Connective Tissue Flashcards

1
Q

Local Anesthesia and Connective Tissue

A

You actually do not numb the nerve directly, you inject into the connective tissue which has blood vessels in it. Blood vessels can then spread the anesthetics into the nerves

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2
Q

Tooth

A

Dentin and pulp tissues are specialized connective tissues in addition to cementum, alveolar bone, and periodontal ligaments

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3
Q

Embryonic Origin of Connective Tissue

A

o Originates from the MESODERM, middle
germ layer of the embryonic tissue.
o The mesenchyme, the multipotential cells
from mesoderm of the embryo, give rise to
the connective tissues and their cells

(different from epithelium which is derived from all embryological layers)

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4
Q

Composition of Connective Tissues

A

NOT JUST CELLS

1) Cells
> fixed and wandering

2) Fibers (extracellular)
> collagen, elastic

3) Ground Substance (extracellular) 
      > Glycosaminoglycans 
        (GAGs) 
      > Proteoglycans 
      > Adhesive proteins
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5
Q

Function

A

o CONNECTS, fills space, cushions, supports

o Protects
    - bone protects underlying organs
    - mast cells-inflammation
    -  plasma cells- antibodies
    -  phagocytes- engulf foreign substances
o Barrier under epithelium
o Contains nerves- sensation
o Contains blood vessels, lymphatic
     - nutrient, waste, gas exchange
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6
Q

Classification of Connective Tissue

A

A) Embryonic Connective TIssue

1. Mesenchymal CT 
2. Mucous CT 
B) Connective tissue proper 
     1. Loose (areolar) CT 
     2. Dense CT 
           i. dense irregular ct
           ii. dense regular ct
                 > colleagenous 
                 > elastic 
     3. Reticular tissue 
     4. Adipose tissue 

C) Specialized CT

  1. Caritlage
  2. Bone 
 3. Blood
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7
Q

Mesenchymal Connective Tissue

A
Found only in embryo
o Mesenchymal cells
o A gel-like, amorphous ground substance
o Scattered reticular fibers
o Frequent mitosis: pluripotential
o Eventually depleted and do not exist as such in the 
adult except in the pulp of teeth****
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8
Q

Mucous Connective Tissue

A

A loose, amorphous connective tissue:

o fibroblasts

o a jelly-like matrix: hyaluronic acid (more solid compared to the mesenchymal ct)

o Sparse type I and type III collagen fibers

o Wharton’s jelly: found only in the umbilical cord
and subdermal connective tissue of the embryo

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9
Q

Loose Connective Tissue

A

Fills spaces beneath epithelium tissues
o Fixed connective tissue cells:
- fibroblasts
- adipose cells
- macrophages
- mast cells
- Many transient cells
- responsible for immune response
o Abundant ground substance and tissue
fluid (extracellular fluid)
-Loosely woven collagen, reticular, and elastic
fibers
- Small nerve fibers and blood vessels supply the
cells with oxygen and nutrients

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10
Q

Three Attributes of Loose CT

A
  1. Cells:
    • Mast cells (MC): largest cells in the field and
      possess a granular cytoplasm
      - Fibroblasts (F): posess oval nuclei, paler and larger
      - Macrophages (M): smaller, darker
  2. Fibers:
    -Collagen fibers (CF): thicker, wavy, ribbon-like,
    interlacing
    - Elastic fibers (EF): thin, straight, branching
  3. Ground substance (GS): invisible
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11
Q

Dense Connective Tissue

A

More fibers and fewer cells than loose connective tissue
o Resistant to stress: collagen bundles

o Dense IRREGULAR connective tissue: collagen fiber
bundles are arranged randomly

o Dense REGULAR connective tissue: collagen fiber
bundles are arranged in parallel or organized fashion.
- collagenous
- elastic

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12
Q

Dense Irregular Collagenous Connective Tissue

A

Bundles of collagen fibers oriented in various directions (meshwork)

Limited grounds substance and cells (fibroblasts)

