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Histo Exam CU > 4th Exam histoo > Flashcards

4th Exam histoo Flashcards

1
Q

What transition of muscle is seen in the esophagus

A

From skeletal to smooth

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2
Q

Nervous tissues that innercate the digestive tract wall

A

ANS ganglia and nerve fibers, enteric NS

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3
Q

Mucosa of the GI wall

A

Simple columnar Epithelium, LCT (lamina propria), smooth muscle

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4
Q

Function of the mucosa of GI wall

A

Protection, absorption, secrete/synthesize hormones and enzymes.

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5
Q

Submucosa of GI wall

A

DICT, vessels, submucosa/meissner’s plexus

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6
Q

Function of submucosa of GI wall

A

Blood supplies nutrients, nerves control fluid and gland secretion and muscle movement

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7
Q

Muscularis externa of the GI wall

A

Contains myenteric/auerbachs plexus

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8
Q

Function of muscularis externa

A

Nerves control smooth muscle to perform perstalsis, mixing, propulsion, segmentation

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9
Q

Adventitia or serosa of GI wall

A

DICT/LCT. (Serosa is LCT and mesothelium)

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10
Q

Function of adventitia/serosa of GI wall

A

Supply nutrients/protect outer surface

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11
Q

What is the intrinsic NS of the GI tract

A

Enteric NS

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12
Q

What is the ENS/INS capable of

A

Local autonomous functions such as motility, secretion, mixing and integration of local hormones released from cells.

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13
Q

How do the ENS, CNS, and ANS interact

A

ENS is functionally coupled to the CNS and ANS adn it receives input and modification parasympathetic and sympathetic system.

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14
Q

What gives extrinsic supply to the GI tract

A

ANS and it works cooperatively with the ENS to regulate mucosal secretion and peristalsis

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15
Q

ANS and ENS provide __________ input to the GI tract

A

Visceral sensory

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16
Q

What two ganglionic plexuses are formed by the ENS and ANS

A

Submucosal and myenteric plexuses

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17
Q

Where are the neuron cell bodies of the plexuses formed by the ENS and ANS derived from

A

Neural crest

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18
Q

The mucosa of the GI tract has variations in the epithelium. What areas vary and what epithelium do they contain

A

The mucosa of the esophagus contains SSNK as opposed to simple columnar. Also varies in the Pharynx and oral cavity.

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19
Q

What is the key feature of the lamina propria in the GI tract

A

Glands throughout the layer

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20
Q

What is the lamina propria composed of

A

Glands, LCT, blood and lymphatics capillaries/lacteals; lymphatic/WBC’s.

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21
Q

What cells are located in the glands of the GI tract

A

Multipotent stem cells

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22
Q

Glands in the lamina propria of the lower 1/3 of the esophagus

A

Esophageal cardiac glands

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23
Q

Glands in the lamina propria of the stomach

A

Gastric glands that are named based on their location in the stomach (cardiac, fundic, pyloric)

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24
Q

Glands in the lamina propria of the intestine (small and large)

A

Intestinal glands or crypts

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25
Q

What layer is unique to the GI tract

A

Muscularis mucosa

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26
Q

What is the composition and function of the muscularis mucosa

A

Composition: thin band of smooth muscles that marks the boundary between mucosa and submucosa
Function: provide local movement/mixing of contents and folding of mucosa

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27
Q

What digestion is done in the oral cavity

A

Mechanical by chewing and chemical digestions of carbs and fats.

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28
Q

Digestions of the stomach

A

Mechanical-peristaltic mixing and propulsion
Chemical-digestion of proteins, fats
Absorption

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29
Q

Digestion of small intestine

A

Mechanical-mixing and propulsion via segmentation
Chemical-digestion of carbs, fats, polypeptides, nuclei acids
Absorption

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30
Q

Digestion of large intestine

A

Mechanical-segmental mixing and propulsion
Absorption

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31
Q

Waht is the submucosa of the GI tract derived from

A

Mesoderm

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32
Q

Composition of the submucosa in the GI wall

A

DICT, large arterioles, venules and lymphatic vessels

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33
Q

What supplies innervation to the submucosa of the GI wall

A

Meissner’s plexus. contains ENS/ANS neurons and fibers.

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34
Q

What parts of the GI tract wall contains glands in teh submucosa

A

Th esophagus and the duodenum

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35
Q

Where is the muscularis externa derived from

A

Mesoderm

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36
Q

Composition of the muscularis externa in the GI tract wall

A

Contains two layers of smooth muscle; inner circular and outer longitudinal.

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37
Q

Auerbach’s plexus

A

Myenteric plexus of nerves that contains ENS and ANS neurons and fibers. It is located in the muscularis externa of the GI tract wall

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38
Q

What variation of muscularis externa is seen in the esophagus

A

Transition from skeletal to smooth and skeletal to just smooth in the lower 1/3

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39
Q

What variation of muscularis externa is seen in the stomach

A

Three layers of smooth muscle. Inner oblique, middle circular, outer longitudinal.

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40
Q

What variation of muscularis externa is seen in the large intestine

A

Teniae coli

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41
Q

What variation of muscularis externa is seen in the sphincters

A

Localized thickening’s of smooth muscle that act as valves in certain areas

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42
Q

What classification of neurons does each plexus contain

A

Enteric neuron cell bodies and fibers, Parasympathetic postganglionic (vagus), sympathetic nerve fibers (splanchnic), visceral afferent/sensory nerve fibers.

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43
Q

What is another name for serosa in the GI tract

A

Peritoneum

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44
Q

What are all intraperitoneal organs covered with

A

Serosa/serous membrane

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45
Q

What is the name of the epithelium that makes up serosa

A

Mesothelium

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46
Q

What organs do serosa cover

A

Organs with “free” surface—not attached to surrounding structures

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47
Q

Adventitia

A

LCT—>DICT. Located between two adjacent organs, or b/w an organ and body cavity retroperitoneal.

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48
Q

Where are all retroperitoneal organs anchored and what are they covered with

A

Anchored to the posterior wall posteriorly and covered with serosa anteriorly

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49
Q

Another name for
Serosa
Adventitia

A

Pariteal peritoneum
Peritoneal cavity

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50
Q

Function of the mucosa of the digestive tract

A

Function in protection, absorption, and secretion

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51
Q

What layer of the mucosa exhibits the most variation

A

Epithelium

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52
Q

Where is the protective mucosa located

A

Oral cavity, pharynx, esophagus, and anal canal

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53
Q

Histological appearance of protective mucosa

A

SSNK with a layer of CT called the lamina propria. Few glands in the LP. Will see glands in submucosa of esophagus that produce mucus.

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54
Q

Where is the secretory mucosa located

A

Stomach

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55
Q

What is the histological appearance of the secretory mucosa

A

Simple columnar epithelium; the cells of the epithelium, are secretory and invaginate into lamina propria to form gastric glands. Also see glandular epithelium, mucus cells, and other cell types.

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56
Q

Where is the absorptive mucosa. And what is the primary absorption occurring?

A

Small intestine and mainly nutrient absorption

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57
Q

Histological appearance of the absorptive mucosa

A

Mucosa folds appear as finger-like projections called villi. Some parts of epithelium invaginate into LP and form intestinal glands. Also see simple columnar epithelium w/microvilli

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58
Q

Enterocytes

A

Simple columnar epithelium with microvilli and involved in nutrient absorption

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59
Q

What kind of mucosa are present in the large intestine

A

Absorptive and protective

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60
Q

Histological appearance of mucosa(s) in the large intestine

A

Simple columnar epithelium w/microvilli (enterocytes that are structurally diff from cells in small intestine). Epithelial cells, and epithelium invaginates into the lamina propria to form glands and contains abundant goblet cells.

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61
Q

What kind of glands are formed by the epithelium in the LP throughout all regions of tubular gut

A

Exocrine glands

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62
Q

What are the key identifying features of the proximal 1/3 of the esophagus

A

SSNk, glands may be present in submucosa, muscularis mucosa becomes pronounced moving distally, only contains skeletal muscle.

