Respiratory System & Urinary Tract

Objectives:

1. Learn to identify slides of the different regions of the respiratory tract including, olfactory epithelium, larynx, epiglottis, trachea, bronchi, bronchioli and alveoli.
2. Learn to identify slides of the different organs of the urinary tract including kidney, ureter and bladder and urethra.
Reading: RR&K Chapters 18, 19. Atlas pages 548-557; 584-595. Before examining the slides, read the Differential Diagnosis section which summarizes the level of detail required in the unknown identification. The kidney histology in particular is extensive. Not all features can be found on every slide.
 
I. Respiratory System
 
A. Olfactory epithelium.

1. Tall pseudostratified columnar epithelium with numerous layers of nuclei. Three cell types present

a. Olfactory cells
1. Nuclei form most of the intermediate layers
2. Non-motile cilia extend into the lumen of the epithelium
b. Sustentacular cells
1. Nuclei form the layer closest to the lumen
2. Microvillus brush border
 
c. Basal cells 1. Nuclei form the basal layer
2. Lamina propria forms the layer between the epithelium and the underlying periosteum
a. Bowmans's glands
1. Branched tubular glands
2. Secrete into narrow ducts that extend through the epithelium
b. Vasculature

c. Olfactory nerves
 

1. Bundles with clearly identifiable "cuboidal" Schwann cells
2. Nerve fibers are non-myelinated
3. Perineurium
   
 
119 Olfactory epithelium, H&E

This tissue looks very much like Plate 88-2 in R,R&K. There is both olfactory epithelium (identifiable by the rather large number of cells in the epithelium) as well as regions of respiratory epithelium (identifiable by the low height and presence of ciliated cells). The lamina propria has a large number of nerve bundles containing mostly non-myelinated nerves, and Bowman’s glands. The non-myelinated nerves seem to consist of cuboidal cells, the Schwann cells, and endothelial cells. A thin capsule surrounds the nerves. Oddly enough, there are many very obvious glands but the ducts are not very obvious. The nuclei of the sustentacular cells occupy the apical row of nuclei, the olfactory cell nuclei occupy the middle layers and basal cell nuclei occupy the basal row. They are the only cells that do not reach the lumen. Do not bother to look for brush cells which are the other major cell type present.

The slide of this epithelium is well worth looking at. The picture shown above corresponds to a small number of slides. However, it should serve to help most of you with the other slide to find the particular features in your slide. The preservation is excellent and the slide contains pieces of the respiratory epithelium to compare with the olfactory segment. Pay particular attention to the olfactory nerves. These are unusual in that the Schwann cells have an almost cuboidal shape and are tightly packed within the nerve fiber bundle. The nerve fibers are non-myelinated and so the individual fibers cannot be distinguished. However, up to 50 nerve fibers can be ensheathed by a single Schwann cell. Contrast the olfactory epithelium with the respiratory segment which is ciliated and visible in the same slide.

 
B. Epiglottis See plate 14 on page 147

The large number of epiglottis slides in this laboratory exercise belies the importance of this organ. It is not essential to swallowing. However, the slides do reveal several interesting features. One is the presence of metaplastic changes in the epithelium from stratified squamous to pseudostratified columnar. The other is the replacement of elastic cartilage with adipose tissue. It is not necessary to spend too much time viewing this organ.
1. Thin foliate lamella of elastic cartilage covered by a non-keratinized stratified squamous epithelium.
2. Seromucous glands are frequent overlying the cartilage.

a. Ducts range from simple cuboidal to stratified columnar
b. Serous & mucous tubuloacinar glands with serous demilunes
3. Elastic cartilage may frequently be partially replaced by adipose tissue
    121A Epiglottis, H&E, human

This is a nicely preserved piece of epiglottis tissue. The elastic cartilage is well intact and not even partially replaced by adipose tissue. There are many seromucous glands in the lamina propria. Metaplastic changes in the epithelium can be observed in locations where lymphatic infiltrations are found.

