Lecture 22 - The Digestive Tract (Histology)
Lecture 22 - The Digestive Tract (Histology)
Lecture 22 - The Digestive Tract (Histology)
The GI tract
(gastrointestinal tract)
The muscular alimentary canal Mouth Pharynx Esophagus Stomach Small intestine Large intestine Anus
Mechanical digestion
Chewing Churning in stomach Mixing by segmentation
Chemical digestion
By secreted enzymes: see later
Absorption
Transport of digested end products into blood and lymph in wall of canal
Defecation
Elimination of indigestible substances from body as feces
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Chemical digestion
Complex food molecules (carbohydrates, proteins and lipids) broken down into chemical building blocks (simple sugars, amino acids, and fatty acids and glycerol) Carried out by enzymes secreted by digestive glands into lumen of the alimentary canal
Ways to divide.
The more common
Three sub-layers
*
Lamina propria
Loose connective tissue with nourishing and absorbing capillaries Contains most of mucosa-associated lymphoid tissue (MALT)
Muscularis mucosae
Thin layer of muscle producing only local movements 8
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Exceptions: *
Parts not in peritoneal cavity have adventitia, lack serosa Some have both, e.g. retroperitoneal organs
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Smooth muscle
Smooth muscle
6 major locations:
Muscles are spindle-shaped cells One central nucleus Grouped into sheets: often running perpendicular to each other Peristalsis No striations (no sarcomeres) Contractions are slow, sustained and resistant to fatigue Does not always require a nervous signal: can be stimulated by stretching or hormones
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1. inside the eye 2. walls of vessels 3. respiratory tubes 4. digestive tubes 5. urinary organs 6. reproductive organs
Nerves
Enteric nervous system: the guts own
Visceral plexuses within gut wall controlling the muscles, glands and having sensory info
Myenteric: in muscularis Submucosal
Sympathetic
Inhibits digestion
Largely automatic
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New definitions
Mesentery
Double layer of peritoneum Extends to digestive organs from body wall Hold organs in place Sites of fat storage Route by which circulatory vessels and nerves reach organs Most are dorsal
Extend dorsally from gut to posterior abdominal wall
Ventral mesentery from stomach and liver to anterior abdominal wall Some mesenteries are called ligaments though not technically such
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Mesenteries
Note dorsal, ventral and formation of retroperitoneal position
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Mesenteries
Two ventral mesenteries
Falciform ligament
*
Binds anterior aspect of liver to anterior abdominal wall and diaphragm
Transverse mesocolon
Transverse colon held to posterior abdominal wall Nearly horizontal sheet fused to underside of greater omentum
Sigmoid mesocolon
Connects sigmoid colon to posterior abdominal wall see next slides for pics
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Note: greater omentum, lesser omentum, falciform ligament, transverse mesocolon, mesentery, sigmoid mesocolon
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Tend to cause back pain, instead of abdominal pain (This is as opposed to the organs which are intraperitoneal, or just peritoneal)
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The Mouth
Mouth = oral cavity
Lining: thick stratified squamous epithelium
Uvula
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Tongue
Mostly muscles
Grip and reposition food Forms bolus of food (lump) Help in swallowing Speech help form some consonants
Note frenulum on previous slide: can be too tight Taste buds contained by circumvallate and fungiform papillae Lingual tonsil back of tongue
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Teeth
Called dentition (like dentist) Teeth live in sockets (alveoli) in the gumcovered margins of the mandible and maxilla Chewing: raising and lowering the mandible and moving it from side to side while tongue positions food between teeth
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Teeth
Two sets
Primary or deciduous
Baby teeth Start at 6 months 20 are out by about 2 years Fall out between 2-6 years
Permanent: 32 total
All but 3rd set of molars by end of adolescence 3rd set = wisdom teeth
Variable
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incisor
canine
premolar molar
Tooth structure
Two main regions
A. Crown (exposed) B. Root (in socket) C. Meet at neck
A
Enamel
99% calcium crystals Hardest substance in body
Dentin bulk of the tooth (bone-like but harder than bone, with collagen and mineral) Pulp cavity with vessels and nerves
Root canal: the part of the pulp in the root
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Tooth structure
Cementum bone layer of tooth root
Attaches tooth to periodontal ligament
Anchors tooth in boney socket of the jaw Continuous with gingiva (gums)
A
Periodontal ligament
B
External to mouth Ducts to mouth Secrete saliva only right before or during eating
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+
#
Compound = duct branches Tubo = tubes Alveolar = sacs 31
Pharynx
___oropharynx
___laryngopharynx
*
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Esophagus
Continuation of pharynx in mid neck Muscular tube collapsed when lumen empty Esophagus___________ Descends through thorax
On anterior surface of vertebral column Behind (posterior to) trachea
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Esophagus continued
Passes through esophageal hiatus in the diaphragm to enter the abdomen Abdominal part only 2 cm long Joins stomach at cardiac orifice*
Cardiac sphincter at cardiac orifice to prevent regurgitation (food coming back up into esophagus) Gastroesophageal junction and GERD
___________________esophageal hiatus
(hiatus means opening)
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Esophagus histology
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Stomach
