GI- Path- Non-neoplastic diseases of the Stomach Flashcards
(97 cards)
The stomach is a muscular of the digestive tract where mechanical and chemical digestion occurs.
dilation
The stomach is divided into four major anatomic regions:
the cardia, fundus, body, and pyloric antrum.

The cardia is lined mainly by mucin-secreting cells that form shallow glands.
foveolar
The antral glands are similar cardia but also contain cells, such as cells, that release gastrin to stimulate luminal acid secretion by parietal cells within the gastric and body.
endocrine
G
fundus
The well-developed glands of the body and fundus also contain cells that produce and secrete digestive enzymes such as
chief
pepsin
Pyloric glands. The pyloric region of the stomach has deep gastric pits (P) leading to short, coiled pyloric glands (G) in the

lamina propria (LP)
Parietal cells stain and chief cells stain .
pink (eosinophillic)
purple (basophillic)

Surface mucous cells secrete fluid containing mucin (yellow)
Mucous neck cells secrete fluid containing mucin (light pink)
Parietal cells secrete and HCl (dark pink)
Chief cells secreted pepsinogen and gastric (purple)
G cells (enteroendocrine cells) secrete into the blood (green)
alkaline
acidic
intrinsic factor
lipase
gastrin

Gastritis results from injury.
- When are present, the lesion is referred to as acute gastritis.
- When cell injury and regeneration are present but inflammatory cells are rare or absent, the term is applied.
mucosal
neutrophils
gastropathy
- When cell injury and regeneration are present but inflammatory cells are rare or absent, the term gastropathy is applied.
- Agents that cause gastropathy include , alcohol, bile, and
NSAIDS
stress-induced injury.
- Both gastropathy and acute gastritis may be asymptomatic or cause variable degrees of epigastric pain, nausea, and vomiting.
- In more severe cases, there may be mucosal , ulceration, hemorrhage, , melena, or, rarely, massive blood loss.
erosion
hematemesis
What is hematemesis and melena?
hematemesis = vomiting of blood
melena = dark sticky feces containing partly digested blood
- The gastric lumen is strongly acidic, with a pH close to , more than 1 million times more acidic than the blood.
- This harsh environment contributes to digestion but also has the potential to damage the
1
mucosa.

What are some normal damaging forces and protective forces in the stomach?
Damaging = gastric acidity, peptic enzymes
Defensive= mucus, bicarb, mucosal blood flow, epithelial regeneration, prostaglandins

Ulcers contain layers of necrotic debris, acute ,
granulation tissue, and (fibrosis).
inflammatory cells
scarring

Multiple mechanisms have evolved to protect the gastric mucosa.
- secreted by surface foveolar cells forms a thin layer of mucus that prevents large food particles from directly touching the epithelium.
- The mucus layer also promotes formation of an “unstirred” layer of fluid over the epithelium that protects the mucosa; it has apH as a result of secretion of ions by surface epithelial cells.
- The rich of the gastric mucosa efficiently buffers and removes that back-diffuse into the lamina propria.
Mucin
neutral
bicarbonate
blood supply
protons
Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit cyclooxygenase (COX)- dependent synthesis of E2 and I2, which stimulate nearly all of the above defense mechanisms including and bicarbonate secretion, mucosal flow, and restoration.*
prostaglandins
mucus
blood
epithelial

The gastric injury that occurs in uremic (kidney failure) patients and those infected with urease-secreting H. pylori may be due to inhibition of gastric transporters by ions from the urease.
bicarbonate
ammonium
Ingestion of harsh chemicals, particularly acids or bases, either accidentally or in a suicide attempt, leads to severe gastric damage as a result of direct injury to and cells.
mucosal
epithelial
stromal (supportive cells)
• Direct cellular damage also contributes to gastritis induced by excessive consumption, use, and therapy.
alcohol
NSAID
radiation
Agents that inhibit DNA synthesis or the mitotic apparatus, including those used in , may cause generalized mucosal damage due to insufficient epithelial renewal.
cancer chemotherapy
What signifies active gastritis?
presence of neutrophils above the basement membrane in contact with epithelial cells
-note: the epithelium is inbetween the squiggly lines and the neutrophils are circled (inside the lines=active gastritis)

inflammation is preferred over acute inflammation throughout the luminal GI tract, since inflammation may be present in both acute and chronic disease states.
active
What can happen with more severe mucosal damage?
erosions and hemorrhage develop




















