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E3: GI Flashcards

1
Q

What are the primary components of the Oral cavity?

A
  1. Lip
    1. External Skin
    2. Vermillion Zone
    3. Internal Mucosa
  2. Tongue
    1. Surface;
      1. Lingual Papillae
      2. Taste Buds
    2. Core
  3. MALT
    1. Palatine Tonsils
    2. Nasopharyngeal Tonsils (Adenoids)
  4. Major Salivary glands
    1. Parotid
    2. Sublingual
    3. Submandibular
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2
Q

What is this image of?

What are the components that can be seen here?

A

Lip:

Interior: Oral mucosa (NK.St.Sq & minor Salivary Glands)

Vermillion zone: Thin, lightly K.St.Sq | No oil/sweat glands

Exterior: Haired Skin (K.St.Sq), Sebaceous g.

Underlying Skeletal m.: Orbicularis Oris m.

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3
Q

What is this?

What are the labels?

A

Oral mucosa:

  • NK.St.sq. epithelium
  • Minor saliv glands
  • Replenished every 2-3 wks

P: Papillary Lamina

R: Reticular Lamina

MSG: Minor Salivary Glands

SM: SMooth m.

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4
Q

What are the types of Lingual papillae?

Which have Tastes buds?

A

Lingual papillae:

  1. Filiform p.
  2. Foliate p.
  3. Fungiform p.
  4. Vallate p.

Those with Taste buds are bolded

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5
Q

This image is of what?

Where is it located?

Characteristics?

A

Filliform papillae

Located sparsely around surface of the tongue

Lightly keratinized pointed projections, creating a rough surface allowing the tongue to “grip” food

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6
Q

This image is of what?

Where is it located?

Characteristics?

A

Foliate Papillae

Located on the lateral edges of the tongue

Forms deep moats; Taste buds in lateral surface epithelium

Receives saliva from lingual glands.

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7
Q

This image is of what?

Where is it located?

Characteristics?

A

Fungiform p.

Located sparsely placed on the anterior surface of the tongue

Projects above the anterior surface of the tongue

Taste buds on apical surface

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8
Q

This image is of what?

Where is it located?

Characteristics?

A

Vallate p.

Located at posterior of tongue; forms a V-shaped row

Dome shaped

Largest & least numerous of the papillae

Taste buds located on the lateral surface of the pits

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9
Q

What are the 5 tastes?

Is there any regional specificity?

Which lingual papillae are there taste buds on?

A

Tastes:

  1. Bitter
  2. Salty
  3. Sweet
  4. Sour
  5. Umami

No regional specificity

Located on;

  • Fungiform p.
  • Foliate p.
  • Vallate p.
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10
Q

What is this a picture of?

What are the components?

A

Tongue: Core

Skeletal m. & Minor Salivary Glands

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11
Q

ID the MALT within the oral/ nasopharyngeal cavities

A

Palatine tonsils:

  • Left & right at back of throat
  • Removed if subject to recurring Infections

Lingual tonsils:

  • Posterior of the tongue

Nasopharyngeal tonsils: Adenoids

  • Roof of nasopharynx
  • Epithelial lining; St.Sq*
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12
Q

What are the Major Salivary glands of the oral cavity?

Where are they located?

A

3 major salivary glands:

  • Divided into lobules by CT capsule
    1. Parotid gland
    2. Sublingual gland
    3. Submandibular gland
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13
Q

What does the Major Salivary glands look like?

A
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14
Q

What type of gland is this?

ID the Duct

A
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15
Q

What type of gland is this?

ID the duct

A
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16
Q

What is Barretts esophagus?

A

Dx: Barrett’s Esophagus

Long-standing gastroesophageal reflux disease (GERD), which causes stomach contents to back up into the esophagus

Increased risk for esophageal adenocarcinoma

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17
Q

Describe the BASIC layer trend of the GI tract

A

Superficial to Deep;

  1. Serosa:
  2. Muscularis Externa:
    1. Outer longitudinal
    2. Inner circular
  3. Submucosa:
  4. Mucosa:
    1. Muscularis mucosae
    2. Lamina Propria
    3. Epithelium
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18
Q

Describe the esophagus histologically

A

Mucosa:

  • NKstSq
  • LP
  • Muscularis mucosa: Thicker than most of GI

Submucosa:

  • Sporadic glands

Muscularis propria:

  • Inner: Circular
  • Mid: Myenteric Plexus
  • Outer: Longitudinal
  • Up 1/3: SkM
  • Mid 1/3: Mixed
  • Low 1/3: Sm

Esophagus lining:

  • Mostly thoracic: Adventitia
  • Short segment in peritoneum: Serosa
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19
Q

ID this tissue

A

Esophagus

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20
Q

ID this image.

