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IBMS SR > Gut mucosa in health and disease > Flashcards

Gut mucosa in health and disease Flashcards

1
Q

what are the functions of the git

A

ingestion and digestion of food
absorption of nutrients
elimination of waste products
seceretion (saliva, hormones, enzymes, mucous)

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2
Q

what does the upper git consist of

A

oral cavity
oesophagus
stomach

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3
Q

what does the lower git consist of

A

small intestine
large intestine

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4
Q

list the general structure of the git

A

epithelium
lamina propria
muscularis mucosa
submucosa
muscularis propria
adventitia/serosa

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5
Q

what is the epithelium supported by

A

lamina propria which is loose connective tissue

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6
Q

what is the muscularis mucosa made up of

A

smooth muscle

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7
Q

what is the sub mucosa made up of

A

loose connective tissue that has blood, lymph and nerva supply to the git

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8
Q

what 2 types of muscle is the musuclaris propria made up of

A

external longitudinal muscle layer
internal circular muscle layer

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9
Q

what is the adventitia

A

connective tissue that seperates the gut and peritoneal membrane

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10
Q

what is the adventitia called when it is covered by a single layer of epithelium

what is this single layer called and made up of

A

serosa

mesothelium-simple squamous epithelial layer

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11
Q

what are the main 3 types of mucosa in the git

A

protective
secretory
absorptive

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12
Q

what is protective mucosa charcterised by

where is it found

A

stratified squamous epithelium

oral cavity, pharnyx, oesophagus and anal canal

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13
Q

what is the difference between the stratified squmaous epithelium found in the oesphagus, pharnyx and anal canal compared to that found in some places of oral cavity

A

first is non-keratinised and oral cavity is keratinised (in some places)

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14
Q

the cells in the secretory mucosa are responsible for what

where is secretory mucosa found

A

secretion of digestive enzymes and acids

stomach

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15
Q

what is absorptive mucosa responsible for in the small intestine

A

absorbing digested nutrients

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16
Q

what is absorptive mucosa responsible for in the large intestine

A

water absorption and electrolyte balance

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17
Q

why is the epithelial coverage of the oesophagus non-keratinised stratified squamous

A

has to act as mechanical protective barrier from rough food bolus

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18
Q

what are the 2 types of tissue in the musucularis propria

A

inner circular
outer longitudinal

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19
Q

list general structure of oesophagus

A

muscosa
submucosa
muscularis externae
esophageal glands proper

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20
Q

why do some parts of the muscularis externae in the oesophagus contain skeletal muscle

A

to help swallowing of the food bolus

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21
Q

what is the distinguishing feature of the stomach compared to the git

A

glandular structure in stomach musoca

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22
Q

what is the role of the cardiac sphincter

A

closes to prevent food coming back up

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23
Q

junctions in the stomach can change from what type of epithelial coverage to what other type

A

stratified squamous to secretory (which is simple columnar)

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24
Q

what are rugae

A

folds of mucosa of the stomach around the lumen

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25
Q

what is the stomach entirely made of

A

glands

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26
Q

how many gastric glands are there in the stomach

A

15 mill

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27
Q

what are the opening of gastric glands in to the lumen called

A

gastric pits

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28
Q

how many gastric pits in stomach

A

3.5 mill

therefore every 3/4 glands share one opening

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29
Q

list general structure of stomach

A

mucosa
submucosa
muscularis
serosa

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30
Q

what is the role of gastric pits

A

allows transports of secretion from glands to lumen

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31
Q

what are gastric pits lined with

A

columnar epithelium

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32
Q

what is 4 parts is the gastric gland made up of

A

pit, neck, body and base

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33
Q

where are mucous neck cells in the gland

A

neck

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34
Q

what do mucous neck cells secrete

A

mucus
bicarbonate

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35
Q

what is the purpose of the mucus that is secreted by the mucous neck cells

A

form a mucosal blanket (gel-like layer) on surface of epithelial cells as a protective barrier against stomach acid and proteolytic enzymes

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36
Q

what does mucus secreted contain

A

glycoproteins called mucins

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37
Q

what do parietal cells secrete

A

gastric acid (hcl)
intrinsic factor (Ca++ absorption)

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38
Q

what is the role of the intrinsic factor secreted by the parietal cells

A

binds vitamin b12 (important for blood cell formation or fast-growing cells like bone)

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39
Q

what do enterochromaffin-like cells secrete

what is the purpose of this secretion

A

histamine

stimulates secretion of stomach acid

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40
Q

what do the cheif cells secrete

A

pepsin(ogen)
gastric lipase

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41
Q

what is the role of gastric lipase

A

helps digestion of lipids in stomach

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42
Q

what is pepsinogen

A

a precursor of pepsin

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43
Q

what is pepsin

A

proteolytic enzyme that breaks down the proteins in food

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44
Q

when is pepsinogen converted to pepsin

A

when stomach secretes acid and pH drops

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45
Q

what do D cells secrete

what is the role of the secretion

A

somatostatin

inhibits stomach acid formation

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46
Q

what do G cells secrete

what is the role of secretion

A

gastrin

stimulates acid production

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47
Q

D and G cells are what type of cells

A

endocrine cells (secrete hormones not enzymes)

