DIGESTIVE TRACT 1- OESOPHAGUS. 2- stomach Scanned with CamScanneritis important to note that experiments have proved that of the enteric nervous system can function autonomously INS even if the sympathetic and parasympathetic nerve Of supply of the alimentary canal is completely cut. rof Therefore, the enteric nervous system is considered to os be the third division of the autonomous nervous system. the Osa, e f a OPHAG ae The esophagus is a muscular tube whose function is to dis transport food materials from the pharynx to the stomach. ti In cross sections, the lumen of the esophagus is seen to be collapsed. This appearance is due to the presence of longitudinal mucosal folds with intervening grooves. However, when water or a bolus of food passes through the esophagus, the mucosal folds disappear and the sud lumen becomes patent. The wall of the esophagus AIG consists of all the four typical coats of the digestive tube. tem, The mucosa of esophagus is lined by stratified squamous the nonkeratinized epithelium. The lamina propria consists lion _ of fine connective tissue in which are found scattered hese lymphatic nodules. In the upper and lower thirds of sled the esophagus, the lamina propria contains mucus- Scanned with CamScannering simple branched tuby rare called ae is responsible for folds in the mucosa of the = esophagus. e si i be submucosa Consists of loose connective tissue cont 19 thick bundles of collagen fibres. Throughout Raa aera tubuloacinar glands called esophageal glands proper. Ducts of these glands are lined by stratified squamous epithelium. The duct of each ‘esophageal gland proper passes through the mucosa to ‘open onto the luminal surface of the esophagus. The submucosa also contains the Meissner plexus of nerves. The mucus secreted by the esophageal glands lubricates and protects the mucosal surface of this organ. The Fauscularis externa of esophagus consists of the inner circular and outer longitudinal layers but differs from the muscularis externa of rest of the digestive tract in that it contains the smooth as well as skeletal muscle. In the upper third of the esophagus only skeletal muscle is present (which is a continuation of the pharyngeal musculature). n the middle third of the organ, muscularis, externa contains a mixture of skeletal and smooth muscle. However, only smooth muscle is present in the lower third of esophagus. The myenteric plexus of nerves lies between the inner circular and outer longitudinal layers of the muscularis externa. In the cervical and thoracic regions, the esophagus is surrounded byadventitia of loose connective tissue containing blood vessels, nerves and lymphatics. The abdominal part of the esophagus is covered by a serosa. PE SOMO oo ‘The stomach is the most dilated segment of the digestive tube which is capable of considerable distension to accommodate two to three litres of material when full. ‘The food that enters the stomach as small masses (boli) 6f semisolid masticated material, leavesiit as a viscous, 211 the stoy ‘ere: a churns the contained material, mixing it a Shly with the gastric juice secreted by the gastric mucosa, The gastric juice contains hydrochloric acid, e enzymes, and mucus. The enzymes include pepsin and gastriclipase, _ Additional functions of the stomach include secretion of intrinsic factor (a glycoprotein which is essential for the absorption of B12), and production of hormones especially gastrin. Absorption of water, salts, glucose and alcohol occurs in the stomach. Certain drugs are also absorbed through the stomach. The wall of the stomach consists of the usual four coats: mucosa, submucosa, muscularis externa, and serosa. MUCOSA The mucosa of the empty stomach is thrown into numerous longitudi 1ge. However, the Tugae disappear in the distended stomach, The mucosal surface is also divided by shallow grooves into small irregular areas, 1 to 5 mm in diameter, called mamillated areas. Each mamillated area shows numerous dep- ressions, called foveolae or gastric pits, which extend for a variable distance into the mucosa. At the bottom of each pit are several openings of the glands lying in the lamina propria. In the fundus and body of the stomach the foveolae are shallow, occupying about one-third of the thickness of mucosa and, therefore, the glands extend through two-thirds of the thickness. In the Gardiac and pyloric regions of the stomach the foveolae are deeper and occupy two-thirds of the mucosal thickness and the glands occupy only one-third of the thickness of mucosa. any The gastric mucosa consists of the usual three layers epithelium, lamina propria, and muscularis mucosae pishelic, Fete ee ac or # EPITHELIUM OF