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63
Q

What are the key features of the middle 1/3 of the esophagus

A

SSNK, no glands in the LP and submucosa, muscularis externa consists of smooth and skeletal muscle. Smooth is inner circular layer and skeletal is outer longitudinal

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64
Q

Key features of the distal 1/3 of the esophagus

A

SSNK until the cardiac-esophageal sphincter, epithelium changes to simple columnar at junction, glands in the LP by the cardiac junction, muscularis externa is only smooth muscle, thickening of muscularis forms lower esophageal sphincter.

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65
Q

If you see a tube with SSNK what structure are you looking at

A

Esophagus

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66
Q

What germ layer is the esophagus derives from

A

Endoderm

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67
Q

What are the glands. In the cardiac esophageal junction called

A

Esophageal cardiac glands

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68
Q

What nerve stimulates the lower esophageal sphincter

A

Vagal nerve provides parasympathetic innervation to the LES

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69
Q

What happens to the LES if there is a loss of innervation

A

Food accumulation due to the loss of competency (ability to contract) of sphincter. This leads to gastric reflux

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70
Q

What are the regions of the stomach

A

Cardia, fundus, body, pylorus

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71
Q

What are rugae

A

Transient macroscopic folds of mucosa and submucosa in the stomach that allow for distention

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72
Q

Fovea/gastric pits

A

Small macroscopic depression in the stomach that represent the opening of the gastric glands to the luminal surface

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73
Q

What are the three histological regions of the stomach

A

Cardiac, fundic/body, pyloric

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74
Q

What is the principal function of the stomach mucosa

A

Secretion of fluid; mucus, HCL, electrolytes, hormones, Enzymes, production of chyme

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75
Q

What causes gastroesophageal reflux (GERD)

A

Hiatal hernias- cardiac part of stomach slides upward through diaphragm
Loss of patency of LES
These lead to contents of stomach pushing back into esophagus

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76
Q

What are some of the clinical findings of GERD

A

Heartburn, nocturnal asthma due to acid entering airway, acid erosion of enamel, bloating, sensation of fullness

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77
Q

What histological changes can occur with GERD

A

Columnar Metaplasia within the esophagus. SSNK—>simple columnar and may eventually see acid producing parietal cells usually seen in the stomach and intestinal goblet cells.

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78
Q

What is considered a premalignant condition for esophageal cancer

A

Barrett’s esophagus

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79
Q

Esophageal ulcers

A

Secretion of acids into the esophagus causes ulcerations to develop and lead to increased risk of bleeding or lead to scar tissue formation and narrowing of the esophagus.

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80
Q

Esophageal cancers

A

Due to continued Metaplasia in increased glandular intestinal cells leads to esophageal adenocarcinoma—typically effects lower 1/3 of esophagus

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81
Q

What does the stomach function to do

A

Secretion, mixing, and partial digestion. Limited absorption—absorbs lipid soluble water substances like water, aspirin, and alcohol

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82
Q

What substances will the stomach absorb

A

Lipid soluble substances like water, aspirin, and alcohol

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83
Q

What are the key macroscopic features of the stomach

A

Gastric rugae

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84
Q

What are the key microscopic features of the stomach

A

Gastric pits, gastric glands

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85
Q

What do gastric glands do

A

Responsible for the secretion of “gastric juice” into stomach lumen

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86
Q

Mucosa of the stomach

A

Where pits and glands are located.
Contains simple columnar epithelium made of mucous cells that secrete mucus (NO GOBLET CELLS)
Contains an LP with gastric glands and a muscularis mucosa

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87
Q

What are the three types of gastric glands

A

Cardiac glands, fundic glands, pyloric glands.
*galnds contain different types of epithelial cels that open into gastric lumen

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88
Q

Cardiac glands

A

Mucus secreting

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89
Q

Fundic glands

A

Acid-pepsin, hormones, mucus
*largest

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90
Q

Pyloric glands

A

Mucus secreting and hormones

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91
Q

Which glands of the stomach are brightly stained

A

Fundic glands

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92
Q

Stem cells of the gastric glands of the mucosa

A

Replace epithelium—Multipotent differentiation gives rise to all gastric epithelial cells, located near base of gland

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93
Q

Mucous cells of stomach and the two subtypes

A

Line the epithelial surface and pit/neck of the gland through the stomach.
Surface cells-secrete an alkaline mucus to protect against self digestion from HCL
Neck/pit cells-secrete acidic mucous to protect against pathogens

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94
Q

Parietal cells

A

Secretes HCL and IF

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95
Q

Staining pattern of a parietal cell

A

Stain very pink w/a bullseye nucleus

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96
Q

What does IF do

A

It is a co factor necessary for vit b12 absorption in the ileum

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97
Q

What happens when there is a loss of ability to absorb b12

A

It leads to faulty RBC synthesis

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98
Q

Chief cells

A

Synthesize pepsinogen which is the inactive form of pepsin

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99
Q

How does pepsinogen become activated

A

It is activated by HCL secreted from parietal cells

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100
Q

What is pepsin

A

A proteolytic enzyme activated in stomach by HCL NS it is necessary for protein digestion

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101
Q

Enteroendocrine cells and two examples of a hormone they release

A

Produces hormones released into Fenestrated capillaries of the LP.
They release histamine and gastrin

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102
Q

Histamine

A

Stimulates acid secretion by acting on parietal cells

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103
Q

Gastrin

A

(G cells) Stimulates gastric motility and indirectly stimulates HCL

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104
Q

What controls the real ease of acid and enzymes in the GI tract

A

Neural and hormonal control and physical input (food)

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105
Q

What will damage to the epithelium and glands in teh GI result in

A

Impact of secretion in glands and alter digestive function

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106
Q

Where are stem cells located in the GI tract and stomach

A

In the epithelium of mucosa throughout GI and in the mucosa of all gastric glands in the stomach

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107
Q

Where are parietal cells located

A

In the epithelium of mucosa layer- fundic glands of stomach

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108
Q

Where are chief cells located

A

In the epithelium of mucosa layer-fundic galnds of stomach

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109
Q

Where are enteroendocrine cells located

A

Epithelium of mucosa layer-gastric glands of stomach

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110
Q

Where are mucous cells (of stomach) located

A

Epithelium of mucosa layer-surface
Luminal surface of gastric epithelium
Gastric pits of stomach

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111
Q

What is the role of stem cells of the stomach

A

Regeneration of damaged epithelium in stomach and intestine

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112
Q

What is the role of parietal cells

A

Digestion, protection, absorption (IF), and they contain receptors for hormones produced by enteroendocrine cells and NT’s—>gastrin, Ach, histamine all cause HCL secretion

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113
Q

What is the role of chief cells

A

Start protein digestion in the stomach; cleaves vitamin B12 from animal products
Product is released into lumen of gastric glands

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114
Q

What is the role of enteroendocrine cells

A

They release product into LCT surrounding gland and enter capillaries—paracrine effect
Function histamine and gastrin both impact acid secretions of parietal cells (increase it)

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115
Q

Function of mucous cells

A

Protection/lubrication against acids. Thick viscous mucus secretion onto epithelial surface—protects mucosa form autodigestion

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116
Q

Submucosa of stomach

A

Transient longitudinal folds of DICT project into the mucosa called gastric rugae

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117
Q

Muscularis externa of stomach

A

Three layers of smooth muscle that appears thicker when compared to other regions of the GI Tract
Inner oblique
Middle circular
Outer longitudinal

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118
Q

What is the function of the small intestine

A

Digestion of food and absorption of nutrients; protein, carbs lipids.

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119
Q

What does the small intestine require for digestion

A

Pancreatic enzymes and bile

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120
Q

What does the small intestine absorb

A

Minerals, water soluble vitamin (B family and vit C, folate), fat and lipid soluble vitamins (A, E, D, and D that require emulsification by bile)

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121
Q

What is vitamin D needed for

A

Ca absorption

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122
Q

What is vitamin K needed for

A

Synthesis of plasma clotting factors

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123
Q

What are the three regions of the small intestine from proximal to distal

A

Duodenum, jejunum, ileum

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124
Q

Plicae circularis

A

Permanent folds in submucosa that increase surface area. They are absent in the proximal duodenum and distal ileum.