 
121B Epiglottis, l.s.

This slide has several unusual features that are worth noting.

First, the epiglottis characteristically consists of a epithelium, an underlying lamina propria and a layer of elastic cartilage (check plate 14 on page 147). The epithelium is stratified squamous, non-keratinized. The elastic cartilage can be partially replaced by adipose tissue and that is what has apparently happened here except that the cartilage has been mostly replaced. However, there is enough of the cartilage structure remaining for you to perhaps find some islands of chondrocytes and the remnants of a perichondrium.

Second, epithelium changes occur where the lymphatic follicles are located (there were two nodules in the slide I examined). Here the epithelium changes from stratified squamous to pseudostratified columnar with ciliated cells. This is an example of metaplasia (see page 535 of R,R,&K). Note that a piece of hyaline cartilage and seromucous glands can also be found in the tissue.

 

121C Epiglottis, Masson, human

This slide is just like 121a except stained with Masson stain which enhances the connective tissue. Some slides contain stratified columnar ducts associated with the seromucous glands. Metaplastic epithelium changes can also be found but they are not always obviously associated with nodules. Note the orange color of the fibers in the cartilage.
 

  C. Trachea

1. Pseudostratified, ciliated columnar epithelium
2. Goblet cells (mucous secreting)
3. Basal cells
4. Brush cells (MV)
5. Dense granule (APUD)
6. Intermediate cells
7. Serous cells (found in glands)
8. Submucosal glands (sero-mucous) with cuboidal ducts leading directly to surface
9. Cartilaginous rings (hyaline)
10. Membranous wall: smooth muscle, connects ends of cartilaginous rings
120A Trachea, l.s.

This slide was examined in the earlier epithelium lab. It shows the trachea in longitudinal section. The structure consists of overlapping cartilage rings, submucosal glands and a pseudostratified columnar epitheium with ciliated cells and goblet cells. Some simple columnar ducts can be found in the groups of seromucous glands.

 

120 Trachea & esophagus, c.s. 
This slide shows the trachea in cross section. The cartilage appears as a "C" shaped ring with the opening spanned by a bundle of smooth muscle fibers. Submucosal glands are not as common as in a longitudinal section but can be found. In the epithelium, goblet cells are difficult to find because the section is thick. Probably the goblet cells are the ones with the elongated nuclei that are just next of the basal layer. The ciliated cell nuclei are closer to the lumen, whereas the basal cell nuclei are just that, on the base of the epithelium.
 

120A Trachea & Esophagus, H&E
This slide contains both trachea and esophagus, which run in parallel in the mediastinum. Some slides have a small piece of thymus attached, an organ that is also found in this region. The epithelium consists of several apparent cell layers (not just two) but the outer most layer looks columnar. This appearance is characteristic of pseudostratified columnar which often shows nuclei at more than two levels. The surface has many cilia. The C-clip of hyaline cartilage dominates the trachea portion. The two free ends are connected by the trachealis muscle, which is a smooth muscle. Some slides may show submucosal glands in the trachea. The muscularis of the esophagus is typical of upper regions of the organ. It consists of skeletal muscle in two orientations, the longitudinal shows striations. The thick muscularis mucosa consists of smooth muscle. The epithelium of the esophagus is non-keratinized stratified squamous.

