Digestive system - Semmelweis
Transcript of Digestive system - Semmelweis
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Digestive system
Dr. Anna L. Kiss
Department of Anatomy, Histology and
Embryology
Semmelweis University
Budapest
2019
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The gastrointestinal tract (GI tract): digestion and excretion
Upper gastrointestinal tract
The upper GI tract consists of the
mouth, pharynx, esophagus, and stomach.
The lower GI tract.
small intestine, which has three parts:
-duodenum
-jejunum
-ileum
large intestine, which has three parts:
-cecum (the vermiform appendix is attached to the cecum).
-colon (ascending colon, transverse colon, descending colon and sigmoid flexure)
-rectum
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Coeliac trunk
Superior mesenteric
artery
Inferior mesenteric
artery
Umbilical loop
Vitelline duct
Umbilical artery
Primitive Gut Tube
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Abdominal
esophagus
Liver
Gall bladder
& bile duct
Stomach
2.) Transverse colon Jejunum & ileum
Cecum
Appendix 4.) Sigmoid colon
Thoracic
esophagus
Duodenum Pancreas
1.) Ascending colon
3.) Descending colon
Final Position of Parts of Gut Tube
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Final Position of Parts of Gut Tube
Stomach: left hypochondric region (intraperitoneal)
Duodenum: right side (partly retroperitoneal)
Jejunum, ileum: umbilical + iliac region
(intraperitoneal)
Appendix: right side (Mc Burney point)
(intraperitoneal)
Ascending colon: right iliac region
Transverse colon: middle position (intraperitoneal)
Descending colon: left iliac region
Sigmoid colon: sacral and pelvic region (intraperitoneal)
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The stomach lies between the
esophagus and the duodenum
It is on the left side of the abdominal cavity.
highly acidic environment due to gastric acid production
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Stomach
cardia
pylorus
fundus
body
lesser curvature
greater curvature
rugae!!
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Fundus
Diaphragm
Corpus
bodysuperior part
(duodenum)
pyloric
antrum
Jejunum
Greater
curvature
horizontal part
ascending partdescending part
(duodenum)
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Histology of the gut
Mucosa:
• epithelium: simple columnar (goblet cells)
• propria (lymphoreticular connective tissue): glands
(Lieberkhün crypts)
• muscularis mucosae (2 layered smooth muscle)
Submucosa: loose connective tissue (submucosus plexus;
glands, lymphatic follicles)
External muscle layer (t. muscularis): smooth muscle
(inner circular, outer
longitudinal)
Serosa or adventitia
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Histology of the stomach
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Histology of the stomach
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Histology of the stomach
To increase the surface: rugae
Gastric glands in the mucosa
Producing:
pepsinogen: chief cells
HCl+intrinsic factor: parietal cells
mucus (to protect the mucosa)
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Histology of the stomach
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superior part
(duodenum)
pyloric
antrum
horizontal
part
ascending partdescending part
(duodenum)
Duodenum
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Duodenum
• main part of the digestion
• pancreas: empties to the descending part: all kind of digestive
enzymes
• liver: bile
• Histologically: accomodation to the function: increase the
surface:
Kerkring folds (submucosa)
villi: mucosa
microvilli: apical plasma membrane of the enterocytes
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Right colic artery
Uncinate process
Superior mesenteric vein
Head of pancreas
Right colic flexure
Superior pancreatico-
duodenal artery
Bile duct
Proper hepatic artery
Suprarenal gland
Portal vein
Coeliac ganglionInferior phrenic artery
Ganglion coeliacum
Left colic flexure
Quadratus lumborum
Psoas major
Iliacus muscle
UreterSympathetic trunkSuperior mesenteric artery
Left gastric arteryEsophagusOmental tuber
Inferior phrenic artery
Topography of Duodenum
Inferior pancreatico-
duodenal artery
Suprarenal gland
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Small intestine: jejunum and ileum
jejunum+ileum
ascending
colon
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Jejunum and ileum
Main function:
• absorption (jejunum)
• digestion
• passing the non-digested material
Histologically: surface increasing structures:
Kerkring folds: (submucosa)
villi: mucosa
microvilli: apical plasma membrane of
the enterocytes
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Longitudinal Section of Human Duodenum
Circular folds (folds of Kerkring)
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Folds of Kerkring
M
S
Z
P
The GI tract can be divided
into 4 concentric layers:
mucosa
submucosa
muscularis externa (the
external muscle layer)
adventitia or serosa
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Structure of Wall of
Small Intestines
Mucosa
Submucosa
Muscularis
Serosa
circular
longitudinal
muscularis mucosae
propria
epithelium
villi
Crypts
(intestinal
glands)
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Intestinal Villi (Scanning Electron Microscopy)
Intestinal villi Lieberkühn’s crypts
(Intestinal glands)
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Intestinal Villi
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Lymphocytes
(infiltration)
Goblet cells
(GC)
Brushborder (microvilli)
Endothel cells (lymphatic vessel)
Two Neighboring Ileal Villi
