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Histology > 2.3 Digestive System Liver, Pancreas Gallbladder > Flashcards

2.3 Digestive System Liver, Pancreas Gallbladder Flashcards

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0
Q

Parakeritinsed epithelium?

A

Hard palate/masticatory mucosa.
Superficial cells not pyknotic nuclei.

What is pyknotic ? Irreversible condensation of chromatin.

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1
Q

9 main areas of digestive system and function?

A

Oral cavity - ingestion and initial fragmentation

Tongue and pharynx

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2
Q

names for parotid and submandibular gland ducts?

A

Stensens and whartons duct

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3
Q

4 types of tongue papillae?

A

Filiform, fungiform, circumvallate, foliate

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4
Q

How to differentiate between oesophagus and ureter?

A

Muscularis externa - oesophagus inner circular outer longitudinal. Ureter - opposite

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5
Q

Organs of GI tract and accessory organ

A

Mouth, isthmus of fauces, oesophagus, stomach, si, li, cecum, rectum

Teeth, tongue, salivary glands, liver, gallbladder, pancreas

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6
Q

Glands of GI tract?

A

Intraepithelial - goblet cells

Mural
Intra - tunica : mucosa, submucosa
Extra - major salivary glands, liver, pancreas

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7
Q

Functions of digestive system? (6)

A 
Ingestion, swallowing 
H+ secretion, digestive enzymes
Mixing and propulsion
Absorption
Reabsorption of water and undigested mat
Elimination of digested material - defecation
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8
Q

Oral cavity consists of?

What is the isthmus of fauces?

A

Cheeks, hard and soft palate, tongue
Space extends from gums + teeth

Fauces - opening between oral cavity + pharynx

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9
Q

Salivary glands (3)

A

Moist and clean oral cavity
Secretion of mucus increase - chemical digestion
3 pairs of glands

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10
Q

Frenulums - teeth?

A

Decidous - baby teeth, 6months, 20 by 2 years, fall out by 2-6 years

Permanent - 32 total, 3rd set of molars by end of adolecense (Widom teeth)

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11
Q

Tongue structure, extra (2)

A

Mostly muscular -
grip + reposition food
Swallowing
Speech

Taste buds - circumvallate, foliate, fungiform, filiform papillae
Lingual tonsils

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12
Q

What is the isthmus of fauces?

A

.

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13
Q

Pharynx (3)

A

Naso - respiratory

Oral - digestive and respiratory

Laryngo - digestive and respiratory

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14
Q

Opening of laryngopharynx regulated by

A

Epiglottis -> elastic cartilage - 9th cartilage of larynx

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15
Q

What are the different phases of swallowing?

A

.

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16
Q

Structure of pharynx ?

Muscular and adventitia

A

Pseudostratified ciliated
Oro+laryngopharnx -> ssnk

Striated skeletal muscle
Adventitia external to muscle

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17
Q

What are the pharyngeal aponeurosis?

A

Fibroelastic ct -> muscle insertion

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18
Q

Muscle of pharynx(3)

Innervation

A

Constrictor muscles
Sup, mid, inf
Squeeze bolus -> into esophagus
Vagus nerve

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19
Q

Esophagus (5)

A

Food swallow -> folding longitudinal of lumen
C6-T10
25cm length
Behind trachea
Passes thru oesophageal hiatus (diaphragm) -> enter abdomen

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20
Q

4 constrictions of esophagus?

4 parts and length?

A

Cricoid, aortic, bronchial, diaphragmatic

Cervical 4-5, mediastinic 16, diaphagmatic 1-2, abdominal 3

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21
Q

GI Tract - general structure 4

Describe first 2 and how increase SA of first?

A

Mucosa, submucosa, muscularis externa, serosa
Mucosa - epithelium, lamina propria (MALT LCT with capillaries)
Muscularis mucosa - thin layer of sm cells - local movements
Submucosa - CT - minor blood+lymph vessels , nerves - elastic fibres - regain shape

Plicae, microvilli, villi, glands/crypts

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22
Q

Last 2 layers of GI tract?

And innervation of muscularis externa

A

Muscularis externa - 2 layers of SM - peristalsis, segmentation
Inner circular - squeezes, formation of sphincters
Outer longitudinal - shortens gut

Myenteric plexus between ME.

