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GI Midterm > Histology of Small and Large Intestines > Flashcards

Histology of Small and Large Intestines Flashcards

1
Q

4 basic histological layers of small intestine wall

A

Mucosa
Submucosa
Muscularis
Serosa

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2
Q

Describe epithelium of mucosa layer of small intestine

A

Simple columnar epithelium

Lamina propria

Muscularis mucosa

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3
Q

What histological structures are found in the mucosal layer of the small intestine and what is their purpose?

A

Intestinal glands/crypts of Lieberkuhn = invaginations of mucosa that increase intestinal surface area

[note that glands/crypts are also often found in submucosa]

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4
Q

Describe submucosa layer of small intestine

A

Dense irregular CT with neurovasculature and lymphatics, glands may be present

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5
Q

Describe muscularis layer of small intestine

A

Inner circular + outer longitudinal smooth muscle

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6
Q

Describe serosa of small intestine

A

Loose CT covered by visceral peritoneum

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7
Q

______ = folds of mucosa projecting into the lumen of the small intestine, increasing their surface area for absorption

A

Villi

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8
Q

_____ = folds of mucosa and some submucosa that differ from rugae in that they cannot lay flat if distended

A

Plicae circulares

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9
Q

Where in the small intestine would you find the most plicae circularis?

A

Jejunum

They are absent in the duodenum and less prominent in the ileum

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10
Q

____ = folding within the apical domain of enterocytes found in small intestine only

A

Microvilli

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11
Q

In the small intestine:

The first degree of folding = ______, which is evagination of the mucosa and part of the submucosa

The second degree of folding = ______, which is evagination of the mucosa only

The third degree of folding = ______, which are invaginations of the mucosa

The fourth degree of folding = ______, which are evaginations of the apical domain of the enterocyte

A

Plicae

Villus

Glands/crypts

Microvilli

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12
Q

Which histological layer of the small intestine holds the main distribution of blood and lymphatics?

A

The submucosa

[branches supply capillaries to the mucosa and muscularis layers]

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13
Q

Arterioles enter the mucosa of the SI and give rise to what 2 plexuses forming the microvascular system of the villus? What do they supply?

A

Villus capillary plexus - supplies intestinal villus and upper portion of the crypts of Leiberkuhn

Pericryptal capillary plexus - supplies lower half of crypts of Lieberkuhn

[both plexuses drain into the submucosal venule]

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14
Q

____ = single blind-ending central lymphatic capillary found in lamina propria of a SI villus. These structures will form a plexus that branches around a lymphoid nodule, forming the _____. They anastomose with efferent lymphatic vessels and leave the SI.

A

Lacteal; GALT

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15
Q

Motility of the SI is controlled by the ANS. Intrinsic innervation consists of what 2 plexuses? Histologically, where are they located?

A

Submucosal plexus of Meissner - controls glandular secretions from submucosal and mucosal layer

Myenteric plexus of Aurbach - sits between circular and longitudinal layers of muscularis layer

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16
Q

Neurons of the submucosal plexus of Meissner and the myenteric plexus of Aurbach receive intrinsic and extrinsic input from what sources?

A

Intrinsic input from the mucosa and muscle wall of SI

Extrinsic input from the parasympathetic (vagus n.) and sympathetic nerve trunks

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17
Q

What type of glands are found in the duodenum? Which layer are they found in?

A

Brunner’s glands in submucosa

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18
Q

Describe the Brunner’s glands found in the submucosa of the duodenum

A

Tubuloacinar mucous glands

Produce an alkaline secretion that neutralizes acidic chyme

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19
Q

The duodenum collects bile and pancreatic secretions via the ________ ______. The base of the crypts of lieberkuhn may contain ____ cells

A

Hepatopancreatic ampulla; paneth

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20
Q

What is unique about the histology at the gastroduodenal junction?

A

The pylorus of the stomach has simple columnar epithelium like that in the duodenum, but you will notice a massive bed of muscularis muscle at the pyloric sphincter, as will as abundant Brunner’s glands DEEP to the muscularis mucosae of the duodenum. Will also note secretory mucosa with villi, but the distinguishing featuer is usually the presence of glands at the beginning of the SI that were not present in the stomach

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21
Q

Describe the jejunum including its villi, lacteals, brunner’s glands, lamina propria, and paneth cells

A

Long finger-like villi and well-developed lacteal (villus core)

Lacks brunner’s glands

Lymphoid nodules/follicles in the LP

Paneth cells in the base of the crypts

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22
Q

What is the function of paneth cells found in the SI?