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125
Q

What are the key microscopic features common to all parts of small intestinal mucosa

A

Villi, microvilli, crypts (intestinal glands)

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126
Q

Where are intestinal crypts located

A

In the lamina propria of small intestine

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127
Q

Peyers patches

A

MALT/GALT tissue that is very prominent in ileum. Amount of tissue increases distally from duodenum to ileum

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128
Q

Brunner’s glands

A

Alkaline mucous glands found only in submucosa of duodenum

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129
Q

What is the epithelium of the villi in the small intestine and what cell types

A

Simple columnar epithelium with enterocytes (w microvilli) and goblet cells

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130
Q

What cell transfers antigens from epithelial surface into the intestinal crypts and where are these cells

A

M cells in the lamina propria

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131
Q

Where are stem cells in the small intestine located and what do they do

A

In the mucosa at the base of the intestinal gland. Replace cells that are damaged

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132
Q

What do the enterocytes in the small intestine do

A

Produce and secrete enterokinase enzymes on the enterocytes that aid in digestion and absorption

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133
Q

Wha type of epithelium are enterocytes of the small intestine

A

Simple columnar w/microvilli

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134
Q

What do goblet cells in small intestine do and where are they most prevalent

A

They produce mucin and increase in number as you move distally toward anus

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135
Q

What do enteroendocrine cells of the small intestine do

A

Produce and secrete hormones into lamina propria as the food enters.

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136
Q

What two products do enteroendocrine cells of the small intestine release

A

Secretin-cause secretion of bicarbonate ions/fluid from duct cells of pancreas and liver—inhibits gastric motility
Cholecystokinin-CCK which acts on galbladder and pancreas for bile enzymes

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137
Q

What do Panethe cells do and where are they located

A

Secrete lysosome when exposed to bacteria and are ONLY found in the small intestine at the base of the intestinal glands.

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138
Q

What kind of tissue is prominent in the ileum

A

LCT w MALT to peyers patches

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139
Q

What structures reside in the Submucosa of the small intestine

A

Plicae circulares, brunners glands (duodenum only)

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140
Q

What gland is specific to the duodenum

A

Brunners glands

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141
Q

Muscularis externa of the small intestine

A

Contains and inner circular layer and outer longitudinal layer.

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142
Q

What is the pyloric sphincter and what layer is it in

A

B/w stomach and duodenum and is a thickened inner circular layer of muscular externa.

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143
Q

How can you best recognize the pyloric sphincter

A

A transition in the mucosa —-villi and crypts appear

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144
Q

Adventitia and serosa of small intestine

A

Adventitia is between the organ (duodenum) and posterior wall. Serosa covers the anterior surface of the organ

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145
Q

What do retroperitoneal structures in the small intestine exhibit

A

Both layers of an adventitia and serosa

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146
Q

What does the duodenum receive

A

Bile and pancreatic enzymes

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147
Q

What are key features of the duodenum

A

Submucosal brunners glands that contain mucus cells and appear pale in color when compared to intestinal glands of the LP. Can see pancreas because of anatomical position

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148
Q

What parts of the duodenum are brunners glands more numerous

A

1st and 2nd

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149
Q

Jejunum

A

Primary site of nutrient absorption

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150
Q

Key features of jejunum

A

Numerous long villi, large prominent plicae, increased in goblet cell number compared to duodenum, absence of Submucosal glands, NO MALT usually

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151
Q

Ileum

A

Site of vitamin B12 absorption

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152
Q

Key features of the ileum

A

Higher number of goblet cells, paneth cells in the base of the villi, presence of peyers patches, large lacteals, no Submucosal glands.

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153
Q

In what area of the small intestine are peyers patches most visible and a key indetifier of that area

A

Ileum

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154
Q

What is the function of the large intestine

A

No digestion. Conveys chyme to feces via fermentation by bacteria. Some absorption of vit K, B, and ions. Reabsorbs water and electrolytes to compact feces and eliminate wastes

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155
Q

What vitamins do the gut bacteria of the large intestine synthesize

A

Vit K, vit B1, B2, B6, biotin and B12

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156
Q

What is the heme breakdown product excreted in feces

A

Bilirubin

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157
Q

What area the regions associated with the large intestine

A

Cecum, appendix, colon (3 parts) , rectum and anal canal

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158
Q

Gross macroscopic features of lg intestine

A

Tenia coli, Haustra, plicae semilunar, epiploic appendices

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159
Q

Tenia coli

A

3 thickened bands of outer longitudinal muscle

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160
Q

Haustra

A

Outpocketing of wall and give colon its segmented appearance

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161
Q

Plicae semilunar

A

Transient folds of submucosa *not always present

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162
Q

Epiploic appendices

A

Serosa (peritoneum) filled with fat

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163
Q

What are key microscopic features of the large intestine

A

Intestinal glands **no villi*, MALT/peyers patches

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164
Q

Two layers of mucosa

A

Epithelium and LP

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165
Q

Epithelium of the mucosa of the large intestine

A

Absorptive simple columnar called enterocytes that contain microvilli, goblet cells (increase and move distally)

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166
Q

LP of mucosa in lg intestine

A

Intestinal glands—abundant glands that appear straight

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167
Q

What are the specific cell types of the intestinal glands in the colon

A

Absorptive columnar cells, goblet cells, enteroendocrine cells, stem cells, peyers patches

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168
Q

What channels do the absorptive columnar cells w/microvilli in the lg intestine contain

A

Ion channels, Na/K.

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169
Q

What does ATPase activity promote

A

Na+ absorption and H2O follows passively (in the lg intestine in absorptive columnar cells w/microvilli)

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170
Q

What cell lubricate mucosa for ease of passage and are abundant in the lg intestine

A

Goblet cells

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171
Q

What cells produce hormones in the lg intestine

A

Enteroendocrine cells and they affect motility and absorption

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172
Q

Stem cells are only located in the small intestine T/F?

A

FALSE. They are consistent throughout GI

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173
Q

Submucosa of lg intestine

A

Contain plicae semilunaris

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174
Q

Muscularis externa of lg intestine

A

Inner circular layer that mixes contents and an outer longitudinal muscle

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175
Q

What structures do the muscularis externa of the lg intestine contain

A

Tenia coli- 3 distinct regions of thickened bands of outer longitudinal muscle (shorter than length of colon)
Haustra-pouches between Tenia coli that independently segmented mixing of chyme

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176
Q

Adventitia and serosa of lg intestine

A

Adventitia between the organ and posterior wall
Serosa covers anterior surface of organ

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177
Q

All retroperitoneal structures of the lg intestine exhibit adventitia and serosa T/F

A

True

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178
Q

What structures of the large intestine are retroperitoneal

A

Ascending colon and descending colon

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179
Q

Is the transverse colon intraperitoneal or retroperitoneal

A

Intraperitoneal

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180
Q

What are the types of accessory glands

A

Salivary, pancreas, liver, gallbladder

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181
Q

Where do the excretory ducts of the liver, pancreas and gallbladder open into

A

The 2nd part of the duodenum via the duodenal papilla

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182
Q

What are the major salivary galnds

A

Parotid, submandibular, and sublingual

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183
Q

Where do salivary glands deliver their products

A

Into the lumen of the oral cavity

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184
Q

How do the salivary glands connect to the oral cavity

A

Exrectory ducts

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185
Q

Where does the parotid gland develop from

A

Ectoderm

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186
Q

Where do submandibular and sublingual galnds derived from

A

Endoderm

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187
Q

What are the key features of minor salivary glands

A

Non-encapsulated groups of excretory units, locates in submucosa/intraorally, short w multiple excretory ducts and few intralobular, epithelium or skeletal muscle may be seen

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188
Q

What are the key features of the major salivary glands

A

Encapsulated CT divided into lobules and lobes, extra-oral location bilaterally, numerous intra and interlobular ducts, long excretory ducts

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189
Q

What salivary gland produces more saliva during stimulation

A

Parotid

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190
Q

What type of secretion does the parotid have and what is the name of its main excretory duct

A

Pure serous and Stenson’s duct that opens to buccal 2nd max molar

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191
Q

What kind of secretion does the submandibular gland have and what is the name of its main duct

A

Mixed (60% serous, 40% mucus). Wharton’s duct on floor of mouth

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192
Q

What type of secretion does the sublingual gland have and what is the name of its main duct

A

Mixed (70% mucus, 30% serous). Ducts of rivinus joins bartholins in floor of mouth

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193
Q

Are major or minor salivary gland duct systems more extensive

A

Major

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194
Q

What are the parotid and submandibular galnds mainly controlled by

A

ANS

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195
Q

What controls the secretory activity of the sublingual gland

A

ANS and constitutive exocytosis

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196
Q

What are the structural components of salivary glands

A

Supportive tissue and glandular tissue

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197
Q

Supportive/stromal tissue

A

DICT

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198
Q

Glandular/parenchymal tissue

A

Myoepithelial cell, secretory acinar cells, duct cells

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199
Q

What are the histological features of structural components in stromal supportive tissue

A

CT in major glands forms a capsule that divides tissue into lobes and lobules. Conveys BV’s and nerves.

