CTB II Progress Exam Study Guide 2016
The CTB II first exam will focus only on the specific topics listed and will contain 30 items. Each question will have an associated histology photo for reference and orientation; therefore, although the primary focus will be lecture material, all laboratory study will be of considerable benefit to providing you with an understanding of histology.
Below is the APPROXIMATE breakdown of items by subject area for the Progress Exam. Some questions span more than one subject area.
|Subject||# of items|
|Oral cavity through stomach|| 5|
|Endocrine system|| 9|
|Urinary system || 6|
A Learning Objectives list and Objects list are provided for you use in preparing for the exam. There is always an attempt to make these lists comprehensive, but it is still your responsibility to study the lectures, slides, discussions and to make all identifications requested in lab, as well as to refer to the textbook for added explanations.
The following is recommended for mastering histology by using the objects list:
1. Go through the list the first time quickly to make sure that you recognize each term and are familiar with each name.
2. Go through the list a second time, but this time make sure you can image the structure in your mind. If you cannot see the structure in your mind or are unsure, look up that structure in a textbook, lecture slide, or the virtual slides. Then repeat this exercise until you see the structure in your mind.
3. Go through the list a third time and write or state the function of each object term, especially in relation to the morphology.
4. Make a final review of all lecture notes and read the textbook where appropriate to fill in the finer details. This last effort will help with the few questions that are meant to challenge your reasoning abilities.
Exocrine Glands: Liver, Pancreas, Gallbladder, Salivary
1. Identify and discuss the basic histological organization of the liver, gallbladder and pancreas; correlate function with histological structures
2. Identify and define the following histological terms: hepatic cords; central vein (venule), portal triad, periportal limiting plate, hepatic portal vein (venules), hepatic artery (arteriole), bile duct, lymphatic vessel, liver sinusoids, sinusoidal endothelium, classical hepatic lobule, portal lobule, hepatic acinus, hepatocyte, polyploid hepatocyte, binucleate hepatocyte, Kupffer cell, hepatic stellate (Ito) cell, glycogen, rough endoplasmic reticulum, peroxisome, space of Disse, bile canaliculus, duct of Herring, bile, gallbladder epithelium, Islets of Langerhans, pancreatic lobule, septa, pancreatic acinus, zymogen granules, centroacinar cell, intercalated duct, intralobular and interlobular ducts, pancreatic duct
3. Understand the flow of blood into and out of the liver and identify the morphological structures involved in this physiological activity
4. Understand the organization and morphology of the portal triad.
5. Understand the concepts of the classical hepatic lobule, portal lobule and hepatic acinus (sometimes called Acinus of Rappaport) and recognize their locations within the liver and the structures making up their regions of the liver.
6. Understand the basic structure and function of cells of the liver: hepatocyte, polyploid hepatocyte, binucleate hepatocyte, stem cell, Kupffer cell, hepatic stellate cell, endothelial cell
7. Discuss the production of bile and the cellular structures involved in getting bile to the duodenum.
8. Identify the histological features of the gallbladder
9. Identify, understand and discuss the production of exocrine secretions by the pancreas; the cell types involved, their histology and relationship to the pancreatic acinus, intercalated duct, lobule, and ductal system.
10. Identify, understand and discuss the Islets of Langerhans endocrine cells of the pancreas.
central vein (venule)
classical hepatic lobule
periportal limiting plate
hepatic portal vein (venules)
hepatic artery (arteriole)
Islets of Langerhans
intralobular and interlobular ducts
serous, mucous and mixed salivary glands
intralobular and interlobular ducts
Oral Cavity through Stomach
1. Identify histologically and understand the following terms: tongue filiform and circumvallate papillae, taste bud, tooth enamel, dentin, cementum, dental pulp.
2. Identify and describe the basic structure of taste bud.
3. Identify and understand tooth development; enamel organ, ameloblasts, odontoblasts.
4. Discuss which cells in the adult would need to be replaced by stem cells to grow a new tooth.
5. Identify histologically and understand the following terms: mucosa, epithelium, lamina propria, muscularis mucosa, submucosa, muscularis externa, adventitia, serosa. Apply these terms to the gastrointestinal tract.
6. Identify histologically and understand the layers of the following: fundic and pyloric stomach, small and large intestine.
7. Identify histologically and understand the function associated with and location of the following terms: gastric pits, parietal and chief cells of stomach, mucous surface and mucous neck cell and stem cell area, enteroendocrine cells, parietal canaliculus.
8. Understand the cells and secretions that fail when Helicobacter pylori bacteria induce ulceration.
9. Understand and explain why cells stain blue with hematoxylin and pink with eosin.
10. Correlate histological organization with function of the gastrointestinal regions.
11. Compare epithelia, mucosa and submucosa along the gastrointestinal tract.
12. Identify and discuss where glands are found in the gastrointestinal tract.
tooth enamel, dentin, cementum, dental pulp
Mucosa, epithelium, lamina propria, muscularis mucosa
Submucosa, muscularis externa, adventitia
Esophagus submucosal glands
Esophagus muscularis externa (type of cells)
Stomach: cardiac, fundic and pyloric
Stomach mucosa, lamina propria, muscularis mucosa
Stomach submucosa and muscularis externa
gastric pits, Isthmus, Neck and Body
parietal cells and chief cells
mucous surface cells
neck cell and stem cell locations
1. Identify histologically and understand the following terms: mucosa, epithelium, lamina propria, muscularis mucosa, submucosa, muscularis externa, adventitia, serosa. Apply these terms to the gastrointestinal tract.
