1

Chapter 4Chapter 4The Tissue Level of The Tissue Level of

OrganizationOrganization Group of similar cellsGroup of similar cells

common embryonic common embryonic originorigin

common functioncommon function HistologyHistology

study of tissuesstudy of tissues PathologistPathologist

looks for tissue looks for tissue changes that indicate changes that indicate diseasedisease

2

4 Basic Tissues (1)4 Basic Tissues (1) Epithelial TissueEpithelial Tissue

covers surfaces because cells are in contact covers surfaces because cells are in contact lines hollow organs, cavities and ductslines hollow organs, cavities and ducts forms glands when cells sink under the forms glands when cells sink under the

surfacesurface Connective TissueConnective Tissue

material found between cellsmaterial found between cells supports and binds structures togethersupports and binds structures together stores energy as fatstores energy as fat provides immunity to diseaseprovides immunity to disease

3

4 Basic Tissues (2)4 Basic Tissues (2)

Muscle TissueMuscle Tissue cells shorten in length producing cells shorten in length producing

movementmovement Nerve TissueNerve Tissue

cells that conduct electrical signals cells that conduct electrical signals detects changes inside and outside the detects changes inside and outside the

bodybody responds with nerve impulsesresponds with nerve impulses

4

Origin of TissuesOrigin of Tissues Primary germ layers within the Primary germ layers within the

embryoembryo endodermendoderm mesodermmesoderm ectodermectoderm

Tissue derivationsTissue derivations epithelium from all 3 germ layersepithelium from all 3 germ layers connective tissue & muscle from connective tissue & muscle from

mesodermmesoderm nerve tissue from ectodermnerve tissue from ectoderm

5

BiopsyBiopsy

Removal of living tissue for Removal of living tissue for microscopic examinationmicroscopic examination surgerysurgery needle biopsyneedle biopsy

Useful for diagnosis, especially Useful for diagnosis, especially cancercancer

Tissue preserved, sectioned and Tissue preserved, sectioned and stained before microscopic viewingstained before microscopic viewing

6

Cell JunctionsCell Junctions

Tight junctions Tight junctions

Adherens Adherens junctionsjunctions

Gap junctionsGap junctions

DesmosomesDesmosomes

HemidesmosomeHemidesmosomess

7

Tight JunctionsTight Junctions

Watertight seal Watertight seal between cellsbetween cells

Plasma membranes Plasma membranes fused with a strip of fused with a strip of proteinsproteins

Common between Common between cells that line GI and cells that line GI and bladderbladder

8

Adherens JunctionsAdherens Junctions

Holds epithelial cells Holds epithelial cells togethertogether

Structural Structural componentscomponents plaque = dense layer plaque = dense layer

of proteins inside the of proteins inside the cell membranecell membrane

microfilaments extend microfilaments extend into cytoplasminto cytoplasm

9

DesmosomesDesmosomes

Resists cellular Resists cellular separation and cell separation and cell disruptiondisruption

Cellular support of Cellular support of cardiac musclecardiac muscle

10

HemidesmosomesHemidesmosomes

Half a desmosomeHalf a desmosome Connect cells to Connect cells to

extracellular extracellular materialmaterial basement membranebasement membrane

11

Gap JunctionsGap Junctions

Tiny space between plasma Tiny space between plasma membranes of 2 cellsmembranes of 2 cells

Crossed by protein channels Crossed by protein channels called connexons forming called connexons forming fluid filled tunnelsfluid filled tunnels

Cell communication with ions Cell communication with ions & small molecules& small molecules

Muscle and nerve impulses Muscle and nerve impulses spread from cell to cellspread from cell to cell heart and smooth muscle of gut heart and smooth muscle of gut

12

Epithelial Tissue --Epithelial Tissue -- General General FeaturesFeatures

Closely packed cells forming Closely packed cells forming continuous sheets continuous sheets