 
D. Lung
Bronchi

1. Pseudostratified, ciliated columnar epithelium with goblet cells
2. Cartilage is now in plates (secondary and tertiary bronchi)
3. Cartilage decreases as you move distal into the system
4. Bronchi bifurcate (primary to secondary to tertiary)
5. Glands decreasing as you move distal into the system
6. Smooth muscle decreasing as you move distal into the system
 
 Bronchioles 1. Ciliated, simple columnar epithelium (number of ciliated cells decreasing)
2. Clara (bronchiolar epithelial) cells replacing Goblet cells
3. No cartilage
4. Smooth muscle layer prominent in larger bronchioles
5. Epithelium beginning to show reduction in height from columnar to cuboidal in the terminal bronchioles
Respiratory bronchioles 1. Simple cuboidal epithelium making transition to simple squamous back to simple cuboidal
2. Clara cells abundant
3. First appearance of alveoli (in the walls of the bronchiole)
4. Have both conducting and respiratory portions together
5. Smooth muscle still present
Alveolar ducts/alveolar sacs 1. Ducts are surrounded exclusively by alveoli (no conducting portions)
2. Sacs are 2-3 alveoli sharing the same airspace
3. Thin bundles of smooth muscle surround the openings of alveoli
Alveoli 1. Identifiable by the thin walls lining the air spaces. Walls contain 5 different cell types
2. Alveolar type I epithelial cells. Squamous cell lining the alveolar septa
3. Alveolar type II epithelial cells. Cuboidal cell with a vacuolated appearance due to abundance of lamellar bodies
4. Capillary endothelial cell. Squamous cells lining the inside of capillaries
5. Interstitial cell
6. Alveolar macrophage. Large cell found on the surface of alveolar septa.
115A Lung & bronchioli

There are two groups of slides of equal quality. However, the newer slides have better looking bronchi with more complete cartilage layers. The pictures come from that group of slides. In the newer slides the lung is more inflated making it easier to visualize the alveoli. In the older group of slides, the visceral pleura is visible. The section is rather thick for identifying the different cell types of the alveoli such as endothelial, alveolar Type I & II cells. Alveolar macrophages can occasionally be observed. They appear as isolated cells on the surface of the alveoli. Clara cells on the bronchiolar epithelium are easy to find. You should be able to identify pulmonary arteries and veins in this slide.

 
 

115B Lung, human

For observing bronchi and bronchioli this slide is not as good as 115a.  However, it gives a better impression of the distribution of capillaries and alveolar Type I cells in the alveoli. Endothelial cells can be seen in the capillaries whereas between the capillaries in the alveolar septum is a rounder nucleus with very little apparent cytoplasm attached to it. This is the Type I cell. A visceral pleura lines part of the tissue surface.

 
115C Lung periph. monkey, H&E
This slide is a bit strange. There is a lot of large vasculature but very little in the way of conducting airways. Some alveoli are badly distended, others are collapsed. Associated with the largest vessels are some very large openings which seem artifactual. The only thing that I am comfortable identifying is the visceral pleura which covers nearly all sides of this tissue.

 

116A Lung, monkey, Mallory
116B Lung, monkey, H&E 
These 2 companion slides, one stained with H&E, the other with Mallory, contains secondary bronchi and smaller branches of the airways. The connective tissue capsule and its mesothelium are intact. The bronchi can be identified by the cartilage, which in some cases is accompanied by submucosal glands. Mallory stains the connective tissue blue, nuclei red, RBCs are red. The Mallory stain is a bit too intense thereby blocking recognition of cell types. The preservation of the ciliated cells is poor. You will have to hunt for small purely conducting passageways but there are both conducting and respiratory bronchioles present.

 Lung, rabbit, 1.5µm, BF-TB
This is a 1.5µm thick plastic section stained with basic fuschin and methylene blue. The alveoli are distended making it relatively easy to identify the thin capillary walls where gas exchange occurs. Examine some of these at 40x to observe some which have endothelial cell nuclei within them. Alveolar type I cells are the nuclei that are adjacent to the capillaries. Capillaries in the alveoli are mostly free of blood, but the larger vessels are not. Alveolar Type II cells have a foamy appearance with clear granules in their cytoplasm. Alveolar macrophages are the large cells that seem to be free standing in the alveoli. Other cell types are not easily distinguished. Each slide has a bronchus which is identifiable by the presence of cartilage and a large muscular artery adjacent to it. Most of the cells lining the lumen of the bronchus are ciliated cells. Goblet cells are not apparent. The brownish-red substance is collagen. Underlying the bronchial epithelium is a layer of smooth muscle, identifiable by its blue appearance. The muscular artery is cut in oblique section so that the t. intima appears unusually large. You can identify an internal and external elastic lamina clearly. This slide seems to be essentially free of bronchioles.

