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Tubular GI tract

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




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

Small Intestine
                                        Duodenum
    Digestion                           Jejunum
    Absorption                          Ileum

    Endocrine secretion


Large Intestine
    Absorption of water [passive, follows sodium]
    Formation and propulsion of feces
How to get the most out of your
             intestine

           Start with a long tube

                                        Source Undetermined



Convolute the absorptive surface of the tube


Add enzymes that break down luminal contents


   Keep the tube moving, mix contents
Multiple strategies for convolution
         of small intestinal absorptive surface

                                                                                           Microvilli




Plicae
                                                                          Villus




                                                                                                 Louisa Howard and Katherine Connolly

                                                                                    Original: Fig 14.16 from Young & Heath, Wheater’s
                                                                                    Functional Histology, 4th ed. (2000), p262

                      University of Delaware Library Institutional Repository

         Original: Fig 14.16 from Young & Heath, Wheater’s Functional Histology ,
         4th ed. (2000), p262
Convolute the surface of the tube




                 Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p535 Fig 17.17




Plicae circulares (circular folds) – aka valves of Kerckring: permanent transverse folds of
mucosa with submucosal connective tissue core; extend halfway to two-thirds around
circumference of lumen; function to slow movement of chyme & increase surface area.
Convolute the surface of the tube




                             Plicae circularis
     Source Undetermined
                             (Kerckring’s valves)
Primarily found in jejunum
Plicae are covered with villi,
fingerlike projections of mucosa…..




                       Drawing of intestinal
                         plicae removed.
                       Original: is Fig 16-32
                         from Kelly et al.
                       Bailey’s Textbook of
                        Histology, 18th ed.
                           (1984), p543.
Plicae are covered with villi,
fingerlike projections of mucosa…..




            [
                                                                                                     LUMEN

    Villi




Submucosal core


 Crypts of
              [
 Lieberkühn
 (glands)



                   Slide 246 of the Univ. of San Francisco School of Medicine Histology Collection
Villus cells have a
                                                “brush border”

                                 Brush
                                 border




                                Lamina
                                Propria

                                               Simple
                                               columnar
                                               epithelium
          Source Undetermined

Core of each villus contains
      lamina propria
The Brush border is composed of microvilli




   Source Undetermined
Electron microscopic view of the brush border
    Apical surface (luminal surface) of absorptive cells

                                                         Microvilli,
                                                       cross section




Microvilli    Terminal web

       ~3000 microvilli/cell !!!      Sources Undetermined (All Images)
The microvilli have a well-developed surface
                 glycocalyx




 Source: Fig 26-6 from Fawcett and Raviola, Bloom and Fawcett, a Textbook of Histology, 12th ed. (1994), p622
Intestinal tube = 20 ft long
          Plicae                            Villi                                  Microvilli
          (3 fold)                      (10 fold)                                 (20-30 fold)



Total: 600-900
fold
(area 200 m2) !


                                                                                      Source Undetermined




                  University of Delaware Library Institutional Repository


                  Original: Fig 14.16 from Young & Heath, Wheater’s Functional Histology,
                  4th ed. (2000), p262
How to get the most out of your
             intestine

           Start with a long tube


Convolute the absorptive surface of the tube


Add enzymes that break down luminal contents


   Keep the tube moving, mix contents
Enzymes/bile digest luminal contents:
“Chyme” enters from stomach, stimulates intestinal
     enteroendocrine cells in intestine to secrete:
     Secretin                  pancreatic secretion
     CCK (cholecystokinin)     pancreatic secretion
                               gall bladder contraction

Ampulla of Vater: intestinal segment of the common
duct that delivers secretions to duodenum
       from pancreas (trypsin*, chymotrypsin*, amylase,
                            lipase)
       from liver via gall bladder (bile-emulsifies fat)

Enzymes in small intestinal absorptive cell (enterocyte)
     membrane complete the process of digestion and
     absorb the breakdown products

    *Secreted as inactive forms, activated by enterokinase
           cleavage (enterokinase produced in duodenum)
Enzymes/bile digest luminal contents:
activation of zymogens via enterokinase/trypsin

Chymotrypsinogen                                            Chymotrypsin
Proelastase                                                 Elastase
Procarboxypeptidase A                                       Carboxypeptidase A
Procarboxypeptidase B                                       Carboxypeptidase B
Prophospholipase A2                                         Phospholipase A2

     Zymogens                                                      Active enzymes


          Trypsinogen                                         Trypsin




                          Enterokinase

                    Enterocyte
                   Regents of the University of Michigan
                   Replaced: Image is Fig 17.29 from Ross and Paulina,
                   Histology: A Text and Atlas, 5th ed. (2006), p546.
Keep the tube moving, mix contents