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200
Q

What cells are seen in stromal tissue

A

Lymphocytes, macrophages, fibroblasts, plasma cells

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201
Q

What do the plasma cells in the CT of stromal tissue secrete

A

IgA

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202
Q

How is IgA transferred from CT

A

By transcytosis from CT to secretory Acinar salivary gland cells

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203
Q

What cells are in the parenchymal tissue of salivary glands

A

Serous acinar cells, mucous acinar cells, mixed seromucous acinar cells

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204
Q

Serous acinar cells

A

Synthesize glycoproteins and enzymes (protein adn enzyme rich). Watery electrolyte secretion aids in digestion and protects tooth with buffering capacity

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205
Q

Mucous acinar cells

A

Synthesize mucin and anti microbial proteins. Carb rich, viscous secretion aids in protection/bolus formation

206
Q

Appearance of mucous acinar cells

A

Pale stained cytoplasm with flattened basal located nucleus

207
Q

Mixed seromucous acinar cells

A

Found in submandibular and sublingual glands. Contain a serous cap called a serous demilune.

208
Q

All parenchymal tissue (secretory and duct cells) in gland are NOT derived form the same germ layer T/F

A

FALSE! They are

209
Q

where are myoepithelial cells found adn what do they do

A

B/w acinar cell or duct cell and basement membrane of salivary glands
Supportive; facilitate secretory discharge of secretory acinar cell (ANS control)

210
Q

What are the two major classifications of ducts

A

Intralobular and interlobualr

211
Q

What are teh two types of intralobular ducts

A

Intercalated and striated

212
Q

Intercalated ducts

A

Receive primary saliva directly from acinar cells. Have low/flattened cuboidal epithelium

213
Q

Primary saliva is ____________ relative to plasma

A

Isotonic

214
Q

Striated duct

A

Receives primary saliva from intercalated duct. It modifies ion concentration and pH of primary saliva.

215
Q

In modification of saliva by striated ducts what is reabsorbs vs what is secreted

A

Na+ and Cl- are reabsorbs and duct cells secrete HCO3- and K+ into the saliva BUT duct is impermeable to water. This causes saliva to be hypotonic relative to plasma and more alkaline pH.

216
Q

What epithelium are in striated ducts

A

Simple cuboidal to simple columnar

217
Q

Interlobular ducts

A

Excretory ducts found in CT between lobules and they contain simple columnar to stratified cuboidal epithelium.

218
Q

What is the epithelium of the main excretory ducts of the major salivary glands

A

Stratified columnar to SSNK in oral cavity

219
Q

Path of salivary flow

A

Acinar cell—>intercalated duct—>striated duct to interlobular duct—>main excretory ducts

220
Q

What affects the amount of modifications in salivary ducts

A

Flow rate through the ducts

221
Q

What is flow rate of the salivary ducts controlled by

A

ANS—cooperatively para and symp

222
Q

Merocrine

A

How minor glands release their products and it is done through constitutive exocytosis

223
Q

What is regulated exocytosis controlled by

A

The ANS both
symp-greater protein response
parasympathetic-greater volume response

224
Q

Untimulated/resting flow of saliva

A

Higher amount of mucous b/c the role of saliva protection of tooth and mucosa via salivary pellicle. Saliva is more hypotonic relative to plasma

225
Q

Stimulated flow

A

Higher amount of enzymes, volume, bicarbonate, adn electrolytes. The role of saliva is clearance, buffering, remineralization—higher pH due to faster flow rate. Saliva is less hypotonic

226
Q

Unconditioned refelx

A

Tactile or gustatory input stimulates; present at birth

227
Q

Pathway of unconditioned reflex

A

Afferent (GSA<,SVA) input form peripheral receptors, mechanoreceptor, chemo receptor, nociceptors

Salivatory centers in BS nuclei

ANS parasympathetic and sympathetic terminate on salivary gland acinar and duct cells

228
Q

Examples of salivary reflexes

A

Gustatory- salivary reflex:stimulation of tase buds (sour highest)
Masticatory-SR:stimulation of chewing from PDL and mucosa
Olfactory-SR:smell stimulates submandibular and sublingual glands

229
Q

Conditioned reflex

A

Acquired response due to stimulation through special senses; requires processing through higher brain centers and may stimulate or inhibit salivation

230
Q

Conditioned reflex pathway

A

Stimuli from smell, nausea,s tress, fear

Cortex and higher CNS centers process input; may stimulate/inhibit salivatory centers

Salivatory centers in BS nuclei

ANS fibers terminate on acinar/duct cells

231
Q

Unstimulated resting flow rate

A

Primary saliva—rich in proteins, electrolytes and water. Isotonic

232
Q

How is saliva modified as it flows through the duct in unstimulated conditions

A

Removal of Na/Cl, secretion of HCO3-, no water absorbed in duct. NaCl absorption greater than HCO3-!

233
Q

What does a slower flow rate in unstimulated conditions result in

A

A more hypotonic saliva due to more time for absorption

234
Q

Stimulated conditions

A

Outcome of ANS stimulation saliva composition—>increased secretion and flow rate.
Parasympathetic: produces ting watery low viscous material
Sympathetic: produces viscous enzyme rich saliva with low fluid solution

235
Q

How is primary saliva modified in the duct during stimulated conditions

A

Removal of NaCl (little), secretion of HCO3- (high rate), no water removed in duct.

236
Q

What does primary saliva increase in during stimulated conditions

A

Increases in electrolytes and water; proteins

237
Q

In stimulated conditions what does an increased flow rate result in

A

A less hypotonic (more isotonic) saliva due to less time to reabsorb

238
Q

Is a stimulated pH higher or lower than resting levels

A

Higher

239
Q

What does low flow rate due to pH

A

Lowers it (6.5-6.6); more hypotonic

240
Q

What does high flow rate do to pH

A

Higher pH (6.7-7.6); less hypotonic

241
Q

What are the biochemical components of primary saliva

A

Water, electrolytes, mucopolysaccharides(mucin), salivary proteins, enzymes, antibodies, small organic molecules

242
Q

What three active components function in protection in saliva

A

Water, mucin, salivary proteins

243
Q

What active components function in buffering capacity in saliva

A

PO4^-3, HCO3

244
Q

Antimicrobial/anti-fungal active components of saliva

A

Mucin, IgA, lysozyme, lactoferrin, histatins

245
Q

Active components of saliva that function in digestion/taste

A

Water, amylase, lipase

246
Q

What active components of saliva function in tissue repair

A

GF’s, histatins

247
Q

Where are the biochemical components of primary saliva secreted from

A

Acinar cell/intercalated duct

248
Q

Cellular components of whole saliva

A

Desquamated epithelial cells, lymphocytes, bacteria

249
Q

What are the components of whole saliva

A

Biochemical components (primary saliva), cellular components

250
Q

Acquired pellicle

A

Protective layer of mucin and salivary proteins that coats the tooth surface

251
Q

Plaque

A

Colonization/attachment of bacteria to pellicle- amount and type of bacteria influence plaque pH

252
Q

Exocrine secretion of sublingual, submandibular, and parotid glands and pancreas and what types of ducts do they contain

A

SL-mixed, mainly mucus (acinar)
SM-mixed; mainly serous (acinar)
P-only serous
**all intercalated and striated intralobular ducts
Pancreas- serous only; intercalated intralobular ducts only

253
Q

What type of epithelium is found in the three main salivary gland interlobular ducts

A

Stratified epithelium

254
Q

What kind of gland is the pancreas gland

A

Endocrine and exocrine

255
Q

Exocrine secretion of pancreas

A

digestive enzymes, fluid, bicarbonate

256
Q

What synthesizes digestive enzymes of the pancreas

A

Serous acinar cells and release them into intercalated ducts

257
Q

Endocrine function of the pancreas

A

Produces hormones that influence blood sugar and glucose metabolism

258
Q

What hormone do enteroendocrine cells from the duodenum release to stimulate pancreatic acinar cells to secrete digestive enzymes

