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Tubular GI tract


                                                        Pharynx
                                                        Esophagus
                                                        Stomach
                                                        Small Intestine
                                                        Cecum and appendix
                                                        Large intestine
                                                        Rectum/Anus




                                                    J. Matthew Velkey
National Digestive Diseases Information
Clearinghouse US Federal Government                 M1 – GI Sequence
Original: Fig 14.1 from Young & Heath, Wheater’s       Winter, 2009
Functional Histology, 4th ed. (2000), p250
Ingestion:
2L/day



                                     Saliva:1L
                                     Stomach: 2L
   Absorption:   Secretion:          Bile: 1L
   8.8L/day      7L/day              Pancreas: 2L
                                     Small intestine:
                                            1L




                  Feces: 0.2L/day
                       Deb Gumucio, UMich, Dept of Cell & Dev. Biol.
Tubular GI tract


                                                                    Four distinct layers
                                                                    in the GI tube:
                                                                    • Mucosa (*)
                                                                    • Submucosa
                                                                    • Muscularis externa
                                                                    • Serosa

                                                                          Epithelium
                                                              *Mucosa =   Lamina propria
                                                                          Muscularis mucosae

           Frank Boumphrey, M.D, Wikipedia

Original: Fig 14.1 from Young & Heath, Wheater’s Functional
Histology, 4th ed. (2000), p250
Functions of the GI mucosa*
(*Mucosa = Epithelium, lamina propria, muscularis mucosae)


 Protection - Esophagus, stomach, colon
 Absorption - Small intestine (colon)
 Secretion - Stomach (Small intestine)


Secretion is accomplished by glands located:
a.  In the mucosa (stomach, small + large intestine)
b.  In the submucosa (only in esophagus, duodenum)
c.  Outside of the tubular gut (extramural glands)
     e.g., liver, pancreas.
Pharynx

Short region connecting oral cavity
with the larynx and esophagus.

Passageway for air and food;
Resonating chamber for speech
Pharynx                                                                                       Epithelium:
                                                                                              stratified
                                                                                              squamous
                                                                                              non-keratinized

                                                                                              Prominent
                                                                                              elastic fibers in
                                                                                              lamina
                                                                                              propria

                                                                                              Muscle wall:
                                                                                              striated muscle
                                                                                              No muscularis
                                                                                              mucosae,
                                                                                              no submucosa.



                             University of Michigan Virtual Microscopy collection Slide 152


(accessory salivary gland)
Esophagus
Delivers food and liquid from pharynx to stomach

Attributes:
Straight tube, ~25 cm long
Expandable lumen: extensive muscularis mucosae, elastic fibers
                     in submucosa

Protective epithelium (stratified squamous non-keratinized)
Muscularis externa:
        upper 1/3 = striated (skeletal) muscle
        middle 1/3 = mixed smooth and striated
        lower 1/3 = smooth muscle
Esophagus                                                                                   Epithelium (E):
                                                                                               Stratified squamous
                                                                                               Non-keratinized


                                                                                                Extensive muscularis
                                                                                                mucosae (MM)

                                                                                                Glands (G)
                                                                                                • Mostly in submucosa
                                                                                                • Primarily mucous
                                                                                                  secretion
                                                                                                • Note: upper and lower
                                                                                                  esophagus also has
                                                                                                  MUCOSAL glands (called
                                                                                                 “cardiac” due to similarity to
                                                                                                 cardiac glands of the
                                                                                                 stomach)

             Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p253 Fig 14.4a   Muscularis externa
                                                                                             (Muscularis propria):
                                                                                             Inner circular (CM)
                                                                                             Outer longitudinal (LM)

As with any region of the GI tract, lymph nodules (Ly) may be present –usually in
the lamina propria and occasionally extending into the submucosa
Esophagus




             Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p522 Fig 17.2




Lymphatic nodules in lamina propria and/or submucosa (part of GALT,
      gut-associated lymphoid tissue)

Esophageal glands (submucosal) secrete acidic mucous - lubricates
      the luminal wall; ducts carry secreted mucous to the lumen.
Esophagus: mucosa & submucosa




      Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006)



• Stratified squamous epithelium (stem cells
  in stratum basale)
• Thick muscularis mucosae (circular layer &
  longitudinal layer)                                                 Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006)
• Submucosal mucous glands
Muscularis externa & Myenteric plexus (Auerbach’s plexus)




            University of Michigan Virtual Microscopy Slide Collection, slide #155.



