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81 Cards in this Set

  • Front
  • Back
four structural layers of the GI tract (in to out)
mucosa, submucosa, muscularis, serosa
three layers of mucosa
specialized epithelial layer, lamina propria, muscularis mucosae
describe submucosa
connective tissue with lots of blood vessels, lymphatics, and nerves
describe muscularis
smooth muscle, inner circular, outer longitudinal
describe serosa
thin connective tissue layer and single layer of squamous epithelium moistened by transudate
describe esophageal mucosa lining
stratified squamous epithelium
describe esophageal muscularis mucosae
elastic fibers in upper, smooth muscle in lower
describe esophageal muscularis externa
upper 1/3: skeletal only, middle 1/3: skeletal and smooth, lower 1/3 smooth only
describe esophagus outermost latyer
lacks serosa, has adventitia which blends with thoracic connective tissue
what is the cardia?
narrow ring around gastro-esophageal junction
where are cardiac glands?
in the cardia
where are pyloric glands?
mucosa in distal antrum and pylorus
where are fundic glands?
fundus and body of stomach (aka gastric or oxyntic glands)
what do fundic glands do?
secrete HCl and pepsinogen
what are surface mucous cells?
tall columnar cells in stomach surface epithelium, secrete mucigen
what are gastric pits?
funnel shaped invaginations in stomach, lead into gastric glands
list the 4 cell types in the gastric glands
mucous neck cells, chief cells, parietal cells, enteroendocrine cells
describe mucous neck cells
small cells in transition zone between gastric pit and gastric gland, differentiate and migrate upwards to replace surface mucous cells
describe chief cell appearance
large cuboidal cells in the middle to lower portions of gastric gland, large zymogen granules
describe parietal cell appearance
largest, pyramidal/oval, in upper and middle portions of gland, intracellular secretory canaliculi on apical surface, lots of mitos
what is intrinsic factor?
glycoprotein, binds B12 and helps its absorption, secreted by parietal cells
describe enteroendocrine cell appearance
in deeper gastric and pyloric glands
difference between gastric and intestinal lamina propria
gastric is very delicate, reticular fibers fibroblasts, few lymphocytes, intestinal is highly cellular with lots of lymphocytes
describe gastric muscularis externa
highly developed, 3 layers of muscle
name the three structures that increase small intestine surface area
plicae circulares, villi, microvilli
what are plicae circulares?
transverse concentric folds of submucosa
what are villi?
projections of mucosa, lamina propria core, extend from plicae, covered by absorptive epithelia and goblet cells
what are microvilli?
apical brush burder, fingerlike projections of plasma membrane
two types of epithelial cells on villi surface
absorptive epithelia and goblet cells
describe absorptive epithelial cells
tall columnar cells
describe goblet cells
apical mucinogen droplets
describe villus structure
beneath epithelium, plexus of fenestrated capillaries, lots of lymphoid cells, then a central lacteal (blind ended lymphatic capillary)
where are crypts of Lieberkuhn?
bases of the villi
describe paneth cell appearance
lage, pyramidal, apical cytoplasm has lots of eosinophilic granules
what do paneth cells secrete?
lysozyme and defensins
how does lysozyme function?
digests bacterial cell wall
how do defensins function?
small peptides that permeabilize bacterial plasma membranes
what are peyer's patches
collections of lymphoid elements in the lamina propria in the ileum
What do M cells do?
sampel luminal contents and transfer antigens to peyer's patches
where is Meissner's Plexus
submucosa
where is Auerbach's Plexus
between the circular and longitudinal layers of the muscularis externa
What do Brunner's glands do?
secrete alkaline mucus that neutralizes acid from the stomach
where are Brunner's glands?
in the duodenum
how is large intesting mucosa diff from small intestine mucosa?
absence of villi, abundant crypts of Lieberkuhn, lots of lymphoid cells in lamina propria
describe blood flow trends in liver
flows centripetally, from terminal hepatic arterioles and portal venules to sinusoids to central vein
describe hepatocyte sinusoid surface
basal, incomplete basement membrane and microvilli
what are oval cells?
pluripotent cells in zone 1, mature into hepatocytes
what cells line sinusoids?
sinusoidal epithelial cells
what is so special about sinusoidal epithelial cells?
discontinuous fenestrated endothelium, incomplete BM, lots of fenestrae
what is the space of disse
area with basement membrane
what are kupffer cells?
immobile macrophages in the liver, monocyte derived
where do you find stellate cells?
in the space of disse or between hepatocytes
primary histological feature of stellate cells?
contains lots of fat droplets (retinol)
stellate cells play a critical role in the onset of which disease?
hepatic fibrosis
which cells store retinol?
stellate cells
gross appearance of liver in acute hepatitis?
swollen, bulging, red/yellow, soft and mushy
microscopic features of acute hepatitis?
acidophilic necrosis, balooning degeneration, inflammation, cholestsis, bile duct proliferation
what color is acidophilic necrosis?
eosinophilic shrunken hepatocytes
is ballooning degeneration reversible?
yes
where does bile ductular proliferation take place?
periportal zone
what are necrotic hepatocytes replaced by?
macrophages and hemorrhage
list the 4 clinical phases of hepatitis
incubation, pre-icteric, icteric, recovery
microscopic features of chronic hepatitis
portal tract monos, periportal fibrosis
inflammation pattern in acute hepatitis
more lobular
what is interface hepatitis?
focal cell necrosis and inflamm changes mostly at edge of portal tracts
what is disrupted terminal plate?
chronic inflammatory cells that penetrate into lobule adjacent to portal zone
where is hepatocyte regeneration seen?
edge of portal tract
what is bridging hepatic necrosis?
parenchymal hepatocyte loss extending across lobules, confluent necrosis
what are ground glass hepatocytes?
seen in HBV, hepatocytes stuffed with HBSag, light pink cyto
histo features of HCV?
prominent aggregates of lymphos in portal tracts
microscopic appearance of chronic hepatitis?
interface, disrupted terminal plate, regeneration, fibrosis/scarring, apoptosis, bridging necrosis, ground glass
where does steatohepatitis usually occur?
in central zone near central vein
where does fibrosis start in steatohepatitis?
central zone, called centrizonal hepatitis
what are mallory bodies?
masses of cytokeratin filaments in cytoplasm of hepatocytes
in which disease do you get mallory bodies?
alcoholic steatohepatitis
Do you get mallory bodies in NASH?
nope
microscopic appearance of Cirrhosis?
fibrosis, architectural distortion, hepatocyte regeneration, mono inflammation, intrahepatic shunts
what are intrahepatic shunts?
reorganization of vascular architecture, new shunts which connect inflow with outflow, bypassing lobules
list the patterns of scarring in cirrhosis
portal based, centrizonal based
in which diseases does portal based scarring occur?
chronic hepatitis, chronic biliary tract disease, PBC, PSC, HH
in which diseases does centrizonal based scarring occur?
alcoholic and non-alcoholic steatohepatits, ischemic injury, venous outflow obstruction