組織學(xué)與胚胎學(xué) 血液與肌組織課件

1、 血液和血細(xì)胞的發(fā)生Blood and Hematopoiesis血 液 Blood血 漿plasma: 55% 紅細(xì)胞 白細(xì)胞 血小板 Platelets血漿白細(xì)胞，血小板紅細(xì)胞血細(xì)胞血液不加抗凝劑即凝固成塊，周圍析出的淡黃色清明液體。血清 serum:組成:血象 hemogram 定義：是血細(xì)胞形態(tài)、 數(shù)量、比例及血紅蛋白含量的測(cè)定。血涂片的常用染色方法是Wright或Giemsa染色。意義：血象的變化是多種疾病診斷、預(yù)后及治療效果的重要指標(biāo)。血 細(xì) 胞 紅細(xì)胞 femal (3.55.5) *1012/L mal （4.0-5.5）*1012/L 白細(xì)胞 （410）109 /L 血小板

2、（100300）109/ L 中性粒C 有粒白細(xì)胞 嗜酸性粒C 嗜堿性粒C無粒白細(xì)胞 淋巴細(xì)胞 單核細(xì)胞 紅細(xì)胞 erythrocyte, red blood cell 大?。盒螤睿弘p凹圓盤狀。結(jié)構(gòu)特點(diǎn)：無核，無細(xì)胞器內(nèi)含物：充滿血紅蛋白(Hb)紅細(xì)胞骨架:臨床聯(lián)系 Medical Application A decreased number of erythrocytes in the blood is usually associated with anemia（貧血）. An increased number of erythrocytes (erythrocytosis, or pol

3、ycythemia紅細(xì)胞增多癥) may be a physiologic adaptation. Polycythemia which is often associated with diseases of varying degrees of severity, increases blood viscosity;Polycythemia might be better characterized as an increased hematocrit紅細(xì)胞壓積. Erythrocytes with diameters greater than 9 m are called macrocy

4、tes, and those with diameters less than 6m are called microcytes. 網(wǎng)織紅細(xì)胞（reticulocyte)骨髓進(jìn)入血液的未完全成熟的紅細(xì)胞。用煌焦油藍(lán)染色網(wǎng)織紅細(xì)胞內(nèi)有染成藍(lán)色的顆?；蚣?xì)網(wǎng)，是殘留的核糖體。網(wǎng)織紅細(xì)胞進(jìn)入外周血13天后，核糖體完全消失。網(wǎng)織紅細(xì)胞計(jì)數(shù)常作為判斷骨髓造血能力的重要指標(biāo)。成人0.5-1，新生兒高達(dá)3-6。 人血涂片示網(wǎng)織紅細(xì)胞 (煌焦油藍(lán)染色)中性粒細(xì)胞 neutrophil（50%70 %）直 徑：細(xì)胞核：胞 質(zhì):兩種特殊顆粒 （嗜天青顆粒 特殊顆粒）核左移（1-2葉）:核右移（4-5葉）:功 能：

5、趨化作用 吞噬功能 嗜酸性粒細(xì)胞 eosinophil（0.5 %5 % )核多2 葉，胞質(zhì)內(nèi)充滿粗大的鮮紅色嗜酸性顆粒，含組胺酶、芳基硫酸酯酶、陽離子蛋白、過氧化物酶等。功能：抑制過敏反應(yīng), 殺滅寄生蟲。3.嗜堿性粒細(xì)胞 basophil（01 %）形態(tài)：細(xì)胞質(zhì)：細(xì)胞核功能：與肥大細(xì)胞相似參與過敏反應(yīng) 淋巴細(xì)胞 lymphocyte（20 % 40 %)T 細(xì)胞B 細(xì)胞NK 細(xì)胞形態(tài)：胞質(zhì)嗜堿性； 核圓形，占細(xì)胞的大部分。根據(jù)發(fā)生部位、表面特征、免疫功能和壽命不同可分類為：分類：?jiǎn)魏思?xì)胞 monocyte 3%8%形態(tài)： 細(xì)胞表面微絨毛胞質(zhì)內(nèi)有吞噬泡顆粒有溶酶體樣結(jié)構(gòu)功能：參與免疫血小板（L

