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Microscopical Anatomy of the Small and Large Intestines. Histology the Liver, and the Pancreas

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Microscopical Anatomy of the Small and Large Intestines. Histology the Liver, and the Pancreas Microscopical anatomy of the small and large intestines. Histology the liver, and the pancreas Dr. Zsuzsanna Tóth Semmelweis University Department of Anatomy, Histology and Embryology General histology of the GI tract Serosa: mesothel and subserosa: lamina propria, or adventitia (loose connective tissue) Longitudinal layer Myenteric or Auerbach's plexus muscularis externa Circular layer Submucosa Enteric nervous plexus (Meissner’s plexus) Muscularis mucosae mucosa Epithelium and lamina propria Enteric nervous system longitudinal Myenteric plexus Multipolar neurons circular Regulation of the motility of the GI tract Regulation of secretory activity and and local blood (motoneurons) flow (secretomotor and vasodilatator neurons) • eosophagus - m. sphincter ani internus • control: autonomic nervous system, • input: chemo- and mechanoreceptors enteroendocrine cells, digestive enzymes Small Intestine (duodenum, jejunum, ileum) brush border (microvilli) v. portae hepatis 1mm Circular folds of Kerckring Villi Length: approx 5 m Increase of surface area : circular folds -3X, villi-10X, microvilli-20X→ 600X Intestinal glands (crypts of Lieberkühn) epithelium lamina shedding dead enterocytes propria lacteal crypta l. muscularis mucosae • simple tubular glands • mucosal structures • epithelial cell renewal- stem cells Circular folds submucosa Tunica mucosa and submucosa Brunner glands (duodenal glands) • only in the duodenum • branching tubular mucous glands • produce alcaline mucus - neutralizes the acidic chyme entering from the stomach - protection of the mucosal cells -provides optimal pH for the digestive enzymes • produce epidermal growth factor • open into the crypts Pylorus-duodenum transition Muscularis externa layer in the small intestine: continous, outer longitudinal, inner circular layers pyloric sphincter (ps) muscle: formed by the circular layer of the tunica muscularis Small intestinal cell types goblet cell goblet cell enteroendocrine cell Paneth cell Enterocye lubrication regulatory antibacterial agents absorbtion hormones digestion Paneth cell crypts t. submucosa l. muscularis mucosae small intestinal stem cell Smooth muscle cells Human jejunum H&E Crypts: all the cell tpyes Villi: enterocyte, goblet cell, enteroendocrine cell Crosnier et al. Nature Reviews Genetics 7, 349–359 (May 2006) | doi:10.1038/nri1840 Intestinal villi simple columnar epithelium epithelium lamina propria lamina propria Goblet cell lacteal capillary bed smooth musle cells l. musc.mucosae villous contractions: lymph and blood is pushed toward larger vessels Immune defense within the GI tract Mucosa or gut associated lymphatic tissue (MALT, GALT) lamina propria: • cell rich connective tissue • diffusely distributed lymphoid cells and plasma cells enterocytes submucosa: capillary scattered solitary lymphoid follicles plazma cells plasma cells: secretory IgA goblet cell production lamina propria GALT: Peyer’s patches in the ileum • aggregated lymphoid nodules in the mucosa and submucosa • anti-mesenterial location, approx. 100 nodules in humans GALT: vermiform appendix-”intestinal tonsil” Goblet cells mesoappendix tunica serosa • no villi • crypts • circularly arranged lymphatic nodules • thick muscularis externa • serosa Duodenum Jejunum Ileum Colon P B Mucosa: Intestinal villi and Lieberkühn crypts (intestinal glands) no villi, deep crypts Submucosa: Brunner glands Peyer’s patches Tunica muscularis in the large intestine Modified outer longitudinal layer: plicae semilunares • Teniae coli (muscle bands): gastrum o from the cecum to the sigmoid colon 1. free, 2. mesocolic, 3. omental teniae o converge at the roof of the appendix 3. 2. o sigmioid colon: 2 bands only o appendices epiloicae are attached to them haustrum 1. teniae o plicae semilunares-musosa and submucosa o sacculations-haustra o haustra disappears if theniae are dissected off Circular layer: • continous • forms sphincters and valves Tunica mucosa of the colon • epithelium: enterocytes, goblet cells, enteroendocrine cells columnar epithelium (enterocytes) • enterocytes -water and electrolite reabsorbtion -no digestive function • the number of goblet cells increases caudally - thick mucin layer • deep crypts Rectum – intestinal part lymphatic nodule lymphatic nodules goblet cells mucus between crypts • The longitudinal muscle layer is continous, there are no teniae. • Epiploic appendages are missing. • More goblet cells, deeper crypts, than in the colon. • Several solitary lymphatic nodules (GALT). • No semilunar folds, but transverse folds are present. Rectum – anal canal transverse folds Lieberkühn crypts rectum pars intestinalis anal canal stratified