Location of Meissner’s plexus                Location of Auerbach’s plexus
        (Submucosal plexus)                          (myenteric plexus)
                  Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p261 Fig 14.15a
Submucosal plexus (Meissner’s plexus)




     Matt Velkey Slide 169 of the University of Michigan Histology Collection




Controls contraction of muscularis mucosae, submucosal
vascular tone, and secretory activity of mucosal epithelium
Keep the tube moving, mix contents




                                      Young & Heath, Wheater’s Functional Histology,
                                      4th ed. (2000), p261. Fig 14.15a
Location of Meissner’s plexus
       (Submucosal plexus) Location of Auerbach’s plexus
                                  (myenteric plexus)
Muscularis externa & Myenteric plexus (Auerbach’s plexus)




          Matt Velkey Slide 153 of the University of Michigan slide collection



  Controls contraction of muscularis externa; wave-like
        contractions that move contents = peristalsis
Keep the tube moving,
                                                          mix contents


                                                                  Smooth muscle cells run
                                                                  vertically from muscularis
                                                                  mucosae (MM) up the villi


                                                                  Contraction pumps villi;
                                                                  propels lymph, blood
                                                                  from core of villi


                                                                                 L = lamina propria
                                                                                 V = villi
      C                                                                          C = crypt
Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p264 Fig 14.18b
Epithelial cell types: Small intestine
Enterocytes (majority of cells): Absorption (and secretion, e.g. enterokinase)


Goblet Cells: Increase in number as you descend the
         GI tract. Produce acid glycoproteins (mucins).
         Lubrication. Stain with Alcian Blue or PAS.



Enteroendocrine cells: Part of the “diffuse
        neuroendocrine system”. Produce CCK, glucagon,
        secretin, motilin, etc. Hormone secretion.



Paneth cells: Located at base of crypts. Exocrine cells.
        Secrete lysozyme and α-defensins; Antibacterial activity.
Villus tip

                                                                        Blood vessel



                                                                           Goblet cell



                                                                          Enterocytes



Ly = Lymphocyte
P = Plasma cell
M = Muscle
C = Capillary
                  Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p265 Fig 14.20a
Crypt region (H&E+Argentaffin stain)



                                                                                                 lamina
                                                                                                 propria




                                                                                            stem cells
                                                                                            located here

                                                                                              Paneth
                                                                                              cells
                                                                                              muscularis
                                                                                              mucosae

  Slide 247 of the University of San Francisco digital slide collection (UCSF247_40x.svs)
Villi & Crypts - Scanning electron microscopy




       Young & Heath, Wheater’s Functional Histology, 4th ed. (2000),
       p264 Fig 14.18a




Villi project into the lumen

Crypts (glands) invaginate
        into underlying lamina
        propria.                                                        Cormack, Ham’s Histology 9th ed. (1987) p505 Fig 18-29
Interpretation of cross-sections

                                                   G




  Young & Heath, Wheater’s Functional Histology,       Young & Heath, Wheater’s Functional Histology, 4th ed.
  4th ed. (2000), p265 Fig 14.19a                      (2000), p265 Fig 14.20b


                               Intestinal lumen
Crypts                                                                       Villi
The entire villus epithelium turns over every 3-4 days!!
                                                                    Cells at the apex slough
                                                                    off into the lumen




                                                                     Cells differentiate as
                                                                     they migrate out of the
                                                                     crypts and up the sides of
                                                                     the villi.




                                                                     Stem cells (1-4/crypt)
                                                                     in crypt base give rise to
           Cormack, Ham’s Histology 9th ed. (1987) p505 Fig 18-29    four cell lineages

Note: villi and crypts are arranged such that each crypt
contributes cells to a small stripe on multiple villi
Regional Morphology: Pyloric junction
                                            Duodenum (villus epithelium)




 Stomach
 Epithelium (flat)




                               Pyloric     Brunner’s glands
                               Sphincter   (submucosal)
                                           Secrete alkaline mucous
                                           neutralize stomach acid
         Source Undetermined
Duodenum                                       Villi




Crypts                             Brunner’s           Muscularis
(Glands)                           glands              Mucosae


                                                       IC muscle
                                                       OL muscle



             Source Undetermined




      (Brunner’s glands are diagnostic for duodenum….)
Surface
 of villi                               Enterocyte



      Central
      Lacteal
                                        Epithelium
     Lamina
     Propria

                                        Goblet
                                        Cell
Intraepithelial
Lymphocyte
                                        Luminal
                                        Space




   Brush border   Source Undetermined
Duodenum:                        Villi
Periodic
Acid Schiff                                                                   Goblet
                                                                              Cells
Stain (PAS)