Cells sit on basement membraneCells sit on basement membrane Apical (upper) free surfaceApical (upper) free surface Avascular---without blood vesselsAvascular---without blood vessels

nutrients diffuse in from underlying nutrients diffuse in from underlying connective tissueconnective tissue

Good nerve supplyGood nerve supply Rapid cell division Rapid cell division Covering / lining versus glandular typesCovering / lining versus glandular types

13

Basement MembraneBasement Membrane Basal laminaBasal lamina

from epithelial cellsfrom epithelial cells collagen fiberscollagen fibers

Reticular laminaReticular lamina secreted by secreted by

connective tissue connective tissue cellscells

reticular fibersreticular fibers holds cells to holds cells to

connective tissueconnective tissue guide for cell guide for cell

migration during migration during developmentdevelopment

14

Types of EpitheliumTypes of Epithelium

Covering and lining epitheliumCovering and lining epithelium epidermis of skinepidermis of skin lining of blood vessels and ductslining of blood vessels and ducts lining respiratory, reproductive, urinary lining respiratory, reproductive, urinary

& GI tract& GI tract Glandular epitheliumGlandular epithelium

secreting portion of glandssecreting portion of glands thyroid, adrenal, and sweat glandsthyroid, adrenal, and sweat glands

15

Classification of EpitheliumClassification of Epithelium Classified by arrangement of cells into Classified by arrangement of cells into

layerslayers simple = one cell layer thicksimple = one cell layer thick stratified = many cell layers thickstratified = many cell layers thick pseudostratified = single layer of cells where all pseudostratified = single layer of cells where all

cells don’t reach apical surfacecells don’t reach apical surface nuclei at found at different levels so it looks nuclei at found at different levels so it looks

multilayeredmultilayered

Classified by shape of surface cellsClassified by shape of surface cells squamous =flatsquamous =flat cuboidal = cube-shapedcuboidal = cube-shaped columnar = tall columncolumnar = tall column transitional = shape varies with tissue stretchingtransitional = shape varies with tissue stretching

16

Simple Squamous Simple Squamous EpitheliumEpithelium

Single layer of flat cellsSingle layer of flat cells lines blood vessels (endothelium), body cavities lines blood vessels (endothelium), body cavities

(mesothelium)(mesothelium) very thin --- controls diffusion, osmosis and filtrationvery thin --- controls diffusion, osmosis and filtration nuclei centrally locatednuclei centrally located

Cells in direct contact with each otherCells in direct contact with each other

17

Examples of Simple Examples of Simple SquamousSquamous

Section of Section of intestinal intestinal showing serosashowing serosa

Surface view of Surface view of lining of peritoneal lining of peritoneal cavitycavity

18

Simple Cuboidal Simple Cuboidal EpitheliumEpithelium

Single layer of cube-shaped cells viewed from the sideSingle layer of cube-shaped cells viewed from the side Nuclei round and centrally locatedNuclei round and centrally located Lines tubes of kidneyLines tubes of kidney Absorption or secretionAbsorption or secretion

19

Example of Simple Example of Simple CuboidalCuboidal

Sectional view of kidney tubulesSectional view of kidney tubules

20

Nonciliated Simple Nonciliated Simple ColumnarColumnar

Single layer rectangular cellsSingle layer rectangular cells Unicellular glands =goblet cells secrete mucusUnicellular glands =goblet cells secrete mucus

lubricate GI, respiratory, reproductive and urinary systemslubricate GI, respiratory, reproductive and urinary systems Microvilli = fingerlike cytoplasmic projectionsMicrovilli = fingerlike cytoplasmic projections

for absorption in GI tract (stomach to anus)for absorption in GI tract (stomach to anus)

21

Ex. Nonciliated Simple Ex. Nonciliated Simple ColumnarColumnar

Section from small intestineSection from small intestine

22

Ciliated Simple Columnar Ciliated Simple Columnar EpitheliumEpithelium

Single layer rectangular cells with ciliaSingle layer rectangular cells with cilia Mucus from goblet cells moved along by ciliaMucus from goblet cells moved along by cilia

found in respiratory system and uterine tubesfound in respiratory system and uterine tubes