J-shaped; widest part of alimentary canal Temporary storage and mixing 4 hours
Into chyme
Most nutrients wait until get to small intestine to be absorbed; exceptions are:
Water, electrolytes, some drugs like aspirin and alcohol (absorbed through stomach)
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Stomach
Lies mostly in LUQ
But pain can be epigastric or lower
epigastrium
Just inferior to (below) diaphragm Anterior (in front of) spleen and pancreas Tucked under left lower margin of liver junction with Anchored at both ends but esophagus mobile in between contains pyloric Main regions in drawing to sphincter right------------------------------- Capacity: 1.5 L food; max funnel shaped capacity 4L (1 gallon)
dome
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Stomach Regions
Cardiac region Fundus (dome shaped) Body
Greater curvature Lesser curvature
dome junction with esophagus contains pyloric sphincter
Pyloric region
Antrum Canal Sphincter
funnel shaped
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Rugae: longitudinal folds on internal surface (helps distensibility) Muscularis: additional innermost oblique layer (along with circular and longitudinal layers)
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Histology of stomach
Simple columnar epithelium: secrete bicarbonate-buffered mucus Gastric pits opening into gastric glands
Mucus neck cells Parietal cells
HCL Intrinsic factor (for B12 absorption)
Chief cells
Pepsinogen (activated to pepsin with HCL) Stimulated by gastrin: a stomach hormone
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Small intestine
Longest part of alimentary canal (2.7-5 m) Most enzymatic digestion occurs here
Most enzymes secreted by pancreas, not small intestine
Almost all absorption of nutrients 3-6 hour process Runs from pyloric sphincter to RLQ
Small intestine___________
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Blood supply: superior mesenteric artery; Veins drain into hepatic portal vein
Duodenum is retroperitoneal (stuck down under peritoneum); others are loose Duodenum receives bile from liver and gallbladder via bile duct* enzymes from pancreas via main pancreatic duct*
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Absorptivie cell with microvilli to increase surface area & many mitochondria: nutrient uptake is energydemanding
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Intestinal crypts
Cells here divide every 3-6 days to renew epithelium (most rapidly dividing cells of the body) Secrete watery intestinal juice which mixes with chyme (the paste that food becomes after stomach churns it)
*
*
-produce mucus
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Large intestine
Digested residue reaches it Main function: to absorb water and electrolytes
1. Teniae coli (3 longitudinal muscle strips) 2. Haustra (puckering into sacs) 3. Epiploic appendages (omental or fat pouches)
3. 2.
1.
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Colon has segments: ascending, transverse and descending colon; then sigmoid colon Right angle turns: hepatic flexure* in RUQ and splenic flexure* in LUQ
Movement sluggish and weak except for a few mass peristaltic movements per day to force feces toward rectum powerfully
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Rectum
In pelvis No teniae Strong longitudinal muscle layer Has valves
Anal canal
Pectinate line*
Inferior to it: sensitive to pain
* *
*
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External*
skeletal muscle voluntary
Defecation
1. Triggered by stretching of wall, mediated by spinal cord parasympathetic reflex 2. Stimulates contraction of smooth muscle in wall and relaxation of internal anal sphincter 3. If convenient to defecate voluntary motor neurons stimulate relaxation of external anal sphincter (aided by diaphragm and abdominal wall muscles called Valsalva maneuver)
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The Liver
Largest gland in the body (about 3 pounds) Over 500 functions Inferior to diaphragm in RUQ and epigastric area protected by ribs R and L lobes
Plus 2 smaller lobes
Falciform ligament
Mesentery binding liver to anterior abdominal wall
2 surfaces
Diaphragmatic Visceral
Covered by peritoneum
Except bare area fused to diaphragm
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posterior
Fissure on visceral surface Porta hepatis: major vessels and nerves enter and leave - see pics Ligamentum teres: remnant of umbilical vein in fetus, attaches to navel see next slide
anterior
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Fetal circulation
Umbilical vein
___________
Ligamentum teres__________
Navel_______
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Liver histology
Liver lobules (about one million of them)
Hexagonal solid made of sheets of hepatocytes (liver cells) around a central vein Corners of lobules have portal triads (see next pic)
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Portal triad
Portal arteriole Portal venule
Branch of hepatic portal vein Delivers substances from intestines for processing by hepatocytes
Bile duct
Carries bile away
Liver sinusoids
Large capillaries between plates of hepatocytes Contribute to central vein and ultimately to hepatic veins and IVC
Kupffer cells
Liver macrophages Old blood cells and microorganisms removed
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Gallbladder*
Bile is produced in the liver Bile is stored in the gallbladder Bile is excreted into the duodenum when needed (fatty meal) Bile helps dissolve fat and cholesterol If bile salts crystallize, gall stones are formed
Intermittent pain: ball valve effect causing intermittent obstruction Or infection and a lot of pain, fever, vomiting, etc.
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Lies in LUQ kind of behind stomach Is retroperitoneal Has a head, body and tail Head is in C-shaped curve of duodenum Tail extends left to touch spleen Main pancreatic duct runs the length of the pancreas, joins bile duct
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one acinus
Endocrine cells:
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