6、M）Blood platelet血小板（EM）Blood platelet特殊顆粒、致密顆粒、溶酶體血小板platelet功能：止血和凝血.血管受損破裂血栓血小板黏附血塊纖維蛋白原纖維蛋白臨床聯(lián)系 Medical Application Hemophilia（血友?。?A and B are clinically identical, differing only in the deficient factor. Both are due to sex-linked recessive inherited disorders. Blood from hemophiliac patients d

7、oes not coagulate normally: Persons with this disease bleed severely even after mild injuries, such as a skin cut, and may bleed to death after more severe injuries. The blood plasma of patients with hemophilia A is deficient in clotting factor VIII or contains a defective factor VIII; in hemophilia

8、 B, the defect is in factor IX. In severe cases the blood is incoagulable. Generally, only males are affected by hemophilia A, because the recessive gene to factor VIII is in the X chromosome. Females develop hemophilia only when they have the abnormal gene in both X chromosomes.骨髓和血細(xì)胞發(fā)生造血器官胚胎時(shí)期造血各器

9、官的演變 6W 4-5M 出生后 卵黃囊肝脾 骨髓骨髓的結(jié)構(gòu) 紅骨髓：造血組織+血竇 黃骨髓: 脂肪組織+少量的幼稚血細(xì)胞骨髓光鏡結(jié)構(gòu)造血組織：網(wǎng)狀組織+造血細(xì)胞造血誘導(dǎo)微環(huán)境（hemopoietic inductive microenvironment）： 是造血細(xì)胞賴以生長(zhǎng)發(fā)育的環(huán)境。包括：骨髓的神經(jīng)成分、微血管系統(tǒng)和結(jié)締組織。它們不僅起支架作用，還分泌多種細(xì)胞體液因子，調(diào)節(jié)造血細(xì)胞的增殖與分化。造血干細(xì)胞 hemopoietic stem cell 又稱多能干細(xì)胞（multipotential stem cell）起源：卵黃囊等處的血島，出生后主要位于紅骨髓、脾和淋巴結(jié)，少量于外周血形態(tài)

10、：類似小淋巴細(xì)胞，即細(xì)胞體積小，核相對(duì)較大，胞質(zhì)富含核糖體特性：強(qiáng)增殖潛能 多向分化 自我復(fù)制，終身保持?jǐn)?shù)量恒定。 血細(xì)胞發(fā)生圖 臨床聯(lián)系 Medical Application Growth factors have been used clinically to increase marrow cellularity and blood cell counts. The use of growth factors to stimulate the proliferation of leukocytes is opening broad new applications for clinic

11、al therapy. increasing the efficiency of marrow transplants by enhancing cell proliferation; enhancing host defenses in patients with malignancies and infectious and immunodeficient diseases; and enhancing the treatment of parasitic diseases. Hematopoietic diseases are usually caused by suppression

12、or enhancement of some undifferentiated cell production, with a consequent reduction or overproduction of hematopoietic cells. In some diseases, however, suppression and enhancement of proliferation of more than one type of stem cell can occur, sequentially or simultaneously. 肌 組 織Muscle tissue 骨 骼