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23
Q

Submucosal plexus of gi tract?

A

Meissner plexus -> control gland, sensory function, contraction of MM

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24
Structure of esophagus?
Mucosa - ss non keratinised, lp, mm Submucosa – seromucous glands Muscularis externa - inner and outer In thirds : sup - skeletal. Mid - sm and skeletal. Inf - only sm Adventitia - CT, no serosa
25
Esophagus - seromucous glands?
Secrete thin layer of mucus - lubrication | Esophageal cardiac glands - tubular - only LP - terminal part of oesophagus - neutral mucous
26
Muscosa and submucosa form?
Longitudinal folds -> stellate aspect of lumen disappears when swallowing. Reappears -> elastic recoil
27
Muscularis mucosa where evident in esophagus? | Submucosa contain.,
2nd and 3rd part Elastic fibres, venous plexuses, drain into venous + hepatic portal circulation
28
Gastro-oesophageal junction (3)
Z line Abrupt transition Ss - epithelium - secretory mucosa (simple columnar)
29
2 sphincters of eosophagus?
UES - sup - cricopharyngeal sphincter - mech of swallowing + prevent air entrance LES - inf - prevent reflux of acid into esophagus
30
What is reflux esophagitis?
Ulceration, difficulty swallowing (caudal stratified - replaced by columnar - lose resistance
31
Development defect of diaphram?
Hernia hiatus - herniation of abdominal portion of oesophagus
32
Abdomen surgical ares?
Left and right: Hypochrondium Lumber Iliac fossa In the centre : epigastric, umbilical, hypogastric
33
Example of retroperitoneal and extra peritoneal organs!
Pancreas, kidney
34
Duodenum and post abdominal wall?
Not completely surround by peritoneum
35
Abdominal aorta splits into
Celiac ( gastric, common hepatic, gastrodudenal ) sup - (ascending and transverse colon 2/3) inf mesenteric artery - 1/3 transverse, descending, sigmoid Renal - 20% of cardiac output Adrenal
36
Infra and supra mesocolic space ?
.
37
Does retroperitoneal have a mesentery? Lesser omentum is surrounded by? Greater omentum?
No Surrouded by peritoneum Formation of other cavities
38
Stomach ? | Pyloric sphincter function
1.5L, EPIGASTRIC REGION - hypogastric Greater and lesser curvature - ligaments attached - stomach and liver (lesser omentum) Angular incisor, cardiac notch, fundus, body, pyloric antrum and canal Regulation mat from stomach to duodenum
39
crypts of lieberkaun?
Found in SI Brunenrs gland found in duodenum (submucosa) Ileum - peyers patched
40
You need to learn about the stomach?
Posture, wispdth, position of other vicera, extent of filling effect, shape of stomach
41
Stomach position?
Inferior to diaphram, under liver
42
What forms the lesser omentum!
Hepatogastirc and hepatoduodenal ligament- Bv reach liver Portal vein Hepatic artery Extra hepatic billiary duct inserted onto ligament
43
Quick fact about greater omentum?
Behind - adipose tissue
44
Muscularis externa of stomach?
3 layers - oblique, circular, longitudinal. Mechanical contraction - muscles contract Mixing of digestive enzymes and proteolytic enzymes
45
Stomach mucosa epithelium?
Simple columnar, surface mucous cells. Produce mucous -> protect stomach from acidic content No absorption - except h2o, salts, lipids, drugs, alcohol
46
Effect of drugs and alcohol on stomach?
Damage mucosa of stomach, Prostaglandins released Loss protective function of mucosa
47
What level are the greater and lessor curvatures of the stomach located?
Level of the body
48
What angle antrum and body of stomach? Pylorus and duodenum connected via? What is at the surface of the internal wall of stomach? Where/when is this less prominent
90 Pyloric sphincter Rugae, less prominent middle area + when stomach fills
49
Vascularisation of stomach?
Celiac trunk - l-r gastric artery; l-r gastro-omental artery Veins parallel to artery, drained into hepatic portal vein
50
What supplies the fundus and body of stomach? Vascular
Upper gastric arteries
51
Gastric folds?
Longitudinal - distensibility
52
What are mammiliated areas in stomach?
Aeroles - delimited by permanent sulca
53
