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Anatomy Week 10 BT > GI tract and Associated Organs > Flashcards

GI tract and Associated Organs Flashcards

1
Q

What are the 4 general layers for hollow organs?

A

(from lumen out)

  1. Mucosa
    - Endothelial layer
    - Lamina Propria
    - muscularis mucosa
  2. Submucosa
    - dense CT
    - vessels and nerves, glands
  3. Muscularis Externa
    - circularly and longitudinally arranged muscle
  4. Adventitia
    - CT with or w/o mesothelial lining
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2
Q

What are the 3 principle functions of the mucosal layer of the GI tract?

A
  • Secretion
  • Absorption
  • Protection
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3
Q

What are the principle functions of the submucosa?

A
  • provide blood and lymph vessels
  • glands (occasionally)
  • nerve plexus
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4
Q

What is the principle function of the muscularis externa?

A
  • Peristalsis
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5
Q

Explain peristalsis

A
  • Circular layer:
    compresses and mixes contents in the lumen

-Outer layer (longitudinal)
shortens the tub to propel contents along

  • Under control of ENTERIC nervous system
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6
Q

What type of muscle forms digestive tract sphincters?

A

Inner circular layer

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7
Q

Describe the lumen of the esophagus.

A

The lumen is highly involuted and convoluted

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8
Q

Describe the mucosal layer of the esophagus.

A
  1. SS nonkeritinized eptithelium
  2. Thin lamina propria
    - contains cardiac mucous glands at the upper and lower ends
    - contains GALT (GI associated lymphoid tissue)
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9
Q

Where can the GALT be found in the intestine

A

Mucosal layer

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10
Q

What type of glands are contained in the submucosa of the esophagus and what is the purpose of these glands?

A

Esophageal glands proper (mucus-secreting tubuloaveolar glands)

Purpose:

  1. Secrete into Ducts that empty onto the esophageal surface
  2. Provide protection for the mucosa
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11
Q

How do muscle fibers in the muscularis externa of the esophagus change as you move down it.

A
  1. Skeletal muscle
  2. Mixed skeletal and smooth muscle
  3. Smooth muscle only
  • This accounts for voluntary to involuntary control of swallowing
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12
Q

What makes up the upper and lower esophageal sphincters?

A
  • Inner circular layer of musle
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13
Q

What causes GERD?

A

incompetent inferior esophageal sphincter

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14
Q

What is the function of the stomach and how does it do this?

A
  • Digestion = main function

- adds acid and mixes food into chyme

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15
Q

What are the 3 unique structural feature of the stomach?

A
  1. Rugae
  2. Gastric Pits
  3. Gastric Gland
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16
Q

Describe the Mucosa of the stomach and all of its components.

A
  1. Epithelium - simple columnar
  2. lamina propria - GASTRIC GLANDS, lymphatic cells and CT
  3. muscularis mucosa
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17
Q

What layer of the stomach gives rise to the core of rugae?

A

SUBmucosa

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18
Q

What 3 muscular orientation are in the muscularis externa of the stomach, what is unique about this?

A
  1. INNER OBLIQUE
  2. middle circular
  3. outer longitudinal
  • inner oblique layer is unique
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19
Q

T or F: the stomach is covered in adventitia, not serosa

A

FALSE, all surfaces of the stomach are covered by serosa

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20
Q

What are some unique features of the stomach mucosa?

A
  1. SURFACE MUCOUS CELLS = simple columnar epithelia that contain mucous
    - Note this mucous is alkaline to protect the walls of the stomach
  2. GASTRIC PITS - caused by invaginations surface mucous cells (epithelium) into lamina propria
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21
Q

What are the 5 cell types in gastric glands?

A
  1. STEM CELLS
  2. MUCOUS NECK CELLS
  3. CHIEF CELLS
  4. PARIETAL CELLS
  5. ENTEROENDOCRINE CELLS
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22
Q

Where are stem cells found in the stomach?

A

The isthmus between pits and glands

Note: these are for the epithelium

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23
Q

Describe chief cells and where they found in the stomach.