Scattered elastic fibers

Resist stresses from many directions

Found the dermis of the skin, fibrous coverings on the surface of nerve, cartilage and bone, tough capsules around organs and joints

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13
Q

Dense Regular Collagenous Connective Tissue

A

Primarily parallel coarse collagen bundles densely packed into sheets or cylinders; a few elastin fibers, major cell type is the fibroblast

elongated nuclei (N) of the thin, sheet-like fibroblasts lying between collagen bundles

Function: attaches muscles to bones or to muscles; attaches bones to bones; withstands great tensile stress when pulling force is applied in one direction

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14
Q

Achilles tendon rupture

A

Collagen fibers in tendons all go in one direction, so it has less capability go withstand stress from other angles; also does not have the same regenerative properties, so the tendon cannot fuse back together on its own like other parts of the body can when they tear.

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15
Q

Dense Regular Elastic Connective Tissue

A

o Very similar to the organization of fibers in the tendon, BUT the regular elastic connective tissue structure is designed to
extend and return to its original length (resilience)

o Found in the wall of large blood vessels, underlying transitional
epithelium and surrounding respiratory passages.

Can distinguish elastin fibers through specific staining with ORCEIN

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16
Q

Reticular Tissue 9

A

A network of interlacing reticular fibers and reticular cells (fibroblasts); mesh-like with many lymphoid cells interspersing between the reitcular fibers

Found in the stroma (supporting framework) of the liver, spleen, lymph nodes; portion of red bone marrow, basement membrane, and around blood vessels and muscles

Function: forms stroma of organs; binds together smooth muscle tissues; filters and removes worn out blood cells in the spleen and microbes in the lymph nodes.

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17
Q

Adipose Tissue

A

o One of the largest organs in the body
- 15–20% (normal weight men) or 20–25% (normal
weight women) of body weight

o Largest repository of energy (in the form of triglycerides)

o Very cellular (adipocytes) and has little if any matrix and few fibers; limited ground substance

o Filled with lipid in a single droplet or in small droplets

is an endocrine organ and participates in endocrine regulation; example, adipocytes can make a hormone called leptin

fat tissue is also involved inflammation and inflammation is related to PERIODONTAL DISEASE

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18
Q

Unilocular

A

white fat tissue that possess one large lipid droplet

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19
Q

Multilocular

A

brown fat tissue that possess many lipid droplets and also has mitochondria; maintain body temperature

found a lot in newborns

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20
Q

Types of Cells in CT

A

A) Fixed cells

 1. Fibroblasts
 2. Adipocytes
 3. Pericytes
 4. Mast cells

B) Some fixed and some transient
1. Macrophages

C) Transient cells

 1. Plasma cells
 2. Blood cells
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21
Q

Connective Tissue Cells Lineage

A

Adipocytes, fibroblasts, pericytes and other epithelial cells come from UNDIFFERENTIATED MESENCHYMAL cells

The rest are derived from HEMATOPOIETIC STEM CELLS

Macrophages come from MONOCYTES

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22
Q

Fibroblasts

A

Make collagen and secrete it, so they have big nuclei and a lot of cellular organelles like highly active mitochondria, rough ER, and golgi

Function: Synthesize extracellular matrices
– Collagen
– Elas4n
– Glycosaminoglycans (GAG)
– Proteoglycan

• Synthesize growth factors
– influence growth and differentiation

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23
Q

Fibroblast vs Fibrocyte

A

• Fibroblast- active
– abundant, irregularly branched cytoplasm
– ovoid, large pale staining nucleus
– well developed rER, golgi

• Fibrocyte- inactive (quiescent)
– spindle shaped, few cell processes
– smaller, darker, elongated nucleus
– small amount of rER