23

Ex. Ciliated Simple Ex. Ciliated Simple ColumnarColumnar

Section of uterine tubeSection of uterine tube

24

Stratified Squamous Stratified Squamous EpitheliumEpithelium

Several cell layers thickSeveral cell layers thick Surface cells flatSurface cells flat Keratinized = surface Keratinized = surface

cells dead and filled cells dead and filled with keratinwith keratin skin (epidermis)skin (epidermis)

Nonkeratinized = no Nonkeratinized = no keratin in moist living keratin in moist living cells at surfacecells at surface mouth, vaginamouth, vagina

25

Example of Stratified Example of Stratified SquamousSquamous

Section of vaginaSection of vagina

26

Papanicolaou Smear Papanicolaou Smear (Pap smear)(Pap smear)

Collect sloughed off cells of uterus Collect sloughed off cells of uterus and vaginal wallsand vaginal walls

Detect cellular changes Detect cellular changes (precancerous cells)(precancerous cells)

Annually for women over 18 or if Annually for women over 18 or if sexually activesexually active

27

Stratified Cuboidal Stratified Cuboidal EpitheliumEpithelium

MultilayeredMultilayered Surface cells Surface cells

cuboidalcuboidal rare (only found in rare (only found in

sweat gland ducts & sweat gland ducts & male urethra)male urethra)

28

Stratified Columnar Stratified Columnar EpitheliumEpithelium

MultilayeredMultilayered Surface cells columnarSurface cells columnar Rare (very large ducts & part of male Rare (very large ducts & part of male

urethra)urethra)

29

Multilayered Multilayered Surface cells varying in shape Surface cells varying in shape

from round to flat if stretchedfrom round to flat if stretched Lines hollow organs that Lines hollow organs that

expand from within (urinary expand from within (urinary bladder)bladder)

Transitional EpitheliumTransitional Epithelium

30

Single cell layer Single cell layer All cells attach to All cells attach to

basement membrane basement membrane but not all reach free but not all reach free surfacesurface

Nuclei at varying Nuclei at varying depthsdepths

Respiratory system, Respiratory system, male urethra & male urethra & epididymisepididymis

Pseudostratified ColumnarPseudostratified Columnar

31

Glandular EpitheliumGlandular Epithelium Derived from epithelial cells that sank below the Derived from epithelial cells that sank below the

surface during developmentsurface during development Exocrine glandsExocrine glands

cells that secrete---sweat, ear wax, saliva, digestive cells that secrete---sweat, ear wax, saliva, digestive enzymes onto free surface of epithelial layerenzymes onto free surface of epithelial layer

connected to the surface by tubes (ducts)connected to the surface by tubes (ducts) unicellular glands or multicellular glandsunicellular glands or multicellular glands

Endocrine glandsEndocrine glands secrete hormones into the bloodstreamsecrete hormones into the bloodstream hormones help maintain homeostasishormones help maintain homeostasis

32

Structural Structural Classification of Classification of Exocrine GlandsExocrine Glands

Unicellular are single-celled glandsUnicellular are single-celled glands goblet cellsgoblet cells

Multicellular glandsMulticellular glands branched (compound) or unbranched branched (compound) or unbranched

(simple)(simple) tubular or acinar (flask-like) shapetubular or acinar (flask-like) shape

33

Merocrine -- most glandsMerocrine -- most glands cells release their products cells release their products

by exocytosis---saliva, by exocytosis---saliva, digestive enzymes & sweatdigestive enzymes & sweat

ApocrineApocrine smelly sweat & milksmelly sweat & milk upper part of cell possibly upper part of cell possibly

pinches off & dies (perhaps--pinches off & dies (perhaps--see EM data)see EM data)

