• The entire gastrointestinal tract from oesophagus to anal canal

presents certain common structural characteristics.

• It is a hollow tube composed of a lumen whose diameter varies, and
made up of four principal layers: mucosa, submucosa,
muscularis externa and serosa or adventitia
• Mucosa: is made up of three
components:
– an epithelial lining:
• is a protective barrier and the site of
secretion and absorption
• oesophagus and in the terminal part
of the rectum, it is thick, stratified.
Other than in these sites, the
epithelium lining the gut wall is single-
layered, and either cuboidal (in
glands) or columnar
– a supporting lamina propria of loose
connective tissue rich in blood and
lymph vessels and smooth muscle
cells, sometimes also containing
glands and lymphoid tissue;
– muscularis mucosae
• usually consisting of a thin inner
circular layer and an outer
longitudinal layer of smooth muscle
cells separating the mucosa from the
submucosa.
• Its contraction produces local
movement and folding of the mucosa;
propel and mix the food in the
digestive tract
– At four points along the tract, the mucosa
undergoes abrupt transition from one form
to another: the gastro-oesophageal
junction, the gastroduodenal junction, the
ileocaecal junction and the recto-anal
junction
• Four basic mucosal types found in the gastrointestinal tract, which
can be classified according to their main function:
– Protective:
• found in the oral cavity, pharynx, oesophagus and anal canal.
• surface epithelium is of stratified squamous non-keratinized type
in humans (but may be keratinised in animals that have a
coarse diet, e.g. rodents, herbivores)
– Secretory:
• found only in the stomach.
• mucosa consists of long, closely packed tubular glands that are
simple or branched depending on the region of the stomach
– Absorptive:
• is typical of the entire small intestine.
• mucosa is arranged into finger-like projections, called villi,
which increase surface area with intervening short glands called
crypts.
– Absorptive/protective:
• this form lines the entire large intestine.
• the mucosa is arranged into closely packed, straight tubular
glands consisting of cells specialised for water absorption and
mucus-secreting goblet cells to lubricate the passage of faeces.
• Submucosa
– This layer of loose
collagenous (contains large
bundles of collagen)
supporting tissue supports
the mucosa
– contains the larger blood
vessels, lymphatics and
nerves and a submucosal
(also called Meissner's)
nerve plexus. It may also
contain glands and
lymphoid tissue
– is the strongest layer of the
gut wall. However, it is also
pliable and deformable and
can therefore adjust to
changes in the length and
diameter of the gut
• Muscularis propria/externa.
– consists of smooth muscle
that is usually arranged as an
inner circular layer and an
outer longitudinal layer.
– In the stomach only where
movements are more complex,
there is an oblique layer of
muscle internal to the other
two layers .
– The action of these layers is
the basis of peristaltic
contraction
– also contains the myenteric
(or Auerbach's) nerve
plexus, which lies between
the two muscle sublayers, and
blood and lymph vessels in
the connective tissue between
the muscle sublayers
– composed almost exclusively
of smooth muscle, except in
the upper oesophagus, where
smooth muscle blends with
striated muscle
• Serosa or adventitia
– is a thin layer of loose connective
tissue external to the muscularis
externa
– rich in blood and lymph vessels and
adipose tissue
– Where the gut is lies within the
abdominal cavity (peritoneal cavity)
and covered by visceral peritoneum,
the external layer is refered to as
serosa (visceral peritoneum) , which
consists of a thin connective tissue
layer and an external coat of
mesothelium (simple squamous
covering epithelium)
– In places where the digestive organ is
bound to other organs or structures,
connective tissue blends with that of
the surrounding fasciae and the the
external layer is refered to as
adventitia, consisting of connective
tissue containing vessels and nerves,
without the mesothelium
– Where the alimentary tract is
retroperitoneal, the surface facing the
abdominal cavity is covered by serosa,
and the other parts are covered by
adventitia.
 Esophagus
• In general, it has the same layers as the rest of the digestive tract.
– The epithelium is a non-keratinized, stratified squamous epithelium
– Lamina propria:
• Contains scattered groups of lymphoid follicles (mucosa-associated
lymphoid tissue), which are especially prominent near the gastro-
oesophageal junction and
• small tubular mucous glands are also present in the upper part (close to the
pharynx) and lower part (close to gastro-esophageal junction)
• The mucous glands of the abdominal oesophagus closely resemble the
cardiac glands of the stomach and are termed oesophageal cardiac glands.
– Submucosa: small tubulo-acinar mucus-secreting glands, the
esophageal glands are present in the submucosa
– Muscularis externa:
• at the upper end, the muscular contain only striated muscle cells
• in the mid portion, a mixture of striated and smooth muscle cells
• at the distal end of the esophagus, only smooth muscle cells
– Only the lowest portion of the esophagus (which is intra-abdominal) is
covered by serosa. The rest is covered by a layer of connective tissue,
the adventitia, that blends into the surrounding tissue.
Oesophagus Masson's trichrome ×9, CM inner
circular layer of muscularis propria E epithelium G