Where are glands of stomach located? What type? Name? Secretion? Cells in glands? Purpose?
Lamina propria, Tubular, single, branched body, fundus, cardiac, pylorus, Mucous secretion -> protection against high acid level of stomach
54
How to differentiate between stomach and colon?
Lamina propria - stomach glands Colon - mucous secreting cells + intercalated between are enterocytes
55
Submucosa, muscularis, serosa of stomach?
Submucosa - little Muscularis externa - internal :oblique, circ, longi Serosa - peritoneum
56
Defensive forces in the stomach? (6)
Surface mucosa, bicarbonate, mucosal blood flow, membrane transport, epithelium regenerative capacity, elaboration of prostaglandins
57
Injury of stomach leads to?
Ischemia, shock, delayed gastric emptying
58
3 types of stomach glands and where found?
Cardiac - simple compound tubular, mucous secreting - cardiac region, surround esophageal orifice Pyloric - tubular branched coiled mucous + gastric secretion - pyloric antrum Gastric/fundic - simple tubular branched at base - thruout stomach except above areas. Long lifespan of cells - Pariental cells 200days
59
Gastric mucosa - gastric glands. Cells, tubularvesicular system
Pariental(150-200days) - hcl and intrinsic factor (b12 vit absorption -> rbc production) -> tubulovesicular system -> proton pump, maintain acidic ph of stomach. Large no. Of mito. Chief (60-90days) - pepsinogen (zymogen granules) + hcl -> pepsin Neuroendocrine cells -gastrin Surface/neck mucous cells Pariental cells - larger - bud from lining epithelium, darker well stained compared to chief cells
60
Stomach glands -> Fundic mucosa, -3 levels and what cells located within
Surface neck cells - mucous cloudy production - level of lining epithelium + gastric pit Neck cells - soluble clear secretion Gastric pit(surface mucous cells) - isthmus (stem cells located, pariental, mucous neck) - fundus (chief and enteroendocrine cells)
61
Enteroendocrine cells (g cells)
Hcl Gastric motility Growth of epithelial cells Open (chemoreceptors) and closed.
62
Gastrin, ghrelin, cck, secretin, gip, motilin. Where synthesised, stim and inhibit what?
Gastrin - g cells stomach - gastric acid - nothing Ghrelin-cells in stomach-gh secretion-lipid met+fat usage in adipose Cck - i cells duo+jujenum- gallbladder contraction,same as secretin-gastric emptying Secretin - s cells duodenum - pancreatic enzyme, bicarbonate, growth- inhibit gastric acid secretion Gip - k cells duo + jujenum - insulin released - gastric acid secretion Motilin - m cells duodenum + jujenum - gastric+intestinal motility - nothing
63
Zollinger ellison syndrome?
Gastrinomas -> gastric + duodenal ulcers - damage of mucosa
64
2 types of neuroendocrine cells?
Open - cytoplasmic prolongement exposed to lumen - chemoreceptors Closed - not reach lumen
65
Gastric serosa continuous with?
Parietal peritoneum of abdominal cavity via greater omentum Visceral peritoneum of liver - lesser omentum
66
Small intestine - mesenteric arteries
Jej and ileum
67
Duodenum length and 2 extras
25cm - different structure and relationship to peritoneum
68
Si Function of enterocytes ->
Enterokinase - trypsinogen -> trypsin Trypsin : pancreatic zymogens (inactive proenzymes) ->active enzymes Eg pro:elastase, carboxypeptidase, phospholipase -> without pro. Chymotrypsinogen -> trypsinogen
69
SI (4)
Continues digestive process started in stomach Absorbs food and water Food exiting stomach : chyme -> chymus Chymus exposed to pancreatic and biliary secretion -> chyle
70
Pancrease and duodenum. | Wall of intestine?
Exocrine pancreas secrete into duodenum | Wall of intestine - lacteal + bv
71
SI Macroscopic and microscopic devices
Plicae, villi, crypts and glands, microvilli
72
Si where are plicae most numerous? | And plicae points
Distal - duo Beginning of jej Perm tranverse folds - cont core of submucosa
73
Biochemical devices of si digestion
Luminal - pancreatic enzymes and bile | Membrane - enzymes of microvilli (glycocalyx)
74
Mechanical devices of si?
Contraction and relax of intestinal wall (muscularis externa - cl)
75
Duodenum?