A

Regulate the microbiome by secreting anti-microbial proteins

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23
Q

In which part of the SI would you find Peyer’s patches?

A

Ileum

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24
Q

Describe the ileum in terms of peyer’s patches, brunner’s glands, villi, and paneth cells

A

Peyer’s patches, lymphoid follicles (also called nodules) found in the mucosa and part of submucosa

Absence of Brunner’s glands

Shorter finger-like villi compared to jejunum

Paneth cells found at base of crypts

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25
Q

Intestinal mucosa and crypts of Lieberkuhn are simple tubular glands lined by what type of epithelium?

A

Simple columnar

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26
Q

What cell types are associated with intestinal mucosa and crypts of lieberkuhn?

A 
Enterocytes (absorptive cells)
Goblet cells
Enteroendocrine cells
Paneth cells
Intestinal stem cells

[bottom 3 are within each gland/crypt, enterocytes and goblet cells found throughout]

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27
Q

How would you histologically distinguish goblet cells from enterocytes in terms of surface features?

A

Goblet cells lack microvilli at their surface

28
Q

Each enterocyte has an apical domain with a prominent _____ (striated) border that contains about 3000 closely packed microvilli to increase SA. Each ends on the _______ ____, a zone with cytoskeletal filaments

A

Brush; terminal web

29
Q

Microvilli are 0.5-1 micrometer with a core bundle of 20-40 cross-linked actin filaments.

Each actin bundle:
Projects into the apical portion of the cell as a ______ and is cross linked to its neighbors. The end of each rootlet attaches to _________ filaments. The cross-linking proteins form part of the terminal web, maintaining the _____ position and shape of microvillus

A

Rootlet; intermediate; upright

30
Q

Columnar mucus-secreting cells scattered among enterocytes

A

Goblet cells

31
Q

Describe the 2 domains associated with goblet cells

A

Apical = goblet-shapped, with large mucus granules released by exocytosis

Basal = houses RER, golgi, and nucleus (where the granules are made)

32
Q

What is the overall purpose of the presence of goblet cells scattered among the enterocytes of the small intestine?

A

Their secretory product contains glycoprotein-based mucus that hydrates the intestine mucosa, forming a protective shield from abrasion and bacterial invasion

33
Q

What 3 important hormones are secreted by eneteroendocrine cells of the small intestine?

A

Gastrin
Secretin
Cholecystokinin

34
Q

What hormone, released by enteroendocrine cells of the SI, slows emptying of the stomach by acting on pyloric sphincter, stimulates bile release from gallbladder, and stimulates secretion of pancreatic enzymes?

A

Cholecystokinin

35
Q

What hormone, released by enteroendocrine cells of the SI, stimulates bicarb secretion by the pancreatic duct as well as enhances insulin secretion by B cells of the islet of langerhans?

A

Secretin

36
Q

What hormone, released by enteroendocrine cells of the SI, stimulates the secretion of HCl by parietal cells, stimulates insulin secretion by B cells of the iselt of langerhans, and stimulates gastric motility and growth of the mucosal cells?

A

Gastrin

37
Q

The basal domain of paneth cells contains the ______. the apical region shows numerous protein granules of diverse AMPS - like what?

A

RER

Defensins, lysozyme, angiogenin 4 (ANG4)

38
Q

Where would you find intestinal stem cells?

A

ISCs reside in niche at crypt base, near paneth cells

They repopulate the entire epithelial lining of the SI, and may differentiate as goblet cells, enterocytes, and enteroendocrine cells

39
Q

Plicae circularis and intestinal villi are not found beyond which point in the GI tract?

A

Ileocecal valve

[So LI can be distinguished by lack of these things, as well as TONS of goblet cells]

40
Q

The layers of the LI are the same as those in the SI: mucosa, submucosa, muscularis, serosa.

What is the main function of the mucosa in the LI?

A

Absorption of water, sodium, vitamins, and minerals

41
Q

The absorptive capacity of the colon favors the uptake of substances such as sedatives, anesthetics, and steroids. Why might this be clinically important?

A

Medications can be administered there when they cannot be taken orally - due to things like vomiting

42
Q

How are the tubular glands, or crypts of lieberkuhn, oriented differently in the LI vs. the SI?

A

In the LI, they are oriented perpendicular to the long axis of the colon, are much deeper than the SI, and have higher proportion of goblet cells

43
Q

What 4 cell types are found in the mucosa (surface epithelium and tubular glands) of the LI?

