Preface

This medical guidebook was prepared by volunteers of the project partake who are also
medical students of Sante Medical College .We wanted to lessen the loads of our fellow
medical students by providing a guidebook which can guide our medical students in
their journey of preparing for their oral examinations.
This book uses questions and answers compiled from students who went through the
oral exams and different reference books, so we hope it supplies you with all the
answers you need. We hope any medical student will have gained quick review from
this book and get something out of it. We believe this guidebook will help students feel
equipped for their oral examinations and they will know what possible questions they
might face.
In conclusion, we would like to say we have tried to make this guide as
readable as possible. This work is just a start as we hope to be releasing
more books of this kind more details and include more cases in the
coming edition.
So in the meantime we hope these documents might come in handy.

If you have any questions or suggestions with regard to the book, please don’t
hesitate to reach out to us using our contact information below

@SMSAnews

@smsa_news

[email protected]

Project Partake Manager

Hanna Genene
 1. Mention the types of tissues found in our body?
- There are 4 basic types of tissue:
 Connective tissue,
 Epithelial tissue,
 Muscle tissue,
 Nervous tissue
2. What are the classes of Formed elements in blood?
- There are three classes of formed elements.they are:
 Erythrocytes (red blood cells),
 Leukocytes (white blood cells),
 Thrombocytes (platelets).
3. About bone marrow
4. What is the Difference between white and brown adipose tissue
i. White Adipose Tissue
- White adipose tissue is found in many organs throughout the body, typically
forming about 20% of the body weight in adults.
- Adipocytes of white fat are typically very large cells , ranging in diameter from 50
to 150 μm.
- These cells each contain primarily one large lipid droplet (they are unilocular ),
causing the nucleus and remaining cytoplasm to be pushed against the
plasmalemma.
- Fatty acids are released from white adipocytes when nutrients are needed and
carried throughout the body on plasma proteins such as albumin.

ii. Brown Adipose Tissue

- Brown fat comprises up to 5% of the newborn body weight but smaller amounts
in adults.
- Adipocytes of this tissue are typically smaller than those of white fat and contain
primarily many small lipid droplets (they are multilocular) in cytoplasm containing
many mitochondria and a central nucleus.
- Fatty acids released in adipocytes of brown fat are metabolized in
- mitochondria of these cells for thermogenesis rather than ATP synthesis,using
uncoupling protein-1 or thermogenin.
5. What is vasa vasoroum & its use?
- The vasa vasorum (VV) — “vessels on vessels” — are blood vessels located on
the outside of arteries.
- These small vessels serve to provide blood supply and nourishment for tunica
adventitia and outer parts of tunica media of large vessels.
COMMONLY ASKED MICROSCOPIC SLIDES ON ORAL HISTOLOGY
EXAM
1. Tounge(its parts) 19. Lung
2. Tosil(palatine) 20. Kidney
3. Parotid gland 21. Ureter
4. Submandibular 22. Urinary bladder
5. Sublingual 23. Testis
6. Epiglottis 24. Epididymis
7. Esophagus 25. Ductus defrens
8. Stomach 26. Seminal vesicles
9. Duodenum 27. Prostate
10. Jejunum 28. Penis
11. Appendix vermiformis 29. Ovary
12. Liver 30. Uterine tube
13. Pacrease 31. Uterus
14. Thyroid 32. Cervix
15. Parathyroid 33. Vagina
16. Thymus 34. Epidermis
17. Bronchi 35. Mammary gland
18. Trachea

 Form of the questions that are commonly asked are:

1. From which organ is this tissue, that you see on the slide, obtained
from?
2. Describe the slide you see under the microscope?
3. What is the epithelium of the slide you identified?
4. What structure is unique to this specific microscopic slide you see?
5. What other tissue do you know that has similar microscopic
morphology as this one?
6. Explain the development of this organ?(E.g if your microscopic
slide is kidney then you will be expected to describe its
development )
1. Tongue
 Histology