25cm, first, shirtest and widest part. Bulbis duodenalis, descending, horizontal, ascending portion C shaped. Retroperitoneal except bulbos duodenalis
76
Sup mesenteric artery and veins drain into?
Portal vein
77
SI Explain bile, pancreatic enzymes, major-minor papillary duct?
Bile - emulsify lipids Pancreatic enzymes - proteases, amylases, lipases, nucleases Minor pap - accessory pancreatic duct Major pap - main pancreatic duct + coleducus -> sphincter of oddi.
78
What stimulates opening/closing of the sphincter of oddi?
CCK
79
Si mesenterial part
Jej(2.5m) ileum(3.5m) - surrounded by peritoneum.
80
Root of mesentary
Length 15cm Aterial arcade - longer in jej, shorter in ileum Vasa recta - jej few large loops, ileum greater no. Of loops Nerves And bv from sup mesenteric artery
81
Structure of SI summary
Mucosa - simple cuboidal epi, villi, tubular glands/crypts, muscularis mucosa(2layers), lamina propria (galt) Submucosa - duo(brunner glands) - acidic secretion - compound tubular Muscularis externa - CL Serosa
82
si villi cross-section
Lamina propria - lacteal, vascular, immune cells Sm cells extending from muscularis mucosa into core of villus Loost ct, cappillaries, lymphatic vessels (lipid absorption)
83
Si - crypts of lieberkaun
Paneth cells - defensins + lysozymes. Basally located
84
5 cells types found in intestinal mucosal epithelium
``` Enterocytes - primary function - absorption Goblet cells - mucous secretion Paneth cells - defensins and lysozomes Enteroendocrine cells - paracrine and endocrine hormones M cells (microfold cells) - modified enterocytes cover lymph nodules in lamina propria ```
85
Si- Enterocytes ?
Simple columnar - line mucosa glycocalyx - important enzymes - digestion Digestion of sugars(di+oligo-saccharides-> mono), proteins (peptidases + brush border)
86
What is the first enzyme involved in digestion | .
Pepsin
87
Si - bile
Convert lipids - smaller molecules -> into lacteal vessels
88
Si - stem cells for renewal -
3/5 days - enterocytes+ mucous cells | 4 weeks - paneth+enteroendocrine cells
89
Ileum (4)
Peyers patches - galt (higher no. In ileum) - mucosa lamina propria / sometimes submucosa Dome b cells Germinal centre (b and t cells, apc) Follicle associated epithelium (m cells(dendritic cells) - take up antigen) However galt/lymphoid tissue found thruout digestive system
90
Lamina propria of villus of illeum
Plasma cells, eosinophils, macrophages, mast cells Sm, bv,lv What does sm do? Connects villus to muscularis mucosae
91
What is inflammatory bowel disese
Crypts knvaded by inflammatory cells - chronic granulomas -> destroy musuclaris mucosae -> fibrosis - replaced by CT (collagen)
92
Distinguish duodenum, jej, ileum
Duo - submucosa - brunner glands. Leaf life villi. Ileum - peyers patches D->I increase in goblet cells
93
2 types of motility?
Segmentation - non-coordinate sm contraction | Peristalsis - co-ordinated
94
Brunenr glands?
Mixed tubular submucosal, duodenum, Zymogen + mucus secreting. Alkaline -> protect proximal si from stomach acid
95
Si, epithelial cell renewal?
Stem cells from base of intestinal gland
96
LI length, portions and relaitons to peritoneum, function, structures
``` 1.5-1.8m. Cecum + vermiform appendix 1 Ascending 15cm 2 Transverse 50cm 3 Descending 25cm 4 Sigmoid Rectum Anal canal 1-3 not covered by peritoneum 2-4 connect to post wall of abdominal wall by mesenteries -> visceral peritoneum - form double layer ```
97
Three distinct features of LI?
Teniae coli - 3 narrow bands outer longitudinal layer of externa. Absent in rectum, anal canal, vermiform appendix Haustra coli - sacculatiojs between external surface of cecum and colon Omental appendices - fatty projections of serosa on outer surface
98
Function of LI
Reabsorption of electrolytes and water, | Elimination of undigested food and waste - propulsion - rectum
99
Columnar to goblet cell ratio in LI. | TOWARDS RECTum the ratio is?
4: 1 1: 1 goblet cell increases
100
LI epithelial cell turnover
Similar to SI
101
Vascularisation of LI
Sup, inf mesenteric arteries Splenic and sup mesenteric vein -> form hepatic portal vein - drain mesentery of sigmoid colon (intra peritoneal) - connected to post wall of abdomen .
