LEARNING OUTCOMES

Knowledge of the main morphological and functional characteristics of human tissues with special regard to cells composing them. Skills in observation and recognition of tissues by the common microscopic observation techniques. Knowledge of the fundamental processes of embryonic development and the major molecular mechanisms that regulate them.

AIMS AND LEARNING OUTCOMES

At the end of the course, the student must acquire the notions of histology and embryology, preparatory to the studies of the following years (in particular anatomy, pathological anatomy and pathology) and necessary for the training of the doctor.
Specifically, the student must:
- know the distribution of tissues in humans
- know in depth the microscopic and ultramicroscopic structure of human tissues with particular regard to the cells that compose them
- know how to correlate the structural and ultrastructural organization of the tissues and of the cells that compose them to their main functional activities
- have mastered the correct terminology and histological classifications
- having acquired skills in the observation, description and recognition of human tissues through the use of the common  techniques for microscope observation and the main histological stainings
- know the fundamental processes of human embryonic development and the main molecular mechanisms that support and regulate it.

During the last lessons of the course, students are given some knowledge assessment tests to which students respond individually and anonymously. Immediately after each test, feedback is provided by the teacher, who immediately shows the correct answers. A moment of discussion of the topics that emerged in the tests follows, with the possibility for the teacher to clarify any doubts.

PREREQUISITES

general knowledge of chemistry and biology

TEACHING METHODS

Frontal teaching and theoretical-practical exercises

The integrated course provides 7 credits of teaching divided into lectures on topics of histology and embryology and in theoretical-practical exercises for small groups of students focalized to the observation and description of histological preparations by the use of an optical microscope. The observation is guided by monitors connected with an optical microscope used by the teacher.
These teaching methods will be essential to be able to critically evaluate pre- and post-operative histological analyzes in the medical-surgical field.

The course consists of lectures, for a total of 65 hours, and theoretical-practical exercises for additional 10 hours per student. To carry out the exercises, students will be divided into 16 groups. This division will be communicated to students via the "aula-web" Unige IT platform at the beginning of the lessons. Attendance to lessons and exercises is mandatory, as indicated by the Didactic Regulations. The exercises will take place in a classroom equipped with optical microscopes and with a microscope connected to a monitor. The exercises will be held by the teachers, assisted by laboratory tutors. At the beginning of each exercise there is a theoretical introduction which aims to provide the basic notions useful for the description and recognition of the histological preparations observed with an optical microscope. Students, with the support of teachers and tutors, will therefore have to apply the notions provided by teachers to the observation, description and recognition of histological preparations. The dates of the exercises will be included in the lessons calendar published online while the dates of pre-exam review exercises will be communicated directly by the teachers via "aula-web" Unige IT platform.

It is possible that the method of conducting the lessons is changed due to emergency situations that prevent the performance of the lessons in attendance. In this case, lessons will be conducted online through the Teams IT platform, using suitable replacement teaching tools. For the practical part, high resolution histological images and/or virtual microscopes will be used.

SYLLABUS/CONTENT

HISTOLOGY

General aspects and classification of tissues

Epithelial tissue:

Main characteristics of epithelia

Lining epithelia: organization and classification

Structural surface differentiations of epithelial cells (microvilli, stereocilia, cilia)

Lateral domain specializations (intercellular junctions). Specializations of the basal domain (the basal lamina).

Exocrine glands: general information on the glands, difference between exocrine and endocrine glands. Structure, classification and function of the exocrine glands.
Endocrine glands: Structure, classification and function of the endocrine glands.

Sensorial epithelia.

Specialized epithelia.

General aspects and classification of connective tissue

Extracellular matrix: fibers and ground substance.

Resident and mobile connective tissue cells: fibroblasts and fibrocytes, mast cells, macrophages, dendritic cells, NK lymphocytes, plasma cells. Mesenchymal stem cells. 

Classification of tissues proper. White and brown adipose tissue: the phenomenon of "browning".

Cartilaginous tissue: cartilaginous matrix and cells (chondroprogenitor cells, chondroblasts and chondrocytes). Perichondrium. Classification and function of the various types of cartilage: hyaline cartilage, elastic cartilage, fibrous cartilage. Chondrogenesis.

