GIT Flashcards
What are the (purpose of) relationship between GIT structure and function?
There is continuous communication between the external (lumen) and internal environment to optimise conditions for digestion and absorption.
What are the 4 factors regulating functions of GIT?
- autonomous smooth muscle function
- intrinsic nerve plexus
- extrinsic nerve
- GI hormone (enteroendocrine)
Describe the function processes of autonomous smooth muscle function.
- non-contractile interstitial cells of Cajal are “pacemakers” establishing rhythmic, slow wave potentials (basic electric rhythm) that spread to SM via gap junctions.
- If wave reaches threshold at depolarisation peak then a volley of AP is triggered, causing muscle contraction - basis for peristalsis.
What are the two structures of the intrinsic nerve plexus? and what are their functions?
- Myenteric plexus - located between the longitudinal and circular layers of muscle and exerts control primarily over digestive tract motility.
- Submucosal plexus - main role of sensing the luminal environment, regulating gastrointestinal blood flow and controlling epithelial cell function.
They function together to control local activities.,
What are the functioning mechanisms of extrinsic nerves?
- formed by autonomic nervous system divisions
- influences the digestive system by acting on intrinsic nerves, hormone secretion and directly on GI cells.
- coordinates activity between different regions of the tract.
What does Gastrointestinal Hormones do?
Enteroendocrine cells in the mucosa of the GIT release hormones into the blood where they exert effects on smooth muscle and glands.
They secrete:
Gastrin
Secretin
Cholecystokinin
Glucose-Dependent Insulinotropic Peptide
Motilin
Please provide an example of how the 4 factors work together to control digestion.
- ASMF - pacemaker cells are causing muscle contraction in stomach antrum (mixing and propulsion).
- Intrinsic nerves - myenteric reflex increasing motility (mixing and emptying).
- Extrinsic nerves - Vagal signalling leading to motility and secretion.
- GI hormones - release of gastrin leads to increased acid secretion (chemical digestion).
Describe the basic structure and functions of the GIT.
What are the tissue layers that make up the GIT and their specific roles.
Lumen
Mucosa (epithelium, lamina propria, muscularis propria)
Submucosa (LCT and submucosal (Meissner’s) nerve plexus)
Muscularis Externa (SKM, SM, myenteric (Auerbach’s) nerve plexus)
Serosa (Adventia)
Can describe the main control mechanisms that regulate function.
Oesophagus S->F
- muscular tube -> transport from pharynx to stomach
- non-keratinised stratified squamous -> tough for protection.
- submucosa contains oesophagus glands -> transport & protects mucosa.
- lamina propria near stomach -> oesophageal cardiac glands -> secrete mucus.
- proximal end - SKM
distal end - SMM
mid oesophagus - mix of SKM and SMM. - Upper is covered by adventia while the lower is covered by serosa.
Stomach S->F
- begins at end of oesophagus and ends at pyloric sphincter.
- rugae - allows expansion
- holds ~ 50 mL when empty; and ~1-1.5L following normal meal.
Stomach Mucosa S->F
- surface epithelium invaginates into lamina propria -> forming gastric pits and glands.
- Lamina propria -> LCT with SMM & lymphoid cells.
- Separating mucosa from submucosa is muscularis mucossae.
- Simple columnar -> secrete alkaline mucus. -> protection and defence.
- Glands contain specialised cells - acid, enzyme and hormone producing.
Histological regions of the Stomach
- cardia
- narrow circular band of 1.5 to 3 cm
- cardiac glands are simple or branched.
- most secretory cells produce mucous & lysozyme
- few parietal cells - fundus
- LP has branched tubular gastric (fundic) glands
- 3~7 gastric glands open into bottom of each gastric pit
- Gastric glands has 3 distinct regions: isthmus, neck & base.
- most acid producing cells in this region - pylorus
- LP has deep gastric pits with branched tubular pyloric glands. -> secrete mucus and lysozyme.
Mucous Cells in Stomach S->F
- nucleus at base of the cell + secretory granules near apical surface -> secrete mucus -> protects stomach wall from being digested by gastric juice (acid and enzyme-rich)
- Two types of mucous cells: Mucous surface cells and mucous neck cells.
Surface cells -> produce insoluble mucous -> thick gel layer adhered to epithelial surface.
Neck cells -> irregular shape + located at neck of gastric glands -> produce thinner and more soluble mucous -> mobile and mixes with lumen contents.
Parietal cells S->F
- mainly found in upper parts of gastric glands.
- round with intensely eosinophilic cytoplasm.