 

E. Larynx and vocal cord.
This slide can be treated as an optional slide.

 
 Larynx & vocal cord, Monkey

This tissue seems to contain both the vocal cord and the ventral fold. The vocal cord is identifiable as the flap of tissue bounded by a stratified squamous epithelium. Adjacent to it is a large block of skeletal muscle, the vocalis. Large blocks of cartilage are also present. The epithelium is not well preserved everywhere, but around the ventral fold it is apparently stratified columnar or pseudostratified columnar epithelium. Note the presence of many seromucous glands.

 

II. Urinary System

A. Kidney
1. Cortex/Medulla organization

a. Cortex contains renal corpuscles/Juxtaglomerular apparatus/proximal & distal convoluted tubules/cortical collecting ducts
b. Medulla contains loops of Henle/medullary pyramids/calyces/renal papilla
2. Enapsulated organ with an outer dense, irregular CT capsule and an inner layer of myoepithelial cells
3. Renal corpuscles
a. Glomeruli surrounded by Bowman's capsule/urinary space
b. Tend to be in parallel rows to capsule (run along interlobular arteries)
c. Afferent/Efferent arterioles
d. Cells include endothelial (capillaries), mesangial, and podocytes
e. Juxtaglomerular apparatus
1. Prominent nucleus (cells differentiate from smooth muscle)
2. Macula densa (modified DCT, taller and more prominent nuclei, 6-10 closely packed)
3. Lacis cells (between macula densa and Bowman's capsule)
4. Vasa recta (blood vessels paralling loops of Henle and collecting tubules in medulla)
5. Medullary rays (collecting tubules) radiate from cortex into medulla and end at the tip of the renal papilla
6. Tubule system
a. Proximal convoluted tubule (PCT)
1. Arises from renal corpuscle (look for connection via urinary pole of corpuscle)
2. Tall cuboidal epithelium with a brush border (diagnostic)
3. Nuclei are irregularly spaced
4. Comprise the bulk of the tubules in the renal cortex
b. Loop of Henle 1. Continuation of PCT but no brush border
2. Thin descending & ascending limbs: simple squamous epithelium (regular rounded shape of tube)
3. Ascending thick limbs: low cuboidal epithelium (thick walled, rounded shape of tube)
c. Distal convoluted tubule 1. Continuation of the ascending thick limb of Henle
2. Located in the cortex
3. Cuboidal epithelium
4. No brush border
5. Larger diameter lumen than PCT
6, Tend to be lighter stained wioth regularly spaced nuclei
d. Collecting tubules 1. Epithelial transition from cuboidal to tall cuboial (proximal to distal)
2. Found in the medullary rays
3. No brush border
4. Prominent cell boundaries (cell boundaries of PCT and DCT are invisible)
e. Collecting ducts 1. Tall columnar epithelium (no brush border)
2. Found in the inner medulla
3. Largest ducts are known as Ducts of Bellini
4. Prominent cell boundaries  
122A Kidney, Masson, human 
This is a nice slide to start off kidney with. Although there has been some degradation, the differential staining of tubules and erythrocytes makes it relatively easy to distinguish among the tubules. In the cortex, renal corpuscles are easy to find. They are cut in all differnt orientations so by examining many of them you can find urinary poles, vascular poles, macula densa, afferent and efferent arterioles. Unless you see both afferent and efferent together in the same capsule, you will not be able to distinguish between them. How would you distinguish them? In the visceral layer, podocyte and endothelial cell nuclei can be distinguished by the fact that podocyte nuclei lie outside the capillary whereas endothelialcell nuclei lie within. Mesangial cells are not easy to find. Look for them where you identify macula densa. The capsule has been mostly removed but there is some left.