A

Cholecystokinin (CCK)

259
Q

Islets of langerhans

A

Region of hormone secreting endocrine cells in pancreas

260
Q

Pancreatic acinar units

A

Groups of serous cells, nuclei basally located and numerous in eosinphillic granules

261
Q

What do pancreatic acinar cells do

A

Function to synthesize inactive enzymes that are stored in secretory granules in the apex of the cell

262
Q

What do pancreatic enzymes do

A

Inactive enzymes (zymogens) are transported to small intestine and become activated by the enterokinases enzyme on enterocytes. Required for digestion of proteins, carbs, lipids in SI

263
Q

What hormone do enteroendocrine cells produce in duodenum that acts on pancreatic acinar cells

A

Cholecystokinin (CCK)

264
Q

What happens due to CCK release

A

Pancreatic enzymes released into intercalated ducts of pancreas delivered to duodenum

265
Q

What nervous system contributes to pancreatic enzyme secretion

A

Parasympathetic

266
Q

Path of flow in pancreas

A

Intercalated ducts—>intralobular ducts—>interlobular ducts—>main pancreatic duct

267
Q

What is a key histological feature of intercalated ducts of the pancreas

A

Centroacinar cells that represents the first part of the intercalated duct

268
Q

What epithelium is found in the ducts of the pancreas

A

Simple cuboidal to simple columnar. EXCEPT FOR MAIN DUCT which is stratified cuboidal

269
Q

What do intercalated duct cells produce

A

Fluid and bicarbonate rich solution that neutralizes chyme and keeps digestive enzymes happy

270
Q

What is the physiological mechanism that controls fluid secretion of excretory ducts of pancreas

A

Secretion hormone produced by enteroendocrine cells in duodenum and stimulate bicarbonate and fluid secretion from intercalated duct cells

271
Q

What is the pancreas divided by

A

Divided into lobules by CT

272
Q

What is found in the CT of the pancreas

A

Blood vessels and large interlobular ducts

273
Q

What principle cell types of the pancreas produce what hormone

A

Alpha cells- glucagon
Beta Cells- insulin

274
Q

What do islets cells look like and do

A

Light stained clusters of cells scattered among acini. Function to respond to glucose blood levels, amino acid levels, intestinal hormone

275
Q

What are the minor cells of pancreas what do they produce

A

PP/F cells- pancreatic polypeptide
Delta cells-somatostatin

Minor cells hormones regulate stomach acid secretion, intestinal motility, pancreatic secretion

276
Q

What kind of capillaries are in the pancreas

A

Fenestrated! They receive hormones

277
Q

PSNS effect on pancreas

A

Increase insulin secretion and some glucagon

278
Q

What system modulates hormones secretion of pancreas to maintain responsiveness

A

ANS

279
Q

What gland increases blood glucose levels and what does it secrete to do so

A

Adrenal gland—epinephrine and cortisol

280
Q

What does the inability to produce or respond to insulin cause

A

Diabetes Mellitus—excess glucose in urine and increase urine output

281
Q

Type 1 diabetes

A

Autoimmune destruction of beta cells by T cells (CD+8). Individuals can’t synthesize insulin

282
Q

Type II diabetes

A

Insulin resistant. Still make it but target cells can’t bind insulin so sugar remains in the blood stream

283
Q

What is the impact of hyperglycemia on the body

A

Promotes chronic inflammation and increases risk for periodontal disease!

284
Q

Exocrine function of liver

A

Bile production and excretion from liver cells into bile canaliculi that drain larger ducts into portal area

285
Q

Endocrine function of the liver

A

Secretion/synthesis of plasma proteins and metabolites into sinusoids for delivery to body

286
Q

Principal cell type of the liver

A

Hepatocytes—liver cell involves in metabolism, storage, detoxification, plasma protein production, bole synthesis

287
Q

Kupffer cells

A

Phagocytic cells found in perisinusoidal space of Disse and they store vit A and other fat soluble vitamins. Act as stem cell and synthesize collagen during hepatocyte damage

288
Q

Perisinusoidal space (of Disse)

A

Space located between the hepatocyte and sinusoid capillary and it functions to serve as a site of metabolic exchange

289
Q

Central venule (liver)

A

Terminal hepatic venule located at the center of lobule/centrilobular area

290
Q

Sinusoids of liver

A

Discontinuous capillaries and Fenestrated endothelial cells but no BM

291
Q

What makes up the portal triad/area

A

Portal vein, hepatic artery, bile duct

292
Q

What does a portal area do

A

Supplies each lobe of the liver

293
Q

Interlobular branches of the liver

A

Branches of hepatic and portal vessels found between adjacent lobules

294
Q

What make the sinusoids in the interlobular areas of the liver

A

Discontinuous capillaries —within the lobule receive MIXED blood from venule and arteriole

295
Q

Where does the central vein receive blood form

A

Sinusoids

296
Q

Direction of blood flow in the liver

A

Intraabdominal branches of liver—>inter-hepatic/intralobular—>drainage of lobule and liver in intra abdominal branches

297
Q

Where does the hepatic vein drain

A

IVC

298
Q

Hepatic liver lobule

A

Describes the secretion of proteins and metabolic by-products into the blood (PA to CV)

299
Q

Portal lobules of liver

A

Describes the route of secretion of bile int bile ductules. Flow from centrilobar area to periportal

300
Q

Hepatic acinus

A

Describes the removal of compounds from blood and the amount of oxygen and nutrients delivered along a gradient from the portal area to the central vein of the liver lobule. There are three zones

301
Q

What zone is oxygen rich, highest in nutrients and first exposed to blood born Ag

A

Zone 1

302
Q

What zone is O2 poor, high in detoxification enzymes and can create toxic by products

A

Zone 3

303
Q

What is zone 2

A

Intermediate zone

304
Q

Why does bilirubin need conjugated and where

A

To produce water-soluble excretable bilirubin glucuronide and the lives does this

305
Q

Liver dysfunction and alterations in hepatocytes may manifest in the oral cavity as well as other regions of the body T/F

A

True

306
Q

Functions of liver

A

Glycogen/triglyceride storage, gluconeogenesis, detoxification, secretion of bold acids, bilirubin conjugation, production of blood plasma proteins, vit storages

307
Q

What happens if the live can’t metabolism lipids, carbs, proteins

A

Accumulation of fat in liver cells that can lead to malnourishment

308
Q

What happens if the liver is unable to detoxify drugs, hormones, metabolites, or convert waste

A

Decreased drug clearance, accumulation of toxins in cells

309
Q

What happens if the lives can no longer synthesize bile salts or breakdown RBC’s

A

Jaundice —decreased intestinal absorption of fats —>fatty stool

310
Q

What happens if the liver cannot synthesize blood plasma proteins

A

Bleeding—increased clotting time. Edema of CT because loss of albumin. Impaired immune response

311
Q

What happens if the liver can not longer store and activate vitamins

A

Decreased ability to clot. Anemia. Decreased Ca+ absorption that can lead to osteoporosis

312
Q

What is bile composed of

A

Bile salts and bile pigments from RBC breakdown from spleen

313
Q

Function of bile

A

Required for emulsification of fats adn fat soluble vitamins to allow for intestinal absorption

314
Q

What role do hepatocytes play in bile production

A

Bile synthesis and sectretion
Bilirubin conjugation and excretion

315
Q

Hepatocyte secretion of bile

A

Bile is constitutively secreted along with bicarbonate from hepatocytes into bile ducts and transferred form liver to gallbladder

316
Q

Where is bile stored and concentrated

A

Gallbladder

317
Q

What happens to bile salts after they have been used

A

90-95% of bile salts are reabsorbed form capillary beds in small intestines and recycled back into the liver

318
Q

Without _______________ bile conjugation can’t occur

A

Glucuronyltransferase

319
Q

Path of bile flow

A

Intra hepatic/intralobular excretory ducts—>Bile canaliculus—>canal of hering—>bile duct—>extrahepatic ducts—>common hepatic and cystic duct release bile into common bile duct that enters 2nd part of duodenum