   Controls contraction of muscularis externa; wave-like
         contractions that move contents = peristalsis
Gastroesophageal junction
                                                                             Abrupt epithelial transition:
                                                                             Stratified squamous
                                                                             non-keratinized (esophagus)


                                                                             simple columnar (stomach)


                                                                                   “Cardiac glands” of the esophagus
                                                                                   (mucosal, i.e. IN LAMINA
                                                                                   PROPRIA); secrete neutral mucous,
                                                                                   protect esophagus from stomach
                                                                                   acid


                                                                                   Cardiac glands of the stomach;
                                                                                   also mucosal (in the lamina propria)
                                                                                   and also mucus-secreting
 Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.6, p.525
Gastroesophageal junction
Transition from stratified squamous to simple columnar epithelium




           Bloom and Fawcett, 12th ed. Fig. 25-6, p.599
Ly = lymph nodule
Gastroesophageal junction                                                            Ep*=infolded epithelium

             Esophagus                                                Stomach




                                                   Ly

                                                             Ep*




            University of Michigan Virtual Microscopy slide collection, slide #155

     Inferior esophageal sphincter = a physiological sphincter
     •  Pressure difference between esophagus and stomach
     •  Diaphragmatic contraction
     •  Unidirectional peristalsis
     Prevents reflux of stomach contents into esophagus
Gastroesophageal junction
A medically important region:

Pyrosis (heartburn) –acid reflux

Dysphagia (difficulty in swallowing)
    Generic term used to describe ANY difficulty in swallowing
         Could be something “extrinsic:” mediastinal mass, vascular anomaly
         Could be “intrinsic:” e.g. esophageal tumor, inflammation, motility disorder


Achalasia (“failure to relax”)
    Lack of peristalsis in the lower esophagus due to loss of myenteric neurons
    (chalasis = relaxation)

Barrett’s esophagus/Intestinal metaplasia
    Change in esophageal mucosa from squamous to “intestinal” (i.e. columnar)
    Result of prolonged injury: e.g. chronic reflux, noxious agents (smoking, etc.)
    “pre-cancerous:” 10% risk of progression to adenocarcinoma


Esophageal cancer
    Squamous cell carcinoma –carcinogenesis of basal cells
    Adenocarcinoma –progression of Barrett’s esophagus into cancer or (rarely)
                    from submucosal glands
Stomach
 Mixes and partially digests food        Chyme


  Attributes:
  •  Expanded region where food can reside while
         initial digestion occurs
  •  Mechanism to digest food: acid, enzymes
  •  Mechanisms to prevent self-digestion
  •  Mechanism to prevent undigested food from
         passing on to the small intestine
Stomach                                  fundus                             Four anatomical regions:
                                                                              a.  Cardia - Cardiac glands
                                                                              b. Fundus* - Gastric glands
esophagus                                                                     c. Corpus* - Gastric glands
                                                                              d. Pylorus - Pyloric glands
           cardia

   corpus (body)


   pylorus

                                                                 Rugae - longitudinal folds
                                                                      (allow distention)
 duodenum
     Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.5, p.524

Because they are HISTOLOGICALLY similar, histologists lump fundus and corpus
together (and you may sometimes hear gastric glands referred as “fundic glands”
–the terms are synonymous)
Rugae: folds of mucosa w/ submucosal core –somewhat analogous to intestinal
   Stomach                              plicae*- allow stomach to distend

                                  Pits (foveolae): invaginations of mucosal epithelium (similar to intestinal crypts*);
                                          continuous with the lumen of underlying glands


                                                                       rugae




                                           pits




* More about plicae and intestinal crypts in a later lecture
                 University of Michigan Virtual Microscopy slide collection, slide #156
Cardiac glands - stomach
            pit                                                                     esophageal epithelium


                                                                           In cardiac region - located at
                                                                           gastro-esophageal junction

                                                                           Epithelium consists of simple
                                                                           columnar, mostly mucous cells
                                                                           (pale, homogeneous staining –
                                                                           similar to cells lining the pits)

                                                                           Tubular, somewhat tortuous, and
                                                                           sometimes branched

                                                                           Empty into gastric pits




 Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.14, p.532
Fundic (Gastric) glands - stomach
                                                         Shallow pits open to long
                                                         branched glands

                                                         Pits are lined by mucous
                                                         cells (Pit cells)
                                                         Glands contain:
                                                         •  Stem cells
                                                         •  Mucous neck cells
                                                         •  Parietal cells
                                                         •  Chief cells
                                                         Each cell type takes up stain
                                                         differently so these glands will have
                                                         a heterogeneous appearance