A
  • Deep part of the gland
  • secretory acidophilic granules
  • secrete PEPSINOGEN (inactivated form of pepsin, a proteolytic enzyme)
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24
Q

Describe parietal cells and where they are found in the stomach.

A
  • Upper part of gland
  • acidophilic
  • secrete HCL
  • Secret intrinsic factor for vit. B12 absorption
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25
Q

Describe enteroendocrine cells and where they are found in the stomach.

A
  • Found at all levels

- secrete a variety of gastric hormones into the lamina propria

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26
Q

How do parietal cells show up in H and E?

A
  • Large and pyramidal shaped

- pink

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27
Q

Where does cell division occur in the stomach and why?

A
  • The ISTHMUS, because this is where stem cells are located
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28
Q

Describe the difference between cells moving upwards or downwards after being generated in the isthmus.

A

Upwards:

  • surface mucous cells
  • this is most of the cells
  • lifespan = 3-5 days

Downwards

  • gland cells (parietal, chief, and enteroendocrine)
  • lifespan = 6 month for parietal, 3 months for enteroendocrine and chief
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29
Q

Differentiate the layers involved in the following folds/pits:

  1. Mammillated
  2. Rugae
  3. Pits
A
  • Mammillated - involves only the mucosa
  • Rugae - involve mucosa and submucosa
  • pits - small holes
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30
Q

Where does infection from the helicobacter pylori concentrate and what issues are caused by this?

A
  • concentrates in the neck of gastric glands (lined by stem cells)
  • causes gastritis, ulcers, lymphoma, carcinoma
  • Cancer proliferates quickly do to proliferation of stem cells
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31
Q

What is the major function of the small intestines?

A

Absorption

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32
Q

What 3 modifications are used to increase the surface area for absorption in the small intestines?

A
  1. Plicae circulares
  2. Villi
  3. Microvilli
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33
Q

What are plicae circulares?

A
  • Permanent transverse folds of the MUCOSA
  • increases surface area 3x
  • contains SUBmucosa core
  • most common in jejunum
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34
Q

What layers are included in villi projections

A
  • mucosa

- increases surface area 10x

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35
Q

What are indentations between villi that lead to glands?

A

Intestinal crypts/crypts of Liberkuhn

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36
Q

What structure in the small intestine is associated with gluten intolerance and what is this disease called?

A
  • Villi
  • Celiac disease
  • gluten triggers immune system to damage or destroy villi
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37
Q

Which of the small intestine structures increases the surface area the most?

A
  • Microvilli

- increase surface area 100x or more

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38
Q

What allows microvilli to move?

A
  • actin that extends into the terminal web

- contraction spreads the microvilli

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39
Q

What type of epithelium makes up the small intestine?

A

Simple Columnar

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40
Q

What 6 types of cells make up the epithelium of the small intestine?

A
  1. Enterocytes
  2. Goblet cells
  3. Paneth cells
  4. M cells
  5. Enteroendocrine cells
  6. Intermediate cells (stem cells)
41
Q

What is the primary absorptive cell in the small intestine? Describe it.

A

Enterocytes

  • found on:
    1. villi
    2. general surface
    3. glands
  • Tall cells w/ basal nucleus and striated brush border
  • Tight Junctions attach cell to cell
  • Secrete H2O and electrolytes in glands
42
Q

Describe goblet cells.

  • where are they?
  • what do they do?
A
  • found on the villi and in glands

- apical part of cell contains mucinogen granules

43
Q

Describe Paneth cells.

  • where are they?
  • What do they do?
A
  • Found in the base of crypts of small intestine (basal basophilia), appear as red (acidophilic granules)
  • Regulate bacteria in intestinal glands
  • Digests bacterial cell walls and other antibacterial substances using secreted lysozyme and phagocytize certain bacteria and protozoa
44
Q

T or F: M cells have microvilli.

A

FALSE, they have microfolds not microvilli

45
Q

What are M cells?

A
  • Found in epithelium of small intestine
  • Antigen presenting cells that overlie lymphatic nodules
  • endocytose things from lumen of intestin and release into underlying lymph tissue
46
Q

What do enteroendocrine cells do?