Proximal convoluted tubules are the darker stained tubules with irregularly spaced nuclei and a large diameter. The brush border is not preserved. Distal convoluted tubules are have more regularly stained nuclei, smaller diameter and paler stain. Medullary rays penetrate the cortex. These rays contain collecting tubules and ascending and decending thick limbs, mostly they consist of thick limbs. These limbs resemble the proximal and distal convoluted tubules that they are associated with, except that they are straight..

The medulla is divided into three regions. The outer and inner stripes of theouter medulla and the inner medulla. The inner medulla is the easiest to navigate because it consists of essentially collecting tubules, Henle’s thin limb and vasa recta. Erythrocytes stain a greenish brown. Henle’s thin limb can be distinguished from vasa recta by the absence of erythrocytes. The collecting tubules havae shrunk and separated from their basal lamina. They are darkly stained however and are the only darkly stained tubules in the inner medulla. Arcuate arteries and veins are the large vessels at the boundary of cortex and medulla.

 

122C Kidney sec.

This slide has less blood in it and so it will be more difficult to distinguish thin limbs from vasa recta. That said, the preservation is quite nice for kidney. You will note that there are apparently few distal convoluted tubules. They are generally fewer than theproximal but this tissue has many fewer than expected. There is a pretty good CT capsule associated with this tissue. Medullary rays are difficult to see.

 

122B Kidney, human
This slide has not been perfused so the capillaries contain RBCs. The tissue does not contain much of the entire range of tissues, but does contain a small bit of inner medulla. Medullary rays are very prominent. In this slide the association of vasa recta with the thin limbs is quite proinent because the inner medulla has beencut in cross section. Look for islands of red, which reveal the vasa recta clusters. At higher magnification, you will see small tubules with a squamous epithelium. These are the thin limbs. In addition, you will see other regions consisting of nearly uniform collecting tubules with some capillaries associated with them.

 

123 Kidney, median sag. sec
If you can study only one kidney slide, study this one. It is a sagital section through a unilobar kidney of a small mammal. It shows the calyx, papilla and some transitional epithelium of the renal pelvis. The tissue has not been perfused so that RBCs are found in the capillaries.

 
124B Kidney, rabbit, PAS&H RR&K Fig. 1.2 (page 6), Plates 93-96 (page 585-591)
124C Kidney; rabbit, Masson

You looked at this slide in the epithelium lab. Now go back to it and see if you can find and identify the different structures.
 
B. Ureter

1. Transitional epithelium (multilayered, pillowy cells at surface)
2. "Star" shaped lumen
3. Wall contains two layers of smooth muscle a. Inner longitudinal
b. Outer circular
c. Third outer longitudinal layer present in lower third of ureter
4. Adventitia of loose/dense CT and adipose tissue.

 

125A Ureter, c.s.

This is a good cross section through ureter. The smooth muscle is quite clearly visible showing that the inner layer is longitudinal rather than circular as is seen in GI tract. Some outer longitudinal fibers can also be seen.

  

125B Ureter, M.A., human

This is another typical cross section of ureter stained with Mallory-Azan to highlight connective tissue. A large artery and vein are associated with this tissue. The surface layer of cells in the epithelium has exfoliated but some intact regions remain. Smooth muscle bundles in the muscularis are cut in cross section in the inner layer and longitudinal section in the outer layer.

  

125C Ureter, primate, c.s., H&E
This slide of ureter has some extra cells in the center of the lumen. This is not an artifact (see plate 97). Note that the inner layer of smooth muscle (plainly visible) is cut in cross section. There is a small amount of a 3rd muscle layer cut in cross section. What does this signify? The transitional epithelium is well preserved.
 