                                                         Produce gastric juice
                                                              (~ 2L/day)
   Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p272 Fig 14.31b
Anatomy of a gastric gland

                                                                      Pit lined by surface mucous cells

                                                                      Short isthmus region - contains stem
                                                                      cells (can’t identify without immunostaining, but
                                                                      know their approximate location and function)

                                                                      Several glands (2-3) open into one pit

                                                                      Neck lined by mucous neck cells, with
                                                                      some parietal cells

                                                                      Parietal, chief and enteroendocrine
                                                                      cells occupy glandular portion



                    Frank Boumphrey, M.D, Wikipedia

Original: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.8b, p.527
Gastric gland - PAS* stain
                                          Mucus of the mucous surface cells -
                                          Viscous, insoluble mucus with
                                          bicarbonate (deep purple)

                                          Mucous of the mucous neck cells -
                                          More soluble, watery mucous




                                             Physiologic gastric mucosa barrier


                                            *PAS = periodic acid Schiff (stains mucous)
Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.8a, p.527
Parietal cells
Major secretions:
•  Intrinsic factor
     (binds Vitamin B12; required
     for absorption
     of B12 in ileum)
•  HCl (ATPase exchange pumps                                  Drawing of a parietal cell
   and ion transport channels move                              with ion flow illustrated
   H+ and Cl- into lumen)                                           over membrane
                                                                   surfaces removed
REQUIRES:
   • Lots of mitochondria
   • Lots of surface area


Eosinophilic due to:
•  Abundant membranes
   (microvilli, canaliculi,
   tubulovesicular system
•  Numerous mitochondria
                            Original Source: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.11, p.530
Major secretions:                 Parietal cells
•  Intrinsic factor
     (binds Vitamin B12;
     required for absorption
     of B12 in ileum)
•  HCl (ATPase exchange
   pumps and ion transport
   channels move H+ and Cl-
   into lumen)

REQUIRES:
   • Lots of mitochondria
   • Lots of surface area


Eosinophilic due to:
•  Abundant membranes
   (microvilli, canaliculi,
   tubulovesicular system                     Frank Boumphrey, M.D, Wikipedia

                               Original: Fig 15-15 from Junquiera and Carneiro. Basic Histology,
•  Numerous mitochondria       10th ed. (2003), p305.
EM-
Parietal
Cell
(oxyntic
cell)


Note:
•  mitochondria (m)
•  microvilli (mv) on
   surface & lining
   intracellular
   canaliculi
•  tubulovesicular
   system


                        Junquiera and Carneiro. Basic Histology, 10th ed. (2003), p305 Fig 15-15
Cells of the gastric glands- Chief cell


Chief cells -
                                                          Drawing of a chief cell as
Basophilic base (RER)                                         would appear on
Granules in apex                                            electron micrograph
(variable appearance)                                             removed.

Secrete pepsinogen
   -converted to pepsin by
   acid hydrolysis




                    Original Source: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.9, p.529
Fundic (Gastric) glands - stomach

Parietal cells (blue arrows)
• Large, often triangular
• Eosinophilic
• “Fried egg” appearance
• More often in neck of
  gland


Chief cells (black arrows)
• Basophilic base
• Round nuclei
• Found in lower portions
  of glands

                                          Slide 843 (35mm Kodachrome slide collection)
                               from Mizoguti, Color Slide Atlas of Histology (1985).
Enteroendocrine cells
•  Found throughout GI tract
•  Not very easy to see by LM
   in the stomach, but can
   identify them in EMs




“Open” type:
• Secretory granules in
  basolateral domain
• Microvilli project into lumen




                                  Junquiera and Carneiro, Basic Histology, 10th ed. (2003),
                                  p307. Fig 15-18
Enteroendocrine cells


       Drawing of a
      “closed type”
          entero-
      endocrine cell.