A

Simple columnar absorptive cells - with apical microvilli

Goblet cells

Stem cells at base of glands

Enteroendocrine cells

44
Q

Describe mucosal layer of LI

A

Simple columnar epithelium formed by enterocytes and goblet cells

Glandular epithelium with enterocytes, goblet cells, stem cells, and enteroendocrine cells (+paneth cells in cecum)

Lamina propria and muscularis mucosae present, isolated lymphoid follicle penetrate submucosa

45
Q

Describe submucosa of LI

A

Dense irregular CT that lacks glands, vascularized

46
Q

Describe muscularis layer of LI

A

Inner circular layer is typical (same as SI)

Bundles of the outer longitudinal layer fuse to form taenia coli

3 longitudinally oriented ribbon-like bands that draw the colon into sacculations (haustra)

47
Q

What is unique about the serosa of the LI as compared to SI?

A

Epiploic appendices present (aggregates of adipocytes surrounded by serosa)

48
Q

Describe histological layers of appendix

A

Similar to that of LI

Mucosa of simple columnar with goblet cells (no villi); lymphoid follicles and lymphocytes within LP that extend into submucosa

Submucosa contains adipocytes and dense irregular CT

Muscularis: inner circular layer is well developed, but outer longitudinal layer is NOT

Covered with serosa

49
Q

Abnormal form of constipation caused by aganglionosis in the distal colon

A

Hirschprung’s Disease (congenital megacolon)

[Failure of NCC development (NCCs are what form the ganglion cells in plexuses of Meissner and Auerbach)]

50
Q

What causes Hirschprung’s Disease?

A

Mutations of the RET gene encoding a RTK

RTK signaling required for formation of Peyer’s patches, migration of NCC into distal portions of large intestine, and differentiation of NCC into neurons of the enteric nervous system

51
Q

In a patient with Hirschprung’s disease:

What would an intestinal biopsy show?

How is it treated?

A

Biopsy shows thick, irregular nerve bundles, a lack of ganglion cells, and abundant AChE staining

Treatment = surgical removal of affected colon segment

52
Q

The rectum is divided into 2 parts. Describe them histologically

A

Upper part (rectum proper): similar to colon - simple columnar epithelium with tubular glands

Lower part (anal canal): 8-10 rectal/anal columns with mucosal folds forming anal valves

53
Q

The lower part of the rectum (anal canal) contains columns that form anal valves. What 2 structures are contained within the valves?

A

Anal sinuses

Anal mucous glands

54
Q

At the base of the columns of the lower part of the rectum (anal canal) is the _________, which represents the epithelial transformation zone.

What epithelial transformation occurs here? Why is this transformation functionally important?

A

Pectinate line

Epithelium goes from simple columnar to non-keratinized stratified squamous (so that continuous shedding of cells d/t defecation may occur without issue)

55
Q

Describe histology of the rectum as it transitions to anus below the pectinate line

A

Below the pectinate line, at the level of the anus, the inner circular layer of muscularis thickens to form the internal anal sphincter. At this location, the mucosa consists of stratified squamous epithelium with circumanal glands in the submucosa. The external anal sphincter (skeletal m.) and levator ani m. also present. Epithelium of the anus is highly keratinized stratified squamous

56
Q

IBD includes what 2 diseases? How do those 2 differ?

A

Ulcerative colitis and Crohn’s disease

Both are characterized by diarrhea, pain, and periodic relapses.

UC affects mucosa of LI

Crohn’s affects any segment of intestinal tract, usually terminal ileum and LI

57
Q

Describe pathology of Crohn’s disease

A

Inflammatory cells produce cytokines that cause damage to the intestinal mucosa

Infiltration of neutrophils into crypts of Lieberkuhn —> destruction of intestinal glands d/t crypt abscesses —> progressive atrophy, ulceration of the mucosa

58
Q

Major identifying feature of esophagus histo

A

Mucous glands in submucosa (only found here and in duodenum)

59
Q

Major identifying feature of stomach histo

A

Inner oblique layer of muscularis externa (near border to submucosa)

60
Q

Major identifying feature of duodenum histo

A

Glands in submucosa (Brunner’s)

61
Q

Major identifying feature of jejunum histo

A

Long villi

62
Q

Major identifying feature of ileum histo

A

Peyer’s patches

63
Q

Major identifying feature of appendix histo

A

Abundant lymphoid tissue

64
Q

Major identifying feature of colon histo

A

Tons of goblet cells

65
Q

Major identifying feature of rectum histo

A

Anal columns in submucosa

GI Midterm (14 decks)

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