1. Filiform papillae are very numerous,

- Conical in shape with their tips pointing backward reaching up to 3mm
- Lined with stratiefied squamous keratinized epithelium
- Provide friction surface for mastication
- No taste buds
2. Fungiform papillae
- are much less numerous,
- Lightly keratinized, and interspersed among the filiform papillae.
- They are mushroom-shaped with well-vascularized and innervated cores
of lamina propria.
3. Foliate papillae
- consist of several parallel ridges on each side of the tongue, anterior to
the sulcus terminalis, but are rudimentary in humans, especially older
individuals
- Lined with stratified squamous non keratinized epithelium
4. Vallate (or circumvallate) papillae
- are the largest papillae,
- 7-12 in number located in front of the “V” shaped sulcus terminalis
- Lined with stratified squamous epithelium
- Surrounded by deep furrow that receive openings of mucous &serous
gland
2. Tosil(palatine)
 Histology
- Paired (right & left),located between palatoglossal &palatopharyngeal folds
- Have dense fibrous capsule on deeper aspect
- Superficial aspects with:
 Stratified squamous nonkeratinized epithelium
 10-20 crypts
- Contain many primary and secondary lymphoid nodules
4. Submandibular glands
 Histology
- Branched tubule acinar
- Mixed,but mainly serous
- Serous cells
 With lateral and basal membrane infoldings ,hence indistinct cell boundary
 Serous demilunes with intercellular canaliculi and secret lysozyme
- Main duct is whartons duct that open to the side of frenulum of the tongue
5. Sublingual glands
 Histology
- Composite glands of variable size,8-10 in number
- Mixed,but mainly mucous with serous found as demilunes
- Rare or no secretory ducts
- Several minor ducts(rivinian ducts) to main submandibular duct
6. Epiglottis
 Histology
- Serves to prevent swallowed food or fluid from entering that passage
- Its upper, or lingual, surface has stratified squamous epithelium; at variable
points on its laryngeal surface this epithelium undergoes a transition to ciliated
pseudostratified columnar (respiratory) epithelium.
- Mixed mucous and serous glands are found in the lamina propria beneath the
epithelium.
7. Esophagus
 Histology
- Mucosa is lined by stratified squamous nonkeratinized epithelium
- Langerhans cells are present
- Lamina propria has esophageal cardiac glands
 Are compound tubuloalveolar glands that produce a neutral mucus
 Found mainly at terminal portion
- Muscularis externa :
 Upper 3rd skeletal, middle 3rd mixed & lower 3rd smooth
 Between inner circular and outer longitudinal, Auerbachs plexus
- The distal portion –serosa & the rest is adventitia
8. Stomach
 Histology
- Mucosa :
 Simple columnar epithelium, no goblet cells
 Shows longitudinal folds (rugae) made by mucosa and submucosa that
allow distention of stomach when filled
 Shallow grooves that form buldging irregular areas are known as mamillated
areas
 Gastric pits (foveolae) receive openings of 3-7 gastric glands found in the
lamina propria
 Fundus & body :short pit,long gland
 Cells
The isthmus: contains stem cells & parietal cells
The neck: contains stem cells, parietal cells & mucous neck cells
The base: contains parietal cells, chief cells & enteroendocrine cells

 Cardiac & pylorus: long pit ,short coiled simple branched tubular gland
 Cells
Cardiac region: contains mucous cells, lysozyme producing cells,
few parietal cells & enteroendocrine cells
Pyloric region: contain mucous cells ,lysozyme producing cells,
gastrin cells & D cells
- Muscularis externa made by:
1. Inner oblique
2. Middle circular Gives pyloric sphincter
3. Outer longitudinal

