by dr. sobia ibrahim assistant professor anatomy, kemu
DESCRIPTION
STOMACH Dilated segment od GIT Function: Digestion of carbohydrates Addition of acidic juice to food Transformation of food to chyme Initial digestion of proteins by pepsin Digestion of triglyceridesTRANSCRIPT
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HISTOLOGY OF STOMACH
By Dr. Sobia IbrahimAssistant Professor Anatomy, KEMU
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STOMACH
Dilated segment od GITFunction:• Digestion of
carbohydrates• Addition of acidic juice
to food• Transformation of food
to chyme• Initial digestion of
proteins by pepsin• Digestion of triglycerides
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STOMACH
• PARTS OF STOMACH• Cardia
• Fundus
• Body
• Pylorus
• Rugae
• Three histological zones
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MUCOSA
Simple columnar epithelium
Gastric pit(circular/ovoid)
Gastric glands
• Type• Branched tubular
• Coiled tubular
Parts of gland
• Isthmus
• Neck
• Base
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MUCOSA
• LAMINA PROPRIA• Consists of
• Collagen & reticular fibers• Lymphocytes – diffuse & nodules• Fibroblasts • Plasma cells • Mast cells• Few muscle cells
• MUSCULARIS MUCOSAE• Two layers
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GASTRIC GLANDS
• CARDIAC GLANDS• 1/3 pit • 2/3 gland• Simple branched ,coiled tubular
• FUNDIC GLANDS• ¼ PIT • ¾ gland• Simple branched tubular
• PYLORIC GLANDS• ½ pit • ½ gland• Branched / coiled tubular
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EPITHELIAL CELLS OF STOMACH
SURFACE MUCOUS CELLS
Simple columnar epithelium
Nuclei ovoid
Basal cytoplasmic basophilia
Golgi apparatus
Mucin granules
Staining H & E
PAS
Secrete bicarbonate
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MUCOUS NECK CELLS
Location
Shape irregular
Basally located nucleus
Basal cytoplasmic
basophilia
Golgi apparatus
Mucin granules
Stain
Produce acid mucous
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PARIETAL (OXYNTIC) CELLS
Located mainly in upper half of gastric gland
Rounded/pyramidal shaped Fried egg appearance Intensely eiosinophilic-E/M
mitochondria Intracellular canaliculus Secrete:
HCl Intrinsic factor- glycoprotein
Secretory activity increased by Parasympathetic activity Histamine Gastrin
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PARIETAL & CHIEF CELLS
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MEDICAL APPLICATION
Atrophic Gastritis a condition in which chief & parietal
cells are less numerous
Intrinsic factor bind to Vit B12
Complex absorbed in Ileum
Lack of Intrinsic factor leads to Vit. B 12 defficiency –
PERNICIOUS ANAEMIA
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CHIEF (ZYMOGEN) CELLS
Located at base of
gland
Protein synthesizing cell
Cells have basal
basophilia
Apical zymogen
granules contain
pepsinogen
Cells also produce:
Gastric lipase
Hormone Leptin
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ENTEROENDOCRINE CELLS Present in base of gland- specially in pyloric antrum Small pyramidal cells with clear cytoplasm Are peptide secreting cells Stain with
Silver stains- Argentaffin cells Potassium dichromate – enterochromaffin cells
In fundus – secrete Serotonin In pylorus – G cells produce Gastrin
STEM CELLS Found mainly in neck of gland Low columnar cells with basal oval nuclei High rate of mitosis Replace all kind of cells
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MEDICAL APPLICATION
CACINOID is a tumour of enterochromaffin cells
Causes overproduction of serotinin
Results in:
Hypermotility of gut
Mucosal vasoconstriction
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OTHER LAYERS OF STOMACH SUBMUCOSA
Collagen & elastic fibers Fibroblasts, lymphocytes, plasma cells Blood vessels, lymph vessels, nerves, submucosal plexus
MUSCULARIS EXTERNA Three layers:
Innermost oblique Inner circular Outer longitudinal
Circular layer well developed in Pylorus to form sphincter
SEROSA Adipose cells Blood vessels, nerves etc.
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CARDIA 1/3 pit & 2/3 glad Pit lined by surface cells Simple / branched tubular glands GLAND Isthmus:
Few parietal cells Neck:
Mucous neck cells Stem cells
Base: Enteroendocrine cells
FUNDUS/ BODY ¼ pit & ¾ gland Simple & branched tubular gland GLAND Isthmus:
Parietal cells-abundance Neck:
Mucous neck cells Stem cells PARIETAL CELLS
Base: Chief cells Enteroendocrine cells Parietal cells & mucous neck cells
PYLORUS ½ Pit & ½ gland Branched & coiled tubular gland GLAND Isthmus:
Parietal cell –few Neck: Base:
Mucous neck cell Enteroendocrine cells Stem cells Parietal cell -few Few parietal cells
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FUNDUS OF STOMACH PYLORUS OF STOMACH
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COMPARISON
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MEDICAL APPLICATION
o Disruption of epithelial layer leads to ULCERATION
o Factors:
o Stress
o Drugs
o Ethanol
o H pylori
o Superficial ulcers heal spontaneously
o Imbalance between aggressive & protective factors leads to
pathological alterations – PEPTIC ULCERS
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Line of defence
Surface mucous
Tight intercellular junctions
Underlying circulatory bed