seromucous gland LM outer longitudinal layer of
muscularis propria LP lamina propria Ly lymphoid
aggregates MM muscularis mucosae MP
muscularis propria PG parasympathetic ganglion Sk
skeletal muscle fibres Sm smooth muscle fibres SM
submucosa
 Stomach
• Mucous membrane
– Shows numerous folds
(rugae)
– Epithelium
• Lining epithelium is simple columnar
mucus-secreting epithelium
– Mucous secreted by cells of the lining
epithelium protects the gastric mucosa
against acid and enzymes produced by
the mucosa itself
• Lining epithelium in several places
invaginates to various extents into the
lamina propria, forming gastric pits
• The base of each gastric pit receives
several simple branched tubular
gastric glands that extend deep into
the lamina propria as far as the
muscularis mucosae
• These gastric glands are of three
types
–Main gastric, cardiac and
pyloric
• Main gastric gland
– found in the body and fundus, simple
branched, tubular gastric (fundic)
glands, three to seven opening into
each gastric pit
– Gastric pits occupy the superficial
1/4th or less of the mucosa while
remaining thickness is occupied by
gastric gland
– Each gastric gland has three distinct
regions: the isthmus, neck, and base
• junction with the base of the pit is
termed the isthmus of the gland
and immediately basal to this is
the neck, the remainder being the
base
• The walls of the gland contain at least
five distinct cell types: chief,
parietal/oxyntic, mucous neck, stem and
neuroendocrine
• Chief or peptic or zymogenic cells
– are particularly located towards the bases of the
gastric glands
– recognised by their condensed, basally located nuclei
and strongly basophilic granular cytoplasm
– These are the pepsin-secreting cells
Parietal（oxyntic） cells
– present mainly in the upper half of gastric glands
(in the isthmus ); they are scarce in the base
– large rounded cells with eosinophilic cytoplasm
and a centrally located nucleus
– secrete gastric acid as well as intrinsic factor, a
glycoprotein necessary for the absorption of
vitamin B12
• Mucous neck cells
– are numerous at the necks of the glands
– Have clear cytoplasm with flat basally
displaced nuclei .
– mucus secretion
• Stem cells
– Found in the isthmus and neck regions
– These cells divide continuously to replace all other
types of cell in the glands
# Dividing cells are
shown in white colour
• Neuroendocrine cells,
– part of the diffuse neuroendocrine system, are situated
mainly in the bases of gastric glands among the chief cells
– basally situated and donot reach the lumen
– They secrete serotonin and hormones like gastrin
• Cardiac gland
– confined to a small area
near the cardiac orifice
– Gastric pit are shallow
– Cardiac glands are either
simple tubular glands, or
compound branched
tubular.
– They are composed
mainly of mucous-
secreting cells and
parietal and chief cells,
although present, are few.
• Pyloric
– Located in the pyloric
region of the stomach
– They are simply or
branched that are coiled
– Has longer gastric pit that
occupy 2/3rd of the depth
of the mucosa
– Mucous secreting cells
are predominate with few
parietal and
neuroendocrine cells
• Other layers of stomach
– Lamina propria
– Muscularis mucosa: apart from inner circular
and outer longitudinal muscle layer,
discontinuous external circular layer may be
present outside the longitudinal layer.
– Submucosa
– Muscularis externa: three layers, oblique,
circular and longitudinal (from inside out)
 Small intestine
• The small intestine is relatively long—
approximately 5 m—and consists of three
segments: the duodenum, jejunum, and ileum.
These segments have many characteristics in
common
• the principal site for absorption of digestion
products from the gastrointestinal tract
• combine four factors increase the surface area
of mucous membrane to allow adequate
absorption
Contd..
• They are
– The small intestine is extremely long (4-6
metres in humans).
– The mucosa and submucosa are thrown up
into circularly arranged folds called plicae
circulares or valves of Kerckring which are
particularly numerous in the jejunum.
– The mucosal surface is made up of numerous
finger-like projections called villi
– Thousands of microvilli are present at the
luminal surface of the cells that line the
mucosa
• Mucous membrane
– Viewed with the naked eye, the
lining of the small intestine
shows a series of permanent
circular folds called plicae
circulares or valves of
Kerckring
– Each fold is made up of all layers of the
mucosa (lining epithelium, lamina
propria and muscularis mucosa) and
submucosa.
• They are absent in the 1st one or
two inches of the duodenum and
are prominent in the rest of the
duodenum and in the whole of the
jejunum.
• The fold gradually become fewer
and less marked in the ileum;
absent in the terminal parts of the
ileum
– Intestinal villi are 0.5- to 1.5-mm-
long outgrowths of the mucosa
(epithelium plus lamina propria)
projecting into the lumen of the small
intestine.
– In the duodenum they are most
numerous and are leaf shaped, but
they progressively decrease in
number and size gradually assuming
fingerlike shapes as they reach the
ileum
– Each villus contains a central
lymphatic vessel called a lacteal.
Distally, the lacteal ends blindly near
the tip of the villus, and proximally it
ends in a plexus of lymphatic vessels
present in the lamina propria
lacteal for the
absorption of dietary
lipids--
chylomicrons(lipoprotein
particles that consist of
triglycerides (85–92%),
phospholipids (6–12%),
cholesterol (1–3%), and
proteins (1–2%).).
 ←