2. Identify histologically and understand the layers of the following: small and large intestines.
3. Identify histologically and understand the function associated with and location of the following terms: villi, crypts of Lieberkuhn, absorptive cell (enterocyte), microvilli, goblet cell, stem cells, Paneth cells, smooth muscle cells, Brunner's glands, mucous versus serous cells, Meissner's submucosal and Myenteric nerve plexi, macrophages, Peyer's patch, lymphatic nodules, intraepithelial T-lymphocytes, plasma cells of lamina propria, lacteals, M-cells (Microfold-cells), dendritic cells, lymphoblast cells.
4. Understand and explain why cells stain blue with hematoxylin and pink with eosin.
5. Correlate histological organization with function of the gastrointestinal regions.
6. Compare epithelia, mucosa and submucosa along the gastrointestinal tract.
7. Identify and discuss where glands are found in the gastrointestinal tract.
Villi and epithelium (Duodenum, ileum, cecum, jejunum, colon)
Mucosa, muscularis mucosa, submucosa, muscularis externa
Absorptive cell (enterocyte), microvilli, terminal web, tight junction
Crypts of Lieberkühn, stem cells, and Paneth cell
Intraepithelial lymphocyte (T-cells)
Plasma cells, macrophages, smooth muscle, lacteals
Meissner's submucosal plexus
Myenteric nerve plexus
Peyer's patch, lymphatic nodules
M-cell pocket of dendritic cells, lymphocytes and macrophages
Cecum (appendix like) organization and cells
Colon mucosa and submucosa
Colon mucous or goblet cells, absorptive cells
Endocrine glands - Thyroid, Parathyroid, Adrenal, Hypothalamus, Hypophysis and Pineal
1. Understand endocrine gland organization: discrete organs or portions of organs
2. Understand classes of hormones and features of the cells that produce them
3. Understand thyroid follicle epithelium and morphological changes associated with function
4. Identify histologically and understand follicular cells of thyroid hormone synthesis, storage and mobilization; parafollicular C-cell location, morphology and function
5. Understand parathyroid gland structure, cell types (Chief and Oxyphil) and functions
6. Identify histologically and understand the organization and related functions of the adrenal gland zones
7. Understand blood supply to the adrenal gland
8. Identify major hormones released from the adrenal gland zones
9. Identify histologically and understand the ultrastructure of steroid producing cells
10. Identify the Chromaffin cell and its function in the adrenal medulla
11. Understand gross anatomical organization of the hypothalamus, optic chiasma, hypophysis (pituitary), and hypothalamohypophyseal system
12. Know the organization of the pituitary: neurohypophysis, adenohypophysis
13. Know the major divisions of the neurophypophysis (posterior pituitary): Pars nervosa, Infundibulum (neurostalk), Median eminence
14. Know the major divisions of the adenohypophysis (anterior pituitary): pars distalis, pars tuberalis, pars intermedia
15. Understand the major cell types of the pituitary; their locations; hormones and target organs; how to recognize
16. Understand histological differences between posterior and anterior pituitary
17. Nerve fibers, pituicytes and Herring bodies versus
18. High vascularity, irregular cords or epithelial endocrine cells
19. Understand accumulation of peptide hormones in axon terminals of the neurohypophysis
Endocrine gland organization
Classes of hormones and cellular features
parathyroid hormone producinh
weak androgen producing
fenestrated sinusoidal capillaries
steroid producing cells
Gross anatomical organization hypothalamus
and hypothalamohypophyseal system
hormones associated with pars distalis
nerve axon fibers
hormones of posterior pituitary
calcium brain sand
1. Identify histologically and understand the following terms: kidney hilus, cortex, medulla, papilla, pelvis, calyx, pyramid, medullary ray, arcuate and interlobular arteries and veins, peritubular plexus, vasa recta, arcuate and interlobular arteries and veins, nephron, cortical nephron (short loop), juxtamedullary nephron (long loop), afferent and efferent arterioles, renal corpuscle, glomerulus, filtration basal lamina, Bowman's capsule, vascular and urinary poles, urinary space, Podocyte, pedicels, filtration slits, mesangial cells, capillary fenestrations, PAS stain of glomerulus, proximal and distal convoluted tubules, brush border and basal mitochondria of proximal convoluted tubules, proximal straight (thick descending limb) and distal straight (thick ascending limb) tubules, thin loop of Henle, Macula densa, juxtaglomerular apparatus, collecting tubules and ducts, transitional epithelium, ureter, urinary bladder, urethra (proximal versus distal).
2. Identify and describe the renal histological structures responsible for the following: a) filtration of blood plasma; b) reabsorption of 70% of the water; c) reabsorption of protein, peptides and sugars; d) removal of water from the cortex; e) active transport of sodium; f) Juxtaglomerular apparatus control of blood pressure; i) ADH (anti-diuretic hormone) control of water reabsorption.
3. Distinguish histological differences between urethra, urinary bladder and ureter.
4. Proximal smooth versus distal 1/3 skeletal muscle of urethra
5. Trace a water molecule through the kidney starting in the renal artery and ending in the ureter; select a pathway depending upon whether it is a superficial nephron or a juxtamedullary nephron.
6. Trace a water molecule through the kidney starting in the renal artery and ending in the renal vein, having gone through the proximal convoluted tubule of a juxtamedullary nephron
afferent and efferent arterioles
filtration basal lamina
vascular and urinary poles
PAS stain of glomerulus
proximal and distal convoluted tubules
brush border and basal mitochondria of proximal convoluted tubules
reabsorption of protein/peptides/sugars
Proximal straight tubules
Distal straight tubules
thin descending loop
thick ascending loop of Henle
control of blood pressure
collecting tubules and ducts
ADH and water
arcuate and interlobular arteries and veins
arcuate and interlobular arteries and veins
proximal versus distal