Original: Fig 17.12 from Ross and
Pawlina, Histology: A Text and Atlas, 5th
ed. (2006), p530


                                            Source
Undetermined




                 “Closed” type:
                 Cell rests on basal lamina; does not reach lumen
Enteroendocrine cells
 “Diffuse neuroendocrine system” (DNES)
   • Classified by staining for products
   • ~20 different types
   • ALL secrete primarily into connective tissue space NOT the
     lumen of the GI tract

  Important examples in stomach:
  Gastrin - stimulates parietal cells to secrete HCl
  Somatostatin - Inhibits gastrin release, inhibits HCl
         secretion
  Vasoactive intestinal peptide (VIP) - stimulates
         pancreatic and intestinal enzyme secretion;
         inhibits sphincter contraction

a.k.a:
APUD (Amine Precursor Uptake and Decarboxylation) cells*,
Enterochromaffin cells*, argentaffin cells*, argyrophil cells*
* These terms actually refer to specific sub-types of cells, whereas the term “enteroendocrine” covers ALL types
Pylorus - stomach

                                                                                 Deep pits open to
                                                                                 Relatively straight glands

                                                                                 Mostly mucous cells
                                                                                 (occasional parietal cells)




 Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p533 Fig 17.15
Comparison
of stomach
                                                Drawing of the
glands                                      stomach with sections
                                           from the body, cardiac,
Pit depth (% of mucosa)                     and pyloric regions of
Cardiac - 50%                              the stomach illustrated
Gastric - 25%                                in histological cross-
Pyloric – 66%
                                             section to show the
                                            glands of each region.
Gland morphology
Cardiac – tortuous, homogeneous
Gastric – straight, heterogeneous
Pyloric – ~tortuous, homogeneous

Location
Cardiac – near gastro-esophageal junct.   Original: Fig 15-10 from Junqueira and Carneiro,
Gastric – in fundus and corpus            Basic Histology, 10th ed. (2003), p300

Pyloric – near gastro-duodenal junct.
Gastroduodenal junction:
•  Transition from gastric epithelium (with pits) to intestinal epithelium (with crypts & villi)
•  Duodenal region specifically identifiable by presence of SUBMUCOSAL glands
•  Pyloric sphincter, a true anatomical sphincter, expansion of circular layer of smooth muscle




      Stomach                                             Pyloric
                                                         sphincter
                                                                                                                Duodenum




                                                                                              mm

                                                                                               sm
                                      mm=musc. mucosae; sm=submucosa

                              Matt Velkey Slide 162 of the University of Michigan Histology Collection (All Images)
Learning Objectives
•  Be able to identify and describe the function of the layers AND
   COMPONENT CELLS in the wall of the digestive tract (mucosa,
   submucosa, muscularis (propria), and adventitia/serosa), and
   explain how they differ in the pharynx, esophagus, and stomach.

•  Know the histological differences in the pharynx and the upper,
   middle and lower portions of the esophagus.

•  Be able to recognize gastric glands, identify their constituent
   cells, and know their secretory products.

•  Be able to recognize gastric glands, cardiac glands, and pyloric
   glands of the stomach.
Additional Source Information
                            for more information see: http://open.umich.edu/wiki/CitationPolicy



Slide 3: National Digestive Diseases Information Clearinghouse, US Federal Government,
      http://digestive.niddk.nih.gov/ddiseases/pubs/uppergi/index.htm
Slide 4: Deb Gumucio, UMich, Dept of Cell & Dev. Biol.
Slide 5: Boumphreyfr, Frank Boumphrey, M.D., Wikipedia, http://commons.wikimedia.org/wiki/File:Smallintestine_layers2.png
Slide 8: University of Michigan Virtual Microscopy collection Slide 152
Slide 10:Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p253 Fig 14.4a
Slide 11: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p522 Fig 17.2
Slide 12: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006); Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006)
Slide 13: University of Michigan Virtual Microscopy Slide Collection, slide #155.
Slide 14: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.6, p.525
Slide 15: Bloom and Fawcett, 12th ed. Fig. 25-6, p.599
Slide 16: University of Michigan Virtual Microscopy slide collection, slide #155
Slide 19: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.5, p.524
Slide 20: University of Michigan Virtual Microscopy slide collection, slide #156
Slide 21: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.14, p.532
Slide 22: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p272 Fig 14.31b
Slide 23: Frank Boumphrey, M.D; Original: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.8b, p.527
Slide 24: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.8a, p.527
Slide 25: Original: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.11, p.530
Slide 26: Frank Boumphrey, M.D; Replaced: Fig 15-15 from Junquiera and Carneiro. Basic Histology, 10th ed. (2003), p305.
Slide 27: Junquiera and Carneiro. Basic Histology, 10th ed. (2003), p305 Fig 15-15
Slide 28: Original Source: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.9, p.529
Slide 29: Slide 843 (35mm Kodachrome slide collection) from Mizoguti, Color Slide Atlas of Histology (1985).
Slide 30: Junquiera and Carneiro, Basic Histology, 10th ed. (2003), p307. Fig 15-18
Slide 31: Source Undetermined; Removed Image - Fig 17.12 from Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p530
Slide 33: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p533 Fig 17.15
Slide 34: Removed Image - Fig 15-10 from Junqueira and Carneiro, Basic Histology, 10th ed. (2003), p300
Slide 35: Matt Velkey Slide 162 of the University of Michigan Histology Collection (All Images)