Figure 20 villi(left :jejunum right :duodenum ↑lacreal)

 villi

submucosa

jejunum

Duodenum H&E 120, BGI Bruneers gland, ME

muscularis extrena,, MM musculari mucosa, S
serosa, D ductu of brunner’s gland

ileum
• Between the villi, epithelium
invaginates into the lamina
propria forming a simple
tubular glands called intestinal
glands (crypts of Lieberkuhn)
• The epithelial lining
– The epithelium of the
intestinal villi and mucosal
surface are lined by a
simple columnar cells called
enterocytes/absorptive
cells
– The epithelium of the villi is
continuous with that of the
crypts/glands.
– The intestinal glands
contain stem cells, some
absorptive cells, goblet cells,
Paneth's cells, and
neuroendocrine cells.
• Enterocytes/Absorptive cells , the most numerous cell type, are
tall columnar cells with surface microvilli that are seen as a striated border
in light micrographs. These cells are the main absorptive cells.
• Goblet cells
– are scattered among the enterocytes and produce mucin for lubrication
of the intestinal contents and protection of the epithelium.
– few in the duodenum and increase in number as they approach the
ileum
• Paneth cells
– are found at the base of the crypts and are exocrine cells
– distinguished by their prominent, eosinophilic apical secretory granules.
– Their function is not well unknown. They are known to produce
enzyme lysozyme —(in the large eosinophilic secretory granules of
these cells), an enzyme that digests the cell walls of some
bacteria,Lysozyme has antibacterial activity and may play a role in
controlling the intestinal flora and have a defensive function.
• Neuroendocrine cells produce locally acting hormones that
regulate gastrointestinal motility and secretion. (Secretin,
Gastric inhibitory polypeptide, Cholecystokinin )
• Stem cells, found at the base of the crypts, divide
continuously to replenish all of the above four cell types
Figure 21 absorptive cells and goblet cells
Paneth cells
• Lamina propria
– The lamina propria of the small
intestine is composed of loose
connective tissue with nerve fibers,
smooth muscle cells and a rich
vascular and lymphatic network into
which digestive products are absorbed
– contain aggregates of lymphoid
nodules known as Peyer's patches,
an important component of the GALT .
Lymphoid tissue may occasionally
extend into the submucosa.
– Lymphoid tissue becomes more
prominent in the ileum and is fairly
inconspicuous in the duodenum
– The epithelium overlying lymphatic
follicles contain M (microfold) cells Ileum, lymphoid nodule LN
instead of absorptive cells.M cells can
take up antigens present in the lumen
of the intestine and transport them to
the underlying macrophages and
lymphoid cells, which then migrate to
other compartments of the lymphoid
system (nodes), where they produced
antibodies against the foreign antigens.
• The muscularis mucosae does not
present any peculiarities in this
organ.
• In the duodenum the submucosa
contains compound tubulo-
alveolar glands called duodenal
(or Brunner's) glands. Their cells
are of the mucous type.
• Their ducts pass through the
muscularis mucosa and open into
the intestinal glands.
• The secretion of the glands is
alkaline (pH 8.1–9.3), that protect
the duodenal mucous membrane
from the effects of the acid gastric Duodenum H&E 120, BGI Bruneers gland,
juice and to bring the intestinal ME muscularis extrena,, MM musculari
contents to the optimum pH for mucosa, S serosa, D ductu of brunner’s
gland
pancreatic enzyme action.
• The Brunner’s glands are most
numerous in the proximal part of
the duodenum and are few (or
missing) in the distal parts.
• Brunner’s glands are absent in
jejunum and ileum.
• The major difference between the duodenum on
the one hand, and the jejunum and ileum on the
other,
– is the presence of Brunner's glands in the duodenum.
– The villi tend to be longest in the duodenum and
become shorter towards the ileum.
– Lymphoid tissue becomes more prominent in the
ileum and is fairly inconspicuous in the duodenum.
– The proportion of goblet cells in the epithelium
increases distally.
– Plicae circulares are most prominent and numerous in
the jejunum and proximal ileum, and are generally
absent in the proximal duodenum and distal ileum.
 Large intestine
• The layers of tissue in the large
intestinal wall resemble those
in the small intestine except
that villi and circular folds are
absent and the glands (crypts)
are longer
• Their main function is to absorb
excess water and electrolytes
from intestinal contents.
• Mucosa: is lined by
– numerous columnar absorptive
cells whose main function is to
absorb excess water and
electrolytes from the intestinal
contents
– mucous (goblet) cells, have a
similar structure to those of the
small intestine, but are more
numerous , and
– occasional microfold (M) cells that
are restricted to the epithelium
overlying lymphoid follicles
• The glands are longer,
more numerous and
closer together than
those of the small
intestine
• glands are lined by
columnar epithelial cells,
mainy goblet cells, some Colon H&E 140
stem and neuroendocrine
cells.
• The glands generally lack
Paneth cells, but these
may be present in the
caecum.