keratinized squamous epithelium pectinate line cutaneous zone pigments, hair, intermediate zone sebaceous gl, cirumanal gl. sebaceous gl, hemorrhoids • columnar zone: o columns of Morgagni- stratified squamous non-keratinized epithelium o sinus anales – simple columnar epithelium • intermediate zone (haemorrhagica): stratified squamous non-keratinized epithelium • cutaneous zone: stratified squamous keratinized epithelium, pigmented Next slide: QR code for attendance tracking! Histology of the liver, and the biliary system The liver tissue is organized into units called lobules vena cava portal triad Hepatic lobule interlobular • Hexagonal shaped functional unit consisting of interlobular vein sublobular duct mainly hepatocytes. veins interlobular artery • Lobules are separated by connective tissue – interlobular septa. • Branches of the portal vein, the hepatic artery and the hepatic duct follow the corners of the hexagon and are called portal triad. • Blood flows from the perifery of the lobule toward the center (red arrows). • In the center of the hexagon there is a central vein. • The central (=centrilobular) vein gathers blood and transports it to the sublobular vein, and then into the interlobular septa hepatic vein. Intensive blood supply facilitates the work of hepatocytes sinusoids • Sinusoids are dilatated capillaries. portal (Glisson’s) triad: • Blood from the perilobular vessels falls into the sinusoids and from them to the central vein. • Arterial and venous blood get interlobular artery mixed in the sinusoids. interlobular vein 3 • Sinusoids separate the hepatic interlobular duct plates. • They form anastomoses, thus at least one surface of a hepatocyte is perilobular vein surrounded by blood. hepatic plates • Hepatic cells in the lobule form on cell layer-thick plates. • Within the plates hepatocytes perilobular artery are arranged in radial cords. • The cords are actually branching, interconnected sheets. central vein peribiliar plexus Portal triad The site at which blood enters the lobule and bile leaves it. capsule • connective tissue interlobular artery • round or oval shape • muscular media • may contain red blood cells lymph vessel • irregular shape • very delicate wall • no red blood cells Nerves may be present. interlobular vein interlobular bile duct • irregular shape • round or oval shape • thin wall, only endothelial lining • simple cuboidal (small ones) • surrounding pericytes or columnar (larger ones) epithelium • may contain red blood cells Human liver tissue 1 2 6 c v c v 3 hepatic lobule 5 4 Interlobular septa are less definitive in humans. Central vein with hepatic cords and sinusoids around CV Hepatocytes: • main cell type in the parenchyma • have large, round euchromatic nuclei, and one or more nucleoli • binucleate cells are common (paired nuclei) Concepts of liver lobules Portal lobule: Hepatic acinus: Emphasizes the bile secretion. Emphasizes the blood supply. Liver acinus acinus perilobular vessels perilobular 1/6 1/6 perilobular vessels perilobular CV CV liver acinus According to the deacreasing oxygen gradient toward the central vein, the acinus is divided into 3 zones. Hepatocytes in the zones have different functions. Zone 1: first to receive both nutrients and toxins last to die in case of ishemia and the first to regenerate first to take up glucose to store as glycogen first to show morphological changes following bile duct occlusion Zone 3: first to show ischemic necrosis first to show fat accumulation in obese persons last to respond to toxic substances and bile stasis Zone 2: intermediate zone The liver sinusoid and the perisinusoidal space Easy exchange of large molecules between hepatocytes and blood plasma is facilitated: • the sinusoidal wall is lined with fenestrated endothel, • beside the intercellular fenestrae there are also intercellular pores in the endothelial cells, • the basal lamina is discontinous or missing, • the hepatocytes and the sinusoidal wall is separated by the perisinusoidal space – space of Disse, • plasma may enter, but red blood cells and platelets are exluded form the perisinusoidal space, • microvilli (increasing surface) of the hepatocytes extend into the space of Disse-this is the site of exchange. Reticular fiber network supports hepatocytes in the space of Disse reticular fibers in the space Silver impregnation of type III collagen (reticular) fibers. of Disse • Reticular fibers are in connection with the interlobular connective tissue and with the connective tissue around the central veins. • The ratio of the interstitium and the parenchyma is small, therefore the liver is vulnerable to injuries. microvilli Bile canaliculi bile canaliculus n metabolites TJ TJ • Kupffer cells : in the sinusoids • Ito cells (hepatic stellate cells): in the perisinusoidal space Kupffer cells are resident macrophages Kupffer cells phagocyte ink particles added intravenously.
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