A

Secrete various pepide hormones (similarly to how they do in the stomach)

47
Q

What do intermediate (stem) cells in the small intestine do?

A
  • can divide to form any type of epithelial cell
  • intermediate between enterocyte and goblet
  • make up MOST of the cells in the LOWER half of the gland
48
Q

What is the lifespan for:

  • absorptive cells
  • goblet cells
  • paneth cells
A
  • absorptive and goblet = 5-6 days

- paneth - 4 weeks

49
Q

Describe the lamina propria of the small intestine.

A
  1. GALT (heavily infiltrated with lymph tissue)
  2. PEYER’s PATCHES - best developed in ileum
  3. LACTEALs (lymph capillaries) are present to absorb fat
50
Q

Describe the muscularis mucosa of the small intestine.

A
  • Typical inner circular and outer longitudinal layer

- Fibers extend into villi and enable their movement

51
Q

What are the distinguishing features of the 3 parts of the small intestine?

A
  1. Duodenum - contains BRUNNER’s glands in submucosa (secrete alkaline buffer)
  2. Ileum - PEYER’s PATCHES (aggregations of lymph nodules)
  3. Jejunum - few Brunner’s glands, no Peyer’s patches
52
Q

T or F: the submucosa extends into the plicae circularis

A

True

53
Q

T or F: the small intestine has BOTH a serosa and adventitia.

A

True

54
Q

What is the function of the large intestine?

A
  • absorption of water and electrolytes

- elimination of solid wastes and undigested food

55
Q

What creates the teniae coli?

A
  • three bands created from the outer longitudinal layer of muscularis externa
56
Q

T or F: plicae circulares is a feature of the large intestine

A

False

57
Q

Does the large intestine have villi?

A
  • No, but is have straight tubular glands that dip into lamina propria
58
Q

What is the difference in the epithelial layer makeup of the large intestine vs. the small intestine?

A
  • More goblet cells

- NO paneth cells

59
Q

Describe the lamina propria of the large intestine.

A
  • GALT well developed

- no lymph vessels - slow cancer metastasis

60
Q

What are some distinguishing features of the appendix?

A
  • no teniae coli
  • many lymph nodules (encroach on mucosa)
  • debris in lumen
61
Q

Functions of biliary system.

A
  • Produce proteins and Lipoproteins
  • Storage and regulation of vit. and minerals
  • Drug detox
  • Exocrine gland
  • Endocrine gland
62
Q

What are the exocrine functions of the liver?

A

Bile secretion by hepatocytes contains:

  1. Cholesterol
  2. Phospholipids
  3. bilirubin
  4. bile salts
63
Q

What are the endocrine functions of the liver?

A

Structure modifications then release into blood of the following hormones:

  1. Vitamin D
  2. thyroxine
  3. Growth hormone
  4. insulin
  5. glucagon
64
Q

What is a portal vein?

A

a structure that carries blood between two capillary beds

65
Q

What is the blood supply to the liver?

A
  • Hepatic artery, oxygenated (20-25%)

- Portal vein, deoxygenated (75-80%)

66
Q

Describe the bile output from the liver.

A
  • hepatic bile duct take bile from the liver to the gallbladder then to duodenum.
67
Q

T or F: the triad of portal vessels continues as the original structures subdivide and continue into the organ

A

True

68
Q

What are the contents of a portal canal?

A
  1. Portal Triad
  2. lymphatic vessels
  3. nerves and CT
69
Q

How does blood flow through the liver?

A
  1. Portal (deox) v. + Hepatic a. (ox)
  2. Sinusoids (blood from 1. is combined)
  3. Central v.
  4. Sublobular v.
  5. Hepatic v.
  6. IVC
70
Q

What structure is located in the center of hepatic sinusoids?

A

Central vein

71
Q

Describe the relationship between a portal triad and a central vein.

A

Portal triads run on the outside of sinusoids and send off small branches into sinusoids were venous and arterial blood is combined before entering the central v.

72
Q

What cell type makes up the parenchyma of the liver?

A

Hepatocytes (make up ~80% of liver cells)

73
Q

Describe the morphology and composition of hepatocytes.