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48
Q

what are goblet cells

A

mucus secreting cells

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49
Q

what is the distinguishing feature of the small intenstine

A

macroscopic folding of the mucosa in to villi and microvilli

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50
Q

what is at the bottom of each villi

A

crypts (valleys of the villi) that invaginate into the lamina propria

51
Q

the absorptive epithelium is made of columnar cells, what are these columnar cells called

A

enterocytes

52
Q

what is the role of the mucosal folding (villi)

A

increase sa to increase the rate of nutrient absorption

53
Q

what are the 3 parts of the small inestine

A

duodenum
jejunum
ileum

54
Q

what changes happen as you move down the small intestine

A

lumen widens
microvilli get shorter

55
Q

what is a special histological feature of the duodenum

A

brunner’s glands/mucosal glands

56
Q

what is a special histological feature of the ileum

A

Payer’s patches
(collections and follicles of lymphocytes)

57
Q

mucosal glands and payers patchers are found where in the small intestine

A

submucosa

58
Q

what is the role of paneth cells in the small intestine

what do they secrete

A

anti-microbial (kill bacteri and prevent infection in small intestine)

defensin (self defense peptides)
lysozymes

59
Q

what are the main cells that form the epithelium of the mucosa of the SI called

A

enterocytes

60
Q

what is the brush border

A

border of enterocytes

folding in cell membrane which projects in to the lumen

61
Q

what does the brush border harbour and why

A

enzymes
to aid with the digestion of disaccharides into monosaccharides

62
Q

what type of cells are lymphocytes and plasma cells

where are they present

A

immune cells

in submucosa of SI

63
Q

what are k cells called

where are they found

A

enteroendocrine cells

SI

64
Q

what are the 4 types of endocrine cells in the git

A

G
D
K
L

65
Q

Where are G and D cells found

A

stomach

66
Q

what do k cells secrete and why

A

incretins (hormones that change function of insulin)- helps lower blood sugar levels and help in glucose homeostasis

gastric inhibitory peptide- inhibits secretion of gastric acids

67
Q

what type of cell is an L cell

wher are they found

A

enteroendocrine cell
large intestine

68
Q

what do L cells secrete

why

A

glucagon-like peptides (number 1 and 2)

help increase satiety, aid in weight loss and act like glucagon therefore lowering blood sugar levels in body (have a function in glucose homeostais)

69
Q

what is the distinctive feature of the large intestine

A

crypts but no villi

70
Q

what are crypts

A

invaginations in to the lamina propria

71
Q

what are crypts made up of

A

columnar cells with goblet cells

72
Q

why is there a large number of goblet cells in the large intestine

A

for lots of mucosal secretion, to protect surface epithelium from dehydrated food/material

73
Q

what does the colon end with

A

appendix (small tubular structure)

74
Q

why is the lumen smaller in the appendix

A

bc its full of lymphoid follicles/lymphatic tissue

75
Q

what is the liver formed of

A

lobules

76
Q

what are lobules formed of

A

hepatocytes and a central vein

77
Q

what is there in each corner of a lobule

A

portal triad

78
Q

what is the portal triad made up of

A

bile duct
hepatic portal vein
hepatic artery proper

79
Q

what 2 types of glands is the pancreas made up of

A

exocrine serous acini
endocrine (formed of alpha and beta cells)

80
Q

what is the role of the exocrine srous acini in the pancreas

A

secrete digestive enzymes through the bile duct to the small intestine

81
Q

what is the role of the alpha cells in the endocrine part of the pancreas

A

form and secrete glucagon

82
Q

what is the role of the beta cells in the endocrine part of the pancreas

A

form and secrete insulin

83
Q

what is the role of insulin

A

helps cells take up glucose from the blood therefore lowering blood glucose levels

84
Q

what is the role of glucagon

A

inhibits the insulin effect and allows the glucose to be released from glycogen in the liver, into the blood

85
Q

what is the endocrine organ called

A

Islets of langerhans

86
Q

what is the difference between metaplasia and dysplasia

A

metaplasia- change of one form of cells to another

dysplasia-presence of abnormal cells within tissue/organ

87
Q

what is the normal epithelium type of the oesophagus

A

non-keratinised stratified squamous epithelium

88
Q

what is Barrett’s oesophagus

A

GORD leading to metaplasia
Pathogenesis that can happen in oesophagus due to laxation of gastroesophageal sphincter