Colon H&E 525

• Lamina propria
– Is rich in lymphoid
cells (are most
abundant in the
caecum, appendix and
rectum, but are also
present scattered
along the rest of the
large intestine)
– This richness in
lymphoid tissue (GALT)
is related to the
abundant bacterial Colon (a) H [amp ] E ×4 (b) H [amp ] E ×100 inner circular
population of the large CM and outer longitudinal layers LM muscularis mucosae MM
lymphoid aggregates LA
intestine.
• Muscularis mucosa
– comprises outer longitudinal
and inner circular strands.
– This layer differs from that of
the small intestine, because
fibers of the outer longitudinal
layer are collected to form
three thick longitudinal bands
called teniae coli.
• Serosa
– Missing over the posterior
aspect of the ascending and
descending colon
– In the intraperitoneal portions
of the colon, the serous layer
(visceral peritoneum) forms
small pouch like processes
that are filled with adipose
tissue—the appendices
epiploicae
 Appendix
• The structures of the
vermiform appendix
resembles that of the
large intestine with the
following differences
– Is the narrowest part of
the gut
– fewer and shorter
intestinal glands i.e.
crypt are poorly formed
– has no teniae coli
– Mucosa and
submucosa contains
abundant lymphoid appendix
tissue (that may
completely fill the
submucosa)
 Liver
• the second-largest organ of the body and the largest gland
• situated in the abdominal cavity beneath the diaphragm
• is the organ in which nutrients absorbed in the digestive
tract are processed and stored for use by other parts of the
body
• Most of its blood (75%) comes from the portal vein, arising
from the stomach, intestines, and spleen; the smaller
percentage (25%) is supplied by the hepatic artery
• All the materials absorbed via the intestines reach the liver
through the portal vein, except the complex lipids
(chylomicrons), which are transported mainly by lymph
vessels
• Structural component of liver include
– Connective tissue stroma
– Parenchyma
– Portal triad
– sinusoids
– Bile canaliculi
 Hepatic lobule
• There are three way to describe the
structure of liver
– The classic lobule
– The portal lobule
– Portal acinus
 Classic lobule
• Connective tissue stroma
– liver is covered by a thin connective tissue
capsule (Glisson's capsule) that becomes
thicker at the hilum
– Extends into its interior as numerous
branching septa
– Blood vessels, nerves, lymphatic vessels and
bile ducts travel within these septa.
• Parenchyma
– In cross section, the
substance of liver appears
to be made up of
hexagonal areas that
constitute the hepatic
lobules
– In certain animals (eg,
pigs), the lobules are
separated by connective
tissue septa.
– But in human the septa are
not distinct and the lobules
appears to merge with
each other making it
difficult to establish the
exact limits between
different lobules