Stains complex
carbohydrates
(mucins) and
negative charges
strong magenta

                                                                              Crypts of
                                                                              Lieberkuhn



                                                                            Brunner’s
                                                                            Glands (secrete
                                                                            bicarbonate-rich,
                   Young & Heath, Wheater’s Functional Histology, 4th ed.
                                                                            alkaline mucus)
                   (2000), p263 Fig 14.17b
Jejunum, Ileum: no Brunner’s glands
Jejunum/ileum                               Jejunum has pronounced plicae circularis




      Image is from Slide 246 of the Univ of San Francisco School of Medicine Histology Collection
Jejunum/ileum
                            Villus tips




MM
                                          Source Undetermined

SM
     Crypts of Lieberkuhn (glands)
     Contain stem cells
Jejunum/ileum




 lymphoid
 follicles




 Sr = Serosa    Young & Heath, Wheater Functional Histology, 4th ed. (2000), p261 Fig 14.15b
GALT: Gut Associated Lymphoid Tissue
                (approximately 1/4 of mucosa)

•  Plasma cells, macrophages, lymphocytes located in lamina propria and
   submucosa
•  Also “intraepithelial” lymphocytes – specialized T cells found between
   columnar epithelial cells
•  Lymph nodules (or follicles): aggregations of lymphocytes usually in
   lamina propria, sometimes extending into submucosa
  -activated leukocytes go to nearby lymph nodes, activate T+B cells, which
  “home” to GI mucosa.
  -plasma cells develop from activated B cells in follicles and migrate into
    lamina propria to secrete antibodies (secretory IgA, which can be      selectively
  transported across enterocytes into the gut lumen)

•  “Peyer’s patches:” large aggregates of nodules (technically this term
   applies to aggregates found in ileum)
  -covered by M cells (specialized for uptake & presentation of antigen to   underlying
  macrophages and lymphoid cells)

  Similar large aggregates also found in the APPENDIX
Peyer’s patch histology - TEM




      Junquiera and Carneiro. Basic Histology, 10th ed. (2003), p317 Fig 15-31
Sprue:   Immune reactivity to gliadin (a protein in
           most wheat cereals). Pathology primarily
           in jejunum. Diagnostic biopsy.


 Normal jejunum                    Sprue




                        Source Undetermined



              Therapy: Gluten-free diet
Ileo-cecal junction (SI/LI)
                    Cecum/Appendix

                                                                                                     Colon
                                                                                          (mucosa has
                                                                                          crypts ONLY)




Ileum (mucosa has
villi & crypts)




                     Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p267 Fig 14.26

Ileo-Cecal Valve
(extension of muscularis mucosae)
Appendix
Blind sac extending
from the caecum
• “Colonic” mucosa
 (crypts only)

• Note prominent
  lymphoid infiltrate
  in lamina propria (LP)
  and submucosa (SM)
• Muscularis externa has
  complete inner and outer
  smooth muscle layers
 (outer layer interrupted in
 colon)




                               Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p550. Fig 17.35
Appendix - Lymphoid nodule/follicle




   Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p271.14.29b
Colon -
whole mount

Outer longitudinal muscle:
three discontinuous bands
(Teniae coli, TC)

Semilunal folds (arrows)
caused by contraction of
TC

Sacculations of external
surface = Haustra coli (HC)

Small fatty projections
of the serosa = omental
appendices (OA)

                              Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p548.
Colon
Flat epithelium
(no villi)


 Thick muscularis
 mucosae



 Thick inner circular
 muscle

Three bands of
longitudinal muscle
(discontinuous) =       Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p270. Fig14.28a

teniae coli

Two types of muscle contraction by muscularis externa:
      Segmentation: local contraction, mixes contents
      Peristalsis: moves feces down the tube
Colonic epithelium




             Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p548. Fig 17.33 (Both Images)



Rich in goblet cells; no villi (flat surface); tightly
packed glands; stem cells at base of glands (arrows).
Colonic epithelium




                                                                                          LP

                                                            Young & Heath, Wheater’s Functional Histology, 4th ed.

                  LP                                        (2000), p261. Fig 14.28e



                                                           T = intraepithelial T
  Young & Heath, Wheater’s Functional Histology, 4th ed.
                                                                  lymphocytes
  (2000), p261. Fig 14.28b                                 LP = Lamina Propria
Susceptibility to disease is regional
  in the small and large intestine

     Predominant location of pathology:
               Sprue - jejunum
           Crohn’s disease - ileum
       Ulcerative colitis - colon/rectum
        Hirschprung’s disease -colon
        Bacterial colitis - SI and/or LI



  Cancer is a disease of the large bowel
  and is rarely seen in the small intestine
Recto-Anal junction                                                                               sebaceous gland


                                                           rectum                anal canal




      Slide 177-2 of the University of Michigan Digital Slide Collection (177-2_HISTO_20X.svs).