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01.07.09(b): Tubular GI Tract - Stomach

  • 1. Author(s): Matthew Velkey, 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution – Non-Commercial – Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/ We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize your ability to use, share, and adapt it. The citation key on the following slide provides information about how you may share and adapt this material. Copyright holders of content included in this material should contact open.michigan@umich.edu with any questions, corrections, or clarification regarding the use of content. For more information about how to cite these materials visit http://open.umich.edu/education/about/terms-of-use. Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Please speak to your physician if you have questions about your medical condition. Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.
  • 2. Citation Key for more information see: http://open.umich.edu/wiki/CitationPolicy Use + Share + Adapt { Content the copyright holder, author, or law permits you to use, share and adapt. } Public Domain – Government: Works that are produced by the U.S. Government. (USC 17 § 105) Public Domain – Expired: Works that are no longer protected due to an expired copyright term. Public Domain – Self Dedicated: Works that a copyright holder has dedicated to the public domain. Creative Commons – Zero Waiver Creative Commons – Attribution License Creative Commons – Attribution Share Alike License Creative Commons – Attribution Noncommercial License Creative Commons – Attribution Noncommercial Share Alike License GNU – Free Documentation License Make Your Own Assessment { Content Open.Michigan believes can be used, shared, and adapted because it is ineligible for copyright. } Public Domain – Ineligible: Works that are ineligible for copyright protection in the U.S. (USC 17 § 102(b)) *laws in your jurisdiction may differ { Content Open.Michigan has used under a Fair Use determination. } Fair Use: Use of works that is determined to be Fair consistent with the U.S. Copyright Act. (USC 17 § 107) *laws in your jurisdiction may differ Our determination DOES NOT mean that all uses of this 3rd-party content are Fair Uses and we DO NOT guarantee that your use of the content is Fair. To use this content you should do your own independent analysis to determine whether or not your use will be Fair.
  • 3. Tubular GI tract Pharynx Esophagus Stomach Small Intestine Cecum and appendix Large intestine Rectum/Anus J. Matthew Velkey National Digestive Diseases Information Clearinghouse US Federal Government M1 – GI Sequence Original: Fig 14.1 from Young & Heath, Wheater’s Winter, 2009 Functional Histology, 4th ed. (2000), p250
  • 4. Ingestion: 2L/day Saliva:1L Stomach: 2L Absorption: Secretion: Bile: 1L 8.8L/day 7L/day Pancreas: 2L Small intestine: 1L Feces: 0.2L/day Deb Gumucio, UMich, Dept of Cell & Dev. Biol.
  • 5. Tubular GI tract Four distinct layers in the GI tube: • Mucosa (*) • Submucosa • Muscularis externa • Serosa Epithelium *Mucosa = Lamina propria Muscularis mucosae Frank Boumphrey, M.D, Wikipedia Original: Fig 14.1 from Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p250
  • 6. Functions of the GI mucosa* (*Mucosa = Epithelium, lamina propria, muscularis mucosae) Protection - Esophagus, stomach, colon Absorption - Small intestine (colon) Secretion - Stomach (Small intestine) Secretion is accomplished by glands located: a.  In the mucosa (stomach, small + large intestine) b.  In the submucosa (only in esophagus, duodenum) c.  Outside of the tubular gut (extramural glands) e.g., liver, pancreas.
  • 7. Pharynx Short region connecting oral cavity with the larynx and esophagus. Passageway for air and food; Resonating chamber for speech
  • 8. Pharynx Epithelium: stratified squamous non-keratinized Prominent elastic fibers in lamina propria Muscle wall: striated muscle No muscularis mucosae, no submucosa. University of Michigan Virtual Microscopy collection Slide 152 (accessory salivary gland)
  • 9. Esophagus Delivers food and liquid from pharynx to stomach Attributes: Straight tube, ~25 cm long Expandable lumen: extensive muscularis mucosae, elastic fibers in submucosa Protective epithelium (stratified squamous non-keratinized) Muscularis externa: upper 1/3 = striated (skeletal) muscle middle 1/3 = mixed smooth and striated lower 1/3 = smooth muscle