Holocrine -- oil glandHolocrine -- oil gland whole cells die & rupture to whole cells die & rupture to

release their productsrelease their products

Methods of Glandular Methods of Glandular SecretionSecretion

34

Connective TissuesConnective Tissues Cells rarely touch due to extracellular matrixCells rarely touch due to extracellular matrix Matrix(fibers & ground substance secreted Matrix(fibers & ground substance secreted

by cellsby cells Consistency varies from liquid, gel to solidConsistency varies from liquid, gel to solid Does not occur on free surfaceDoes not occur on free surface Good nerve & blood supply except cartilage Good nerve & blood supply except cartilage

& tendons& tendons

35

Cell TypesCell Types Blast type cells = retain ability to divide & produce Blast type cells = retain ability to divide & produce

matrix (fibroblasts, chondroblasts, & osteoblasts)matrix (fibroblasts, chondroblasts, & osteoblasts) Cyte type cells = mature cell that can not divide or Cyte type cells = mature cell that can not divide or

produce matrix (chondrocytes & osteocytes)produce matrix (chondrocytes & osteocytes) Macrophages develop from monocytesMacrophages develop from monocytes

engulf bacteria & debris by phagocytosisengulf bacteria & debris by phagocytosis Plasma cells develop from B lymphocytesPlasma cells develop from B lymphocytes

produce antibodies that fight against foreign substancesproduce antibodies that fight against foreign substances Mast cells produce histamine that dilate small BVMast cells produce histamine that dilate small BV Adipocytes (fat cells) store fatAdipocytes (fat cells) store fat

36

Connective Tissue Ground Connective Tissue Ground SubstanceSubstance

Supports the cells and fibersSupports the cells and fibers Helps determine the consistency of the Helps determine the consistency of the

matrixmatrix fluid, gel or solidfluid, gel or solid

Contains many large moleculesContains many large molecules hyaluronic acid is thick, viscous and slipperyhyaluronic acid is thick, viscous and slippery condroitin sulfate is jellylike substance condroitin sulfate is jellylike substance

providing supportproviding support adhesion proteins (fibronectin) binds adhesion proteins (fibronectin) binds

collagen fibers to ground substancecollagen fibers to ground substance

37

Types of Connective Tissue Types of Connective Tissue FibersFibers Collagen (25% of protein in your body)Collagen (25% of protein in your body)

tough, resistant to pull, yet pliable tough, resistant to pull, yet pliable formed from the protein collagenformed from the protein collagen

Elastin (lungs, blood vessels, ear cartilage)Elastin (lungs, blood vessels, ear cartilage) smaller diameter fibers formed from protein smaller diameter fibers formed from protein

elastin surrounded by glycoprotein (fibrillin)elastin surrounded by glycoprotein (fibrillin) can stretch up to 150% of relaxed length and can stretch up to 150% of relaxed length and

return to original shapereturn to original shape Reticular (spleen and lymph nodes)Reticular (spleen and lymph nodes)

thin, branched fibers that form framework of thin, branched fibers that form framework of organs organs

formed from protein collagenformed from protein collagen

38

Marfan SyndromeMarfan Syndrome

Inherited disorder of fibrillin geneInherited disorder of fibrillin gene Abnormal development of elastic Abnormal development of elastic

fibersfibers Tendency to be tall with very long Tendency to be tall with very long

legs, arms, fingers and toeslegs, arms, fingers and toes Life-threatening weakening of aorta Life-threatening weakening of aorta

may lead to rupturemay lead to rupture

39

Mature Connective TissueMature Connective Tissue

Loose connective tissueLoose connective tissue Dense connective tissueDense connective tissue CartilageCartilage BoneBone BloodBlood LymphLymph

40

Loose Connective TissuesLoose Connective Tissues

Loosely woven fibers throughout Loosely woven fibers throughout tissuestissues

Types of loose connective tissueTypes of loose connective tissue areolar connective tissueareolar connective tissue adipose tissueadipose tissue reticular tissuereticular tissue