102
Inner wall of LI (3)
Sulci - semilunar plicae Due to tonic contraction of ext longitudinal layer No plicae or villi
103
Structure of LI
Mucosa - no villi, plicae. Smooth surface, crypts of lieberkaun(straight tubular) extend thruout. Simple columnar. Lamina propria - collagen table(collagen and proteoglycans between basal lamina and epithelial cells), pericryptal fibroblast sheath(may differentiate into macrophage), galt, lymphatic vessels(muscularis mucosae) Submucosa - similar to rest of gi tract Muscularis - CL Serosa - peritoneum Goblet cells more numerous in LI than SI
104
How to distinguish stomach and colon?
Lining epithelium - stomach only mucous secreting cells form mucous membrane. Whereas LI other cells present
105
Hirshsprings disease
Congential megacolon - dilation - consitpation | Neural crest cell migration failure - abnormal innervation of bowel
106
Aooendix contain?
Lymphatic follicles in mucosa. Extend into submucosa. Thick circular layer. Thin outer longi layer. Serosa continuous with mesentery of appendix
107
Rectum length and extra point! | Anal canal length and 4
15cm - lacks haustra Anal canal - tenai dilated in ampulla of anal canal - communicates with anus by sphincter system - 3 zones,
108
Anal canal 3 zones and what glands
Colorectal - simple columnar Anal transitional - ss epi. Also stratified columnar between transition of colorectal to ATZ Squamous - ss epi Anal glands - extend into submucosa + muscularis externa. Branches tubular straight mucous. Ducts lined with stratified columnar epi.
109
Also skin surrounding anl orifice!
Large apocrine glands - circumanal glands. Maybe sexual attractant. Hair follicles and sebacous glands found at this site
110
Internal and external sphincter?
Int - sm - involuntary Ext - skeletal - voluntary contraction
111
Anal folds, valves and sinuses
8-10 longitudinal folds Valves - small horizontal plicae at base of folds Anal sinuses - behind valves - where glands open Pectinate line - determined by valves
112
Deep to anal columns there are? | Protrusions int and ext
Av anastomoses. If vascular plexa protrude - int/ext -> int/ext hemmoroids - bleeding
113
Major salivary glands
Extra mural glands Parotid - tubuloacinar - duct of steno - into upper cavity of molar teeth Sublingual - mixed tubuloacinar Submandibular - mixed tubuloacinar
114
Liver exocrine and endocrine function?
Exo - Bile secretion - emulsify fatty acid -> droplets -> absorbed in SI Endo - synthesis of proteins - albumins, globulins etc
115
Liver 6 main functions
Fat met - ox of troglycerides. Synthesis of plasma lipoproteins. Synthesis of cholesterol Carb met - convert carbs and proteins into fatty acids + triglycerides. Regulation of blood glucose conc (glycogenesis, glycogenolysis, gluconeogenesis) Protein met - syn plasma proteins, non essential aa, detox of waste products (deamination of urine) Glycogen storage Detox of drugs and toxins - eg alcohol Secretion of bile
116
Liver protein met -> plasma proteins examples
albumins, globulins, clotting factors
117
Liver where is visceral peritoneum not present?
Bare area where liver adhere/connects to other organs
118
Lesser omentum and liver?
Connects stomach, duodenum and liver
119
Post margin of liver?
Veins draining into vena cava
120
Liver: shape, weight, lobes, ligaments
Kidney shaped. 1.5kg. 4 lobes - left right caudate quadrate. | Falciform, coronary, triangular, round ligament
121
Falciform ligament
Connects diaphragmatic face of liver to diaphram -> only see ligaments and 2 lobes
122
Ligament venosu , round ligament
Residue of embryonic blood vessels,
123
Emrbyonic development of liver?
Endodermal evagination wall of foregut Hepatic diverticulum - proliferates - hepatocytes (cords) Original stalk of diverticulum -> common bile duct. Outgrowth from common bile duct - gallbladder and cystic duct
124
H zone of liver
2 longitudinal and 1 transverse sulci - specific structures | 2 extra lobes seen - only seen inferiorly.
125
Post face of liver