A

Esophageal-Gastric Junction

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21
Q

What are the regional sections of the stomach?

A

Stomach:

  • Cardia
  • Fundus
  • Body
  • Pylorus
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22
Q

Describe the internal surface of the stomach. Function?

What are the secretions of the stomach?

A

Stomach:

Function: digestion

  • Rugae (folds in the mucosa) allow for expansion

Secretions:

  • HCl
  • Gastric lipase
  • Pepsin
  • Intrinsic factor
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23
Q

Describe the mucosa of the stomach & the components

A

Gastric Pits:

  • Apical layer: Epithelial invaginations
    • Lining: Foveolar (surface mucous) cells
    • Basal Nuclei; light cytoplasm
  • Lightly stained

Parietal Cells:

  • Mid-section
  • Highly eosinophilic; Due to high quantity of Mitochondria
  • Secretes: Acid & Intrinsic Factor

Chief Cells:

  • Highly Basophilic
  • Secretes: Pepsinogen & Lipase

Enteroendocrine Cells:

  • Sparsely placed (“dotted”) in base
  • G-cells present in in GI
  • Paracrine Secretion: Gastrin
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24
Q

Describe the Parietal cell function

A

Intracellular canaliculi

  • Deep invaginations of apical pm
  • Thousands of microvilli

[H+/K+ pump]

  • Antiport: H+ in; K+ out
  • Located on

[Carbonic anhydrase]:

  • Catalyze cytoplasmic: [H_2 O+〖CO〗_2→〖HCO〗_3^-+H^+]