Liver (b) Pig, H [amp ] E ×20 (c) Human, H [amp ] E

×20
– Each lobule
consists of
interconnected
plate of liver cells
(hepatocytes),
– These plates are
one cell thick that
branch and
anastomose with
each other to
form network.
– The center of the lobule is
occupied by a central vein
which is a tributary of
hepatic vein
– Along the periphery of each
lobule there are angular
intervals filled by connective
tissue. These intervals are
called portal canal. The
portal canal is separated
from the hepatic plates of
cells by a space called
space of Mall.
– Each portal canal contains a
venule (a branch of the
portal vein), an arteriole (a
branch of the hepatic artery),
a duct (part of the bile duct
system).
– These three structures
collectively form a portal
triad
• venule contains blood
coming from the superior
and inferior mesenteric
and splenic veins.
• The arteriole contains
oxygen-rich blood coming
from the celiac trunk of the
abdominal aorta.
• The duct, carries bile Liver lobule H [amp ] E ×75 terminal hepatic
venule (centrilobular venule) V portal tracts T
synthesized by the fibrous tissue C
hepatocytes and
eventually empties into the
hepatic duct
– The networks of hepatic
cells are separated by
space known as hepatic
lacunae.
– The hepatic lacunae are
occupied by hepatic
sinusoids
– The sinusoids receive a
mixture of blood from both
portal vein and hepatic
artery of the adjacent portal
canals.
– The blood within the
sinusoid passes towards
the center of lobules and
drains into the central vein
(central vein drains into the
hepatic vein which leave the
liver to end in the IVC)
tissue of the portal tract T and terminal hepatic venule V liver cell
plates H sinusoidal spaces S
• The sinusoidal walls are fenerstrated and lined
by flattened endothelial cells.
• In addition to the endothelial cells, the sinusoids
contain macrophages known as Kupffer cells
• Kupffer cells account for 15% of the liver cell
population.
• These cells are found within the sinusoidal
lumen, attached to the endothelial surface
• Their main functions are to remove cellular
debris and microbial agent form the circulating
blood.
• The surface of the hepatocyte is separated from the wall of sinusoid
by a narrow space called space of Disse (perisinusoidial space)
• The fenestrae and discontinuity of the endothelium allow the free
flow of plasma (but not of cellular elements) into the space of Disse,
permitting an easy exchange of molecules (including
macromolecules) from the sinusoidal lumen to the hepatocytes and
vice versa.
• Large number of macromolecules (eg,
lipoproteins, albumin, fibrinogen) manufactured
by liver cells are delivered into the spaces of
Disse and then into the sinusoidal blood.
Moreover, the chylomicrons taken up by the liver
cells are converted into lipo-protein which are
subsequently delivered into the circulating blood
of the sinusoids.
• The space of Disse also contain fat-storing
cells, also called stellate or Ito's cells.
– They store the fat-soluble vitamin A .
– These cells have several other function like synthesis
of several extracellular matrix proteins, secretion of
growth factors for the regeneration of the damaged
liver cells, the regulation of the sinusoidal lumen
diameter in response to different regulators (eg,
prostaglandins, thromboxane A2).
• Bile canaliculi
– Each liver cell is cuboidal presenting six surfaces, out of which two surfaces are
related to the sinusoids and the remaining surface are in contact with the wall
adjacent hepatocyte
