Digestive System

Digestive System consists of the alimentary canal (what?) and principal associated organs (what)

canal begins with: oral cavity (esophagus, stomach, small/large intestines), tongue, teeth, salivary glands, pancreas, and liver

4 layers

Mucosa, sub mucosa, muscularis externa, serosa/ adventia

Mucosa faces the what and includes which components

faces the lumen
includes lining epithelium, lamina propria, muscularis mucsae

Submucosa consists of what kind of tissue? What does it contain?

dense connective tissue
Vascular plexus & submucosal nerve plexus (Meissner's plexus)

Muscularis Externa is composed of what kind of tissue? How organized? What does it contain?

Smooth muscle, skeletal (up 1/3 esophagus) mixed skeletal/smooth (middle 1/3 esophagus)
-organized into two layers: inner circular, outer longitudinal
-contains myenteric (Auerbach's) plexus

Serosa. where in body?

simple squamous epithelium (mesothelium) coving thin underlying layer of connective tissue. In peritoneal cavity.

Adventitia

thin layer loose connective tissue, blends into connective tissue of surrounding structures

Oral Cavity - does NOT have which layers?

muscularis externa, serosa/ adventitia

Oral cavity muscosa - components?

Epithelium (stratified squaous epithelium), lamina propria, NO muscularis mucosae.
-non-keratinized in most of oral cavity, keratinized in hard palate, gingiva, some of tongue

Oral cavity submucosa

not clearly separated from lamina propria. Contains submucosal glands (minor salivary glands)/

Oral cavity minor salivary glands
-secreation?
-shape?
-intrinsic or extrinsic? (located where?)

muscous-secreting, branched tubular, intrinsic within wall of oral cavity

Tongue
-epithelium cell type
-is it keratinized? Where?
-contains intrinsic and extrinsic muscles (Define)

-stratified squamous epihtelium
-often keratinized on dorsal surface
-intrinsic origin/insertion in tongue
-extrinsic origin outside, insertion in tongue

lingual papillae

4 types (filiform, fungiform, circumvallate, foliate)

filiform papillae
-function
-location
-taste buds?
-other features

mechanical
keratinized, points backwards
no taste buds
Over entire dorsal surface

Fungiform papillae
-shape
-location
-taste buds?

mushroom-shaped
more on tip on tongue
taste buds on apical surface

circumvallate papillae
-shape
-location
-features

round, dome shaped
back of tongue, 8-12
surrounded by moat-like groove
grove epithelium is thinner, has taste buds
von Ebner's serous salivary gland ducts empty into moats

Foliate papillae
-location
-shape
-taste buds
-other

few, sides of tongue, lateral ridges
taste buds in grooves, von ebner's serous lingual salivary glads drain into grooves just like circumvallate papillae

Taste buds
-where are they?
-shape
-staining?
-characteristics?
-Cells in taste bud?

fungiform, circumvallate, foliate papillae
oval, pale-staining, usually extend into epithelium
sensory and support cells, stimulation causes nerve impulse along postsynaptic sensory nerve

Major salivary glands
main role & functions
intrinsic or extrinsic?

parotid (in front/ below ear, largest, all serous), submadibular (floor of oral cavity, mixed mostly serous), sublingual (small, floor of oral cavity, mixed mostly mucous)
-production of saliva
-lubricate oral cavity, moisten food
-digestive enzymes, star

Major salivary gland structure
3 parts, components of each

secretory part,
-three types of acini
-serous
-euchromatic nucleus in center of cell, basal cell is basophilic b/c lots RER, apical cell w/ small secretory granules, cells are usually pyramidal shape. Serous acini are spherical in shape.
-mucous
-heteroch

myoepithelial cells

non secretory, in acini
contractile, basal part of secetory cells

salivary gland tumors
-characteristics
-most common type, made of what kinds of cells?

usually in major salivary glands, 80% benign, most common is pleomorphic adenoma (made of ductal and myoepithelial cells)

Esophagus mucosa
-epithelium
-lamina propria
-muscularis mucosae

non-keratinized stratified squamous epithelium
loose connective tissue, less celluar than rest of GI
longitudinally oriented smooth muscle, separated by connective tissue (rest is circularly oriented)

Barrett's esophagus

metaplasia of esophageal lining (displacement with intestinal columnar epithelium). Usually from GERD, males over 50. Common precursor to esophageal adenocarcinoma

esophagus glands
-where found?
-types
-secrete what?

found in mucosa and submucosa
-mucosal glands - esophageal cardiac glands, terminal part of esophagus, sometimes begining
-esophageal glands proper: in submucosa, small tubuloalveolar, along length of esophagus

esophagus submucosa
-tissue?
-contains

dense irregular connective tissue
-blood, lympphatic, nerve/ganglions (Meissner's/ submucosal Plexus)
contains esophageal glands proper

esophagus muscularis externa
-layers
-how differ from rest of GI?

inner circular and outer longitudinal layers
-has skeletal muscle in some parts
-upper 1/3 = skeletal muscle
-middle 1/3 = skeletal and smooth muscle
-lower 1/3 = smooth muscle

esophagus adventitia/ serosa
-mostly what composed of what?
Which part is different, how?

most is adventitia
loose connective tissue blending into surrounding connective tissue
very distal part in peritoneal cavity is serosa.

