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Fall-Foundational Sciences Year 1 > GI > Flashcards

GI Flashcards

1
Q

general layers

A
  1. mucosa with epithelium>lamina propria>muscularis mucosae
  2. submucosa
  3. muscularis externa
  4. adeventitia or serosa
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2
Q

mucosa layer

A
  1. epithelium: rests on basal lamina aka innermost layer
  2. lamina propria: has CT + glands + lymphatics + blood vessels
  3. muscularis mucosa: outermost of mucosa, has inner circular + outer longitudinal layer
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3
Q

submucosa layer

A

has CT + lymphatics + blood vessels + glands (if in duodenum or esophagus)

submucosal nerve plexus

glands pathological if in other places

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4
Q

muscularis externa layer

A

has inner circular + outer longitudinal (like muscularis of mucosa)

myenteric nerve plexus

controls peristalsis

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5
Q

serosa/adventitia layer

A

serosa = CT + simple squamous epi @ intraperiotneal organs (if has mesentary then has serosa)

adventitia = CT @retroperitoneal

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6
Q

enteric nervous system

A
  1. myenteric plexus @ b/t layers of muscularis externa, regulates peristalsis
  2. submucosal plexus = reg glandular secretion + blood flow + muscularis mucosae
    - visceral afferents monitor chemistry/mechanical stimulation

both plexuses have autonomics (symp + para) and visceral afferent fibers

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7
Q

esophagus function

A

transport masticated food to stomach so epithelial lining must resist abrasion

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8
Q

esophagus muscle types

A

upper 1/3 = 100% striated muscle in externa, somatic/voluntary for swallowing
lower 1/3 = 100% smooth muscle

middle 1/3 = mix of both

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9
Q

esophagus layers

A
  1. mucosa= nonker SSE + LP w/cardiac glands + muscularis w/ longitudinal only
  2. submucosa = esophageal glands (mucus + pepsinogen + lysozyme)
  3. muscularis externa = striated > smooth
  4. adventitia = thoracic region
  5. serosa = abdominal region
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10
Q

gastroesophageal junction

A

transition in function from transportation/propulsion to digestion

mucosa goes from protective > secretory

Z line = visible transition marker

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11
Q

barrett’s esophagus

clinical correlate

A

simple squamous > metaplastic columnar epi w/ goblet cells from stomach that migrated up

from chronic gastric secretions i.e GERD or frequent vomiting

inc risk of adenocardcinoma

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12
Q

stomach functions

A
  1. temporarily store food
  2. secrete gastric juice
  3. form chyme via chemical digestion
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13
Q

stomach structure

A

cardiac + fundus + pylorus

rugae = longitid folds for distension, submucosa extends into mucosa layer
-mucosa has simple columnar that make pits that open into glands

some regions have muscularis externa

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14
Q

gastric pit

A

@ fundus

simple columnar epi
-surface mucous cells secrete bicarbonate rich protective mucus

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15
Q

gastric glands

A

@fundus
1. isthmus w/regenerative stem cells
2. neck w/ nucous neck cells + parietal cells (HCl + gastric intrinsic factor)
3. base w/ chief cells (pepsinogen)
4. enteroendocrine cells > hormones

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16
Q

cardiac glands

A

@cardiac portion of stomach

has shallow pits + coiled glands + surface mucous cells

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17
Q

pyloric glands

A

@pyloric region

deep pits + mucous neck cells that secrete lysozyme

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18
Q

gastroduodenal junction

A

mucosa transition from secretory > absorptive

pyloric sphincter (thickened circular layer of muscularis externa)

duodenal glands aka brunner’s @submucosa secrete bicarbonate to neutralize chyme

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19
Q

achalasia

clinical correlate

A

dysfunction of mysenteric plexus prevents relaxation of lower esophageal sphincter

nothing can enter stomach so have to eat moist food

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20
Q

hirschsprung disease

A

congenital megacolon, absence of enteric nervous system in a portion of bowel (from failure of neural crest cells to migrate)

= absence of peristalsis in affected area so feces backs up

21
Q

small intestine modifications

A
  1. plicae circulares (mucosa + sub)
  2. villi (epi + lamina propria)
  3. microvilli (surface epi)

to inc surface area

22
Q

small intestine submucosa

A

@ duodenum has dueodenal/Brunner glands to secrete bicarb mucus to neutralize acidic chyme

23
Q

small intestine layer histology

A

mucosa = villi present + simple columnar epi + intestinal glands in LP
submucosa= lacks glands
muscularis externa = typical, 2 layers
serosa = @most except parts of duo (adventitia)

24
Q

typical mucosa

small intestine

A

simple columnar for absorption and striated border
-goblet cells inc in freq distally (small>large intestine)

lamina propria = extends into villi, has lacteals (lymphatic capillaries) + intestinal glands (open b/t villi)

muscularis: unremarkable

25
Q

intestinal sprue

A

disorder of small intestine, disruption of mucosa = malabsorption

weight loss, diarrhea, anemia, vitamin deficiences

i.e celiac disease = inflamm response triggered by gluten

26
Q

intestinal sprue biopsy

A

-atrophied villus
-disordered epithelial cells w/ micovilli atrophy
-inflamm of LP
-intestinal gland hyperplasia

