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C:\Documents And Settings\User\Desktop\Stomach Histology

  1. 1. DIGESTIVE SYSTEM Stomach Histology Assoc. Prof. Dr. Karim Al-Jashamy IMS/MSU 2010
  2. 2. Stomach Anatomy: • Openings – Gastroesophageal : To esophagus – Pyloric: To duodenum • Regions – Cardiac – Fundus – Body – Pyloric
  3. 3. Regions of the Stomach
  4. 4. Layers of the Gastrointestinal Tract • Mucosa – Epithelium, CT, a little muscle • Submucosa – CT, glands • Muscularis propria – Muscles • Serosa – CT
  5. 5. Mucosa Epithelium Differs with location, functions Lamina propria Loose CT, blood and lymph vessels Muscularis mucosae Thin layer with smooth muscle
  6. 6. SUBMUCOSA Loose/Dense irregular CT Supports mucosa Contains large blood vessels, nerves, lymphatics MUSCULARIS PROPRIA Two layers Peristaltic contractions
  7. 7. SEROSA/ADVENTITIA Loose CT Major vessels, nerves, adipose
  8. 8. The Stomach
  9. 9. Gastric Glands of Stomach
  10. 10. STOMACH x10 LP MM
  12. 12. Stomach Section of the gastric glands in the fundus of the stomach. Note the superficial mucus-secreting epithelium. Parietal cells (light-stained) predominate in the mid and upper regions of the glands; chief (zymogenic) cells (dark-stained) predominate in the lower region of the gland. MM, muscularis mucosae.
  13. 13. Histology LAYERS 1. Mucosa • The first main layer. • consists of an epithelium (simple columnar epithelium), the lamina propria underneath, and a thin layer of smooth muscle called the muscularis mucosae 2. Submucosa • Lies under the mucosa • Consists of fibrous connective tissue, separating the mucosa from the next layer. • The submucosal nerve plexus is in this layer.
  14. 14. 3. Muscularis externa • Consists of three layers: i. inner oblique layer – responsible for creating the motion that churns and physically breaks down the food i. middle circular layer – constricted at the pylorus forming pyloric sphincter, which controls the movement of chyme into the duodenum i. outer longitudinal layer – Auerbach's plexus is found between this layer and the middle circular layer.
  15. 15. 4. Serosa • outside the muscularis externa • consisting of layers of connective tissue continuous with the peritoneum
  16. 16. Stomach Histology • Gastric pits: Openings for gastric glands – Contain cells • Surface mucous: Mucus • Mucous neck: Mucus – Parietal: Hydrochloric acid and intrinsic factor – Chief: Pepsinogen – Endocrine: Regulatory hormones
  17. 17. Normal Histological Features: • The gastric mucosa consists of surface epithelium, gastric pits and gastric glands. • The gastric glands extend from the muscular mucosa extend into the stomach lumen via gastric pits. • The cells lining the surface and gastric pits are identical throughout the stomach • Glands differ in different regions of the stomach. • Gastric pits occupy approximately 25% of the mucosa. Pits lie parallel to one another. • There is more lamina propria separating the pits than between the glands. • In normal gastric biopsy degree of pit and glandular separation should be same throughout the biopsy.
  18. 18. • Cardia- Small area of predominantly mucus secreting glands surrounding the entrance of the esophagus. • The pits are shorter than the antropyloric pits. •Fundus and body Major histological region. Consists of straight, tubular glands.  Strands of muscularis mucosae extend between the glands from the base. The glands secrete gastric juices as well as protective mucus.
  19. 19. • FUNDAL PART OF THE STOMACH Stained with haematoxylin and eosin 1 - tunica mucosa 2 - tunica submucosa 3 - tunica muscularis propria 4 - tunica serosa 5 - epithelium of the mucosa 6 - lamina propria of the mucosa (contains glands) 7 - muscularis mucosae
  20. 20. • Pylorus- Branched glands open into deep irregular shaped pits. Composed of mucus secreting cells. • Mucus secreted by pyloric glands lubricate and protect entrance to the duodenum. Scattered 'G' cells (endocrine cells), secrete gastrin. • Note: Gastric mucosa forms a barrier to diffuse of gastric acid from the gastric lumen.
  21. 21. PYLORIC PART OF THE STOMACH Stained with haematoxylin and eosin 1 - tunica mucosa 2 - tunica submucosa 3 - tunica muscularis propria 5 - lamina propria of the mucosa (contains glands) 7 - gastric pits in the mucosa 8 - muscularis mucosae
  22. 22. Types of cells present in the stomach • Mucous secreting cells (goblet cells)- – Line the luminal surface of the stomach and gastric pits and gastric glands. – produce mucus and bicarbonate. •Mucous neck cells- Present in the neck of the gland. Produce mucin. •Parietal cells (oxyntic cells) Distributed throughout the length of the gland, but numerous in the middle portion.  Large, rounded cells with eosinophilic cytoplasm and centrally located nucleus. Produce gastric acid.
  23. 23. • Chief cells (peptic or zymogenic cells) – Clustered at the base of the gland. – Identified by basally located nuclei and strongly basophilic granular cytoplasm. Produce pepsinogen, digests protein.
  24. 24. The Lamina Propria • Consists of a layer of areolar tissue that contains: – blood vessels – sensory nerve endings – lymphatic vessels – smooth muscle cells – scattered areas of lymphoid tissue
  25. 25. Assignment 1