THE STOMACH The mucosal surface of the stomach and foveolae ar lined by a simple columnar epithelium. These column: epithelial cells are called surface mucous cells. These cel secrete mucus and bicarbonate (due to which the muc becomes alkalinized), This mucus forms a gel-like mater that adheres to the luminal surface of the stomach. Th - horauce af its clouc Scanned with CamScannerScanned with CamScannerdower Ouephags Scanned with CamScannerScanned with CamScanners also called insoluble mucus because it t mix with the chyme. < apical cytoplasm of the surface mucous cellsis filled ‘th mucinogen granules. During preparation of tissue oF light microscopy these granules are washed away 2nd, in the routine H&é stained sections, the apical regions of the cells appear empty and unstained. The nucleus of ach surface mucous cell is roughly spherical in shape and is located in the basal region of the cell. EM studies feveal that the apical surface of the cell bears short microvilli, However, no brush border, like that of small intestinal epithelium, can be seen. A Prominent Golgi apparatus is present between the nucleus and the ‘apical Cup of mucinogen granules. The basal cytoplasm of these cells contains mitochondria and a moderate amount of rough endoplasmic reticulum. The cells are attached to each other by juxtaluminal. ‘occluding junctions and have ‘occasional desmosomes on their Jateral surfaces. ‘The mucus produced by the surface mucous ‘cellsforms a lubricating layer that protects the mucosal epithelium from abrasion by the ingested food. In addi tion, the thick layer of mucus constitutes a barrier which protects the mucosa from digestion by the acid and proteolytic enzymes cf the gastric juicer The lamina propria of the gastric mucosa is a loose, highly vascularized connective tissue that contains a rich population of fibroblasts, mast cells, plasma cells, and lymphocytes. Most of the space within the lamina propria is occupied by the glands of stomach, These glands have different structure in various regions of the stomach. A detailed description of the gastric glands Is given later, The muscularis mucosae of the stomach isa thin layer in which smooth muscle fibres are arranged into inner circular and outer longitudinal laminae. SUBMUCOSA The submucosa consists of loosely arranged, collagenous connective tissue containing variable amounts of adipose tissue. The submucosa also contains larger blood vessels ‘and submucosal plexus of nerves. No glands are present _in the submucosa of the stomach. MUSCULARIS EXTERNA ‘The muscularis externa of the stomach is composed of i = ‘of smi ae an outer longitudinal layer. 1h fongitudinal layer is well-developed along the grey and lesser curvatures of the stomach but s very thin op absent on th rior and posterior surfaces of the organ. The middle circular layer is greatly thickened at pyloric sphincter. The myenter the pylorus to form the) e plexus of nerves s present between the middle circular and outer longitudinal layers. SEROSA, eer The serosa consists of i ar nective tissue covered by mesotheliuri) The serosa provides a nearly friction-free environment for the churning movements of the stomach. GLANDS OF STOMACH The lamina propria of the gastric mucosa contains a large number of glands that open into the gastric pits. On the basis of distribution and difference in structure, these glands are classified into the following three varieties: 1. Fundic glands which are found in the fundus and body of the stomach. 2. Cardiac glands which lie in a narrow ring-shaped area around the cardia. 3. Pyloric glands which are located in the pyloric antrum and pyloric canal. * FUNDIC GLANDS (Fig. 18-7) The fundic glands, also titled as gastric glands, make the greatest contribution to the gastric juice and are responsible for the production of the acid and most of the enzymes secreted by the stomach. The fundic glands are simple branched tubular glands and each gland is. ivided into three regions: isthmus, neck, and base. sub The isthmusis the upper short segment of the gland that opens into the gastric pit. The neck is the narrower, relatively long middle part of the gland. The base is the terminal, shorter and wider part of the gland that is usually branched. The epithelium lining the fundic glands contains five types of célls: (mucous neck cells, Q parietal cells, © chief cells, @ enteroendocrine cells, and © stem cells. Scanned with CamScannerFUNDIC GLAND Surface mucous cell GASTRIC PIT ISTHMUS | Parietal cells NECK Mucous neck cells Enteroendocrine BASE Chief cells Enteroendocrine € cell Fig. 18-7 Diagram showing the cell types of the stomach surface, gastric pit, and fundic