Epithelial cells
(enterocytes)
propria (lymphocytes)
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Enterocytes with
brushborder or
microvilli
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Goblet Cells
Mucinogenic granules
Golgi-apparatus
Endoplasmatic reticulum
Microvilli
Endoplasmatic reticulum
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Paneth cells: secrete antibacterial enzyme: lysozime
Lieberkühn crypt
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Serosa
Tunica muscularis (outer
longitudinal and inner
circular)
submucosa + Brunner’s
glands
Tunica muscularis mucosae
Lamina propria mucosae
(+ Lieberkühn’s crypts)
Mucosal epithelium
Duodenum
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Duodenum villi
propria
Lieberkühn’s
crypts(glands)
muscularis
mucosae
submucosa
Brunner’s
glands
(submucosa)
Brunner
glands: secrete
alkalic substance
to neutralise the
acidic pH
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Jejunum
Goblet cells
1.) epithelium
stroma of villus
(longitudinal section
of a villus)
Lieberkühn’s crypts
Submucosa
2.) propria: wide,
containes
Lieberkühn
crypts: glands
Mucosa layer
3.) muscularis
mucosae
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tunica muscularis
+ serosa
muscularis
mucosae
submucosa
Jejunum
Intestinal villi
Kerkrings’s folds
mucosa
epithelium of mucosa
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Ileum
Peyer’s
plaques
villi
serosa
muscle layer
submucosa
crypts(Aggregated
lymphatic
follicles)
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Lymphoid tissue in the gut is comprised of the following :
Tonsils and Adenoids (Waldeyer's ring)
Peyer's patches in the small intestine
Lymphoid aggregates in the appendix and large intestine
Lymphoid tissue accumulating with age in the stomach
Small lymphoid aggregates in the oesophagus
Diffusely distributed lymphoid cells and plasma cells in the lamina propria of the gut
GALT
About 70% of the body's immune system is found in the digestive tract.
The GALT is made up of several types of lymphoid tissue that produce
and store immune cells that carry out attacks and defend against pathogens.
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Right colic
flexure
ascending
colon
descending
colon
transverse
colon
sigmoid
colon
symphysisrectum
appendix
ileum
caecum
Left colic
flexure
Radiology of
Large Intestines
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Semilunar
folds Haustra
epiploic appendices
tenia
Anal canal
Vermiform appendix
sigmoid colon
Rectum
ascending
colon
descending
colon
transverse
colon
right colic flexure
Caecum
Large
Intestines
Semilunar folds :
(tela muscularis, inner, circular layer, ring fold)
Teniae of colon: (tela muscularis, outer, longitudinal
layer)
Haustra: outpouches between tenias and circular folds
Epiploic (omental) appendices: fat bodies of the
subserous connective tissue
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Large Intestine
from the outside
and from the
Inside
taenia
haustra
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Large Intestinal
Mucosa
• lack of villi
• deeper crypts
• rich in goblet cells
• absence of Paneth-cells
• adipose tissue in
• submucosa and subserosa
• only single lymph nodes
(solitary lymphatic follicles)
Histologic Characteristics of Large Intestines
as Compared to Small Intestines
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Goblet cellsLamina propria
mucosae
Mitotic cells (M)
Muscularis
mucosae
Wall of Large Intestines
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Appendix Vermiformis
human vermiform process
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Sphincter ani
internusLymphatic
follicles
Skin: stratified squamous
keratinized epithelium
Anorectal JunctionColon: simple
cylindrical epithelium
Transition: stratified
columnar (cuboidal)
epithelium
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Inf. mesenteric art.
Stomach
Aorta
descending colonascending colon
Small intestines
Left gastric artery
Celiac trunk
Duodenum
Sup. mesenteric art.
Liver
Blood Supply
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Vena portae system
3 main veins:
• splenic vein
• sup. mesentheric
• inf. mesentheric
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Venous dranaige of the rectum
upper 1/3: portal
system
lower 2/3: inf. v. cava
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Liver
Right hypochodric
region
diaphragmatic surface
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Topography of the liver
transpyloric plane
Diaphragmatic surface
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Gross anatomy of the liver
visceral surface
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Hepatic lobule
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Portal circulation
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Histology of the liver
hepatocytes
sinusoids
central vein
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PancreasExocrine and endocrine gland
Serous exocrine acini:
• produce digestive enzymes
• ducts open to the duodenum
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Pancreas
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Pancreas
Endocrine pancreas: insulin , glucacon
Langerhans islet
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References
Bruce M. Carlson (2004).
Human Embryology and Developmental Biology,
3rd edition, Saint Louis: Mosby.
Richard Coico, Geoffrey Sunshine, Eli Benjamini (2003).
Immunology: a short course.
New York: Wiley-Liss.
Abraham L. Kierszenbaum (2002).
Histology and cell biology: an introduction to pathology.
St. Louis: Mosby.