- Covered lastly by Serosa

9. Duodenum
 Histology
- Mucosa
 Lined by simple columnar epithelium
 Plicae circularis more numerous at the distal part
 Broad and leaf shaped villi
 Microvilli- Brushborder
- Brunners gland found in the submucosa
 Are muco-seous branched coiled tubular glands
 For protection and optimum ph for the action of pancreatic enzyme
- Muscularis externa: well developed with inner circular and outer longitudinal layer
- Serosa: outer layer
10. Jejunum
 Histology
- Mucosa
 Simple columnar epithelium + numerous Goblet cells
 Long and finger shaped villi
 Plicae circularis more numerous in the proximal part
 Main absorption site
- Muscularis externa and serosa are same as Duodenum
11. Appendix vermiformis
 Histology
- Small and irregular lumen
- Simple columnar epithelium
- Fewer and shorter intestinal glands
- Many lymphoid nodules in lamina propria and submucosa
- No taenia coli while it is present in colon
12. Liver
 Histology
- As exocrine gland secretes bile
- As endocrine gland synthesizes protein such as :
albumin,prothrombin,fibrinogen&lipoproteins into blood
- Hepatocytes: polyhedral with 6 or more surfaces
- Radiate from centre to the periphery as anastomosing hepatic plates of one cell
thick in the adult,but two cells thick in the young up to 6yrs of age.
- Sinusoids are present between adjacent reows of hepatocytes
- Portal triads
 Portal vein-drains centrally into the sinusoids
 Hepatic artery-drains into same sinusoids as that of portal vein
 Bile duct
- Kupfer cells :dark dots at the sinusoids
 Metabolize aged erythrocytes and digest haemoglobin converting some of
the ferritin iron to hemosiderin granules and store them
 Secrete protiens related to immunological processes
- Hepatic acinus vs hepatic lobule
 The lobule is typically hexagonal in cross section, with a central vein at its
center and portal areas at its peripheral corners. In contrast, a liver acinus
encompasses the liver tissue that is served by a single terminal branch of
the hepatic artery.
 Hepatic acinus is divided into 3 imaginary concentric elliptical zones with
their relative location to the short axis:
 Zone 1: first to recive O2,nutrients &toxin from the sinusoid
 Zone 2
 Zone 3:first to show ischemic necrosis
13. Pacrease
 Histology
- The pancreas is a mixed exocrine-endocrine gland that produces both digestive
enzymes and hormones
- Islets of Langerhans –endocrine function ,lightly staining,spherical
- Pancreatic acini-Exocrine function,darkly staining, berry like shape
- Intercalated duct-flattened cuboidal,centroacinar cells
- Intralobular duct-classical cuboidal
- Interlobular duct:smaller- cuboidal
Larger-columnar
14. Thyroid
 Histology
- Fibrous Capsule made by the deep cervical fascia,and sends septae
- Contains 2 types of cells
1. Follicular cells(principal cells)
 Lined by Simple epithelium that changes from squamous ,when
hypoactive to low columnar,when active
 Surround the colloid which store secretory products
2. Para follicular cells(clear or C cells)
 Pale staining cells with 2-3 times larger than the follicular cells
 Produce calcitonin which inhibit bone resorption
15. Parathyroid
 Histology
- Small and ovoid gland
- Thin capsule that sends septae
- Stroma has some adipocytes which make about 60% of the gland in the elderly
person
- Has 3 types of parenchymal cells:
1. Chief(principal cells)- small rounded cells with vesicular nuclei
2. Oxyphil cells-larger and polygonal cells,
 Stain deeply eosinophilic because of abundant mitochondria with
abundant cristae
3. Transitional cells- with smaller nuclei that stain deeply than the other cell
types
16. Thymus
 Histology
- Central,Primary lymphoid organ
- Bilateral connective tissue capsule
- Cortex – darker than medulla due to high density of T lymphocytes
 rich in small lymphocytes
- Medulla
 Cytoreticulum of epithelial reticular cells
 Less densely packed T-lymphocytes
 Thymic(hassals) corpuscles- concentrical epithelial reticular cells,filled with
keratin & sometimes calsified
 17. Bronchi
 Histology
- Lined by respiratory epithelium
- Irregular plates of hyaline cartilages forming complete rings in the larger,and
isolated plates in the smaller bronchi
- Crisscrosing bundles of smooth muscles,making continuous layer proximally but
loosely packed distally
- Lamina propria with:
 Rich elastic and reticular fibers
 Mucous and serous glands
 Lymphoid tissue (BALT) increase at branching points

18. Trachea
 Histology
- Mucosa
 Lined by respiratory epithelium with:
 Ciliated cells increase but gobet and basal cells decrease distally
 Thick basal lamina
- Submucosa-16-20 Cshaped ,hyaline cartilage
 Trachialis muscle on the posterior surface against esophagus
 Mucoserous glands
- Adventitia-Connective tissue, surround & bind to adjacent structures
19. Lung
 Histology
- Alveoli- simple squamous epithelium
- Alveolar ducts: a few cuboidal cells lining between the alveoli
 Lamina propria with elastic collagen fibers and smooth muscle
cells as sphincters of the alveoli
 Open into atria that lead to 2 or more alveolar sacs
20. Kidney’
 Histology
- Has a capsule that consists of the following 2 layers:
1. An outer layer of fibroblasts and collagen fibers
2. An inner layer with a circular component of myofibroblasts that may be
involved resisting volume and pressure variations
- Parenchyma of the kidney called urineferous tubules are made by:
1. Nephrons- the secretory unit of the kidney,consists of:
 Renal(malpigian) corpuscles
 Proximal convoluted tubules
 Loop of henle
 Distal Convoluted tubules
2. Collecting tubules & ducts: the excretory portion of the kidney
 Collecting tubules :cuboidal epithelium
 Collecting ducts:columnar epithelium
- Medulla,made by:
 8-18 medullary pyramids with the base directed toward the capsule and
apex.each pyramin is divede into :
1. Outer medulla, which is subdivided into inner stripe and an outer stripe
reflecting the location of distinct parts of the nephron
2. Inner medulla
- Cortex made by regions between:
 The medullary rays known as cortical labyrinths,made by renal
corpuscles,convoluted tubules and collecting tubules
21. Ureter
 Histology
- Is made up of 3 layers
1. Mucosa made by:
 Transitional epithelium
 Lamina propria is thrown into a number of longitudinal folds when the
ureter is empty
2. Muscular coat:
 An inner longitudinal and outer circular layers of smooth myocytes
in the upper 2/3rd part
 An inner longitudinal,a middle circular and outer longitudinal layers
of smooth myocytes in the lower 1/3rd part
3. Adventitia
 Outer loose connective tissue fibrous coat