gland. ~ Scanned with CamScannerjucous Neck Cells < by their name, the mucous neck cells are neck region of the fundic glands, ersed among the parietal cells. They are generally ar of pyramidal in shape with oval basal nuclei. we long axis oftheir nucleus is usually perpendicular to axis of the cell. Apical region of the cell contains mucinogen granules. The mucous neck cells secrete a soluble mucus that mixes with the chyme and functions to lubricate the gastric contents Parietal Cells (rig. 16-4) The parietal cells secret hydrochloric acid and are also aallled oxyntic ces (.e., acid-forming cells). These cells are focated mainly in the isthmus and neck of the fundic glands among the mucous neck cells. However, occasionally they are also found in the base of thé fundic. glands. They are large, round.to pyramidal cells, which are located in the periphery of the gland and appear to bulge into the surrounding lamina propria (hence the name parietal cells). Each parietal cell contains a centrally located, rounded nucleus, a large Golgi apparatus, some profiles of RER, and a great number of mitochondria. Due to presence of abundant imitochondria the cytoplasm appears intensely eosinophilicin stained sections examined under LM. The presence of plentiful mitochondria in the cytoplasm of the parietal cells correlates with the high levels of energy needed by these cells for acid secretion. Electron microscopic studies reveal that a special feature of the parietal cells is the presence of an intracellular canaliculus, which communicates with the lumen of the fundic gland. This canaliculus is actually a deep invagination of the luminal plasmalemma into the cell and is meant to increase the surface area available for HCI secretion. In the resting parietal cells, the intracellular canaliculus is generally shallow and partially encircles the nucleus. But in actively secreting oxyntic cells this canaliculus is very deep and extends almost to the base of the cell. Numerous microvilli project from the plasmalemma into the cavity of the intracellular canaliculus. EM also shows that the cytoplasm of a parietal cell contains membrane-bound tubules and vesicles. In an inactive (resting) parietal cell the number of these sicular structures is very high. However, when the parietal cells a icles of these cells, cytoplasmic tubules and vesicles = the plasmalemma ofthe cell, which results in: () deep ofthe intracellular canaliculus, and (i) an increase inthe umber of microvilli projecting into the intracellular tubules and vesicles ‘canaliculus. Therefore, the number of is very low in the cytoplasm of an active parietal cell. Inaddition to HCl the parietal cells secrete a glycoprotein called intrinsic factor, which is synthesized in the RER. This glycoprotein binds with vitamin B12 in the stomach and duodenum and aids in its absorption. Chief Cells The chief cells, also called zymogenic cells or peptic cells, are located in the bases of fundic gla They secrete Repsinogen and a weak lipase called gastric lipase. The chief cells, are €olumnar or pyramidal cells, each having a spherical nucleus that lies toward the base of the cell. The chief cells exhibit the characteristic features of protein-secreting cells. The basal region of the chief cells contains abundant RER, due to which this region of the cell takes a basophilic stain. A well-developed Golgi apparatus is present in the supranuclear position. The apical region contains secretory granules that house the Proenzyme pepsinogen. These granules impart acidophilia to the apical region of the chief cells. After its release into the acidic gastric juice, the pepsinogen is rapidly converted into pepsin, which is a highly active proteolytic enzyme. The gastric lipase is also secreted by the chief cells. Enteroendocrine Cells These are small cells located in the necks and bases of the fundic glands. They rest on the basal lamina but usually do not reach the lumen of the gland. These cells. belong to the diffuse neuroendocrine system (ONES). EM shows that the cytoplasm of these cells contains small membrane-bound secretory granules. However, these granules are lostin the routine HE preparations and the cytoplasm of the enteroendocrine cells appears clear (unstained) under the light microscope. The secretory granules of the enteroendocrine cells are released into the blood capillaries (and lymph capillaries) present in the lamina propria surrounding the gland. The enteroendocrine cells secrete gastrointestinal polypeptide hormones and some other hormones or Scanned with CamScannerScanned with CamScannerScanned with CamScannerScanned with CamScannerScanned with CamScannerScanned with CamScanner