  • 10. Esophagus Epithelium (E): Stratified squamous Non-keratinized Extensive muscularis mucosae (MM) Glands (G) • Mostly in submucosa • Primarily mucous secretion • Note: upper and lower esophagus also has MUCOSAL glands (called “cardiac” due to similarity to cardiac glands of the stomach) Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p253 Fig 14.4a Muscularis externa (Muscularis propria): Inner circular (CM) Outer longitudinal (LM) As with any region of the GI tract, lymph nodules (Ly) may be present –usually in the lamina propria and occasionally extending into the submucosa
  • 11. Esophagus Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p522 Fig 17.2 Lymphatic nodules in lamina propria and/or submucosa (part of GALT, gut-associated lymphoid tissue) Esophageal glands (submucosal) secrete acidic mucous - lubricates the luminal wall; ducts carry secreted mucous to the lumen.
  • 12. Esophagus: mucosa & submucosa Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006) • Stratified squamous epithelium (stem cells in stratum basale) • Thick muscularis mucosae (circular layer & longitudinal layer) Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006) • Submucosal mucous glands
  • 13. Muscularis externa & Myenteric plexus (Auerbach’s plexus) University of Michigan Virtual Microscopy Slide Collection, slide #155. Controls contraction of muscularis externa; wave-like contractions that move contents = peristalsis
  • 14. Gastroesophageal junction Abrupt epithelial transition: Stratified squamous non-keratinized (esophagus) simple columnar (stomach) “Cardiac glands” of the esophagus (mucosal, i.e. IN LAMINA PROPRIA); secrete neutral mucous, protect esophagus from stomach acid Cardiac glands of the stomach; also mucosal (in the lamina propria) and also mucus-secreting Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.6, p.525
  • 15. Gastroesophageal junction Transition from stratified squamous to simple columnar epithelium Bloom and Fawcett, 12th ed. Fig. 25-6, p.599
  • 16. Ly = lymph nodule Gastroesophageal junction Ep*=infolded epithelium Esophagus Stomach Ly Ep* University of Michigan Virtual Microscopy slide collection, slide #155 Inferior esophageal sphincter = a physiological sphincter •  Pressure difference between esophagus and stomach •  Diaphragmatic contraction •  Unidirectional peristalsis Prevents reflux of stomach contents into esophagus
  • 17. Gastroesophageal junction A medically important region: Pyrosis (heartburn) –acid reflux Dysphagia (difficulty in swallowing) Generic term used to describe ANY difficulty in swallowing Could be something “extrinsic:” mediastinal mass, vascular anomaly Could be “intrinsic:” e.g. esophageal tumor, inflammation, motility disorder Achalasia (“failure to relax”) Lack of peristalsis in the lower esophagus due to loss of myenteric neurons (chalasis = relaxation) Barrett’s esophagus/Intestinal metaplasia Change in esophageal mucosa from squamous to “intestinal” (i.e. columnar) Result of prolonged injury: e.g. chronic reflux, noxious agents (smoking, etc.) “pre-cancerous:” 10% risk of progression to adenocarcinoma Esophageal cancer Squamous cell carcinoma –carcinogenesis of basal cells Adenocarcinoma –progression of Barrett’s esophagus into cancer or (rarely) from submucosal glands
  • 18. Stomach Mixes and partially digests food Chyme Attributes: •  Expanded region where food can reside while initial digestion occurs •  Mechanism to digest food: acid, enzymes •  Mechanisms to prevent self-digestion •  Mechanism to prevent undigested food from passing on to the small intestine
  • 19. Stomach fundus Four anatomical regions: a.  Cardia - Cardiac glands b. Fundus* - Gastric glands esophagus c. Corpus* - Gastric glands d. Pylorus - Pyloric glands cardia corpus (body) pylorus Rugae - longitudinal folds (allow distention) duodenum Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.5, p.524 Because they are HISTOLOGICALLY similar, histologists lump fundus and corpus together (and you may sometimes hear gastric glands referred as “fundic glands” –the terms are synonymous)
  • 20. Rugae: folds of mucosa w/ submucosal core –somewhat analogous to intestinal Stomach plicae*- allow stomach to distend Pits (foveolae): invaginations of mucosal epithelium (similar to intestinal crypts*); continuous with the lumen of underlying glands rugae pits * More about plicae and intestinal crypts in a later lecture University of Michigan Virtual Microscopy slide collection, slide #156