• Transition from columnar epithelium to stratified squamous epithelium (stratified
  epithelium is non-keratinized proximal, keratinized distal)
• Internal and external anal sphincters: smooth and skeletal m., respectively
• Note also dermal sebaceous glands and adipose tissue in wall of anal canal
Recto-Anal Junction: anal sphincters
  internal: smooth muscle




                              Slide 177-2 of the University of Michigan Digital Slide Collection (177-2_HISTO_20X.svs).



  external: skeletal muscle
Recto-Anal junction
             Rectal mucosa -                                                      Anal canal - stratified
             Columnar epithelium                                                  squamous epithelium

mm=muscularis
mucosae;
Ly=lymph nodule


                                                                            Ly
                                     mm



                     submucosa




                          muscularis externa
                        177-3 of the University of Michigan Digital Slide Collection (177-3_HISTO_20X.svs).




                  dilated submucosal vessels = “internal” rectal hemorrhoids
Recto-Anal junction
  Rectum                                                                                  Anus
                                                                             transition




     Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p271. Fig14.31h
Learning Objectives
•  Be able to identify and describe the function of the layers AND
   COMPONENT CELLS/TISSUES in the wall of the digestive tract
   (mucosa, submucosa, muscularis externa and adventitia/serosa),
   and be aware of how the layers may differ in the small and large
   intestine.


•  Be able to identify and know the general functions of the following
   regions of the GI tract:
    –    Duodenum
    –    Jejunum/ileum
    –    Colon
    –    Appendix
    –    Rectum
    –    Anal canal
Additional Source Information
                               for more information see: http://open.umich.edu/wiki/CitationPolicy


Slide 3: US Federal Government; Replaced: Fig 14.1 from Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p250
Slide 6: University of Delaware Library Institutional Repository, http://dspace.udel.edu:8080/dspace/handle/19716/2169; Replaced: Fig 14.16
       from Young & Heath, Wheater’s Functional Histology ,4th ed. (2000), p262
Slide 7: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p535 Fig 17.17
Slide 8: Source Undetermined
Slide 9: Original: is Fig 16-32 from Kelly et al. Bailey’s Textbook of Histology, 18th ed. (1984), p543.
Slide 10: Slide 246 of the Univ. of San Francisco School of Medicine Histology Collection
Slide 11: Source Undetermined
Slide 12: Source Undetermined
Slide 13: Sources Undetermined (All Images)
Slide 14: Source: Fig 26-6 from Fawcett and Raviola, Bloom and Fawcett, a Textbook of Histology, 12th ed. (1994), p622
Slide 15: University of Delaware Library Institutional Repository,http://dspace.udel.edu:8080/dspace/handle/19716/2169; Replaced: Fig 14.16
       from Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p262
Slide 18: Regents of the University of Michigan Replaced: Image is Fig 17.29 from Ross and Paulina, Histology: A Text and Atlas, 5th ed.
       (2006), p546.
Slide 19: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p261 Fig 14.15a
Slide 20: Matt Velkey Slide 169 of the University of Michigan Histology Collection
Slide 21: Young & Heath, Wheater’s Functional Histology,4th ed. (2000), p261. Fig 14.15a
Slide 22: Matt Velkey Slide 153 of the University of Michigan slide collection
Slide 23: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p264 Fig 14.18b
Slide 25: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p265 Fig 14.20a
Slide 26: Slide 247 of the University of San Francisco digital slide collection (UCSF247_40x.svs)
Slide 27: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p264 Fig 14.18a; Cormack, Ham’s Histology 9th ed. (1987) p505
       Fig 18-29
Slide 28: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p265 Fig 14.19a; Young & Heath, Wheater’s Functional Histology,
       4th ed. (2000), p265 Fig 14.20b
Slide 29: Cormack, Ham’s Histology 9th ed. (1987) p505 Fig 18-29
Slide 26: Slide 247 of the University of San Francisco digital slide collection (UCSF247_40x.svs)
Slide 27: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p264 Fig 14.18a; Cormack, Ham’s Histology 9th ed. (1987) p505
       Fig 18-29
Slide 28: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p265 Fig 14.19a; Young & Heath, Wheater’s Functional Histology, 4th ed.
       (2000), p265 Fig 14.20b
Slide 29: Cormack, Ham’s Histology 9th ed. (1987) p505 Fig 18-29
Slide 30: Source Undetermined
Slide 31: Source Undetermined
Slide 32: Source Undetermined
Slide 33: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p263 Fig 14.17b
Slide 34: Image is from Slide 246 of the Univ of San Francisco School of Medicine Histology Collection
Slide 35: Source Undetermined
Slide 36: Young & Heath, Wheater Functional Histology, 4th ed. (2000), p261 Fig 14.15b
Slide 38: Junquiera and Carneiro. Basic Histology, 10th ed. (2003), p317 Fig 15-31
Slide 39: Source Undetermined
Slide 40: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p267 Fig 14.26
Slide 41: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p550. Fig 17.35
Slide 42: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p271.14.29b
Slide 43: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p548.
Slide 44: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p270. Fig14.28a
Slide 45: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p548. Fig 17.33 (Both Images)
Slide 46: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p261. Fig 14.28b and Fig 14.28e
Slide 48: Slide 177-2 of the University of Michigan Digital Slide Collection (177-2_HISTO_20X.svs).
Slide 49: Slide 177-2 of the University of Michigan Digital Slide Collection (177-2_HISTO_20X.svs).
Slide 50: 177-3 of the University of Michigan Digital Slide Collection (177-3_HISTO_20X.svs).
Slide 51: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p271. Fig14.31h