13、肌光鏡結(jié)構(gòu):胞體：長(zhǎng)圓柱狀，胞核:數(shù)十至數(shù)百個(gè),位周邊胞質(zhì)：充滿肌原纖維， 與肌纖維長(zhǎng)軸平行排列， 有周期性橫紋肌節(jié) sarcomere定義:相鄰2條Z線之間的一段肌原纖維，由1/ 2 I 帶+A帶+1/ 2 I 帶構(gòu)成，是骨骼肌纖維結(jié)構(gòu)和功能的基本單位暗帶（A帶）,中央有H 帶,H 帶中央有M 線明帶（I 帶）,中央為Z 線二、骨骼肌纖維的超微結(jié)構(gòu)1、肌原纖維 粗肌絲和細(xì)肌絲構(gòu)成；肌原纖維間有肌漿網(wǎng)，大量線粒體、糖原、肌紅蛋白粗肌絲肌球蛋白頭（ATP酶）桿細(xì)肌絲 肌動(dòng)蛋白（肌球蛋白頭部結(jié)合位點(diǎn)) 原肌球蛋白 肌鈣蛋白（可與Ca2+ 結(jié)合)肌動(dòng)蛋白：兩條相互纏繞串珠狀螺旋鏈組成。原肌球蛋白：雙

14、股螺旋多肽鏈,嵌于肌動(dòng)蛋白雙股螺旋兩側(cè)的淺溝內(nèi)。肌原蛋白：由3個(gè)球形亞單位組成，細(xì)肌絲的分子結(jié)構(gòu)2 、橫小管transverse tubule位置：明帶、暗帶交處。形成：肌膜凹陷于肌質(zhì) 成。功能：傳遞膜電位。肌膜向肌漿內(nèi)凹陷形成的管狀結(jié)構(gòu)，與肌纖維長(zhǎng)軸垂直，同一平面的橫小管分支吻合，環(huán)繞肌原纖維3. 肌質(zhì)網(wǎng)sarcoplasmic reticulum概念：特化的滑面內(nèi)質(zhì) 橫小管之間結(jié)構(gòu)：縱行包繞肌原纖維 縱小管 扁囊稱終池三聯(lián)體：每條橫小管與兩側(cè) 的終池功能：貯存和釋放Ca2+肌絲滑動(dòng)原理運(yùn)動(dòng)神經(jīng)末梢將沖動(dòng)傳遞給肌膜興奮經(jīng)橫小管傳遞給肌漿網(wǎng)，釋放Ca2+Ca2+與肌鈣蛋白結(jié)合，使原肌球蛋白和肌

15、鈣蛋白構(gòu)型變化，肌動(dòng)蛋白上的肌球蛋白結(jié)合位點(diǎn)暴露，與肌球蛋白橫橋結(jié)合ATP被分解釋放能量，橫橋彎，細(xì)肌絲牽向M 線細(xì)肌絲向M線滑動(dòng)，明帶、肌節(jié)、肌纖維收縮Ca2+ 被泵回肌漿網(wǎng)，肌鈣蛋白等復(fù)原，肌纖維松弛舒縮時(shí)肌節(jié)的變化 臨床聯(lián)系 Medical application The variation in diameter of skeletal muscle fibers depends on such factors as the specific muscle and the age and sex, state of nutrition, and physical training of

16、 the individual. It is a common observation that exercise enlarges the musculature and decreases fat depots. The increase in muscle thus obtained is caused by formation of new myofibrils and a pronounced growth in the diameter of individual muscle fibers. This process, characterized by augmentation

17、of cell volume, is called hypertrophy ；tissue growth by an increase in the number of cells is termed hyperplasia. Hyperplasia does not occur in either skeletal or cardiac muscle but does take place in smooth muscle, whose cells have not lost the capacity to divide by mitosis. Hyperplasia is rather f

18、requent in organs such as the uterus, where both hyperplasia and hypertrophy occur during pregnancy.臨床聯(lián)系 Medical Application Myasthenia gravis（重癥肌無力） is an autoimmune disorder characterized by progressive muscular weakness caused by a reduction in the number of functionally active acetylcholine rece

19、ptors in the sarcolemma of the myoneural junction. This reduction is caused by circulating antibodies that bind to the acetylcholine receptors in the junctional folds and inhibit normal nerve-muscle communication. As the body attempts to correct the condition, membrane segments with affected receptors are internalized, digested by lysosomes, and replaced by newly formed receptors. These receptors are again made unresponsive to acetylcholine by the same antibodies, and the disease follows its progres