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24
Q

Adipocyte

A
  • Stores lipids
  • Energy supply
  • Padding, protection, shock absorber
  • Insulation
  • Generation of heat (brown fat)
  • Endocrine function
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25
Development of Fat Cells
They come from mesenchymal stem cells which can become fibroblasts or lipoblasts and then the lipoblast can become white or brown fat cells
26
Lipid Transport
Adipocyte to Capillaries 1) adipocytes store fat (energy) and this energy is used when we need it to burn fat to produce energy 2) triglyceride will be cleaved, perfused into a capillary, and then picked up. 3) It can also shift back to be stored by the fat cells
27
Pericyte
o Surround endothelial cells (rounded cell that wraps around) o Have characteristics of endothelial cells and smooth muscle cells: contractile- involved in blood flow; main function is contraction o Plays a role in the blood–brain barrier o Angiogenesis and the survival of endothelial cells o Multipotential: wound healing-gives rise to connective tissue and blood vessels (i.e undifferentiated stem cell-like)
28
Mast Cells
``` • Oval to round • IgE on surface • Filled with metachromatic secretory granules – histamine – heparin – neutral proteases – ECF-A (eosinophil chemotactic factor of anaphylaxis) – NCF (neutrophil chemotactic factor) – leukotrienes – prostaglandins – cytokines ``` * have single nuclei along with course and OBVIOUS granules * found in the loose ct in skin and under the mesentry in intestines * Because it is actively producing proteins, it is common to see a lot of the cellular organelles needed for protein synthesis in the mast cells
29
Macrophage
- Phagocytic - Antigen presenting - long living - fixed and wandering "Scavenger cells that find and destroy the bad guys"
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Phagocytosis
1) Recognition and Attachment: microbes bind to phagocyte receptors 2) Engulfment: Phagocyte membrane zips up around microbe 3) Kill and Degrade: Killing of microbes by lysosomal enzymes in phagolysosome
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Opsonization
- the process by which a pathogen is marked for ingestion and destruction by a phagocyte
32
Types of Macrophages
Monocyte - found in blood and is a precursor to macrophages Macrophage - found connective tissue, lymphoid organs, lungs, production of cytokines, chemotactic factors, and other imflamatory dense molecules; antigen presentation Kupffer cell - found in liver; same function as macrophages Microglia - found in nervous tissue Langerhans cells - found in skin Osteoclast - found in founds; digestion of bone Multinuclear giant cell - digestion in ct
33
Plasma Cell
• Arise from B-lymphocytes • Ovoid, basophilic • Well developed rER • Juxtanuclear golgi • Secretes antibodies***** • clumps of heterochromatin create a "clock face" pattern of nuclear chromatin in which the nucleolus is eccentrically located and surrounded by CH like clock
34
Connective Tissue Fibers
* Collagen * Reticular * Elastic
35
Main types of Collagen
type I = dermis, bone, capsules of organs, fibrocartilage, dentin, cementum type II = hyaline and elastic cartilages type III = eticular fibers type IV = basal lamina type V = placenta type VII = anchoring fibrils of the basal lamina (example: anchoring the fibrils produced in epithelium; epidermis is anchored by dermis) *NOTE* When you say "collagen" by default, you are referring to Type I collagen; "collagenous tissue" means having type I collagen
36
Collagen Organization
(largest) Collagen fiber bundle>>fibers>>smaller fibrils >> aggregates of tropocollage molecules (smallest) Tropocollagen molecules self-assemble: gap and overlap The gap and overlap: in register with tropocollagen molecules of neighboring rows Hydroxyproline residues of α chains: maintain the stability of the tropocollagen molecule (3 alpha chains) The gaps are actually stained darker compared to the areas of overlap because the gaps hold more dye
37
Reticular Fibers
* Type III collagen * THINNER and MORE CARBOHYDRATES than type I fiber * stains black with silver stain and is invisible with H&E * produced by reticular cell * produce a scaffolding network (MESH-LIKE and less organized than collagen so it can hold a lot of cells) Common in lymph nodes and spleen (specifically a major constituent of splenic cords in the red pulp)