41

Areolar Connective Areolar Connective TissueTissue

Cell types = fibroblasts, plasma cells, macrophages, Cell types = fibroblasts, plasma cells, macrophages, mast cells and a few white blood cellsmast cells and a few white blood cells

All 3 types of fibers presentAll 3 types of fibers present Gelatinous ground substanceGelatinous ground substance

42

Areolar Connective Areolar Connective TissueTissue

Black = elastic fibers,Black = elastic fibers, Pink = collagen fibersPink = collagen fibers Nuclei are mostly fibroblastsNuclei are mostly fibroblasts

43

Adipose TissueAdipose Tissue

Peripheral nuclei due to large fat storage dropletPeripheral nuclei due to large fat storage droplet Deeper layer of skin, organ padding, yellow marrowDeeper layer of skin, organ padding, yellow marrow Reduces heat loss, energy storage, protectionReduces heat loss, energy storage, protection Brown fat found in infants has more blood vessels and Brown fat found in infants has more blood vessels and

mitochondria and responsible for heat generationmitochondria and responsible for heat generation

44

Liposuction or Suction Liposuction or Suction LipectomyLipectomy

Suctioning removal of subcutaneous Suctioning removal of subcutaneous fat for body contouringfat for body contouring

Dangers include fat emboli, Dangers include fat emboli, infection, injury to internal organs infection, injury to internal organs and excessive painand excessive pain

45

Reticular Connective Reticular Connective TissueTissue

Network of fibers & cells that produce Network of fibers & cells that produce framework of organframework of organ

Holds organ together (liver, spleen, lymph Holds organ together (liver, spleen, lymph nodes, bone marrow)nodes, bone marrow)

46

CartilageCartilage

Network of fibers in rubbery ground Network of fibers in rubbery ground substancesubstance

Resilient and can endure more stress Resilient and can endure more stress than loose or dense connective tissuethan loose or dense connective tissue

Types of cartilageTypes of cartilage hyaline cartilagehyaline cartilage fibrocartilagefibrocartilage elastic cartilageelastic cartilage

47

Hyaline CartilageHyaline Cartilage

Bluish-shiny white rubbery substanceBluish-shiny white rubbery substance Chondrocytes sit in spaces called lacunaeChondrocytes sit in spaces called lacunae No blood vessels or nerves so repair is very slow No blood vessels or nerves so repair is very slow Reduces friction at joints as articular cartilageReduces friction at joints as articular cartilage

48

FibrocartilageFibrocartilage

Many more collagen fibers causes rigidity & Many more collagen fibers causes rigidity & stiffnessstiffness

Strongest type of cartilage (intervertebral Strongest type of cartilage (intervertebral discs)discs)

49

Elastic CartilageElastic Cartilage

Elastic fibers help maintain shape after Elastic fibers help maintain shape after deformationsdeformations

Ear, nose, vocal cartilagesEar, nose, vocal cartilages

50

Growth & Repair of Growth & Repair of CartilageCartilage

Grows and repairs slowly because is Grows and repairs slowly because is avascularavascular

Interstitial growthInterstitial growth chondrocytes divide and form new matrixchondrocytes divide and form new matrix occurs in childhood and adolescenceoccurs in childhood and adolescence

Appositional growthAppositional growth chondroblasts secrete matrix onto surfacechondroblasts secrete matrix onto surface produces increase in widthproduces increase in width

51

Spongy boneSpongy bone sponge-like with spaces and trabeculaesponge-like with spaces and trabeculae trabeculae = struts of bone surrounded by trabeculae = struts of bone surrounded by

red bone marrowred bone marrow no osteons (cellular organization)no osteons (cellular organization)

Compact boneCompact bone solid, dense bonesolid, dense bone basic unit of structure is osteon (haversian basic unit of structure is osteon (haversian

system)system) Protects, provides for movement, stores Protects, provides for movement, stores

minerals, site of blood cell formationminerals, site of blood cell formation

Bone (Osseous) TissueBone (Osseous) Tissue

52

Compact BoneCompact Bone

Osteon = lamellae (rings) of mineralized matrixOsteon = lamellae (rings) of mineralized matrix calcium & phosphate---give it its hardnesscalcium & phosphate---give it its hardness interwoven collagen fibers provide strengthinterwoven collagen fibers provide strength