Stomach functions
-what's chyme?

food storage
food digestion: HCL and enzymes (pepsin, lipase) - break down food into triglycerides/ proteins
regulation of GI function (secretes hormones (gastrin)
mix food with gastric juices = chyme

Stomach rugae

when stomach is empty, folds of submucosa/ mucosa - decrease in height as stomach expands

stomach regions, contains?

cardiac - contains cardiac glands
fundic - largest, contains fundic glands
body (only anatomy)
pyloric - proximal to pyloric sphincter, contains pyloric glands

Layers

mucosa, submucosa, muscularis externa, serosa

surface epithelium
-epithelium type
-cell type -> produce what?
-apical portion filled with
-forms what?

simple columnar epithelium
surface mucus cells, produce INsoluble, thick, viscous, gel-like coat that adheres to epithelial surface, protects from chyme abrasion
apical protion filled with mucinigen granules

Gastric pits
-formed by what
-lined with what?
-are they glands?
-where loctated?

invaginations of surface epithelium
lined with surface mucus cells
stomach mucosa
NOT glands

Stomach mucosa glands
-located in which layer?
-open into what?
-types of gastric mucosal glands?

located in the lamina propria
open into bottom of gastric pits
fundic, cardiac, pyloric

Fundic glands
-shape
-3 segments
-location and course

brnached tubular, straight in middle, coiled at base
everywhere except cardiac/pyloric , from muscularis
3 segments: isthmus (apical), neck (middle), base/fundis (bottom) adjacent to muscularis mucosae.
mucosae to gastric pits

Cell types in fundic glands

parietal, gastric cheif, mucous neck, enteroendocrine, progenitor

Parietal cells
functions
structure
Clinical - loss of parietal cells?

produce HCL (starts protein digestion, converts pepsinogen to pepsin, kills bacteria) and Intrinsic factor (for intestine to absorb B12)
-largest, "fried eggs," intracellular canaliculi, microvilli, lots of plasma membrane - apcial membrane of non-secreat

Tubulovesicular system

where apical membrane of non-secreting cells stored
when parietal cells stimulated to secrete HCL, tubovesicular system fuses with apical membrane, allows formation of microvilli in the intracellular canaliculus

Gastric cheif cells
-location
-main function
-other characteristics

-base of the gland
-seceation of pepsinogen - converted to proteolytic enzyme, pepsin
-protein secreting
abundent RER in basal part of cell
basophilic appearance
secretory granules in apical protion of cell

Mucous neck cells
-location
-main function

-neck of gland
-secreate soluble mucous
-small cells, heterochromatic nucleus, at base of cell, cytoplasm filled with mucinogen granules, "frothy

Enteroendocrine cells
-where
-secrete product into what?
-function

-base of gland
-secrete product into lamina propria
-secrete gastrointestinal hormones, regulate alimentary canal function
eg, gastrin -> gastric aci d secretion, ghrelin-> appetite, hunger perception
small cells, rest on basement membrane, form microvill

Porgenitor cells

in isthmus of gland
replace mucous cells and fundic gland cells (like parietal, mucous neck, chief, enteroendocrin cells)
Short lifespan (3-5 days), cells within the fundic gland live longer (6-8 months) - which cells? enteroendocrine, mucous, gastic chei

Cardiac glands
-location
-function
-structure

-narrow ring surrounding esophageal orifice
-produce mucus for gastric juice, protects against acid reflux
-branched tubular, mucus-secreting cells
basally placed flattened nucleus, cytoplasm filled with mucinogen granules
NO praietal or cheif cells
Gastr

Pyloric Glands
-location
-function

in pyloric antrum
produce mucus that protects pyloric mucosa
deep gastric pits, more than 1/2 muscoa

Stomach lamina propria

loost connective tissue
between gastric pits/ glands
immune system elements (lymphocytes, plasma cells, macrophages)
if inflammation, neutrophils, eosinophils.

Stomach muscularis mucosae
-clinical - malignant tumors of gastric epithelium

sheet of smooth muscle with 2-3 thin layers
orthogonal (circular and longitudinal) orientation
-from surface epithelial cells, or from glandular epithelium
early stage = no penetration into submucosa, late - into muscularis externa/ further

STomach submucosa
-tissue type
-glands

dense irregular connective tissue
No glands
plexus of blood vessles, nerve plexus: meissner's (submucosal) plexus

Stomach Muscularis externa
-layers

3 layers of smooth muscle
-inner oblique
-middle circular
-out longitudinal
-myenteric nerve plexus (Auerbach's plexus) between middle circular and longitudinal layers

Stomach Serosa

mesothelim with thin layer of subserosal connective tissue

Small intestine
-characteristics
-Regions
-functions
-general strucutre and layers
*unique feature

longest part of alimentary cnal (over 6m)
Regions: duodenum, jejunum, ileum
principal site of digestion
nutrient absorption
synthesis and secretion of digestive enzymes
microbial growth control in lumen
regulate GI function via ndocrine secretion by enter