Antiporter on basal surface exchanges HCO3– for Cl-

Result: Acidic lumen & Neutral LP

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25
How is the stomach protected from it's own production?
How is the stomach protected? 1. HCl forms in the lumen (not in the cell) 2. Pepsin forms in the lumen, not in the cell 1. Pepsinogen is secreted & cleaved 3. [Gastric Lipase] is an acidic lipase 1. Works only in acidic pH 4. Surface mucus protects against acid 1. Traps components that neutralize acid near the epithelium 5. Gastric acid reduces ingested microbial burden 1. Limits colonization 2. 1 exception; H. Pylori
26
What are the sections of the Small intestine? What is the function?
_Sections:_ Duodenum, jejunum, ileum * Similar histology Exceptions; * Duodenum: Brunner’s glands * Ileum: Peyer’s patches _Function:_ 1. Terminal food digestion 2. Nutrient absorption 3. Endocrine secretion 4. Mucosal immunity 1. Peyer’s Patches (Ileum)
27
Where are Peyer Patches concentrated? Why?
Peyers patches: * Concentrated in distal Ileum Why? * Due to high concentration of microbiome in colon
28
Describe the histology of the Gastroduodenal Junction
**Pylorus:** * Mostly gastric pits * Gastric glands (parietal/chief) become sporadic **Duodenum:** * Mucosa: intestinal villi appear to increase SA (absorptive epithelium) * Submucosa: Brunner’s glands * Secrete an alkaline mucus
29
Describe the 3 levels of Small intestine surface area
1. Plicae Circulares 2. Villi 3. Microvilli
30
Describe the mucosa of the small intestine
Mucosa: Villi lined with; * Enterocytes (S. Columnar) * Goblet cells * Enteroendocrine cells (Sporadic) * Stem cells (base) * Paneth cells (base) Lamina propria * Vessels * Lymphatics * Immune cells
31
What are enterocytes? What is their function?
Enterocytes: * Simple Columnar epithelium * Absorb nutrients * Paracellular Transport * Transcellular Transport * Secrete digestive enzymes
32
What are Paneth cells? What do they secrete?
**Paneth Cells:** * Located @ Base of crypts in Small intestine * Eosinophilic granules * Lysozyme: Cell wall breaking enzyme * AntiMicrobial Peptides (AMP)
33
What is the function of enteroendocrine cells?
Enteroendocrine cells: * Sense nutrients * Activation triggers basolateral release of peptide hormones * Diffuse in tissue fluid Role: * Gut motility * Enzyme secretion * Bile secretion * Satiety Just know G-cells which secrete Gastrin
34
What distinguishes the Duodenum?
Brunners gland in Submucosa
35
Describe the Duodenal mucosa & Submucosa
Mucosa: Epithelium lined villi * LP in the center of villi; Lumen in between * Lining: simple columnar (enterocytes) * Numerous goblet cells **Submucosa:** * Brunner’s glands
36
Describe the Ileum mucosa
Mucosa: Typical small intestinal villi * Sporadic goblet cells in epithelium within a villus is classic ileum * \*Goblet cells are staining darker due to stain * Abundant MALT: Peyer’s patches
37
Where are stem cells located in the; 1. Esophagus 2. Stomach 3. Small intestine
1. Esophagus: Basal 2. Stomach: isthmus/neck of gastric pit 3. Small intestine: in the crypts
38
Identify this tissue: * Esophagus * Tongue * Oral Mucosa * Epiglottis
Tongue: Vallate Papillae
39
Identify this tissue * Esophagus * Jejunum * Duodenum * Gastric Pit * Ileum * Esophageal-Gastric Junction
Esophagus:
40
Identify this tissue: * Small intestine * Esophagus * Oral Mucosa * Stomach * Gastro-duodenal Junction
Stomach: gastric tubules
41
What is the arrow pointing to? * Myenteric Plexus * Villus * Muscularis Propria * Serosa
Serosa
42
Identify this tissue: * Stomach * Small intestine * Esophageal-Gastric Junction * Gastric-duodenal Junction
Small intestine
43
Describe the basic structure & functions of the large intestine
**Anatomy:** * Gross: Wall divided into sacs **(haustra)** * Micro: all regions similar histologically * Sections: Ascending \> Transverse \> Descending \> Sigmoid **Function:** * Water Absorbtion * Waste Elimination * Microbiome (enormous)
44
ID this tissue.
Cross-section of Colon Mucosa Straight tubular glands; lined with goblet cells Nuclei at the base form the dark outline LP in between circular tubules
45
ID this tissue
Colon Mucosa Epithelium invaginates into straight tubular glands w/ many goblet cells Cross section of colon can be distinguished from the Small intestine via presence of LP in between glands, while in SI, it is the lumen
46
What type of cell is this? Where is it located? What does it secrete?
Paneth cell Base of the Small intestine crypts. Secreted Lysozyme & AntiMicrobial Peptides
47
What is the arrow pointing to?
Teniae coli m. * Outer longitudinal layer form 3 separate longitudinal ribbons * Contraction causes the wall to bunch into haustra * Teniae coli disappear at the rectum (back to MP) * Converges together at Appendix
48
Describe the trend of microbiota within the GI tract
Sterile at birth, colonized by feeding Microbiota varies by location: Mouth: Abundant Stomach: Scant (due to acid) Small intestine: Scant, except distal ileum Colon: Largest microbiome in the body 50% of dry fecal weight is alive The gut-brain axis? Major focus of study Dysbiosis of the gut microbiome: (out of order) Ex.: * Use of Antibiotics * C-Diff