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01.05.09: GI Intro

  • 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 National Digestive Diseases Information Clearinghouse US Federal Government J. Matthew Velkey Original: Fig 14.1 from Young & Heath, Wheater’s M1 – GI Sequence Functional Histology, 4th ed. (2000), p250 Winter, 2009
  • 4. Intestine - Functions Small Intestine Duodenum Digestion Jejunum Absorption Ileum Endocrine secretion Large Intestine Absorption of water [passive, follows sodium] Formation and propulsion of feces
  • 5. How to get the most out of your intestine Start with a long tube Source Undetermined Convolute the absorptive surface of the tube Add enzymes that break down luminal contents Keep the tube moving, mix contents
  • 6. Multiple strategies for convolution of small intestinal absorptive surface Microvilli Plicae Villus Louisa Howard and Katherine Connolly Original: Fig 14.16 from Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p262 University of Delaware Library Institutional Repository Original: Fig 14.16 from Young & Heath, Wheater’s Functional Histology , 4th ed. (2000), p262
  • 7. Convolute the surface of the tube Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p535 Fig 17.17 Plicae circulares (circular folds) – aka valves of Kerckring: permanent transverse folds of mucosa with submucosal connective tissue core; extend halfway to two-thirds around circumference of lumen; function to slow movement of chyme & increase surface area.
  • 8. Convolute the surface of the tube Plicae circularis Source Undetermined (Kerckring’s valves) Primarily found in jejunum
  • 9. Plicae are covered with villi, fingerlike projections of mucosa….. Drawing of intestinal plicae removed. Original: is Fig 16-32 from Kelly et al. Bailey’s Textbook of Histology, 18th ed. (1984), p543.
  • 10. Plicae are covered with villi, fingerlike projections of mucosa….. [ LUMEN Villi Submucosal core Crypts of [ Lieberkühn (glands) Slide 246 of the Univ. of San Francisco School of Medicine Histology Collection
  • 11. Villus cells have a “brush border” Brush border Lamina Propria Simple columnar epithelium Source Undetermined Core of each villus contains lamina propria
  • 12. The Brush border is composed of microvilli Source Undetermined
  • 13. Electron microscopic view of the brush border Apical surface (luminal surface) of absorptive cells Microvilli, cross section Microvilli Terminal web ~3000 microvilli/cell !!! Sources Undetermined (All Images)
  • 14. The microvilli have a well-developed surface glycocalyx Source: Fig 26-6 from Fawcett and Raviola, Bloom and Fawcett, a Textbook of Histology, 12th ed. (1994), p622
  • 15. Intestinal tube = 20 ft long Plicae Villi Microvilli (3 fold) (10 fold) (20-30 fold) Total: 600-900 fold (area 200 m2) ! Source Undetermined University of Delaware Library Institutional Repository Original: Fig 14.16 from Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p262
  • 16. How to get the most out of your intestine Start with a long tube Convolute the absorptive surface of the tube Add enzymes that break down luminal contents Keep the tube moving, mix contents
  • 17. Enzymes/bile digest luminal contents: “Chyme” enters from stomach, stimulates intestinal enteroendocrine cells in intestine to secrete: Secretin pancreatic secretion CCK (cholecystokinin) pancreatic secretion gall bladder contraction Ampulla of Vater: intestinal segment of the common duct that delivers secretions to duodenum from pancreas (trypsin*, chymotrypsin*, amylase, lipase) from liver via gall bladder (bile-emulsifies fat) Enzymes in small intestinal absorptive cell (enterocyte) membrane complete the process of digestion and absorb the breakdown products *Secreted as inactive forms, activated by enterokinase cleavage (enterokinase produced in duodenum)
  • 18. Enzymes/bile digest luminal contents: activation of zymogens via enterokinase/trypsin Chymotrypsinogen Chymotrypsin Proelastase Elastase Procarboxypeptidase A Carboxypeptidase A Procarboxypeptidase B Carboxypeptidase B Prophospholipase A2 Phospholipase A2 Zymogens Active enzymes Trypsinogen Trypsin Enterokinase Enterocyte Regents of the University of Michigan Replaced: Image is Fig 17.29 from Ross and Paulina, Histology: A Text and Atlas, 5th ed. (2006), p546.
  • 19. Keep the tube moving, mix contents Location of Meissner’s plexus Location of Auerbach’s plexus (Submucosal plexus) (myenteric plexus) Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p261 Fig 14.15a