– Wherever two hepatocytes are in contact, they make a tubular space between
them known as the bile canaliculus
– So canaliculi have no discrete structure of their own but consist merely of fine
channels formed by the separation of plasma membranes of adjacent
hepatocytes
– Bile is synthesised by hepatocytes and secreted into bile canaliculi
– Bile canaliculi of adjacent hepatocyte plates merge to form canals of Hering or
bile ductules which latter finally drain into the bile duct in the portal canal
 Portal lobule
• The main function of the liver bile secretion
• The portal lobule emphasizes the exocrine functions of the liver
• The portal lobule includes the territory of liver tissue centered around a portal triad,
and is drawn by joining the central veins of the three adjacent liver lobules
• The territory of portal lobule includes those portion of three classic lobules that
secrete the bile that drains into its axial bile duct.
 Liver acinus
• Liver acinus is the structural unit that provides the best
correlation between blood perfusion and metabolic
activity
• It consists of the area of liver tissue supplied by one
hepatic arteriole running along the line of junction of two
hepatic lobule. Two central veins lie at the ends of the
acinus.
 Gall bladder
• Is a hollow flask-shaped organ attached
to the lower surface of the liver with a
capacity of up to 50 ml
• The main function of the gallbladder is
to store bile, concentrate it by absorbing
its water, and release it when necessary
into the digestive tract
• The gallbladder wall microstructure
generally resembles that of the small
intestine but lacks muscularis mucosa
and submucosa
• consists of a mucosa composed of
simple columnar epithelium and lamina
propria, fibromuscular layer, and a
serous membrane
• Mucous membrane:
– lined by is a single layer of tall columnar
absorptive cells bearing numerous short
irregular microvilli . Goblet cells are absent.
– Mucosa is highly folded, and the folds are
called rugae
Contd..

• The fibromuscular coat: is composed of

fibrous tissue mixed with smooth muscle
cells which are arranged loosely in
longitudinal, circular and oblique bundles
but do not form distinct layers
+ inflammation of gall bladder is called
cholesystitis. Stones may form in the gall
bladder called gall stones; cholelithiasis. In
such surgical removal of the gall bladder may
be necessary (cholecystectomy)
 Pancreas
• Mixed gland; partly exocrine and
partly endocrine
• The bulk of gland is composed
by exocrine part
• Exocrine part
– exocrine part is in the form of
serous, compound tubulo-acinar
gland similar to that of parotid gland
– surrounded by delicate loose
connective tissue capsule (devoid
of definite fibrous capsule)
– Septa extend from the capsule
divide the gland into numerous
lobules
– Exocrine part secretes enzymes
(like trypsinogens,
chymotrypsinogen, amylase,
lipases) and watery secretion rich
in bicarbonate which help to Exocrine part
neutralize the acid contents
entering the duodenum from the
stomach.
• Endocrine part
– Is in the form of numerous
spherical or ellipsoid clusters of
cells embedded in the exocrine
tissue
– This collection of cells are called
the pancreatic islets or islets of
Langerhans
– human pancreas may contain
more than a million islets, usually
most numerous in the tail
– With the help of special procedure
(immunohistochemical
techniques), three major types of
cell, designated alpha, beta and
delta
• Alpha cells secrete glucagon Islet of Langerhans
• Beta cells secrete insulin
• Delta cells secret somatostatin and
gastrin