89
Q

what is barrett’s oesophagus caused by

A

obesity, bulimia, use of non-steroidal anti-inflammatory

90
Q

what does continual reflux lead to

A

metaplasia from the stratified squmaous protective type into columnar secretory type

91
Q

what does barrett’s oesophagus type epithelium contain lots of and why

A

goblet cells
to wall of acidity by secreting mucus and bicarbonate

92
Q

what can barrett’s oesophagus lead to

A

cancer

93
Q

what is an ulcer

A

loss of surface epithelium exposing the connective tissue in lamina propria underneath (but can go as deep as submucosa)

94
Q

what are damaging factors of the upper git

name 2 types in normal git

A

factors that erode epithelial coverage

gastric acidity
peptic/proteolytic enzymes

95
Q

what are the 3 protective factors in the stomach against damaging factors

A

mechanical barriers
regenerative barriers
chemical barriers

96
Q

name 2 types of mechanical barriers in the stomach

A

epithelial coverage
mucosal blanket

97
Q

what is a regenerative barrier in the stomach

A

stem cells that divide and differentiate into new cells that replace any damaged cells from the epithelial surface

98
Q

name 2 chemical barriers in the stomach

A

secretion of mucus and bicarbonate (lower the pH)
prostaglandis (inflammatory cytokines secreted in response to hyperacidity in stomach, also inhibits secretion of acids to protect mucosal lining)

99
Q

name other factors which can cause injury of the stomach

A
  • increasing gastric acidity
  • H. pylori infection (makes stomach prone to ulceration)
  • use of non-steoridal anti-inflammatory drugs (e.g aspirin and ibuprofen)- they counteract effect to prostaglandis and will stimulate acid secretion
  • duodenal gastric reflux
  • tobacco and alcohol (stimulates acid secretion leading to gastric hyperacidity)
100
Q

what does the submucosa in the stomach form in response to ulcers

A

fibrous and granulous tisse to wall off damage (will lead to scarring)

101
Q

what happens if an ulcer reaches a capillary

issue with this?

A

can lead to microleakage of blood and minimal internal bleeding

cant be detected and so can lead to anaemia

102
Q

what happens if an ulcer perforates a bigger blood vessel

A

hematemesis (vomiting of blood)
severe bleeding
cancer (if multiple or bigger ulcers)
death

103
Q

why can an ulcer cause pernicious anaemia

A

because of loss of parietal cells
leads to loss of intrinsic factors
leads to malabsorption/ no absorption of vitamin b12

104
Q

what is malabsorption syndrome

A

failure to absorb nutrinets from the diet due to a disease of small intestine resulting in a combo of diarrhoea, steatorrhoea, malnutrition, weight loss and anaemia

105
Q

what are the 2 causes of malabsorption syndrome

A

maldigestion- partial or total gastrectomy leading to lack of mechanical mixing or insufficiency of digestive mediators

mural/mucosal causes- loss or damage of mucosa of small intestine

106
Q

what is steatorrhoea

A

fatty diarrhoea

107
Q

what causes mucosal causes leading to malabsorption syndrome

A

trauma
surgery

108
Q

what is gluten sensitive enterothapy/coeliac disease

A

exaggerated immune response to eating gluten

109
Q

what is autoimmune enteropathy

A

autoimmune reaction to body cells themselves (i.e. intestinal enterocytes)

110
Q

what is intestinal lymphangiectasia

A

overdilation of lympathtic vessels

111
Q

what is crohns disease

A

wide spread ulceration of git

112
Q

where does ulcerative colitis occur

A

small and large intestines

113
Q

what is acrodermatitis enteropathica

A

genetic disease causing blunting of villi

114
Q

what does immune deficiency HIV/AIDS-related enteropathy lead to

why isnt it easily treated

A

loss of epithelium due to high infection rate

due to low immunity

115
Q

what are microbial causes

what are they caused by

A

disturbance or chnages in microbiota

immune supression, irresponsible use of antibiotics, chemotherapy, trauma to intestine and parisitic/bacterial infection

116
Q

what is mural disease

A

scleroderma

117
Q

why does coeliac disease lead to malabsorption

A

due to loss of structure of mucosa of small intestine in form of losing villi structure

118
Q

what is marsh 1
marsh 2
marsh 3

A

preliminary stage
moderate progression of disease
late stage of disease

119
Q

describe marsh 1

A

villi still present but lots of inflammatory cells in lamina propria and submucosa

120
Q

describe marsh 2

A

flattening of villi and increase in inflammatory cells leading to tissue damage (inflmmation and inflammatory cytokines secreted lead to tissue damage)

121
Q

describe marsh 3

A

microvilli structure lost entirely and huge invasion of inflammatory cells in tissues

122
Q

what vitamins arent taken up due to malabsorption

A

vitamin b
vitamin k
vitamin c

123
Q

what can lack of vitamin b lead to

A

anaemia
loss of hair
oral ulcers

IBMS SR (38 decks)

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