histology of esophagus & gastro esophageal junction by dr. sobia ibrahim assistant professor...
TRANSCRIPT
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HISTOLOGY OF ESOPHAGUS &GASTRO ESOPHAGEAL JUNCTION
By Dr. Sobia Ibrahim
Assistant Professor Anatomy,
KEMU
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ESOPHAGUS
Is muscular tube
Extends from pharynx
to stomach
Wall has four layers:
Mucosa
Epithelium
Lamina propria
Muscularis interna or
muscularis mucosae
Submucosa
Muscularis externa
Adventitia / Serosa
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UPPER 1/3 OF ESOPHAGUS MUCOSA
Epithelium: Stratified squamous non-keratinized
Lamina propria: scattered lymphocytes, few lymphatic nodules, mucous glands, blood vessels
Muscularis mucosae: Thick, smooth muscles
longitudinally arranged
SUB-MUCOSA Collagen & elastic fibres,
mucous glands, blood vessels, nerves
MUSCULARIS EXTERNA Skeletal (striated) muscles
ADVENTITIA Collagen & elastic fibers,
blood vessels
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MIDDLE 1/3 OF ESOPHAGUS MUCOSA Epithelium: stratified squamos non-
keratinized Lamina propria: : scattered lymphocytes,
few lymphatic nodules, mucous glands, blood vessels
Muscularis mucosae: thick, smooth muscles longitudinally
arranged
SUB-MUCOSA Collagen & elastic fibres, mucous glands,
blood vessels, nerves
MUSCULARIS EXTERNA Skeletal (striated) muscles, Smooth muscles
ADVENTITIA Collagen & elastic fibers, blood &
lymphatic vessels
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LOWER 1/3 OF ESOPHAGUS
MUCOSA Epithelium: Simple columnar
Lamina propria: scattered lymphocytes, few lymphatic nodules, mucous glands, blood vessels
Muscularis mucosae: thick, smooth muscles
longitudinally arranged
SUB-MUCOSA Collagen & elastic fibres, mucous
glands, blood vessels, nerves
MUSCULARIS EXTERNA Smooth muscles
ADVENTITIA/ SEROSA Collagen & elastic fibers, blood &
lymphatic vessels
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GASTROESOPHAGEAL REFLUX DISEASE
It is associated with incompetent barriers at this junction; caused by hiatal hernia, decrease in lower esophageal sphincter tone.
Results in reflux esophagitis as mucosal barriers are not sufficient to protect esophagus from acids, pepsin & bile
causing heart burns/atypical chest pain
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BARRETT’S ESOPHAGUS
Reflux of gastric contents throu lower esophageal sphincter Gastric acid in esophagus Heart burn With time, metaplasia of epithelium (protective) Barrett’s esophagus High risk for carcinoma
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STOMACH
PARTS OF STOMACH
Cardia
Fundus
Body
Pylorus
Rugae
Three histological zones
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CARDIOESOPHAGEAL JUNCTION
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Esophageal cardiac junction
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MUCOSA:1:Epithelium changes from: Startified squamous non keratinised into simple columnar.2: Lamina propria: esophageal cardiac glands but in stomach (cardiac, fundic and pyloric glands).They are tubular and deep.3:Muscularis mucosae: thick longitudinal in esophagus but thin and two layered in stomach.Submucosa: esophageal glands proper disappear. No glands in submucosa of stomach.Muscularis externa: three layered in stomach an additional oblique layer is there
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GASTROESOPHAGEAL REFLUX DISEASE
• It is associated with incompetent barriers at this junction; caused by hiatal hernia, decrease in lower esophageal sphincter tone.
• Results in reflux esophagitis as mucosal barriers are not sufficient to protect esophagus from acids, pepsin & bile
• causing heart burns/atypical chest pain