  • 21. Cardiac glands - stomach pit esophageal epithelium In cardiac region - located at gastro-esophageal junction Epithelium consists of simple columnar, mostly mucous cells (pale, homogeneous staining – similar to cells lining the pits) Tubular, somewhat tortuous, and sometimes branched Empty into gastric pits Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.14, p.532
  • 22. Fundic (Gastric) glands - stomach Shallow pits open to long branched glands Pits are lined by mucous cells (Pit cells) Glands contain: •  Stem cells •  Mucous neck cells •  Parietal cells •  Chief cells Each cell type takes up stain differently so these glands will have a heterogeneous appearance Produce gastric juice (~ 2L/day) Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p272 Fig 14.31b
  • 23. Anatomy of a gastric gland Pit lined by surface mucous cells Short isthmus region - contains stem cells (can’t identify without immunostaining, but know their approximate location and function) Several glands (2-3) open into one pit Neck lined by mucous neck cells, with some parietal cells Parietal, chief and enteroendocrine cells occupy glandular portion Frank Boumphrey, M.D, Wikipedia Original: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.8b, p.527
  • 24. Gastric gland - PAS* stain Mucus of the mucous surface cells - Viscous, insoluble mucus with bicarbonate (deep purple) Mucous of the mucous neck cells - More soluble, watery mucous Physiologic gastric mucosa barrier *PAS = periodic acid Schiff (stains mucous) Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.8a, p.527
  • 25. Parietal cells Major secretions: •  Intrinsic factor (binds Vitamin B12; required for absorption of B12 in ileum) •  HCl (ATPase exchange pumps Drawing of a parietal cell and ion transport channels move with ion flow illustrated H+ and Cl- into lumen) over membrane surfaces removed REQUIRES: • Lots of mitochondria • Lots of surface area Eosinophilic due to: •  Abundant membranes (microvilli, canaliculi, tubulovesicular system •  Numerous mitochondria Original Source: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.11, p.530
  • 26. Major secretions: Parietal cells •  Intrinsic factor (binds Vitamin B12; required for absorption of B12 in ileum) •  HCl (ATPase exchange pumps and ion transport channels move H+ and Cl- into lumen) REQUIRES: • Lots of mitochondria • Lots of surface area Eosinophilic due to: •  Abundant membranes (microvilli, canaliculi, tubulovesicular system Frank Boumphrey, M.D, Wikipedia Original: Fig 15-15 from Junquiera and Carneiro. Basic Histology, •  Numerous mitochondria 10th ed. (2003), p305.
  • 27. EM- Parietal Cell (oxyntic cell) Note: •  mitochondria (m) •  microvilli (mv) on surface & lining intracellular canaliculi •  tubulovesicular system Junquiera and Carneiro. Basic Histology, 10th ed. (2003), p305 Fig 15-15
  • 28. Cells of the gastric glands- Chief cell Chief cells - Drawing of a chief cell as Basophilic base (RER) would appear on Granules in apex electron micrograph (variable appearance) removed. Secrete pepsinogen -converted to pepsin by acid hydrolysis Original Source: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.9, p.529
  • 29. Fundic (Gastric) glands - stomach Parietal cells (blue arrows) • Large, often triangular • Eosinophilic • “Fried egg” appearance • More often in neck of gland Chief cells (black arrows) • Basophilic base • Round nuclei • Found in lower portions of glands Slide 843 (35mm Kodachrome slide collection) from Mizoguti, Color Slide Atlas of Histology (1985).
  • 30. Enteroendocrine cells •  Found throughout GI tract •  Not very easy to see by LM in the stomach, but can identify them in EMs “Open” type: • Secretory granules in basolateral domain • Microvilli project into lumen Junquiera and Carneiro, Basic Histology, 10th ed. (2003), p307. Fig 15-18
  • 31. Enteroendocrine cells Drawing of a “closed type” entero- endocrine cell. Original: Fig 17.12 from Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p530 Source
Undetermined
 “Closed” type: Cell rests on basal lamina; does not reach lumen
  • 32. Enteroendocrine cells “Diffuse neuroendocrine system” (DNES) • Classified by staining for products • ~20 different types • ALL secrete primarily into connective tissue space NOT the lumen of the GI tract Important examples in stomach: Gastrin - stimulates parietal cells to secrete HCl Somatostatin - Inhibits gastrin release, inhibits HCl secretion Vasoactive intestinal peptide (VIP) - stimulates pancreatic and intestinal enzyme secretion; inhibits sphincter contraction a.k.a: APUD (Amine Precursor Uptake and Decarboxylation) cells*, Enterochromaffin cells*, argentaffin cells*, argyrophil cells* * These terms actually refer to specific sub-types of cells, whereas the term “enteroendocrine” covers ALL types