  • 20. Submucosal plexus (Meissner’s plexus) Matt Velkey Slide 169 of the University of Michigan Histology Collection Controls contraction of muscularis mucosae, submucosal vascular tone, and secretory activity of mucosal epithelium
  • 21. Keep the tube moving, mix contents Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p261. Fig 14.15a Location of Meissner’s plexus (Submucosal plexus) Location of Auerbach’s plexus (myenteric plexus)
  • 22. Muscularis externa & Myenteric plexus (Auerbach’s plexus) Matt Velkey Slide 153 of the University of Michigan slide collection Controls contraction of muscularis externa; wave-like contractions that move contents = peristalsis
  • 23. Keep the tube moving, mix contents Smooth muscle cells run vertically from muscularis mucosae (MM) up the villi Contraction pumps villi; propels lymph, blood from core of villi L = lamina propria V = villi C C = crypt Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p264 Fig 14.18b
  • 24. Epithelial cell types: Small intestine Enterocytes (majority of cells): Absorption (and secretion, e.g. enterokinase) Goblet Cells: Increase in number as you descend the GI tract. Produce acid glycoproteins (mucins). Lubrication. Stain with Alcian Blue or PAS. Enteroendocrine cells: Part of the “diffuse neuroendocrine system”. Produce CCK, glucagon, secretin, motilin, etc. Hormone secretion. Paneth cells: Located at base of crypts. Exocrine cells. Secrete lysozyme and α-defensins; Antibacterial activity.
  • 25. Villus tip Blood vessel Goblet cell Enterocytes Ly = Lymphocyte P = Plasma cell M = Muscle C = Capillary Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p265 Fig 14.20a
  • 26. Crypt region (H&E+Argentaffin stain) lamina propria stem cells located here Paneth cells muscularis mucosae Slide 247 of the University of San Francisco digital slide collection (UCSF247_40x.svs)
  • 27. Villi & Crypts - Scanning electron microscopy Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p264 Fig 14.18a Villi project into the lumen Crypts (glands) invaginate into underlying lamina propria. Cormack, Ham’s Histology 9th ed. (1987) p505 Fig 18-29
  • 28. Interpretation of cross-sections G Young & Heath, Wheater’s Functional Histology, Young & Heath, Wheater’s Functional Histology, 4th ed. 4th ed. (2000), p265 Fig 14.19a (2000), p265 Fig 14.20b Intestinal lumen Crypts Villi
  • 29. The entire villus epithelium turns over every 3-4 days!! Cells at the apex slough off into the lumen Cells differentiate as they migrate out of the crypts and up the sides of the villi. Stem cells (1-4/crypt) in crypt base give rise to Cormack, Ham’s Histology 9th ed. (1987) p505 Fig 18-29 four cell lineages Note: villi and crypts are arranged such that each crypt contributes cells to a small stripe on multiple villi
  • 30. Regional Morphology: Pyloric junction Duodenum (villus epithelium) Stomach Epithelium (flat) Pyloric Brunner’s glands Sphincter (submucosal) Secrete alkaline mucous neutralize stomach acid Source Undetermined
  • 31. Duodenum Villi Crypts Brunner’s Muscularis (Glands) glands Mucosae IC muscle OL muscle Source Undetermined (Brunner’s glands are diagnostic for duodenum….)
  • 32. Surface of villi Enterocyte Central Lacteal Epithelium Lamina Propria Goblet Cell Intraepithelial Lymphocyte Luminal Space Brush border Source Undetermined
  • 33. Duodenum: Villi Periodic Acid Schiff Goblet Cells Stain (PAS) Stains complex carbohydrates (mucins) and negative charges strong magenta Crypts of Lieberkuhn Brunner’s Glands (secrete bicarbonate-rich, Young & Heath, Wheater’s Functional Histology, 4th ed. alkaline mucus) (2000), p263 Fig 14.17b
  • 34. Jejunum, Ileum: no Brunner’s glands Jejunum/ileum Jejunum has pronounced plicae circularis Image is from Slide 246 of the Univ of San Francisco School of Medicine Histology Collection
  • 35. Jejunum/ileum Villus tips MM Source Undetermined SM Crypts of Lieberkuhn (glands) Contain stem cells
  • 36. Jejunum/ileum lymphoid follicles Sr = Serosa Young & Heath, Wheater Functional Histology, 4th ed. (2000), p261 Fig 14.15b