Functions:
1. secretes H+ and Cl- to form HCl.
2. secretory activity initiated through variety mechanisms:
- histamine and gastrin
- stretch
- neural (ACh)
3. secrete intrinsic factor - VitB 12 absorption.
What are the two types of parietal cells in stomach?
Resting cell:
1. Tubulovesicles (TV) -> sequestered proton pump H/K-ATPase
2. Few microvilli (MV)
Active cell:
1. increased surface area
2. Abundant mitochondria
3. deep circular invagination of the apical plasma membrane - intracellular canaliculus (IC).
3. TVs fuse with the cell membrane and MV projects into the canaliculi.
Chief (zymogenic) cells S->F
- found in lower regions of glands -> protein synthesising & exporting cell
- granules contain inactive pepsinogen -> pepsin in the presence of HCl.
- granules located luminal aspect -> produce lipase
Enteroendocrine (and paracrine) cells in stomach S-> F
- found in neck & base of gastric glands
- fundus of stomach -> serotonin.
- body of stomach -> histamine.
- pylorus of stomach -> gastrin and somatostatin.
- Granules located basolateral aspect.
Summary of Digestive activities in the Stomach
Small intestine S->F
- longest portion (~6m) of the alimentary canal and fills much of the peritoneal cavity. -> site of most enzymatic digestion & absorption)
- Position stabilised by mesentery (peritoneal membrane).
- three subdivisions:
- Duodenum (~5%)
- Jejunum (~40%)
- Ileum (~60%)
Enterocytes S->F
- tall columnar cells
- Oval nucleus in basal half
- Apex contains brush border (Mv) -> protrusion of apical cytoplasm. -> absorb nutrients.
- secrete enzymes which bind to Mv aiding in breakdown into simple sugars for easy absorption.
Goblet cells in Small Intestine S->F
- interspersed between enterocytes -> increase as progress down tract
- produce mucins -> protection against acidic contents + lubrication of lining.
Paneth cells S in small intestine ->F
- located in base of crypts -> contain lysozyme -> antimicrobial activity.
Enteroendocrine cells in small intestine
- Located in crypts
- two types:
Open-type - apex of cell presents Mv & contacts lumen
Closed-type - cellular apex covered by other epithelial cells - secretes a variety of hormones with a variety of actions.
Lamina propria to serosa in SI
- composed LCT, BV, LV, NE, SM.
- submucosa contains duodenal glands (brunner’s glands) which protects duodenal mucous membrane from acidic juice.
- LP has Peyer’s Patches - MALT
- muscularis allows for movement - 2 layers.
How does small intestine exert its motility?
- segmentation - ring-like contraction and relaxation of muscularis causes mixing (controlled by pacemaker cells).
- migrating motility complex - propagating contractions propel chyme forward (controlled by hormones).
Summary of SI
Anatomy of LI
- Extends from ileocaecal junction to anus
- consists of caecum, colon, rectum, anal canal and secretion of mucus
- movements sluggish (18~24h) - chyme converted into faeces by absorption of water & salts with extensive action of microflora.
- 1500 mL of chyme enters caecum; 90 % of volume reabsorbed = 80~150 mL of faecal matter excreted.
What is the main difference in the mucosal architecture of the large intestine compared to the small intestine.
Small Intestine: Contains villi and plicae circulares, maximizing surface area for nutrient absorption.
Large Intestine: Lacks villi; has a smooth mucosa with deep crypts and numerous goblet cells, focusing on water absorption and mucus secretion.
Histology of LI
- No villi or circular folds
- Simple columnar epithelium (except anal canal: stratified squamous) with many goblet cells
- Taeniae coli (longitudinal muscles) in muscularis form haustra (pouches) through contractions
- Intestinal crypts in lamina propria
- Absorptive cells: absorb water
- Goblet cells: secrete mucus for lubrication
Describe the absorption & faeces formation in LI
- Na and Cl ions
- after 3-10 hours, 90% of water has been removed from chyme.
- Faeces are semi-solid when reaches transverse colon.
- faeces include: dead epithelial cells, undigested food such as cellulose, bacteria (live & dead).
Describe LI motility
- important for storage, drying, and excretion.
- 2 types of motility patterns:
- non-propulsive
- propulsive
Describe Haustral Contractions
- colon’s main motility
- initiated by autonomous rhythmicity of colonic pacemakers.
- segmental (one section that is relaxed gradually contracts while a previously contracted area relaxes to form a new sac).
- slow and non-propulsive (1 per 30 mins).
- moves chyme back and forth for absorption of salt and water.