HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU...

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HISTOLOGY OF HISTOLOGY OF GASTROINTESTINAL TRACT GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.201 5

Transcript of HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU...

Page 1: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

HISTOLOGY OF HISTOLOGY OF GASTROINTESTINAL GASTROINTESTINAL

TRACTTRACT

Dr. Archana Rani

Associate Professor

Department of Anatomy

KGMU UP, Lucknow

29.04.2015

Page 2: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Contents

• Oesophagus

• Stomach

• Small Intestine

• Large Intestine

Page 3: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Histology of the Digestive System

Basic Histological Layers:1. Mucosa:

a. Epitheliumb. Lamina Propriac. Muscularis Mucosae

2. Submucosa:Submucosal plexus

“Plexus of Meissner”

3. Muscularis:Myenteric plexus

“Plexus of Auerbach4. Serosa

Page 4: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Histology of the Mucosa

Organ Epithelium

Mouth Nonkeratinized Stratified Squamous

Pharynx Nonkeratinized Stratified Squamous

Esophagus Nonkeratinized Stratified Squamous

Stomach Simple Columnar

Small Intestine Simple Columnar

Large Intestine Simple Columnar

Anus Nonkeratinized Stratified Squamous

Page 5: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Histology of the Mucosa

Organ Folds of the epithelium

Esophagus none

Stomach L: Rugae, S: gastric pits

Small Intestine L: Plicae circulares, Villi S: Crypts of Lieberkuhn, microvilli

Large Intestine L: Haustra S: Intestinal glands

Page 6: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Histology of the Submucosa

Organ Specialized structures

Esophagus Submucosal mucous glands

Stomach None

Duodenum Brunner’s glands

Ileum Peyer’s Patches

Large Intestine None

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Histology of the Muscularis

Organ Smooth muscle layers

Esophagus 2, circular and longitudinal

Stomach 3, oblique, circular, and longitudinal

Small Intestine 2, circular and longitudinal

Large Intestine 2, circular and longitudinal

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Histology of the Serosa

Organ Serosa

Esophagus Adventitia due to the fact that the esophagus is not in a cavity

Stomach Visceral Peritoneum

Small Intestine Visceral Peritoneum

Large Intestine Visceral Peritoneum

Anus Adventitia

Page 9: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Oesophagus

• Mucosa: Stratified squamous non - keratinized epithelium

• Submucosa: contains Meissner’s plexus and oesophageal glands

• Muscularis externa:

Upper one-third: skeletal fibres

Middle one-third: mixed fibres

Lower one-third: smooth fibres

• Adventitia: loose areolar connective tissue

Page 10: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Oesophagus

Page 11: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Oesophagus

Page 12: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.
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Stomach

• Mucosa:simple columnar epithelium and presence of gastric pits.

• Stomach is divided into three histological regions on the basis of nature of glands:

Cardiac region Fundic region (fundus &

body) Pyloric region

Page 14: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Stomach (Cardiac Region)

• Mucosa: simple columnar with oval nuclei, mucous secreting cardiac glands in lamina propria.

• Submucosa: connective tissue.

• Muscle layer: inner circular, outer longitudinal.

• Serosa: simple squamous epithelium.

Page 15: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Stomach (Fundic Region)

• Mucosa: simple columnar with oval nuclei, presence of gastric glands in lamina propria.

Page 16: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Stomach (Fundic Region)

Cells of fundic region:• Mucous neck cells• Parietal (oxyntic) cells• Chief (peptic/zymogen) cells• Enteroendocrine cells• Undifferentiated cells

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Cells of fundic region

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Cells of fundic region

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Stomach (Fundic Region)• Submucosa: contains blood

vessels, lymphatics and Meissner’s plexus.

• Muscularis Externa: an inner oblique (absent in pylorus), middle circular and outer longitudinal layer.

• Serosa: consist of surface layer of flattened mesothelial cells resting on a thin layer of loose connective tissue with blood vessels and lymphatics.