  • 37. GALT: Gut Associated Lymphoid Tissue (approximately 1/4 of mucosa) •  Plasma cells, macrophages, lymphocytes located in lamina propria and submucosa •  Also “intraepithelial” lymphocytes – specialized T cells found between columnar epithelial cells •  Lymph nodules (or follicles): aggregations of lymphocytes usually in lamina propria, sometimes extending into submucosa -activated leukocytes go to nearby lymph nodes, activate T+B cells, which “home” to GI mucosa. -plasma cells develop from activated B cells in follicles and migrate into lamina propria to secrete antibodies (secretory IgA, which can be selectively transported across enterocytes into the gut lumen) •  “Peyer’s patches:” large aggregates of nodules (technically this term applies to aggregates found in ileum) -covered by M cells (specialized for uptake & presentation of antigen to underlying macrophages and lymphoid cells) Similar large aggregates also found in the APPENDIX
  • 38. Peyer’s patch histology - TEM Junquiera and Carneiro. Basic Histology, 10th ed. (2003), p317 Fig 15-31
  • 39. Sprue: Immune reactivity to gliadin (a protein in most wheat cereals). Pathology primarily in jejunum. Diagnostic biopsy. Normal jejunum Sprue Source Undetermined Therapy: Gluten-free diet
  • 40. Ileo-cecal junction (SI/LI) Cecum/Appendix Colon (mucosa has crypts ONLY) Ileum (mucosa has villi & crypts) Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p267 Fig 14.26 Ileo-Cecal Valve (extension of muscularis mucosae)
  • 41. Appendix Blind sac extending from the caecum • “Colonic” mucosa (crypts only) • Note prominent lymphoid infiltrate in lamina propria (LP) and submucosa (SM) • Muscularis externa has complete inner and outer smooth muscle layers (outer layer interrupted in colon) Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p550. Fig 17.35
  • 42. Appendix - Lymphoid nodule/follicle Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p271.14.29b
  • 43. Colon - whole mount Outer longitudinal muscle: three discontinuous bands (Teniae coli, TC) Semilunal folds (arrows) caused by contraction of TC Sacculations of external surface = Haustra coli (HC) Small fatty projections of the serosa = omental appendices (OA) Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p548.
  • 44. Colon Flat epithelium (no villi) Thick muscularis mucosae Thick inner circular muscle Three bands of longitudinal muscle (discontinuous) = Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p270. Fig14.28a teniae coli Two types of muscle contraction by muscularis externa: Segmentation: local contraction, mixes contents Peristalsis: moves feces down the tube
  • 45. Colonic epithelium Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p548. Fig 17.33 (Both Images) Rich in goblet cells; no villi (flat surface); tightly packed glands; stem cells at base of glands (arrows).
  • 46. Colonic epithelium LP Young & Heath, Wheater’s Functional Histology, 4th ed. LP (2000), p261. Fig 14.28e T = intraepithelial T Young & Heath, Wheater’s Functional Histology, 4th ed. lymphocytes (2000), p261. Fig 14.28b LP = Lamina Propria
  • 47. Susceptibility to disease is regional in the small and large intestine Predominant location of pathology: Sprue - jejunum Crohn’s disease - ileum Ulcerative colitis - colon/rectum Hirschprung’s disease -colon Bacterial colitis - SI and/or LI Cancer is a disease of the large bowel and is rarely seen in the small intestine
  • 48. Recto-Anal junction sebaceous gland rectum anal canal Slide 177-2 of the University of Michigan Digital Slide Collection (177-2_HISTO_20X.svs). • Transition from columnar epithelium to stratified squamous epithelium (stratified epithelium is non-keratinized proximal, keratinized distal) • Internal and external anal sphincters: smooth and skeletal m., respectively • Note also dermal sebaceous glands and adipose tissue in wall of anal canal
  • 49. Recto-Anal Junction: anal sphincters internal: smooth muscle Slide 177-2 of the University of Michigan Digital Slide Collection (177-2_HISTO_20X.svs). external: skeletal muscle
  • 50. Recto-Anal junction Rectal mucosa - Anal canal - stratified Columnar epithelium squamous epithelium mm=muscularis mucosae; Ly=lymph nodule Ly mm submucosa muscularis externa 177-3 of the University of Michigan Digital Slide Collection (177-3_HISTO_20X.svs). dilated submucosal vessels = “internal” rectal hemorrhoids
  • 51. Recto-Anal junction Rectum Anus transition Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p271. Fig14.31h