320
Q

An opening between adjacent hepatocytes that receive bile

A

Canaliculus—joined by tight junctions

321
Q

Histological features of gallbladder

A

Mucosa—simp columnar w no microvilli. LP present.
Muscularis externa —random orientation of smooth muscle
Excretory ducts—cystic duct

322
Q

What causes gallstones (cholelithiasis)

A

High amounts of cholesterol or low amounts of bile salts

323
Q

Cholecysititis/inflammation of gallbladder

A

Caused by blockage of cystic ducts due to gallstones

324
Q

Obstructive hepatic jaundice

A

Caused by blockage of bile in common bile ducts due to gallstones

325
Q

What causes the galbladder to release bile

A

CCK from duodenum via enteroendocrine cells

326
Q

What does CCK act on

A

Smooth muscle to cause contraction

327
Q

What causes bile release from the liver

A

Secretin released form the duodenum

328
Q

After fats are emulsified and absorbed by enterocytes of small intestine where do they go

A

Enter lacteals as chylomicrons

329
Q

Waht are majority of bile salts absorbed by

A

Intestinal epithelium—enterocytes

330
Q

Where are all hematopoietic cells derived from

A

Mesoderm

331
Q

Site of hematopoiesis in fetus

A

Shifts sites from liver—>spleen—>bone marrow long bones by 5th month in utero

332
Q

Newborn hematopoiesis

A

Occurins in marrow cavity of all bones (red marrow)

333
Q

Adult hematopoiesis

A

Marrow cavity of flat bones of skull and axial skeleton. Seen in red marrow of areas with high amounts of trabeculae

334
Q

Megakaryocyte

A

Remain in bone marrow cause they are too big to leave and they release platelets/thrombocytes that remain in circulation.
Polyploidy-multiple nuclei

335
Q

Erythrocytes

A

Anucleated RBC’s. Remain in circulation within a BV (peripheral blood)

336
Q

Cells of myeloid lineage

A

Erythrocytes, granulocyte (neut, eos, baso), mast cells, megakaryocytes, monocytes

Eat
Good
Make
More
Money

337
Q

Cells of Lymphoid lineage

A

Lymphocytes (b cells), thymocytes (T cells), T helper, T cytotoxic, T memory

338
Q

What cells circulate in peripheral blood

A

Erythrocytes, granulocytes (neut, eos, baso), platelets

339
Q

Peripheral blood

A

Specialized CT composed of cellular fragments suspended in a protein fluid called plasma

340
Q

What cells from whole blood

A

Erythrocytes, leukocytes (granulocytes and agranulocytes), thrombocytes.

341
Q

Function of erythrocytes

A

Transport gases and maintain pH

342
Q

Polymorphic leukocyte

A

A granulocyte; neutrophils, eosinophils, basophils

Non-specific or innate immune response. Local and fast (min to hours) destruction of pathogens. No memory

343
Q

Mononuclear leukocytes

A

Agranulocytes; monocytes, natural killer cells, B and T lymphocytes

Specific (adaptive) immune response. Specific recognition of pathogen. Have memory

344
Q

Thrombocytes

A

Hemostasis and clotting

345
Q

Plasma

A

PH 7.4. Aqueous ECM solution with no ECM fibers. Comprised of water, plasma, proteins*, electrolytes and inorganic acids.

346
Q

Function of plasma

A

Transport nutrients, cells, proteins, hormones, waste, blood gasses, maintain pH, body temp, blood pressure and volume, and osmotic pressure between blood vessels and tissues

347
Q

Albumin

A

Most abundant plasma proteins adn made by hepatocytes. Primarily maintains osmotic pressure of blood and is a carrier protein for hormones, drugs, and fatty acids

348
Q

What activates fibrinogen

A

Prothrombin

349
Q

Fibrinogen and prothrombin

A

Plasma proteins made by hepatocytes both help in blood clotting

350
Q

Complement proteins

A

Important in inflammation and destruction of microorganisms. Synthesized by liver

351
Q

Globulins

A

Made by hepatocytes functions as enzymes and proteins that transport compounds in the body

352
Q

Y-globulins or antibodies

A

Synthesized and secreted by PLASMA cells in many locations

353
Q

Whole blood

A

Plasma and cells

354
Q

Plasma composition

A

Blood fluid only no cells. Includes clotting factors and proteins synthesized by liver

355
Q

Serum composition

A

Plasma minus clotting factors

356
Q

Whole blood transfusion

A

Patient receives plasma and cells

357
Q

Blood component therapy

A

Patient receives specific components; RBC’s, platelets, plasma, and WBC’s

358
Q

Complete blood count

A

Used for routine checkups, diagnosis of disease such as anemia, infection, malignancy, clothing problems and monitoring treatments

359
Q

CBC

A

Calculates the cellular formed elements found in volume of blood—frequently expressed as a percentage indicating ratio between to vol of specific cells/vol of total blood

360
Q

Differential count

A

Refers to percentage of each type of leukocyte in the Buffy count gives the number of specific type of WBC’s

361
Q

Hematocrit

A

The % of RBC’s in a volume of blood. The measurements depends on the number size of red blood cells

362
Q

Anemia

A

Low RBC/low hemoglobin count. Many types of anemia and may be cause by other diseases

363
Q

Polycythemia

A

High RBC count. Increased RBC’s causes increases viscosity of plasma due to high cell #. Increased risk for blood clots

364
Q

Leuokopenia

A

Low WBC count. Type depends on WBC afffected—signs of infection causing symptoms of high fever and sweating

365
Q

Leukemia

A

High WBC count. Increased WBC due to uncontrolled proliferation of WBC in bone marrow

366
Q

Lymphocytosis

A

High lymphocyte

367
Q

Thrombocythemia

A

High platelet. Increased risk of blood blots within vessels

368
Q

Lymphopenia

A

Low lymphocytes

369
Q

Thrombocytopenia

A

Low platelet count. Prolonged clotting time, excessive bleeding and bruising

370
Q

What blood cells increase during an allergic reaction

A

Eosinophils and basophils

371
Q

Reticulocyte

A

Immature RBC, no nucleus, will have some granules and is larger than mature RBC. Make up 1-2% of RBC in peripheral blood and increase in number during some types of anemia

372
Q

Lifespan of a RBC

A

120 days

373
Q

Histological feature of erythrocyte

A

Anucleated, small size, biconcave shape. Flexible so they can pass in capillaries and increase surface area for max binding of O2

374
Q

Waht is the oxygen binding protein on a RBC

A

Hemoglobin—iron containing groups

375
Q

Cell surface receptors on RBC palms membrane

A

Refers to different types of proteins and complex carbohydrates bound to the surface of RBC. Surface receptors are called antigens and serve as basis of blood typing

376
Q

Blood types and their antigens

A

A- only A antigen
B- Only B antigen
AB-both A and B antigen
O-no antigen

377
Q

What blood type is the universal donor

A

Type O

378
Q

What blood type is the universal recipient

A

Type AB

379
Q

Histological features of platelets

A

Anucleated cell fragment with intracellular granules

380
Q

What do the different types of granules in platelets function to do

A

Activation and release facilitates blood coagulation
Facilitate clot retraction and wound healing

381
Q

Four steps of clot formation

A

1) vasoconstriction
2)platelet plug formation
3)activation of circulating plasma clotting proteins
4) fibrous clot—fibrin strands strengthen plug

382
Q

Hemostasis

A

Stopping blood flow and clot formation

383
Q

Thrombosis

A

Clot forms within intact vessel

384
Q

Thromboembolism

A

Clot breaks fee

385
Q

Bruising and prolonged bleeding

A

Increased with low platelet numbers

386
Q

Primary and secondary hemostasis

A

Primary is platelet plug formation and secondary is fibrous clot formation

387
Q

What do neutrophils function to do

A

Non specific immune response and acute inflammation, phagocytosis, elevated numbers during a bacterial infection. 1st to the scene to fight infection

388
Q

Histological appearance of neutrophil

A

Segmented multi lobed nuclei with pink staining granules

389
Q

Basophil

A

Immediate hypersensitivity allergic reactions. Segmented bi-lobed nucleus with basophilic stained (purple) granules

390
Q

What receptors are located on a basophil surface

A

IgE receptors

391
Q

What secondary granules are contained in a basophil

A

Histamine and heparin granules. Histamine causes vasodilation of blood vessels and heparin is an anticoagulant

392
Q

Immediate allergic reaction

A

Pollen, food proteins, bee stings

393
Q

Primary and secondary exposure of basophil

A

Primary- In response to allergen exposure the IgE antibody is produced and bind to the IgE receptor on basophil

Secondary- allergen specific for IgE antibody which is bound to IgE receptor on the basophil will bind and trigger granule release

394
Q

What exposure causes a reaction in allergies

A

Second

395
Q

Eosinophil

A

Anti-parasitic, chronic inflammation involving chronic allergies. Stains acidophillic and has a segmented bi-lobed nucleus

396
Q

What do the granules of an eosinophils contain

A

Proteins that are anti parasitic and cytokines that respond to allergens

397
Q

What receptors are found on an eosinophil

A

IgE that bind IgE antibodies

398
Q

When will eosinophil cell count be high

A

During a parasitic reaction and during chronic inflammatory conditions such as asthma and hay fever (allergic reaction)

399
Q

Monocyte

A

Acute inflammation and acts and an antigen present in cell that is needed for specific immunity. Kidney shaped nucleus with no granules and abundance cytoplasm.