27
Q

intestinal glands

A

aka crypts of lieberkuhn
+has paneth cells @ base to secrete antibiotic agents and maintain intestinal flora
+goblet cells
+enteroendocrine (DNES) cells for hormones
+stem cells

paneth only in small intest

28
Q

jejunum features

A

lacks distinct distinguishing features
plicae circulare well developed
narrow villi

29
Q

ileum features

A

has peyer’s patches aka aggregated lymphoid nodules that extend from LP to submucosa
-M cells transport antigens + immune response

fewer plicae circulares and shorter villi (vs jejunum)

30
Q

large intestine histology layers

A
  1. mucosa = lack villi, irreg microvilli, straight intestinal glands, more goblet cells
  2. muscularis externa= complete inner layer + reduced outer layer (3 teniae coli)
    -appendix and rectum have 2 uniform layers
  3. serosa = intraperitoneal portions (transverse, sigmoid)
  4. adventia= retroperitoneal portions (asc/dec)
31
Q

vermiform appendix

A

has abundant lymphoid nodules in LP and submucosa, but not form big patches like in ileum

-2 uniform layers of muscularis externa
-epi typical of lg intestine

32
Q

appendicitis

A

imflammation of appendix

blockage = buildup mucus, inc pressure, rupture
infection of mucosa = inflamm and ulceration

33
Q

rectum

A

has transverse rectal folds from inner layer of externa
+ temporary longitudinal folds @mucosa and sub for distension

2 layers of muscularis externa have no tenia coli

34
Q

anal canal

transtions

A

transition from:
-simple columnar to simple cuboidal to stratified squamous
-autonomic to somatic inn
-muscle transition

35
Q

anal canal features

A

anal columns mark anorectal junction
anal sinuses has mucous glands
anal valves compress sinuses

pectinate line

intersphincteric line b/t internal and external (nonkeratinized SSE above to pectinate, keratinized SSE below aka skin)

36
Q

major salivary glands

A
  1. parotid= biggest, serous only
  2. submandibular = mostly serous + some mucous
  3. sublingual = mostly mucous + some serous
37
Q

salivary gland function

A

secrete saliva
-digestion, gustation, lubrication, antibacterial
has proteins + enzymes + ions (protect teeth) + mucins

38
Q

exocrine pancreas

histology

A

acinar cells (pyramidal shape) with zymogen granules to contain inactive digestive enzymes

intercalated duct of centroacinar cells that project into acini + ductal cells that secrete waater and bicarb

39
Q

liver structure

A

glisson’s capsules = CT capsule covered by liver mesothelium (simple squamous)

hepatic lobules = hepatocytes + sinusoids (spaces b/t hepatocytes) + central vein

40
Q

ways to organize liver

A
  1. classic lobule = hexagonal
  2. portal lobule = triangular
  3. hepatic acinus= quadrangular
41
Q

classic lobule

A

central vein @center + portal canal @corners

traces flow of blood thru liver so 75% from portal vein + 25% from hepatic artery
1. blood from portal cein and hepatic artery anastomose =sinusoids
2. thru sinusoid for processing by hepatocytes
3. flow into central vein
4. hepatic veins
5. IVC

42
Q

portal lobule

A

bile duct/portal canal @center + central veins @corners

traces bile production (oppo of blood flow)
1. syn by hepatocytes into bile canaliculi
2. flow to bile duct in portal canal

43
Q

hepatic acinus

A

short axis = opposting portal canals
long axis = opposing central veins

describes blood perfusion/metabolic activity
-zone 1 = more oxy/nut/toxins + less co2/waste, first to regen
-zone 3 = less oxy/nut/toxins + more co2/waste, first to die

44
Q

portal canal

A

has portal triad (portal vein + bile duct + hepatic artery)
+CT/lymphatic vessel
+periportal space/space of mall b/t hepatocytes and portal canal

45
Q

sinusoids

A

formed by anastomosis of hepatic artery and portal vein in canal
-lining cells = endothelial, line sinusoids, simple squamous, discontinous
-kupffer cell = macrophage, part of lining
-perisinusoidal space = exchange b/t blood plasma and hepatocytes (hepatocytes microvilli)
-stellate cells for lipid and vitamin A storage

46
Q

hepatocytes

organelles

A

25% have 2 nuclei
+ RER
+ SER
+ golgi apparatus
+ mitochondria

47
Q

hepatocytes function

A
  1. syn bile
  2. lipid metabolism/storage
  3. carb metabolism/storage
  4. protein metabolism
  5. vit A, K, D, B12 storage
  6. detox drugs
  7. degrade hormones
  8. immune response
  9. jaundice (acc unconj bilirubin in blood, obstructive, hemolytic)
48
Q

biliary tract

bile flow

A
  1. bile canaliculi (b/t hepatocytes)
  2. canal of hering (simple cuboidal lined w/ cholangiocytes)
  3. intrahepatic bile ductules (cuboidal)
  4. interlobular bile ducts (@w/i portal canal, cuboidal)
  5. hepatic duct (simple columnar)
  6. gallbladder
49
Q

gallbladder

histology

A
  1. mucosa = simple columnar epi with microvilli and LP
  2. no muscularis mucosae or submucosa
  3. disorganized externa
  4. adventitia and serosa

Fall-Foundational Sciences Year 1 (33 decks)

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