C. Bladder

1. Transitional epithelium

a. Thick and highly folded in the empty bladder
b. Thinner and less folded in the extended bladder. However, does not change to an apparent stratified squamous appearance.
2. Wall contains three layers of smooth muscle a. Inner longitudinal
b. Outer circular
c. Outer longitudinal
3. Adventitia of loose/dense CT and adipose tissue over most of the surface
4. Serosa may cover the dorsal surface in contact with the peritoneum
 

127B Urinary bladder, collapsed, human
This slide reveals a highly folded transitional epithelium characteristic of urinary tract. The muscularis contains large bundes of smooth muscle in at least two orientations. An adventitia lies outside the muscularis. Urinary bladder is surrounded with an adventitia over most of its surface except at the top which lies just below the abdominal peritoneum cavity. The epitheium has suffered some exfoliation of the surface cells.

 
 

127A Urinary bladder, Masson
This slide shows a distended bladder mucosa. The epithelium is degraded but still retains characteristics of transitional structure. Two clear layers of smooth muscle lie underneath the epithelium and submucosa.

 
Respiratory System and Urinary Tract Terms

 
Respiratory nasal cavities  vestibule 
respiratory segment 
olfactory segment 
olfactory mucosa 
Bowman’s glands 
ofactory epithelium  olfactory cells 
sustentacular cells 
basal cells 
brush cells
nasal septur 
turbinates/conchae 
turbulent precipitation
nasopharynx 
pharyngeal tonsil 
oropharynx 
larynx  vocal folds/cords 
glottis 
vocalis muscle 
ventricular folds 
false vocal cords
trachea  trachealis muscle 
elastic membrane
respiratory epithelium  ciliated cells 
goblet cells 
brush cells 
small granule cells 
basal cells
bronchi  primary/extrapulmonary 
intrapulmonary 
lobar /secondary 
segmental/tertiary
bronchioles  pulmonary lobules 
pumonary acini 
conducting bronchiole 
respiratory bronchiole 
terminal bronchiole 
Clara cells
cystic fibrosis 
alveolar ducts 
alveolar sacs 
alveoli 
aveolar septum 
Type I cells 
Type II cells 
septal cells 
surfactant 
lamellar bodies 
air-blood barrier 
thin portion 
thick portion 
alveolar macrophages pores of Kohn
pulmonary circulation 
bronchial circulation
Kidneys 
hilum 
cortex/medulla 
renal pelvis 
renal sinus 
nephron 
pyramids 
papilla 
minor calyx 
major calyx 
area cribrosa 
lobe 
collecting tubules 
medullary rays 
uriniferous tubule 
cortical labyrinths 
countercurrent exchange 
renal columns 
proximal thick segment 
proximal convoluted tubule/pars convoluta proximal straight segment/pars recta
thin segment 
loop of Henle 
distal thick segment 
distal convoluted tubule/pars convoluta 
distal straight segment/pars recta
cortical/subcapsular nephrons 
juxtamedullary nephrons 
intermediate nephrons 
cortical collecting ducts 
ducts of Bellini 
medullary rays 
renal corpuscles 
macula densa 
glomerulus 
Bowman’s capsule 
vascular pole 
urinary pole 
renal/malphigian corpuscles 
semipermeable barrier 
podocytes 
pedicels/foot processes 
filtration slits 
filtration slit membrane 
glomerular basement membrane 
mesangium/mesangial cells 
parietal layer 
juxtaglomerular apparatus 
juxtaglomerular cells 
kidney hormones 
erythropoietin 
renin 
vitamine D 
renin 
angiotensis I/II 
aldosterone 
antidiuretic hormone ADH)
vascular network 
renal artery 
interlobar branches 
arcuate artery 
interlobular arteries 
afferent arteriole 
efferent arteriole 
vasa recta 
peritubular capillary network 
transitional epithelium  plaques
Ureter 

Bladder 

internal sphincter Urethra 
prostatic urethra 
membranous urethra 
penile urethra 
glans penis