400
Q

Receptors on monocyte and macrophages

A

Receptors non specifically bind bacteria and antibody bound to foreign antigen. MHC class II receptors

401
Q

What receptor is found on anucleated cells

A

MHC I

402
Q

What receptor is found on all antigen presenting cells

A

MHC II

403
Q

When do monocytes differentiate into macrophages

A

After they circulate for 1-3 day and then when they move into CT they differentiate

404
Q

A macrophage may not act as an APC T/F

A

FALSE. They can act as an APC neeed to activate T cells

405
Q

Lymphocytes

A

Antibody production—specific humoral immune response
They usually reside in lymphoid organs after maturation in bone marrow

406
Q

B cells

A

Naive and haven’t encountered an antigen yet but they are immunocompetent

407
Q

Plasma B cell

A

Makes antibody (immunoglobulins) that gets rid of antigen

408
Q

Memory B cell s

A

Involved in secondary response

409
Q

What receptors are found on B cells surface

A

IgD and IgM receptors and they also have MHC class II receptors

410
Q

What does the type of Ab produced depend on

A

Antigen, time of exposure, first response vs secondary response and location of infection

411
Q

After an antigen encounter what do b-lymphocytes differentiate into

A

Antibody secreting plasma cells and memory B cells

412
Q

IgM

A

First Ab produced in response to antigen. Primary response

413
Q

IgD

A

Bound to B cell also IgR

414
Q

IgG

A

Majority of Ab in circulation after IgM initially produced so a secondary response; CROSSES PLACENTA.

415
Q

IgA

A

Ab secreted into bodily fluids like saliva, GI fluid, respiratory fluid etc

416
Q

IgE

A

Ab produced during an allergic reaction and is secondary Ab

417
Q

Thymocytes (T cells) and the two types

A

Specific immune response—cell mediated and humoral immunity
T cytotoxic (CD8+)
T helper (CD4+)

418
Q

Cell mediated immunity

A

T cell cause direct lysis of infected cells

419
Q

Humoral antibody response

A

T helper cells activate B cells to have antibody production by plasma cells

420
Q

T memory cells

A

Involved in second exposure to antigen

421
Q

T regulatory cells

A

Regulatory T cells aid in preventing auto immunity

422
Q

Histological feature of T cells

A

Large round nuclei and eccentric position. No specific granules

423
Q

CD8+ involvement in T cell mediated immune response

A

Destroy intracellular pathogen

424
Q

CD4+ cells involved in T cell helper response

A

Activates B cells and causes plasma cells to produce antibodies in response to extracellular pathogens

425
Q

2x4=1x8

A

MHC 2 with CD4 and MHC 1 with CD8

426
Q

Natural killer cells

A

Recognize and kill cells that lack MHC on surface—cell meditated immunity. Large round nuclei with secondary granules taht containe cytotoxic proteins.

427
Q

Cell mediated/cytotoxic killing

A

NK cell cause direct cell lysis of virally infected cells, tumor cells, or stressed cells

428
Q

Specific receptor is on surface of NK cells los for ________

A

MHC I

429
Q

Innate immune response

A

Innate immunity constitutes the firs line of defense. Involved inflammation and occurs as site of infection. Mediated by cutaneous and mucous membranes, innate immune cells, complement proteins. No memory of encounter

430
Q

Adaptive immune response

A

Occurs after an innate response occurred but did not resolve. Mediated by T and B lymphocytes. Requires and APC to present an antigen bound to MHC to a T cell

431
Q

Primary adaptive immune response

A

Weak and slow. This response primes cells for second encounter

432
Q

Secondary adaptive immune response

A

Second response to same antigen—fast, strong and involves memory

433
Q

Primary lymphoid organs

A

Site of lymphocyte formation and maturation. No immune reaction
Bone marrow and thymus

434
Q

Secondary lymphatic tissues

A

Sites of specific immune reaction due to LOCAL antigen exposure MALT, diffuse lymphatic tissue, lymphatic nodules

435
Q

Secondary lymphatic organs

A

Site of a specific immune reaction for SYSTEMIC antigen exposures Lymph node—lymph born
Spleen—blood born

436
Q

A specific immune reaction involves….

A

The activation of B cells and T cells through interactions with an antigen presenting cell and a specific antigen

437
Q

Function of bone marrow

A

Site of hematopoietic cell differentiation and maturation.
Erythropoiesis
Granulopoiesis
Lymphopoiesis

438
Q

Histological features of marrow cavity

A

Vascular sinusoids (discontinous capillary), stroma, developing hematopoietic cells.

439
Q

Route of lymphocytes from bone marrow

A

Exit BM via blood vessel—>natural killer and b lymphocytes enter blood as immunocompetent—>T cells migrate first to THYMUS—>mature T cells released from thymus into peripheral blood as immunocompetent—>lymphatic secondary organs

440
Q

Outcome of maturation of lymphocytes

A

Immunological tolerance and immunocompetence—learn to distinguish between self and non self and not react to self antigen with immune response. Ability to react specifically to no self antigens and adapt a response is immunocompetence

441
Q

Autoimmunity

A

Immune response against self proteins. Self is seen as foreign because failure of B and T cells to establish tolerance during maturation

442
Q

Thymus

A

Responsible for T cell education and maturation.

443
Q

CT capsule

A

DICT surrounds two lobes of thymus and cat ties blood vessels and efferent lymphatic vessels

444
Q

Thymic lobules

A

Cortex-outer region
Medulla-central region
Cortex is a darker stained than medulla

445
Q

Epithelial reticular cells

A

In thymus. Supportive cells that facilitate T cell maturation (teachers). Endoderm derived.

446
Q

Thymocytes undergo maturation into three types

A

CD4+ T cells—t helper that recognize MHC II and foreign Ag
CD8+ T cells—t cytocoxic recognize MHC I and foreign Ag
T regulatory cells—prevent autoimmune response; inhibit auto reactive T cell which escape thymus

447
Q

Macrophage function in phagocytosis

A

Eliminate self reactive or incompetent T cells. “House cleaning”

448
Q

The thymus atrophies with age T/F

A

TRUE

449
Q

Where do T cells undergo their final maturation

A

Medulla of the thymus and then exits thymus via postcapillary venules and efferent lymphatics

450
Q

Thymic cortical cells

A

Immature thymocytes (T lymphocytes) that migrate from bone marrow and enter via blood vessels at corticomedullary junction then migrate to cortex

451
Q

What do epithelial reticular cells of the thymus do

A

Produce hormones to stimulate maturation of thymocytes, thmhyic education, contribute to selective blood thymus barrier

452
Q

What do macrophages in the thymus do

A

Phagocytose self reactive thymocytes

453
Q

Blood thymus barrier

A

Protects thymus from blood born foreign antigens during T cells maturation by providing a selective barrier to circulating molecules

454
Q

Layers of the blood thymus barrier

A

Endothelial cells of continuous capillary
Basement membrane
Epithelial reticular cells

455
Q

What is a key functional event in the cortex of the thymus

A

Before cortical thymocytes can enter the medulla they must be:
T cell must have a functionally unique antigen receptor on surface so T cell can bind antigen
T cell must be able to recognize self MHC I or MHC II