22. Urinary bladder

 Histology
- 3 coats:
1. Mucus membrane
 Transitional epithelium
 Lamina propria
 When empty thrown into many folds,except in the region of trigon
covering the base.
2. Muscle coat
 Called detrusor muscle
 Poorly defined inner lontiudinal,middle circular and outer
longitudinal layers of smooth myocytes
 The middle circular layer forms the sphincter vesicae near the neck
of the bladder around the opening into the urethra
3. Adventitia
 Made by loose fibrous connective tissue,with addition of
mesothelium in the regions covered by peritoneum
23. Testis
 Histology
- Each testis is surrounded by a thick capsule of dense connective
tissue, the tunica albuginea.
- The tunica albuginea is thickened on the posterior surface of the testis
to form the mediastinum testis, from which fibrous septa penetrate the
gland, And dividing it into about 250 pyramidal compartments called
the testicular lobules
- Leydig cells found between seminiferous tubules
- Sertoli cells within the seminiferous tubules nourish developing sperm
- The seminiferous tubules are lined with a complex stratified epithelium
called germinal or seminiferous epithelium.
24. Epididymis
 Histology
- Is a single highly coiled tube about 4-6 m in length.
- It is lined with pseudostratified columnar epithelium composed of
rounded basal cells and columnar cells.
- These cells surrounded by smooth muscle cells, whose peristaltic
contractions help to move the sperm along the duct,
- Their surface is covered by long, branched, irregular microvilli
called stereocilia.
- The epithelium of the epididymis participates in the uptake and
digestion of residual bodies that are eliminated during
spermatogenesis
25. Ductus deferens
 Histology
- A straight tube with a thick, muscular wall, continues toward the
prostatic urethra and empties into it.
- It is characterized by a narrow lumen and a mucosa with
longitudinal folds,
- Covered along most of its extent by pseudostratified columnar
epithelium with stereocilia
- The lamina propria is rich in elastic fibers, and the thick muscular
layer consists of longitudinal inner and outer layers separated by a
circular layer.
- The mucous layer of the ductus deferens continues through the
ampulla into the ejaculatory duct, but the muscle layer ends after
the ampulla.
26. Seminal vesicles
 Histology
- Consist of two highly twisted tubes about 15 cm in length.
- It has folded mucosa that is lined with cuboidal or pseudostratified
columnar epithelium rich in secretory granules.
- The lamina propria of which is rich in elastic fibers and surrounded by a
thin layer of smooth muscle
- They are glands that produce a viscid, yellowish secretion that contains
spermatozoa-activating substances such as carbohydrates, citrate, inositol,
prostaglandins, and several proteins.
27. Prostate
 Histology
- Is a collection of 30-50 branched tubuloalveolar glands
- The tubuloalveolar glands of the prostate are formed by a cuboidal or a
columnar pseudostratified epithelium
- Rich fibromuscular stroma exceptionally surrounds the glands.
- Surronded by smooth muscle
- The prostate has three distinct zones:
1. The central zone occupies 25% of the gland's volume.
2. Peripheral zone: forms70%of the gland, which is the major site of
prostatic cancer.
3. The transition zone is of medical importance because it is the site at
which most benign prostatic hyperplasia originates.