A
  • Large Polyhedral Cells
  • Many cells are Binucleated
  • lots of rER, sER, Golgi, heterochromatin (think about why)
74
Q

T or F: hepatocytes are capable of regeneration

A

True

75
Q

How are hepatocytes organized in the liver?

A
  • plates of cells surrounded by sinusoids
76
Q

What 2 other cell types besides hepatocytes are important in the liver?

A
  • Ito (stellate) cells - important for vit. A storage

- Kupffer cell - removes bacteria and damaged RBCs

77
Q

What is the location of Kupffer and Ito cells in the liver?

A
  • Kupffer - in the sinusoid

- Ito cell - amongst the hepatocytes

78
Q

What lines the What is the space of Disse?

A
  • aka perisinusoidal space

- located between the fenestrated endothelium of sinusoids and hepatocytes

79
Q

What tissue lines the sinusoids of the liver?

A

Thin fenestrated endothelium

80
Q

What structure projects into the space of Disse from hepatocytes?

A

Microvilli

81
Q

What produces bile and how does it get to the hepatic ducts?

A
  • Hepatocytes make bile which is secreted from all 6 sides into the canaliculi

Path:

  1. Canaliculi
  2. Canal of Hering
  3. Interlobular Bile Ducts
  4. R and L hepatic Duct
82
Q

T or F: canaliculi have tight junctions

A

True

83
Q

What is the 1st structure to receive bile from the canaliculi?

A

Canal of Hering (aka intrahepatic ductule)

84
Q

What is does bile take to the intestines for reabsorption?

A
  1. Phospholipids and cholesterol
  2. Bile Salts (keep phospholipids and cholesterol in solution)
  3. ELECTROLYTES: Na+, K+, Ca2+, Cl-, HCO3-
85
Q

What does the bile take to the gut for disposal?

A
  • Bile Pigments

- Bilirubin

86
Q

What is the shape of the classic lobule and what is this based on?

A
  • Hexagon

- based on blood flow

87
Q

What is the shape of a portal lobule and what is this shape based on?

A
  • Triangle formed between central veins

- Based on drainage to a given portal area

88
Q

What is the shape of a liver acinus and what is this shape based on?

A
  • Oval drawn between two central veins
  • based on relationship between blood flow, metabolism, and pathology
  • moving towards the central veins the blood becomes less and less oxygenated (divided into 3 zones)
89
Q

What zone in the acinus model would you expect to see pathology in first if a patient experience heart failure?

A
  • You would see pathology in zone 3 nearest the central vein
  • the heart is not pumping blood hard enough to get it into this region
90
Q

What is the function of the gallbladder?

A

concentrates bile and stores it during fasting

91
Q

How does the tissue of the gallbladder differ from the rest of the intestinal tract?

A
  1. Mucosa layer LACKS a MUSCULARIS MUCOSA
  2. NO SUBMUCOSA
  3. muscularis externa is Irregularly arranged
92
Q

How does the gallbladder concentrate bile?

A
  • Removal of H2O through an osmotic gradient
  • Hydrostatic pressure

*Note: gallstones form when bile hardens

93
Q

T or F: like the liver, the pancreas is also an endocrine and exocrine gland.

A

True

94
Q

Where are the endocrine and exocrine parts of the liver located?

A
  • exocrine = acinar (alveoli)W pancreas

- endocrine = Islets of Langerhans

95
Q

T or F: acini have serous cells

A

True

96
Q

What is secreted by acini?

A

ZYMOGENs
- proteolytic, amyloytic, lipases, nucleolytic enzymes

  • Secrete into duct system for transport into the intestines where enzymes become active
97
Q

What are intercalated ducts and what are they composed of?

A
  • located within acini to carry material out of acini
  • they add H2O and bicarb to the secretion
  • made of CENTROACINAR cells
98
Q

What is the ducts hierarchy in the pancreas and what cells make up each type?

A
  1. Intercalated duct (squamous cells)
  2. Intralobular duct (cuboidal, low columnar)
  3. interlobular duct (low columnar, lots of CT, located between lobules)
  4. pancreatic duct

Anatomy Week 10 BT (6 decks)

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