Osteocytes in spaces (lacunae) in between lamellaeOsteocytes in spaces (lacunae) in between lamellae Canaliculi (tiny canals) connect cell to cellCanaliculi (tiny canals) connect cell to cell

53

Connective tissue with a liquid matrix = the plasmaConnective tissue with a liquid matrix = the plasma Cell types = red blood cells (erythrocytes), white blood Cell types = red blood cells (erythrocytes), white blood

cells (leukocytes) and cell fragments called plateletscells (leukocytes) and cell fragments called platelets Provide clotting, immune functions, carry O2 and CO2Provide clotting, immune functions, carry O2 and CO2

BloodBlood

54

LymphLymph

Interstitial fluid being transported in Interstitial fluid being transported in lymphatic vesselslymphatic vessels

Contains less protein than plasmaContains less protein than plasma Move cells and substances (lipids) Move cells and substances (lipids)

from one part of the body to anotherfrom one part of the body to another

55

MembranesMembranes

Epithelial layer sitting on a thin Epithelial layer sitting on a thin layer of connective tissue (lamina layer of connective tissue (lamina propria)propria)

Types of membranesTypes of membranes mucous membranemucous membrane serous membraneserous membrane synovial membranesynovial membrane cutaneous membrane (skin)cutaneous membrane (skin)

56

Mucous MembranesMucous Membranes

Lines a body cavity that opens to the Lines a body cavity that opens to the outsideoutside mouth, vagina, anus etcmouth, vagina, anus etc

Epithelial cells form a barrier to Epithelial cells form a barrier to microbesmicrobes

Tight junctions between cellsTight junctions between cells Mucous is secreted from underlying Mucous is secreted from underlying

glands to keep surface moistglands to keep surface moist

57

Serous MembranesSerous Membranes

Simple squamous cells overlying loose CT Simple squamous cells overlying loose CT layerlayer

Squamous cells secrete slippery fluidSquamous cells secrete slippery fluid Lines a body cavity that does not open to the Lines a body cavity that does not open to the

outside such as chest or abdominal cavityoutside such as chest or abdominal cavity ExamplesExamples

pleura, peritoneum and pericardiumpleura, peritoneum and pericardium membrane on walls of cavity = parietal layermembrane on walls of cavity = parietal layer membrane over organs in cavity = visceral layermembrane over organs in cavity = visceral layer

58

Synovial MembranesSynovial Membranes

Line joint cavities of all freely Line joint cavities of all freely movable jointsmovable joints

No epithelial cells---just special cells No epithelial cells---just special cells that secrete slippery fluidthat secrete slippery fluid

59

MuscleMuscle

Cells that shortenCells that shorten Provide us with motion, posture Provide us with motion, posture

and heatand heat Types of muscleTypes of muscle

skeletal muscleskeletal muscle cardiac musclecardiac muscle smooth musclesmooth muscle

60

Skeletal MuscleSkeletal Muscle

Cells are long cylinders with many peripheral Cells are long cylinders with many peripheral nucleinuclei

Visible light and dark banding (looks striated)Visible light and dark banding (looks striated) Voluntary or conscious controlVoluntary or conscious control

61

Cardiac MuscleCardiac Muscle

Cells are branched cylinders with one central nucleiCells are branched cylinders with one central nuclei Involuntary and striatedInvoluntary and striated Attached to and communicate with each other by Attached to and communicate with each other by

intercalated discs and desmosomesintercalated discs and desmosomes

62

Smooth MuscleSmooth Muscle

Spindle shaped cells with a single central nuclei Spindle shaped cells with a single central nuclei Walls of hollow organs (blood vessels, GI tract, Walls of hollow organs (blood vessels, GI tract,

bladder)bladder) Involuntary and nonstriated Involuntary and nonstriated

63

Nerve TissueNerve Tissue

Cell types -- nerve cells and neuroglial (supporting) Cell types -- nerve cells and neuroglial (supporting) cellscells