*Benign prostatic hyperplasia is present in 50% of men more than 50 years

of age and in 95% of men more than 70 years of age. It leads to
obstruction of the urethra with clinical symptoms in only 5-0% of cases.
28. Penis
 Histology
- Most of the penile urethra is lined with pseudostratified columnar epithelium; in
the glans penis, it becomes stratified squamous epithelium.
- Mucus-secreting glands of Littre are found throughout the length of the penile
urethra.
- The prepuce is a retractile fold of skin that contains connective tissue with
smooth muscle in its interior.
- Sebaceous glands are present in the internal fold and in the skin that covers
the glans.
- The corpora cavernosa of the penis and the corpus cavernosum of the urethra
are composed of erectile tissue.
- This is a tissue with a large number of venous spaces lined with endothelial
cells
- And separated by trabeculae of connective tissue fibers and smooth muscle
cells.
29. Ovary
 Histology
- Their surface is covered by a simple squamous or cuboidal epithelium, the
germinal epithelium.
- Under the germinal epithelium is a layer of dense connective tissue, called the
tunica albuginea, Which is responsible for the whitish color of the ovary.
- Underneath the tunica albuginea is the cortical region, where ovarian follicles-
structures that contain the oocytes—predominate.
- The follicles are embedded in the connective tissue (stroma) of the cortical
region.
- Blood vessels At the medulla
- There are no sharp limits between the cortical and medullary regions
30. Uterine tube
 Histology
- The wall of the oviduct is composed of three layers:
 Mucosa, has longitudinal folds that are most numerous in the ampulla.
 Along its entire length, the mucosa is lined by simple columnar
epithelium on a lamina propria of loose connective tissue . The
epithelium contains two interspersed, functionally important cell
types:
1. Ciliated cells in which ciliary movements sweep fluid toward the
uterus,
2. Secretory peg cells, nonciliated and often darker staining, often
with an apical bulge into the lumen, which secrete glycoproteins
of a nutritive mucus film that covers the epithelium.
 A thick muscularis composed of smooth muscle disposed as an inner
circular or spiral layer and an outer longitudinal layer,
 A serosa composed of visceral peritoneum.
- Has 4 regions:
1. The infundibulum, a funnel-shaped opening fringed with fingerlike
extensions called fimbriae (L., fringes) next to the ovary;
2. The ampulla, the longest and expanded region where fertilization normally
occurs;
3. The isthmus, a more narrow portion nearer the uterus;
4. The uterine or intramural part, which passes through the wall of the uterus
and opens into the interior of this organ.
31. Uterus
 Histology
- The wall of the uterus is relatively thick and is composed of three layers.
1. Outer serosa (connective tissue and mesothelium) or adventitia
(connective tissue).
2. Myometrium, a thick tunic of smooth muscle,
3. The endometrium or mucosa of the uterus.
 Simple columnar epithelium
- Proliferative (follicular )phase:
 Staright empty glands
 Narrow empty duct
- Secretory phase:
 Coiled & highly dilated glands
 Lumen filled with secretions
 Epithelium hypertrophies
 Arcuate artery straight and spiral
32. Cervix
 Histology
- The lining consists of a mucus-secreting simple columnar epithelium.
- The cervix has few smooth muscle fibers and consists mainly (85%) of dense
connective tissue.
- The external aspect of the cervix that bulges into the lumen of the vagina is
covered with stratified squamous epithelium.
33. Vagina
 Histology
- The wall of the vagina is devoid of glands and consists of three layers:
1. Mucosa, abundant sensory nerve
 lamina propria-elastic fiber(connective tissue Lymphocytes &
neutrophils )
2. Muscular layer,
3. Adventitia.
- The mucus found in the lumen of the vagina comes from the glands of the uterine
cervix.
- The epithelium of the vaginal mucosa of an adult woman is stratified squamous
34. Epidermis
 Histology
- Has four types of cells
 ,Melanocytes ,Keratinocytes,langerhans cells & Merkels cells
- Keratinocytes:
- Found as stratified squamous keratinized epithelium making 5 layers:
1. Stratum basale(stratum germinativum): by a single layer of basophilic
low columnar cells on basal lamina
2. Startum Spinosum: by polygonal,cuboidal or slightly flattened cells
3. Stratum granulosom: cells show breakdown of the nucleus and
organelles and thickening of the plasma membrane
4. Stratum lucidum: extremely eosinophilic,flattened dead cells with no
nuclei and organelles
5. Stratum Corneum: several layers of flattened dead cells.thick plasma
membrane filled with tonofilaments embedded in amorphous matrix

35. Mammary gland

 Histology
- Highly modified apocrine sweat gland
- Each mammary gland consists of 15–25 lobes of the compound tubuloalveolar
type whose function is to secrete milk to nourish newborns.
- Each lobe, separated from the others by dense connective tissue and much
adipose tissue, is really a gland in itself with its own excretory lactiferous duct.
- Parenchyma –glandular part:
 L.sinus :stratified columnar or cuboidal epithelium
 L.duct :simple cuboidal
 Alveoli
- Stroma-connective tissue supporting the glandular part
- Areola:nipple
- Lactating: increased number of secretory vacuoles and fat droplets
 Decreased number of connective tissue and adipose tissue relative to
parenchyma