  • 52. Learning Objectives •  Be able to identify and describe the function of the layers AND COMPONENT CELLS/TISSUES in the wall of the digestive tract (mucosa, submucosa, muscularis externa and adventitia/serosa), and be aware of how the layers may differ in the small and large intestine. •  Be able to identify and know the general functions of the following regions of the GI tract: –  Duodenum –  Jejunum/ileum –  Colon –  Appendix –  Rectum –  Anal canal
  • 53. Additional Source Information for more information see: http://open.umich.edu/wiki/CitationPolicy Slide 3: US Federal Government; Replaced: Fig 14.1 from Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p250 Slide 6: University of Delaware Library Institutional Repository, http://dspace.udel.edu:8080/dspace/handle/19716/2169; Replaced: Fig 14.16 from Young & Heath, Wheater’s Functional Histology ,4th ed. (2000), p262 Slide 7: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p535 Fig 17.17 Slide 8: Source Undetermined Slide 9: Original: is Fig 16-32 from Kelly et al. Bailey’s Textbook of Histology, 18th ed. (1984), p543. Slide 10: Slide 246 of the Univ. of San Francisco School of Medicine Histology Collection Slide 11: Source Undetermined Slide 12: Source Undetermined Slide 13: Sources Undetermined (All Images) Slide 14: Source: Fig 26-6 from Fawcett and Raviola, Bloom and Fawcett, a Textbook of Histology, 12th ed. (1994), p622 Slide 15: University of Delaware Library Institutional Repository,http://dspace.udel.edu:8080/dspace/handle/19716/2169; Replaced: Fig 14.16 from Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p262 Slide 18: Regents of the University of Michigan Replaced: Image is Fig 17.29 from Ross and Paulina, Histology: A Text and Atlas, 5th ed. (2006), p546. Slide 19: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p261 Fig 14.15a Slide 20: Matt Velkey Slide 169 of the University of Michigan Histology Collection Slide 21: Young & Heath, Wheater’s Functional Histology,4th ed. (2000), p261. Fig 14.15a Slide 22: Matt Velkey Slide 153 of the University of Michigan slide collection Slide 23: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p264 Fig 14.18b Slide 25: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p265 Fig 14.20a Slide 26: Slide 247 of the University of San Francisco digital slide collection (UCSF247_40x.svs) Slide 27: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p264 Fig 14.18a; Cormack, Ham’s Histology 9th ed. (1987) p505 Fig 18-29 Slide 28: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p265 Fig 14.19a; Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p265 Fig 14.20b Slide 29: Cormack, Ham’s Histology 9th ed. (1987) p505 Fig 18-29 Slide 26: Slide 247 of the University of San Francisco digital slide collection (UCSF247_40x.svs) Slide 27: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p264 Fig 14.18a; Cormack, Ham’s Histology 9th ed. (1987) p505 Fig 18-29
  • 54. Slide 28: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p265 Fig 14.19a; Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p265 Fig 14.20b Slide 29: Cormack, Ham’s Histology 9th ed. (1987) p505 Fig 18-29 Slide 30: Source Undetermined Slide 31: Source Undetermined Slide 32: Source Undetermined Slide 33: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p263 Fig 14.17b Slide 34: Image is from Slide 246 of the Univ of San Francisco School of Medicine Histology Collection Slide 35: Source Undetermined Slide 36: Young & Heath, Wheater Functional Histology, 4th ed. (2000), p261 Fig 14.15b Slide 38: Junquiera and Carneiro. Basic Histology, 10th ed. (2003), p317 Fig 15-31 Slide 39: Source Undetermined Slide 40: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p267 Fig 14.26 Slide 41: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p550. Fig 17.35 Slide 42: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p271.14.29b Slide 43: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p548. Slide 44: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p270. Fig14.28a Slide 45: Ross and Pawlina, Histology: A Text and Atlas, 5th ed. (2006), p548. Fig 17.33 (Both Images) Slide 46: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p261. Fig 14.28b and Fig 14.28e Slide 48: Slide 177-2 of the University of Michigan Digital Slide Collection (177-2_HISTO_20X.svs). Slide 49: Slide 177-2 of the University of Michigan Digital Slide Collection (177-2_HISTO_20X.svs). Slide 50: 177-3 of the University of Michigan Digital Slide Collection (177-3_HISTO_20X.svs). Slide 51: Young & Heath, Wheater’s Functional Histology, 4th ed. (2000), p271. Fig14.31h