38
Elastic Fibers
• Can stretch 150% of length • Fiber composed of – Outer- microfibrils of fibrillin (glycoprotein) – Inner- amorphous core of elastin Stains darker than collagen fibers in H&E staining and also appear much thinner than the collagen bundles Van Gieson staining is also a special staining that allows you to see elastic fibers (stain a dark blue/black color)
39
Artery Walls and Elastic Fibers
Blood vessels have an internal elastic membrane called the tunica intima under the epithelium (simple squamous) Next is the tunica media layer which is layer of smooth muscle containing elastic fibers as well and then the tunica externa is the collagen fibes Need the elasticity for expansion and contraction of theses thick vessels
40
Ground Substance
• Complex of macromolecules • Fills space between fibers and cells – organizes Lssue topography, supports cell migration, orients cells, induces cell behavior – binds growth factors, cytokines-reservoir • Three classes of compounds – Glycosaminoglycans (GAGs) – Proteoglycans – Multiadhesive glycoproteins
41
Glycosaminoglycan (GAGs)
* Repeating disacharide: Hexozamine +uronic acid * Hydrophilic polyanions (can bind cations such as sodium) * Part of proteoglycan * Osmotic pressure leads to increased water content- firmness, flexibility * Hyaluronic acid is the most ubiquitous GAG
42
Structure of GAGs and Proteoglycans
Glycosaminoglycans are made up of repeated disaccharide units which then come together and attach onto one large core protein The GAGs attached on to a core protein = a PROTEOGLYCAN (has a brush-like appearance)
43
Multiadhesive glycoproteins
* Protein component predominates * Globular protein with carbohydrate, attached carbohydrates are usually branched * Cell-cell and cell-substrate 1. Fibronectin: synthetized by fibroblasts and epithelial cells 2. laminin: participate in adhesion of epithelium cells to basal lamina 3. Integrins: Matrix receptor
44
Fibronectin
Exists as a protein dimer, consisting of two nearly identical monomers linked by a pair of disulfide bonds Three binding domains 1) cells 2) collagens 3) GAGs
45
Laminin
Trimeric proteins that contain three chains participate in adhesion of epithelium cells to basal lamina Three binding domains 1) cells 2) collagens 3) GAGs
46
Integrins
Have two different chains - the α (alpha) and β (beta) subunits Are cell-surface molecule that bind to collagen, fibronecytin and laminin Are transmembrane receptors or linker proteins and interact also with cytoskeleton AcHn microfilaments Plays a role in signaling transduction and can bind to specific ligands and activate down stream cell signaling
47
Process of how cells react to antigens
BASICALLY, secretory granules will come to the plasma membrane, fuse, and secrete the products out and ilicit an inflammatory response DETAILS BELOW: 1) Binding of antigen to IgE-receptor complex causes cross-linking of IgE and consequent clustering of receptors 2) Activation of adenylate cyclase 3) Activation of protein kinase 4) Phosphorylation of protein 5) Release of Ca2+ 6) Fusion of granules 7_ Release of granules' contents or secretion of leukotrienes, thromboxanes/prostaglandins
48
Inflammatory Response
Histamine: vasodilation and increased vascular permeability (why we have stuff noses) Eosinophil Chemotactic Factor (ECF) recruits eosinophil to take care of parasitic infections Neutrophil Chemotactic Factor: released in response to bacterial infection (microorganisms) Leukotrienes: increase vascular permeability/enhance effects of histamine Thromboxane A2: platelet-aggregating mediator and VASOCONSTRICTION
49
Tissue Fluid
o Similar to blood plasma in ions o Similar to blood plasma in diffusible substances o Contains low molecular weight plasma proteins o Circulation to feed cells and remove waste
50
Hydrostatic and Osmotic Pressure Tissue Fluid Movement
In a blood vessel, there is an arteriole end and a venule end and two pressures exist between them: hydrostatic and osmotic pressure There is a decrease in hydrostatic pressure and an increase in osmotic pressure from the arterial to the venous ends of blood capillaries Fluid leaves the capillary through its arterial end and re-penetrates (enters) the blood at the venous end while some fluid is also drained by the lymphatic capillaries
