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WEEK 2:
Upper GI tract and pathology:
| Question | Answer |
|---|---|
| all parts of alimentary canal have what layers (4) | mucosa (towards lumen), submucosa (deep to mucosa), muscularis externa )distinct from muscularis mucosae) and serosa/ adventitia |
| nerve plexuses in layers of tissue in alimentary canal (2) | submucous plexus and myenteric plexus |
| mucosa is made of | surface epithelium, lamina propria, and muscularis mucosae |
| surface epithelium in mucosa everywhere else consists of | simple columnar epithelium |
| surface epithelium in mucosa in mouth, pharynx, oesophagus and anus consists of | non keratinised stratified squamous epithelium |
| lamina propria in mucosa consists of | collagen basement membrane and contains a lot of glands |
| muscularis mucosae in mucosa consists of | smooth muscle layer which separates mucosa above from submucosa below |
| difference between mucosae and externa | mucosae is smooth muscle but externa is skeletal |
| submucosa | dense network of connective tissue which attaches mucosa to muscularis externa |
| key features in submucosa | highly vascularised (blood vessels and lymphatic vessels) and contains submucous nerve plexus (network of sensory and parasympathetic motor neurons) |
| what is in the submucous nerve plexus in submucosa | sensory and parasympathetic motor neurons |
| what vessels are found in the submucosa (2) | blood and lymphatic vessels |
| muscularis externa consists of | skeletal muscle |
| function of muscularis externa | peristalsis via contraction of skeletal muscle |
| layers in muscularis externa | inner (circular muscle) and outer (longitudinal) muscle |
| inner layer in muscularis externa | circular |
| outer layer in muscularis externa | longitudinal |
| how many layers of muscularis externa in stomach | 3 (arranged obliquely) |
| what plexus is found between the muscularis externa layers | myenteric plexus |
| myenteric plexus | found between layers to coordinate nerve impulses that stimulate peristalsis |
| serosa | covering of peritoneum |
| adventitia | connective tissue |
| adventitia/ serosa purpose | acts as the outermost layer |
| difference between serosa and adventitia | serosa covers the peritoneum but adventitia is connective tissue |
| which TWO organs have glands in submucosa (2) | oesophagus and duodenum |
| describe the mucosa in oesophagus | highly folded mucosa |
| oesophagus epithelium consists of | stratified squamous non keratinised epithelium with glands in mucosa and submucosa |
| where are mucous glands in oesophagus | mucosa and submucosa |
| describe the muscularis externa in oesophagus | unusual - skeletal in first third and smooth in last third mixed in middle third |
| describe the outer layer of the oesophagus | can be both adventitia and serosa but last part beyond the diaphragm is covered with serosa (as its covered with peritoneum) |
| stomach epithelium | simple columnar epithelium which dips down to form gastric pits |
| where do gastric pits open into | gastric glands |
| layers in stomach | inner oblique, middle circular and outer longitudinal |
| gastric glands cell types (3) | parietal cells, HCL, chief cells and enteroendocrine cells |
| role of parietal cells | secrete intrinsic factor (needed for B12 absorption) and HCL (to keep pH at 1-2 to kill microorganisms and create ideal pH for peptidase enzymes) |
| chief cells role | |
| enteroendocrine cells role | |
| cells in gastric pit | |
| mucous cells role | |
| small intestine wall feature | many circular folds (plicae circularis) made of mucosa and submucosa (especially in jejunum) |
| plicae (intestinal villi) show | villi and microvilli |
| small intestinal villi sl18** | |
| cell types in villi | |
| lamina propria in small intestinal villi | extends between crypts and core of villus and has vessels and lymphatics |
| intestinal villus** sl20 | |
| sl21 | |
| role of glands in duodenum | Brunner's glands secrete alkaline fluid containing mucin to protect mucosa from acidic stomach contents entering duodenum |
| features of jejunum | prominent plicae and well developed villi |
| features of ileum | Peyer's patch (enormous collection of lymphocytes) and shorter plicae and villi |
| difference in jejunum and ileum plicae and villi | jejunum has prominent plicae and well developed villi but ileum has shorter plicae and villi |
| Barrett's oesophagus (metaplasia Barrett's oesophagus) | occurs when lining changes from squamous to columnar epithelium (glandular) due to repeated damage from gastric reflux |
| stomach pathology | |
| gastric ulcer caused by | H polyri infection |
| what happens in gastric ulcer | H pylori breaks down protective mechanisms (mucus) by producing ureas and acid damages stomach wall epithelium |
| what happens to continuing process in gastric ulcer | deep chronic ulcer |
| when damage and repair occurs simultaneously in gastric ulcer what occurs | |
| parietal cell | |
| intestinal pathology | |
| Meckel's diverticulum | congenital outpouching of small intestine leading to incomplete resorption of the vitelline duct with no symptoms or treatment needed and surgical removal if it causes bleeding/obstruction |
| obstruction | |
| symptoms of obstruction | |
| obstruction can lead to | |
| obstruction results in | |
| malabsorption causes | |
| manifestations of malabsorption | |
| coeliac disease | |
| coeliac disease risk factors | |
| coeliac disease diagnosis | |
| coeliac disease treatment | |
| coeliac disease has an increased risk for | |
| cystic fibrosis | |
| mechanism of CF |