Bone tissue: bone matrix and cells (osteoprogenitor cells, osteoblasts, osteocytes, osteoclasts, lining cells). Periosteum, endosteum. Non-lamellar and lamellar bone tissue. Compact and spongy bone tissue. Direct and indirect ossification; mantle ossification. Long bone growth: the epiphyseal disc.

Blood: plasma and figurative elements. Erythrocytes. Platelets. Leukocytes: neutrophilic, eosinophilic and basophilic granulocytes; monocytes; lymphocytes.
Hematopoiesis: erythropoiesis, granulocytopoiesis, monocytopoiesis, lymphocytopoiesis.

Lymphoid tissue: primary lymphoid organs (bone marrow and thymus). Secondary lymphoid organs (lymph nodes, spleen, lymphoid tissue associated with mucous membranes). Innate and adaptive immune system cells (T and B lymphocytes).

Muscle tissue. Skeletal striated muscle tissue: Structural and molecular organization of skeletal muscle fiber, myofibrils and sarcomere. Sarcoplasmic reticulum and sarcoplasmic triad.  Skeletal muscle contraction process.

Cardiac striated muscle tissue: Structural and molecular organization of cardiac muscle fiber. Specific conduction tissue.

Smooth muscle tissue: Structural and molecular organization of smooth muscle cells. Smooth muscle tissue contraction mechanism. Unit and multiunitary smooth muscles.

Nervous tissue. Morphology, function and classification of neurons. Nuclei and ganglia. Morphology, function and classification of glial cells. Axonic flow. Nerve fibers. Nerves and stretches. Transmission of the impulse. Electrical and chemical synapses. Peripheral nerve endings. Neuro-muscular spindle. Golgi muscle and tendon organs.

EMBRIOLOGY

Sexual development: Elements of gonadal development. Notes on the development of the genital system.

Gametogenesis: Spermatogenesis and its hormonal control mechanisms. Sertoli cells. Blood-testicular barrier. Oogenesis and its hormonal control mechanisms. Ovarian cycle (follicular phase, ovulation, luteinic phase). Uterine cycle.

Fertilization: sperm path in the female genital tract. Sperm activation: capacitation and acrosomal reaction. Molecular mechanisms that regulate these phases. Overcoming the barriers of the egg cell: corona radiata and zona pellucida. Penetration of sperm into the egg cell. Egg cell reactions to fertilization: completion of meiosis and cortical reaction.

Events of the first week. Segmentation: blastomeres and totipotency. Characteristics of the cell cycle of blastomeres. Morula. Blastocyst. Mechanisms that regulate the implantation of the blastocyst. Ectopic implants.

Second week events: Bilaminar embryonic disc. Syncytiotrophoblast, extra-embryonic mesoderm. First circulation. Amniotic sac. Chorion. Primary and definitive yolk sack. Decidual reaction.

Placenta: Primitive placenta. Chorionic villi development. Definitive placenta: leafy and basal deciduous chorion. Placental circulation. Extravillous cytotrophoblast cells.

Immunity and development of the embryo. Maternal-fetal compatibility/incompatibility

Events of the third week: Gastrulation. Primitive line. Hensen's knot. Mesenchymal epithelial transition and invagination of the epiblast. Formation of the trilaminar embryo: endoderm, mesoderm, ectoderm. Evolution of the three germ cell layers. The notochord and the neurulation process. Elements of organogenesis.

Events of the fourth week: Evolution of the three germ cell layers. The folding of the embryo. Elements of organogenesis.

RECOMMENDED READING/BIBLIOGRAPHY

Adamo e coll. – Istologia di Monesi (7^ edizione) - Piccin Editore
Maraldi, Tacchetti - Istologia medica - Edi-Ermes
Ross M.H., Pawlina W.- Istologia. Testo e Atlante - Casa Editrice Ambrosiana
Young, Heath- Atlante: Istologia e Anatomia microscopica - Casa Editrice Ambrosiana
Atlante on-line (free online access): http://www.istologia.unige.it

De Felici e coll.- Embriologia umana (3^ edizione)- Piccin Editore
Barbieri, Carinci – Embriologia – Casa Editrice Ambrosiana