51
Edema
when there is a decrease in colloid osmotic pressure, water accumulates in the connective tissue This is because water leaves blood vessel from arterial end is not drawn back into the capillaries at venous ends Low osmotic pressure means that the fluid will stay in the tissue and it will cause swelling (EDEMA)
52
Skin
Basically made of two parts: epidermis ( stratified squamous epithelium) and dermis (dense irregular collagen ct) Skin also has appendages such as sweat and sebaceous glands, hair, hair follicles and nails
53
Non-Inherited CT Disorders
1) Cellulitis: infection > Requiring intravenous antibiotics > 80% of cases of cellulitis of the submandibular space caused by dental procedure 2) Scarred CT in dermis > collagen bundles are irregular in the tissue but if they are really curvy and abnormal, it is actually scar tissue 3) Keloid Formation: >Excessively thick layer of the dermis; apparent large, eosinophilic, type I collagen fibers
54
Scurvy
Non-Inherited CT disorder Vitamin C (ascorbic acid) deficiency leads to scurvy, a disease characterized by the degeneration of connective tissue. Ascorbic acid is a cofactor for proline hydroxylase, which is essential for the normal synthesis of collagen More pronounced in areas in which collagen renewal takes place at a faster rate (periodontal ligament) leads to a loss of teeth.
55
Inherited Disorders of CT
1) Ehlers-Danlos syndrome (EDS) 2) Marfan syndrome 3) Osteogenesis Imperfecta 4) Epidermolysis bullosa
56
Ehlers-Danlos syndrome (EDS)
Actually a group of more than 10 disorders Defect in collagen synthesis (col I or III): - progressive deterioration of collagens Characterized by over-flexible joints, stretchy skin, and abnormal growth of scar tissue. Depending on the specific form of EDS, other symptoms may include: - A curved spine - Weak blood vessels - Bleeding gums - Problems with the lungs, heart valves, or digestion
57
Marfan Syndrome
abnormal fibrillin gene Fibrillin gene is required to make elastic fibers The elastin protein makes the core and then the fibrillin to cover the core protein to make the functional elastic fiber
58
Osteogenesis imperfecta
Autosomal domninant disease: brittle bones Present at birth Defect type I collagen gene or different defects that can affect this gene Has oral manifestions as lack of/weak dentin and cementum because type I collagen also makes these fibers so the teeth are weak and miscolored
59
Epidermolysis bullosa
Fragile skin: Butterfly children Mutations in the COL7A1 gene: anchoring fibrils Type VII collagen: connect the epidermis to the dermis. When it is abnormal or missing, friction or other minor trauma can cause the two skin layers to separate Causes blistering in response to minor injury, heat, or friction from rubbing, scratching or adhesive tape
60
Autoimmune Diseases
Body's normally protective immune system produces antibodies that target the body's own tissues for attack
61
Scleroderma
Excess production of collagen buildup of scar tissue (fibrosis) in the skin and other organs Hard and thick skin, swelling or pain Localized and systemic sclerosis Women are four times more likely to develop Autoimmune Diseases, exact cause is unknown
62
Connective Tissue related lesion in the Oral Cavity
1) Plasma Cell Gingivitis 2) Irritation Fibroma (traumatic fibroma, focal fibrous hyperplasia) 3) Peripheral Ossifying Fibroma 4) Peripheral Giant Cell Granuloma 5) Desmoplastic fibroma
63
Plasma Cell Gingivitis
caused by an allergic rxn which activates the plasma cells in the area
64
Irritation Fibroma
Also traumatic fibroma, focal fibrous hyperplasia most common of all hyperplastic growths in the oral cavity hyperproliferations of collagen due to injury; not true neoplasm
65
Peripheral Ossifying Fibroma
A form of reactive hyperplasia that frequently contains bone the lesion arises from the PDL structures or periosteum
66
Peripheral Giant Cell Granuloma
Most often affects the gingival Fibroblasts and endothelial cells: often coalesce into multinucleated giant cell forms May surround sinusoidal spaces.
67
Desmoplastic fibroma
Benign fibrous infiltrative proliferation: very dense mature collagen mandible of young patients mandibular resection recurrence rate 25%