  • 33. Pylorus - stomach Deep pits open to Relatively straight glands Mostly mucous cells (occasional parietal cells) Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p533 Fig 17.15
  • 34. Comparison of stomach Drawing of the glands stomach with sections from the body, cardiac, Pit depth (% of mucosa) and pyloric regions of Cardiac - 50% the stomach illustrated Gastric - 25% in histological cross- Pyloric – 66% section to show the glands of each region. Gland morphology Cardiac – tortuous, homogeneous Gastric – straight, heterogeneous Pyloric – ~tortuous, homogeneous Location Cardiac – near gastro-esophageal junct. Original: Fig 15-10 from Junqueira and Carneiro, Gastric – in fundus and corpus Basic Histology, 10th ed. (2003), p300 Pyloric – near gastro-duodenal junct.
  • 35. Gastroduodenal junction: •  Transition from gastric epithelium (with pits) to intestinal epithelium (with crypts & villi) •  Duodenal region specifically identifiable by presence of SUBMUCOSAL glands •  Pyloric sphincter, a true anatomical sphincter, expansion of circular layer of smooth muscle Stomach Pyloric sphincter Duodenum mm sm mm=musc. mucosae; sm=submucosa Matt Velkey Slide 162 of the University of Michigan Histology Collection (All Images)
  • 36. Learning Objectives •  Be able to identify and describe the function of the layers AND COMPONENT CELLS in the wall of the digestive tract (mucosa, submucosa, muscularis (propria), and adventitia/serosa), and explain how they differ in the pharynx, esophagus, and stomach. •  Know the histological differences in the pharynx and the upper, middle and lower portions of the esophagus. •  Be able to recognize gastric glands, identify their constituent cells, and know their secretory products. •  Be able to recognize gastric glands, cardiac glands, and pyloric glands of the stomach.
  • 37. Additional Source Information for more information see: http://open.umich.edu/wiki/CitationPolicy Slide 3: National Digestive Diseases Information Clearinghouse, US Federal Government, http://digestive.niddk.nih.gov/ddiseases/pubs/uppergi/index.htm Slide 4: Deb Gumucio, UMich, Dept of Cell & Dev. Biol. Slide 5: Boumphreyfr, Frank Boumphrey, M.D., Wikipedia, http://commons.wikimedia.org/wiki/File:Smallintestine_layers2.png Slide 8: University of Michigan Virtual Microscopy collection Slide 152 Slide 10:Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p253 Fig 14.4a Slide 11: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p522 Fig 17.2 Slide 12: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006); Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006) Slide 13: University of Michigan Virtual Microscopy Slide Collection, slide #155. Slide 14: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.6, p.525 Slide 15: Bloom and Fawcett, 12th ed. Fig. 25-6, p.599 Slide 16: University of Michigan Virtual Microscopy slide collection, slide #155 Slide 19: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.5, p.524 Slide 20: University of Michigan Virtual Microscopy slide collection, slide #156 Slide 21: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.14, p.532 Slide 22: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p272 Fig 14.31b Slide 23: Frank Boumphrey, M.D; Original: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.8b, p.527 Slide 24: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.8a, p.527 Slide 25: Original: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.11, p.530 Slide 26: Frank Boumphrey, M.D; Replaced: Fig 15-15 from Junquiera and Carneiro. Basic Histology, 10th ed. (2003), p305.
  • 38. Slide 27: Junquiera and Carneiro. Basic Histology, 10th ed. (2003), p305 Fig 15-15 Slide 28: Original Source: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006). Fig. 17.9, p.529 Slide 29: Slide 843 (35mm Kodachrome slide collection) from Mizoguti, Color Slide Atlas of Histology (1985). Slide 30: Junquiera and Carneiro, Basic Histology, 10th ed. (2003), p307. Fig 15-18 Slide 31: Source Undetermined; Removed Image - Fig 17.12 from Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p530 Slide 33: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p533 Fig 17.15 Slide 34: Removed Image - Fig 15-10 from Junqueira and Carneiro, Basic Histology, 10th ed. (2003), p300 Slide 35: Matt Velkey Slide 162 of the University of Michigan Histology Collection (All Images)