أسئلتكم الي كانت تحسسني قديش مهتمين بالمادة ‪ ,‬دعواتكم الي كانت دايما هي المصدر‬
‫الرئيسي الي بستمد منه العزم إني أكمل ‪ ,‬رجوعكم الي بكلشي بخص المادة إلي بالنسبة إلي وسام ع‬
‫صدري ما رح أنساه أبدا ً ‪...‬‬
‫شكرا لكل حدا حضر معي الاليفات ‪ ,‬لكل حدا درس ع الورق ‪ ,‬لكل حدا حب المادة ‪ ,‬لكل حدا بيوم من‬
‫األيام استفاد ‪ ,‬شكرا ع لطفكم و عفويتكم و شكر خاص لحبايبنا البرشلونية الي تحملوني طول الفصل و‬
‫كانوا دايما يوخذوها بروح رياضية ‪...‬‬
‫شكرا ع السهرات الرمضانية الي قضناها سوا ننحت بهالمادة و نراجع فيها مشان الكويزات ‪..‬‬
‫ببالي أسماء كثير اشكرها بس خايف انسى حدا ‪ ,‬لهيك شكرا لكل حدا وصل لهون و عم بقرأ بهاي‬
‫الكلمات ‪ ...‬حب كبير مني و من فريق عمل النادي الطبي ‪..‬‬
‫نراكم في الفصل القادم ‪...‬‬
‫و تذكروا دايما ‪ :‬و لسوف يعطيك ربك فترضي ‪..‬‬

‫‪THE END‬‬
‫‪SANAD ISSAM ALDWAIRI-MEDICAL CLUB‬‬

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