Nerve cell structureNerve cell structure nucleus & long cell processes conduct nerve signalsnucleus & long cell processes conduct nerve signals

dendrite --- signal travels towards the cell body dendrite --- signal travels towards the cell body axon ---- signal travels away from cell bodyaxon ---- signal travels away from cell body

64

Tissue EngineeringTissue Engineering

New tissues grown in the New tissues grown in the laboratory (skin & cartilage)laboratory (skin & cartilage)

Scaffolding of cartilage fibers is Scaffolding of cartilage fibers is substrate for cell growth in culturesubstrate for cell growth in culture

Research in progressResearch in progress insulin-producing cells (pancreas)insulin-producing cells (pancreas) dopamine-producing cells (brain)dopamine-producing cells (brain) bone, tendon, heart valves, intestines bone, tendon, heart valves, intestines

& bone marrow& bone marrow

65

Tissue Repair: Restoring Tissue Repair: Restoring HomeostasisHomeostasis

Worn-out, damaged tissue must be replacedWorn-out, damaged tissue must be replaced Fibrosis = replacement with stromal Fibrosis = replacement with stromal

connective tissue cells (scar formation)connective tissue cells (scar formation) Regeneration = replacement with original Regeneration = replacement with original

cell types (parenchymal cells)cell types (parenchymal cells) some cell types can divide (liver & endothelium)some cell types can divide (liver & endothelium) some tissues contain stem cells that can dividesome tissues contain stem cells that can divide

bone marrow, epithelium of gut & skinbone marrow, epithelium of gut & skin some cell types can not divide & are not some cell types can not divide & are not

replacedreplaced muscle and nervous tissuemuscle and nervous tissue

66

Important Clinical Important Clinical TerminologyTerminology

Regeneration versus fibrosisRegeneration versus fibrosis Granulation tissueGranulation tissue

very actively growing connective tissuevery actively growing connective tissue Adhesions Adhesions

abnormal joining of tissue abnormal joining of tissue occurs after surgery or inflammationoccurs after surgery or inflammation

67

Conditions Affecting Tissue Conditions Affecting Tissue RepairRepair

NutritionNutrition adequate protein for structural componentsadequate protein for structural components vitamin C production of collagen and new blood vesselsvitamin C production of collagen and new blood vessels

Proper blood circulationProper blood circulation delivers O2 & nutrients & removes fluids & bacteriadelivers O2 & nutrients & removes fluids & bacteria

With agingWith aging collagen fibers change in qualitycollagen fibers change in quality elastin fibers fragment and abnormally bond to calciumelastin fibers fragment and abnormally bond to calcium cell division and protein synthesis are slowedcell division and protein synthesis are slowed

68

Sjogren’s SyndromeSjogren’s Syndrome

Autoimmune disorder producing Autoimmune disorder producing exocrine gland inflammationexocrine gland inflammation

Dryness of mouth and eyesDryness of mouth and eyes 20 % of older adults show some 20 % of older adults show some

signssigns

69

Systemic Lupus Systemic Lupus Erythematosus (SLE)Erythematosus (SLE)

Autoimmune disorder -- causes unknownAutoimmune disorder -- causes unknown Chronic inflammation of connective tissueChronic inflammation of connective tissue Nonwhite women during childbearing yearsNonwhite women during childbearing years Females 9:1 (1 in 2000 individuals)Females 9:1 (1 in 2000 individuals) Painful joints, ulcers, loss of hair, feverPainful joints, ulcers, loss of hair, fever Life-threatening if inflammation occurs in Life-threatening if inflammation occurs in

major organs --- liver, kidney, heart, brain, major organs --- liver, kidney, heart, brain, etc.etc.