Page 20: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Stomach (Pyloric Region)

• Mucosa: pyloric glands in lamina propria & deeper gastric pits extending half the thickness of mucosa.

• Muscularis Externa: inner circular (thickened to form pyloric sphincter) and outer longitudinal layer.

• Submucosa & Serosa: same as in fundic part.

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Stomach (Pyloric Region)

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Pyloric Glands

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Gastro-Duodenal Junction

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Small Intestine

It is divided into duodenum, jejunum and ileum.

• Mucosa: characteristic features- Plicae circularis (valves of Kerkring) Villi & Microvilli Goblet cells (few) Crypts of Lieberkuhn (intestinal glands) Glands are lined by columnar cells,

goblet cells, Paneth cells & enteroendocrine cells

Page 25: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Small Intestine

Page 26: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Small Intestine

• Submucosa: contains blood vessels, lymphatics and Meissner’s plexus.

• Muscularis externa: Outer longitudinal and inner circular layers of smooth muscle.

• Serosa/Adventitia

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DuodenumPresence of Brunner’s glands in submucosa

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High power view of the Duodenal Mucosa

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Jejunum

• Villi are tongue shaped.

• Absence of Brunner’s glands.

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Ileum

• Presence of lymphoid aggregations in lamina propria known as Peyer’s patches.

• Villi are short & finger like.

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Large Intestine• It consists of: appendix, colon, rectum and anal canal.

• Mucosa: Absence of Plicae circulares and villi

Presence of Microvilli

Presence of Crypts of Lieberkuhn

Presence of Goblet cells in large number

• Submucosa

• Muscularis externa:

Inner circular layer - thin compared to small intestine.

Outer longitudinal layer- forms Taenia coli.

• Adventitia: Appendices epiploicae (peritoneum forms pouch like processes filled with fat)

Page 32: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Large Intestine

Page 33: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Magnified view of a villus

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Large Intestine

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Vermiform Appendix

• A small blind-ending diverticulum.

• Large accumulations of lymphoid tissue in lamina propria which may extend into submucosa.

• Intestinal villi are usually absent.

• Crypts are poorly formed.

• Muscularis externa is thin.

• Absence of taenia coli.

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Vermiform Appendix

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Rectum

• Intestinal glands are straight, like test tubes.

• A continuous coat of longitudinal muscle is present.

• Absence of taenia.• Absence of appendices

epiploicae.

Page 38: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

Anal Canal

• Epithelium: upper part-simple columnar, middle part-stratified squamous non-keratinized, lower part-covered by true skin.

• Mucosa has characteristic longitudinal folds-Anal columns.

• Small mucosal folds between the anal columns -Pectinate line.

• Crypts disappear below this line.

• Muscularis externa-circular muscle forms involuntary internal anal sphincter.

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Ano-rectal Junction

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Page 41: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

References

1. diFiore’s Atlas of Histology with functional Correlations, 12th Edition.

2. Textbook of Human Histology. Inderbir Singh, 1st Edition.

3. Textbook of Histology. GP Pal, 3rd Edition.

Page 42: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

MCQ

Q1. Stratified squamous non-keratinized

epithelium is a feature of:

a. Oesophagus

b.Stomach

c. Appendix

d.Rectum

Page 43: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

MCQ

Q2. Deep gastric pits is a feature of:

a. Oesophagus

b.Cardiac part of stomach

c. Fundic part of stomach

d.Pyloric part of stomach

Page 44: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

MCQ

Q3. Plica circularis is a feature of:

a. Oesophagus

b.Stomach

c. Small intestine

d.Large intestine

Page 45: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

MCQ

Q4. Taenia coli is present in:

a. Oesophagus

b.Stomach

c. Small intestine

d.Large intestine

Page 46: HISTOLOGY OF GASTROINTESTINAL TRACT Dr. Archana Rani Associate Professor Department of Anatomy KGMU UP, Lucknow 29.04.2015.

MCQ

Q5. Abundant lymphoid tissue in lamina propria

is a feature of:

a. Oesophagus

b.Stomach

c. Duodenum

d.Appendix