GI II

Question 1

submucosa

Answer 1

dense irregular CT
glands in esophagus and duodenum
submucosal (meissner’s) nerve plexus

Question 2

Meissners plexus

Answer 2

between circular muscle layer and muscularis mucosae
regulate secretory cells
regulate blood flow within walls of GI tube
innervates muscularis mucosae

Question 3

Myenteric plexus (auerbach’s)

Answer 3

between longitudinal and circular muscle layers

regulate peristalisis

Question 4

Both plexuses contain _____ neurons

Answer 4

autonomic

Question 5

Muscularis mucosae of esophagus

Answer 5

ill-defined in proximal end

much more developed in distal end of esophagus

Question 6

muscularis externa in esophagus

Answer 6

mostly adventitia in esophagus

distal end as it enters abdominal cavity will be serosa

Question 7

Esophageal cardiac glands

Answer 7

found within the lamina propria

Question 8

Upper 5% of esophagus contains _____ muscle

Answer 8

striated

Question 9

> 50% of distal esophagus is ______ muscle

Answer 9

smooth

Question 10

In between upper and distal esophagus contains _____ and ______ muscle

Answer 10

striated

smooth

Question 11

_______ is present in thoracic esophagus

Answer 11

adventitia

Question 12

Z line

Answer 12

dividing line between esophagus and stomach

is a sharp transition

Question 13

Barrett’s esophagus

Answer 13

abnormal extension of stomach lining into esophagus
metaplasia is present
pt likely to develop cancer

Question 14

How do you confirm barrett’s esophagus, and what type of stain would you use?

Answer 14

goblet cells must be present along with columnar cells

Alcian/PAS stain

Question 15

What third of esophagus is mostly likely to harbor an adenocarcinoma

Answer 15

distal third

Question 16

Deeper the cancer penetrates outward through the wall the ______ the stage

Answer 16

greater

Question 17

HGD

Answer 17

high grade dysplasia
normal cell lining the esophagus with an abnormal growth
initial stage
within in the mucosa

Question 18

Higher the stage, prognosis goes _____

Answer 18

down

Question 19

Lymph and mestastatic cells flow more readily in the ______ _____ channels

Answer 19

submucosal lymphatic

Question 20

Where are the lymphatic channels more abundant?

Answer 20

submucosa of the esophagus

Question 21

How are lymphatic channels oriented?

Answer 21

longitudinally

allows mesastatic cells to spread far cranially or caudally

Question 22

If lymphatics in the upper 2/3 of the esophagus are receiving cancer cells, how will they spread? And what lymph nodes will this impact?

Answer 22

cranially

lymph nodes of the neck

Question 23

If lymphatics in the lower 1/3 of esophagus are receiving how will they spread? And what lymph nodes will this impact?

Answer 23

caudally

cardiac lymph nodes

Question 24

gastric pits

Answer 24

invaginations of the epithelium and into the lamina propria

Question 25

layers of muscularis externa (innermost to outermost)

Answer 25

olique smooth muscle circular smooth muscler longitudinal smooth muscle

Question 26

3 types of glands in the stomach

Answer 26

cardiac glands pyloric gands gastric or fundic glands

Question 27

Where are cardiac glands found

Answer 27

in the cardiac region

Question 28

where are pyloric glands found

Answer 28

pylorus region

Question 29

Where are gastric or fundic glands found

Answer 29

anywhere in between the cardiac and pylorus region

Question 30

Gastric glands

Answer 30

most organized of the 3

Question 31

Isthmus

Answer 31

glandular portion starts here and goes inferiorly | stem cell niche

Question 32

What do parietal cells secrete?

Answer 32

HCl and intrinsic factor

Question 33

Where is the main cell type in the neck

Answer 33

parietal cells

Question 34

what is the function of intrinsic factor

Answer 34

important for absorbing B12 in distal GI tube

Question 35

What are the acidophilic cell seen in the neck

Answer 35

parietal cells

Question 36

What are the dark stained cells in the neck

Answer 36

chief cells

Question 37

What is the main cell type in the fundus

Answer 37

chief cells

Question 38

What is the function of chief cells

Answer 38

secrete pepsinogen

Question 39

Cardiac glands

Answer 39

deeper into the lamina propria | irregular arrangement

Question 40

What is the function of G cells

Answer 40

secrete gastrin

Question 41

What type of ions are found in mucous. And is it acidic or alkaline?

Answer 41

bicarbonate | alkaline

Question 42

Erosion

Answer 42

ulcer is confined to the mucosal layer, has not penetrated into the submucosa

Question 43

Pyloric spinchter

Answer 43

junction between the stomach and duodenum

Question 44

Esophagus and duodenum are two segments of the GI tube that will harbor ____ units

Answer 44

glandular

Question 45

Plyoric sphiner is the thickening of what

Answer 45

muscularis externa

Question 46

What layers does the pyloric spinchter have?

Answer 46

inner circle layer and outer longitudinal layer

Question 47

Pilicae circulares

Answer 47

``` permanent folds of mucosa and submucosa largest modification slow movement of chyme increase the time available for enzymatic degradation of nutrients and their subsequent absorption increase surface area 3 fold ```

Question 48

How is fat absorbed

Answer 48

through lymphatics that exist in the villi

Question 49

Villus

Answer 49

fold of mucosa has goblet cells interspersed amound columnar cells core is lamina propria increases surface area 10 fold

Question 50

MIcrovilli

Answer 50

along apical domain of columnar cells form brush or striated border increase surface area 20 fold

Question 51

told increase in surface area

Answer 51

600 fold

Question 52

4 signature histologic features of gluten enteropathy (celiac sprue)

Answer 52

enterocytes disarrayed villus atrophy crypt (intestinal gland) hyperplasia inflammation of lamina propria

Question 53

Zollinger-Ellison syndrome

Answer 53

tumor of gastrin-producing cells has gastrinoma more robust rugae increased acid production

Question 54

gastrinoma

Answer 54

large number of gastrin producing cells

Question 55

90% of gastrinomas are located where

Answer 55

within the gastrinoma or passaro's triangle

Question 56

What are the points of gastrinoma (passaro's) triangle

Answer 56

junction of cystic and common hepatic ducts junction of parts 2 and 3 of duodenum point of the triangle is junction of pancreatic head and neck