Plicae Circulares
-contain
-structure
-location

contain mucosa and submucosa
-transverse folds
-distal duedenum, proximal jejunum, increase surface for absorption

Enterocytes/ intestinal absorptive cells
-functions
-structure
-location

-nutrient absorption
-produce digestive enzymes for final digestion (carb protein final stages in glycocalyx of the cells)
-monoglycerides/ fatty acids from lipids diffuse accross absorptive cell membrane, syth into triglycerides in GOlgi, become chylomic

Goblet cells
-functions
-cell structure

-prodcution of mucus
-narrow base, wide apex
-filled with mucinogen granules
-frothy cytoplasm
-very pale.
nucleus is small, traingular, heterochromatic, located at cell base

M-Cells
-function
-cell structure

--antigen transport: take microorganisms from epithelial lumen to lymphoid follicles. Macromolecules are endocytosed, discharged in intercellular space near T-lymphoctyes
-large, dome-shaped. basal surface is invaginated, forms large pocket, separated fro

Intestinal Enteroendocrine cells

same as stomach
-base of gland
-secrete product into lamina propria
-secrete gastrointestinal hormones, regulate alimentary canal function
eg, gastrin -> gastric aci d secretion, ghrelin-> appetite, hunger perception
small cells, rest on basement membrane

Intestinal intraepithelial lymphocytes
Type of...
Derived from...
Provide...

T-lymphocyte
Blood-derived
provide mucosal immunity

Crypts of Lieberkuhn
-2 types of cells found in crypts of lieberkuhn, not in surface epithelium

mucosal glands
throughout intestine
tubular glands
invaginations of surface epithelium
-paneth cells, progenitor cells.

Paneth Cells
-location
-function
-structure

-bottom of crypts of lieberkuhn
-regulate bacterial growth
-numerous large, refractile eosinophilic granules in apical protion of cell
-contain antibacterial enzyme lysozyme, alha-defensins, etc.
-kills some bacteria, sustain normal bacterial flora in int

Progenitor cells
-location
-function

-in crypts of Lieberkuhn
-undifferentiated cells, replacement cells for surface epithelial cells, except intraepithelial lymphocytes,

Intestinal lamina propria
-cell type
-contains?
-blood supply
lymphatics

loose connective tissue
-lymphoid follicles - form the GALT (gut-asscuated lymphoid tissue), immunolgoic barrier between intestinal lumen and body)
-capillary loops, begin from artierioles, return to venules of plexus. Soluble nutrients (AA, carbs) transp

Peyer's patches

large groups of lymphoid follicles in the ileum
large structures
follicle-associated epithelium covering peyer's patches, mostly M-cells/

Small intestine lymphoma

on of most common cancer of small intestine
from B or T-lympocyte in lamina propria
wall of intestine becomes thickened, infiltrated by lympohocytes

lacteal

blind ended lymphatic capillary in lamina propria of small intestine villus
-drain into larger lymphatic vessels in submucosa
transport lipds as chylomicra produced by enterocytes
-chylomicra are secreted into laminao propria by enterocytes, picked up. tr

small Intestinal muscularis mucosae
-composed of

several sheets of smooth msucle

small Intestinal submucosa

typical, consists of dense connective tissue
contains vascular and nerve plexus (Miessner's)
-contains submucosal glands in the duodenum (Brunner's glands)

Brunner's glands

mucus producing
branched tubular
most abundent in proximal duodenum
highly alkaline secretions - protect intestinge by netralizing acid-containing chyme

small Intestinal muscularis externa

tpical
inner circular layer
outer longitudinal layer
nerve plexus (Auerbach's) between the two layers

small Intestinal adventita/ serosa

duodenum covered by adventitia
jejunum, ileum by serosa

How to identify regions of small intestine
-duodenum
-jejunum
ileum

-Dudenum: submucosal Brunner's glands, least # of goblet cells.
-Jejunum: tallest, villi, most prominent lacteals
-ileum: Peyer's patches, highest concentration of goblet cells, villi are shorter than duodenum/ jejunum

Large intestine
-regions
-functions
-general structure

cecum (+ veriform appendix), colon, rectm, anal canal
-reabsorption of electrolytes and water, elimination of undigested food and waste
-typical structure - mucosa, submucosa, muscularis externa, serosa/adventita

Large intestine mucosa

NO Villi
mucosal epithelium is like small intestine
-columnar intestinal absorptive cells (enterocytes)
-NO paneth cells
-goblet cells are more abundent than in small intestine - extensive mucus production, moves waste
-crypts of lieburkhun, same cells as

Large intestine submucosa

same as rest of alimentary canal (dense connective tissue, mseissner's plexus

large intestine muscularis externa

2 layers of smooth muscle
inner circular,
outer longitudinal
-outer longitudinal forms three layers, equally spaced bands called teniae coli

Large intestine serosa

has small fatty projections - omental appendices, visible on outer intestinal surface

Large intestine regional differences

colon - largest part. Well expressed taeniae coli (not in appendix or rectum)
veriform appendix - no important role in digestion or absorption, has a lot of aggregated lymphatic follicles
Rectum - mucosa similar to distal colon, contains prominent Transve