456
Q

How many T cells are positively selected to survive and move to the medulla

A

Only 10%

457
Q

Where do T cells forms become immunocompetent

A

In Thymic cortex by expressing TCR

458
Q

Cell types in the Thymic medulla

A

T helper cells—cell mediated and humoral immune response
T cytotoxic cells—cell mediated immune response

459
Q

What is a key feature of the thymus

A

Hassall’s corpuscle or Thymic corpuscle which are old epithelial reticular cells that form groups of worn out cells. Appear as flattened epithelial cells concentrically arranged with keratinized center

460
Q

What determines a cells survival in the thymus

A

The affinity of maturing CD4 or CD8 T cells to bind self proteins. Goal is to recognize but not react

461
Q

Where do T cells migrate after becoming immunocompetent and self tolerant in thymus

A

To secondary lymphoid organs and tissues

462
Q

What is MALT

A

High number of mature immune cells located in the LCT just below epithelium. Associated with mucosal layer of respiratory, urinary, digestive system and oral cavity (name based on location)

463
Q

What are the two regions of MALT

A

Diffuse lymphatic tissue (scattered)
Nodular/follicular lymphatic tissue (spherical aggregate)

**the difference in regions correlates with type of adaptive immune response that occurs

464
Q

Function of MALT

A

Common site of antigen entry across epithelium, site of local antigen recognition by lymphocytes, site of local adaptive immune reaction both cell mediated and humoral

465
Q

MALT has a CT capsule T/F

A

FALSE! Not CT capsule only epithelium covers lymphatic tissue

466
Q

What immune cells are found in MALT

A

B cells, plasma cells, t helper and cytotoxic cells, APC’s—macrophages, dendritic cells. Cells distributed throughout MALT based on adaptive immune response

467
Q

What allows MALT to drain to nodes

A

Lymph capillaries and collecting lymphatic vessels

468
Q

Where do lacteals drain

A

Into collecting/efferent lymphatic vessels that will transmit the collect lymph fluid to lymph nodes.

Lacteals only found in ileum CT!!

469
Q

What is a unique feature of MALT

A

Contains High Endothelial Venules—specialized postcapillary blood venules with cuboidal endothelial cells vs simple squamous

470
Q

What allows naive immunocompetent lymphocytes to endure CT from circulation

A

High endothelial venules

471
Q

What is the function of diffuse lymphoid tissue

A

Site of antigen presentation and T cell mediated response

472
Q

Cells in diffuse lymphoid tissue

A

Scattered t lymphocytes, APC’s,plasma cells, granulocytes, mast cells

473
Q

Nodular lymphatic tissue function

A

Site of B cells and humoral antibody mediated immune response

474
Q

Cells in Nodular lymphatic tissue

A

Spherical aggregation of B lymphocytes, plasma cells, APC. All held together by reticular tissue fibers

475
Q

Layers of lymphatic nodule

A

Mantle/corona—outer dark stained layer
Germinal center —central light stained layer

476
Q

Mantle/corona

A

Contains a high number of tightly packed smaller inactive B cells

477
Q

Germinal center

A

Large pale stained cells that represent mature active by lymphocytes differentiating into plasma cells and memory B cells.

478
Q

Mechanism stimulating an IR in MALT

A

Antigen perforates epithelia lining or is transported by an epithelial cell into LCT
Presence of Ag activate B cells and or T cells

479
Q

Where is the site of cell mediated response by t cytotoxic cells in MALT

A

In the diffuse lymphatic tissue

480
Q

Where is the site of antibody-mediated immune response in MALT

A

Lymph nodule

481
Q

Definition of secondary lymphoid organ

A

DICT forms a capsule around the organ; each contains aggregations of lymphoid nodules

482
Q

Function of secondary lymphoid organs

A

Site of adaptive immune response. Ag may be brought in by lymph or blood—route depends of lymphatic organ

483
Q

Both lymph nodes and spleen can only mount a T cell-mediated immune response T/F

A

FALSE. Both can mount cell mediated and a humoral response

484
Q

What are key features of a lymph node

A

Found along lymphatic vessels, receives lymph drainage via afferent lymphatics, contains outer cortex, paracortex and medulla

485
Q

Hilum of lymph node

A

Concave surface where blood vessels enter/exit and efferent lymph vessels EXIT

486
Q

Where do afferent lymphatic vessels enter lymph node

A

On the convex surface

487
Q

What is the lymph node comprised of

A

Reticular CT comprised of reticular fibers (type III collagen) and reticular cells

488
Q

What is the function of a lymph node

A

Lymph filtration and phagocytosis of foreign material from lymph
Facilitate the interaction of the APC and circulating lymphocytes
Regional activation of T and B cells and specific immune response

489
Q

Cortex of lymph node

A

Contains lymphatic nodules often with germinal centers if B cells are activated. B cells predominate in cortex and it is where they are activated and site of humoral immune response

490
Q

Paracortex of lymph node

A

Refers to region of cells located btwn Cortes and medulla. Predominant cell type I T cells. This is the sire of antigen presentation to t helper and cytotoxic cells. Site of cell mediated immune response

491
Q

Medullary cords of lymph node

A

Organized as cluster of cells and CT. Predominate cell is antibody secreting plasma cells and memory B cells, macrophages,activated T cells. Antibodies enter blood and lymph from plasma cells. T and B cells enter medullary sinuses and exit efferent lymph vessel

492
Q

Path of lymph drainage through node

A

Afferent lymph vessel—>subcapsular sinus—>cortical sinus—>medullary sinus—>efferent lymph vessels

493
Q

What brings in new lymphocytes to lymph nodes

A

Post-capillary venule (HEV)

494
Q

Where are HEV’s located in the lymph nodes

A

Paracortex

495
Q

Functions of spleen

A

Filters blood to remove cellular waste, debris, antigen. Adaptive immune response to blood born antigen.

496
Q

Function regions of the spleen

A

White pulp—lymphatic nodules scattered randomly
Red pulp—site of senescent RBC break down and recycling of iron for RBC synthesis in bone marrow

497
Q

Surface appearance of spleen

A

Convex surface covere with visceral peritoneum and underlying CT
Concave surface called Hilum where vessels enter and exit
Capsule of DICT extends into underlying tissue
Stroma which is LCT made of reticular fibers

498
Q

What comprises the bulk of the spleen

A

Red pulp

499
Q

Marginal zone of spleen

A

Boundary b/w white and red pulp. Contains BV’s/sinus and aggregation of lymphocytes, macrophages, dendritic cells

500
Q

Trabeculae of spleen

A

CT invaginating from capsule into organ; conveys BV’s

501
Q

Type of cells in white pulp

A

Macrophages, t helper, B, plasma

502
Q

Key feature of white pulp

A

A central arteriole

503
Q

What cells predominate in lymphatic nodules in white pulp of spleen

A

B cells

504
Q

Where is the primary site of IgM production in the body

A

White pulp of spleen

505
Q

Where is the site of antigen presentation to T and B cells in the spleen

A

Marginal zone.

506
Q

Marginal zone is the site of …

A

Antigen presentation of T cell to B cell, site of cell mediated response, site of naive and memory cell lymphocyte entry

507
Q

Principle function of red pulp

A

Blood filtration

508
Q

Two regions of red pulp

A

Splenic cords and splenic sinuses

509
Q

Splenic cords

A

Clusters of cells organized as cords surrounded by vascular sinusoids. Traps damaged erythrocytes and platelets. Macrophages phagocytose worn out cells

510
Q

Splenic sinuses

A

Linden with discontinuous BM and Fenestrated endothelial cells. Site of platelet and RBC breakdown by the macrophages

511
Q

Hb breakdown

A

Done in splenic sinuses and broken down into;
Iron—retrieved stored as ferritin transported to liver
Heme—broken down to bilirubin, transported to live, conjugated and excreted as bile

512
Q

Path of antigen in blood flow of spleen

A

Splenic artery—> trabecular artery—>central arteriole—>penicillar arteriole—>sheathed capillary with two routes to empty;
Open circulation—empties to sinusoid surrounding splenic artery
Closed circulation —sheathed empties directly into venous sinusoids

Histo Exam CU (3 decks)

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