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TAS Gastroenterology > Histopathology And Cellular Function ✅ > Flashcards

Histopathology And Cellular Function ✅ Flashcards

1
Q

Describe the structure of the GI tract, from mouth to anus?

A

Tubular structure with 4 layers

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2
Q

What are the layers of the GI tract?

A
  • Mucosa
  • Submucosa
  • Muscularis externa
  • Serosa
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3
Q

What is the mucosa of the GI tract made up of?

A
  • Epithelium
  • Connective tissue
  • Thin smooth muscle
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4
Q

What is the submucosa of the GI tract made up of?

A

Connective and supportive tissue

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5
Q

What is the muscularis externa of the GI tract made up of?

A

Two thick layers of smooth muscle

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6
Q

What is the serosa of the GI tract made up of?

A

Thin outer layer of connective and supportive tissue

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7
Q

What epithelium does the oesophagus have?

A

Non-keratinised stratified squamous epithelium

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8
Q

What is the function of the muscularis externa in the oesophagus?

A

Peristaltic contractions of the muscuarlis externa propel the food boluses forward into the stomach

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9
Q

What epithelium is present in the stomach?

A

Columnar epithelium

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10
Q

What does the columnar epithelium of the stomach contain?

A
  • Mucus-secreting cells

- Many immune cells

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11
Q

What do the mucus secreting cells in the stomach mucosa form?

A

Gastric pits

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12
Q

How do the mucus secreting cells in the gastric mucosa form gastric pits?

A

By invaginating down

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13
Q

What happens to the gastric pits from the fundus to the pylorus?

A

They become deeper

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14
Q

What immune cells are present in the gastric mucosa?

A
  • Plasma cells

- Lymphocytes

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15
Q

What is the inner lining of the small intestine formed of?

A
  • Plicae circularis
  • Villi
  • Mucosal epithelium
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16
Q

What are plicae cirecularis?

A

Transverse ridges

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17
Q

What are villi?

A

Tall finger-like projections of mucosa

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18
Q

What is found between the villi in the small intestine?

A

Crypts of Lieberkuhn

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19
Q

What kind of epithelium is found in the small intestine?

A

Columnar

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20
Q

What is the function of microvilli in the small intestine?

A

They greatly increase the surface area

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21
Q

What is the surface area of the small intestine in adults?

A

250m2

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22
Q

How can the duodenum be distinguished histologically?

A

By presence of Brunner’s cells

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23
Q

Where are Brunner’s cells found?

A

At the hepato-pancreatic sphincter (sphincter of Oddi)

24
Q

What is the function of Brunner’s cells?

A

They produce an alkaline substance to aid digestion

25
Q

Which portion of the small intestine has the tallest villi?

A

Jejenum

26
Q

Where do the villi extent from in the jejunum?

A

The permanent circular fold of the mucosa and submucosa

27
Q

How is the ileum identified histologically?

A

Presence of aggregated lymphoid follicles, known as Peyer’s patches, which are found in the submucosa

28
Q

What is the predominant immune cell found throughout the GI system?

A

Lymphocytes

29
Q

Where are lymphocytes found in the GI tract?

A

In the surface epithelium and in the lymphoid follicles

30
Q

What do the lymphocytes found in the GI tract collectively make up?

A

Gut-associated lymphoid tissue (GALT)

31
Q

What other immune-mediating cells are found in the small intestine?

A

Paneth cells

32
Q

Where are Paneth cells located?

A

In the crypts

33
Q

What do Paneth cells contain?

A

Granular material important in lysis of microorganisms

34
Q

What is present in the colon when viewed microscopically?

A

A number of microscopic crypts that extend down to the muscularis mucosa

35
Q

What is found within the crypts of the colon?

A

Goblet cells

36
Q

What is the function of the goblet cells of the colon?

A

Production of mucus

37
Q

What GI abnormalities can be diagnosed with histopathology?

A
  • Coeliac disease
  • Inflammatory bowel disease
  • Eosinophilic diseases
  • Oesophagitis, gastritis, and gastro-oesophageal reflux
38
Q

What is coeliac disease?

A

A multi-system disease, including a small intestinal enteropathy secondary to exposure to gluten

39
Q

What are the classic histological findings of coeliac disease?

A
  • Flattened duodenal mucosa with loss of crypt architecture
  • Intraepithelial lymphocytosis
  • Glandular hyperplasia
40
Q

Are the histological findings in coeliac disease reversible?

A

Yes

41
Q

How can the histological findings in coeliac disease be reversed?

A

Gluten exclusion diet

42
Q

Where can changes be demonstrated histologically in Crohn’s disease?

A

Anywhere from mouth to anus

43
Q

What is found histologically in Crohn’s disease?

A
  • Areas of chronic inflammation, comprising increased lamina propria plasma cells and lymphocytes
  • Skip lesions including patchy erosions or ulcers, vertical fissures, and fistulas
  • Transmural inflammation with multiple lymphoid aggregates and granulomas
44
Q

Where does UC affect?

A

Only the large bowel

45
Q

What is found histologically in UC?

A
  • Alteration of crypt architecture, including cryptitis and crypt abscesses
  • Increased chronic inflammatory cells in the lamina propria, including lymphocytes and plasma cells
46
Q

Are eosinophils normally found in the GI tract?

A

Yes

47
Q

What happens in eosinophilic disease of the GI tract?

A

There is a markedly increased eosinophilic infiltrate in the mucosa

48
Q

What do the symptoms of eosinophilic diseases of the GI tract depend on?

A

The site of the disease

49
Q

How does eosinophilic oesophagitis present?

A
  • Dysphagia
  • Retrosternal chest pain
  • Bolus dysphagia (food bolus lodged in oesophagus)
50
Q

How does eosinophilic intestinal disease present?

A
  • Recurrent abdominal (often epigastric) pain
  • Vomiting
  • Dysphagia
  • Diarrhoea
51
Q

When can inflammation of the oesophagus and stomach occur?

A

When there is excess secretion of gastric acid, and if the contents of the stomach reflux back into the oesophagus

52
Q

Who is gastro-oesophageal reflux common in?

A

Infants

53
Q

Why is gastro-oesophageal reflux common in infants?

A

Due to the immaturity of the lower oesophageal sphincter

54
Q

How does gastro-oesophageal reflux differ in infants compared to adults?

A

In infants, it is rarely associated with the formation of dysplastic cells, such as those seen in Barrett’s oesophagus in adults

55
Q

What are the other causes of oesophageal and gastric inflammation?

A
  • Ingestion of caustic material
  • Presence of H. Pylori
  • General severe systemic illness such as sepsis

TAS Gastroenterology (17 decks)

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