49
What is the function of the pancreas? Basically describe it's histology
**Pancreas:** Both Endocrine & Exocrine organ Exocrine: Secretes digestive enzymes into ducts to the duodenum Endocrine: Islets of Langerhans secretes into fenestrated capillaries
50
What is this tissue? What are the decernable components?
Pancreas: Exocrine Acini & Endocrine glands (islets) Microanatomy: * Capsule * CT divides acini into lobes * All Serous * Similar to a salivary gland
51
What is the tissue displayed? What types of ducts are present?
Secretory acini (serous) * Multiple digestive enzymes; * Secreted as zymogens * Activated by [enteropeptidase] in duodenum Ducts: Intralobular: •Smaller; within the lobules Interlobular: * Large * Simple Cuboidal (sometimes Columnar) * CT surrounding it
52
What is produced from the cells depicted?
**Protein:** * Trypsinogen * Chymotrypsinogen * Carboxypeptidase * Elastase **Carbohydrates:** * α-amylase **Lipids:** * Triacylglycerol lipase * Phospholipase A2 **Nucleic Acids:** * RNAse * DNAse Bicarbonate ions * (From ducts) * Neutralizes the acid from the stomach
53
How do the enteroendocrine cells of the small intestine regulate pancreatic function?
Hormonal: **Enteroendocrine** (EE) cells in the duodenum * _Secretin:_ Promotes secretion of bicarbonate * _Cholecystokinin (CCK), Gastrin_: Stimulates exocytosis of zymogens Neural: * Stimulation of the Vagus n. (CN X) * Anticipation of a meal
54
What structure is shown here?
Islets of Langerhans: * Concentrated in the tail portion * Pale-staining * Clusters of cells * Fenestrated capillaries; Secretes into these Function: * Maintain stable blood glucose levels
55
Describe the breakdown of endocrine cells in the pancreatic islets
a cells: (20%) Glucagon B cells: (70%) Insulin d cells: (\<10%) Somatostatin PP cells: (Rare) Pancreatic Polypeptide
56
Describe the functions of the liver
Functions: 1. _Synthesis of plasma proteins_ 1. Albumins, clotting factors, apolipoproteins, transferrin 2. _Nutrient processing/storage_ 1. Glycogenolysis 2. Synthesis of glucose from non-CHO sources during starvation (gluconeogenesis) 3. AA metabolism/urea cycle (removed by kidneys) 4. Energy storage (glucose/triglycerides) 5. Vitamin A, Fe storage 6. Bile synthesis 3. _Toxin detoxification_ 4. _Structure-function: Major interface with the blood_ 1. 75% of blood comes from the **hepatic portal vein** 1. Stomach/small intestine 2. 25% is from the **hepatic artery**: Oxygen supply
57
What is the functional unit of the Liver?
Functional Unit: **Hepatic lobule** * Plates of hepatocytes radiating from a central venule * Surrounded by sinusoids * Bounded peripherally by 3 to 6 portal triads. * Branch of **hepatic artery** (oxygen) * Branch of **portal vein** (from GI) * Branch of **bile duct** **Bile Flow & blood flow in opposite directions\*** * Blood: Portal -\> Central v. * Bile: Canaliculi -\> Portal
58
What structure is shown?
Portal Triad **Venule** * Thin walled * Large lumen **Arteriole** * Smooth m. * Smaller than venule **Bile Duct** * Simple Cuboidal epi.
59
ID structures present
60
What is ID'ed in blue in this image of Liver tissue?
Sinusoids: •Fenestrae are clustered into Sieve plates **Kupffer cells:** * Permanent liver resident * Patrol the lining * Phagocytize & digest old RBCs
61
Describe the pathway between blood cells to the hepatocytes
Space of Disse: (AKA Perisinusoidal space) * Space between ECs & hepatocytes * Hepatocytes: Numerous microvilli * Bathed in plasma * Contains hepatic stellate cells (aka Ito cells) * Stores vitamin A * HSCs are pericytes (contractile cells surrounding capillaries)
62
What is Bile? Function? Synthesis?
Bile: Function: * Emulsifies lipids, promoting easier digestion by [lipases] Components: * Cholesterol * Salts * Bilirubin (RBC breakdown product) Bile Formation: * Hepatocytes synthesize & secrete Bile within **Bile canaliculi** * Space between 2 adjacent hepatocytes * Drain into bile ducts
63
What structure is displayed?
Bile Duct: S.Cuboidal
64
Hepatic Summary
**Portal Triad:** * Deoxygenated & Oxygenated Blood combine & flow to Central v. **Kupffer cells:** * Patrol sinusoids for sinescent cells **Space of Disse:** * Space between hepatocytes & endothelial lining * Stellate (ito) cells within **Bile:** * Synthesized in Bile canaliculi and flows to Portal Triad
65
What is in the image?
**Gallbladder:** _Function:_ * Stores & concentrates bile from the liver until needed _Anatomical Layers:_ Folded mucosa: * Simple columnar epith; Basal Nuclei * LP Muscularis Adventitia Regulation: * Fat stimulates CCK release (EE/sm intest) * SM contraction * Bile released into duodenum
66
Describe the Enterohepatic circulation
Recycling of bile acids: * Most: small intestine * Some: large Clinical significance: * Hepatoxicity of some drugs * Digestive problems in IBD due to recycling defects

Histology (11 decks)

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