Hepatic veins -> inf vena cava Triangular ligament -> obtained by fusion of 2 peritoneum layers (bare area of liver) Corinary ligament surround bare area
126
How many segments in liver?
8 based on distribution of bile ducts and hepatic vessels
127
Liver vascularisation
Proper hepatic | Inf mesenteric vein -> splenic vein + sup mesenteric -> hepatic portal vein
128
Liver structure
Glisson capsule - parenchymal organ. Sinusoids, hepatic lobules. Central vein Portal triad : at corner of hexagonal lobules. (Bile duct, art, portal vein.)
129
Portal triad
Art, vein, bile duct. Canal of herring, Cholangiocytes (undifferentiated) - epithelial cells, line biliary tree. Primary cilium - detect luminal flow. Initially cuboidal. Increase in duct diameter -> columnar Bile flow in opposite direction to blood flow (to central vein)
130
Classic lobule venous
Central vein (terminal hepatic venule) -> sublobular vein-> hepatic portal vein -> inf vena cav
131
Liver - portal triad - small ducts
Fuse form large duct - common hepatic duct - ultimately empty major papillae in duodenum
132
Liver - cappilaries
Mixed blood from liver and blood from digestive system
133
Liver - Different faces of classic lobule
Biliary face - adjacent to neighbouring hepatocyte - small depression on pm - canaliculi - bile produced - released Vascular face - faces wall of capillary - sinusoid.
134
Liver - space between sinusoid and hepatocyte
Space of disse (0.2-0.5um) Cells of ito (hepatic stellate cells/fat storing) Store vit A. Pathological condition - aSMA expressed - fibroblast prolongement - release collagen- fibrosis - myofibroblast - express specific marker Wall of sinusoid - kupffer cell
135
Liver regen | Aged liver
Cells quintescent. Remove liver portion, cells activated - mitosis proliferation Aged liver - regen - able to be donor
136
Stroma of liver contain?
Reticular fibres - t3 collagen
137
Portal lobules
Triangular Biliary ductule Corners of triangle with central vein. Central part of triangle - portal triad
138
Liver acinus | 3 zones
Rappaporta - diamond shape. 2 opposite corner = central vein. Other 2 = portal triad Zone : 1 most oxygenated - sensitive to bile duct occlusion 2 mediate oxy 3 least oxy - sensitive to necrosis and oxygen deprivation Increase in o2 increase in met activity Damage to liver - zone 3 most vulnerable and involved
139
Mod of kidney
Accumulation of collagen. | Renal fibrosis
140
Which stain for collagen?
Sirus red
141
Biliary tree intra and extra hepatic bile duct
Monitored flow of bile and content regulation by cholangiocytes Canal of herring lined by hepatocytes and cholangiocytes (liver progenitor cells).
142
Difference between space of mall and canal of herring?
Not location. Whether lined entirely by cholangiocytes or partially Space of mall duct lined entirely by above
143
Intra/exta-hepatic bile duct
Intra - ductules to interlobular bile duct to L/R hepatic duct - common hepatic duct Extra - bile to gallbladder and duodenum. Ducts contain - tall columnar epithelium, layers similar to alimentary canal except no Musuclaris mucosa
144
Gallbladder structure and basic info
10cm. 40-60ml. Cystic duct. Concentration of bile. Mucosa with folds. Attached to visceral surface of liver. Remove 90% of water from bile. Simple columnar epithelium.
145
Gallbladder mucosa characteristic features 4
Numerous short apical microvilli Junctional complexes between adjacent cells Apical and basal cytoplasm - conc mito Complex lateral plications Mucous secreting glands present lamina propria near neck of organ.
146
Wall of gallbladder? | What are the deep invaginations of mucosa extending into epm.externa?
No submucosa and muscularis mucosa Rokitansky-ashoff sinuses
147
Pancreas quick points!
L1 and l2 level Retroperitoneal 2 ducts - main pancreatic duct and accessory pancreatic duct
148
What are sphinctors on ducts made of?
Smooth muscle
149
Function of exocrine pancreas?
Tubuloacinar compound serous | Function - synthesis+ secretion if lytic enzymes (zymogens) activated by trypsin

Histology (17 decks)

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