LECTURE 15

DIGESTIVE SYSTEM I Ali Hussein

The Gastrointestinal tract is basically a hollow muscular tube with a layout of 4 layers:
The MUCOUS MEMBRANE consists of a further three layers; a surface epithelium resting on a basal
lamina, with a lamina propria of neurovascular and immune system supporting tissues. This is separated
from the Submucosa with a double layer of smooth muscle known as the muscularis mucosae (not to be
confused with the muscularis externa).
The SUBMUCOSA consists of loose connective tissue containing leukocytes and a variable amount of
fat. The blood vessels and nerves found in the submucosa form the Meissner’s plexus.
The MUSCULARIS EXTERNA is basically two layers of smooth muscle that are mostly involved in
the peristaltic movement of bolus (food) along the gastrointestinal tract. The inner layer of the
muscularis externa is circular muscle and the outer layer is longitudinal muscle, with a plexus of nerves
between them.
The ADVENTITIA (when in fixed position) or SEROSA (when mobile) are both layers of thin
connective tissue continuous with surrounding organs.

Different segments of the gastrointestinal tract have the same layers, but of
different size. Therefore, different segments are usually easily identifiable:
The OESOPHAGUS is identified due to its non-keratinising stratified
squamous epithelium (E) in the mucous membrane closest to the lumen,
appearing as a thick border of the white lumen (MM). The oesophagus is highly
folded in appearance and so should be easily recognisable. The muscularis
externa of the oesophagus contains both skeletal and smooth muscle as in both
longitudinal (LM) and circular muscle (CM), and its purpose to allow the
oesophagus to expand when bolus is travelling.
The STOMACH is involved in the mixing and churning of food. The
stomach adds enzymes, such as pepsin and gastric amylase, which aid in the
digestion of food. The stomach consists of a mucous membrane of simple
columnar epithelium. Mucous secreting cells can be found at the bottom of
GASTRIC PITS that divide the stomach into 3 distinct regions: the body, the
pylorus and the fundus. The fundus is found at the top part of the stomach and
when no food is present, the fundus is mainly air, and is therefore shown as black
on an X-Ray. The stomach is well adapted for the containment of food as it
contains RUGAE, folds that flatten out as the stomach is filled and stretched.
The gastric pits are very important in the digestion of food as they give a larger
surface area for the absorption of water and salt. As there are many secretions along
the Gastrointestinal Tract, fluid must be reabsorbed to prevent dehydration.
However, the main purpose of the gastric pits is the production of acid and
enzymes. The Gastric pits consist of many types of cells, including:
MUCOUS NECK CELLS line the upper part of the gastric pits and are involved in
the secretion of mucous that protects the cells from the gastric juices and digested
foods and their acidic properties.
IMMUNE SYSTEM CELLS, such as lymphocytes, plasma cells and lymphoid
tissue, protect the human body from bacteria and other pathogens. These are mainly
found in the pylorus.
CHIEF CELLS, found in the lower regions of the gastric glands, are stimulated by
the vagus nerve and enteroendocrine cells in the base of the pits. Once stimulated,
the chief cells secrete a protein release in the form of zymogen granules, which
contain digestive enzymes that are activated in the acidic environment of the
stomach. Pepsin is an example of such an enzyme.
PARIETAL CELLS are abundant in mitochondria as they require a lot of ATP to
pump H+ ions into the lumen of the CANALICULUS. The canaliculi are small
channels on the microvilli-lined cell surface of the paretial cells and increase the
surface area. H+ and Cl- ions are produced by reacting CO2 and H2O together to
make H2CO3 and dissociating H+ ions from the molecule. The Cl-, which comes from NaCl, and the H+
ions are pumped out of the cells into the lumen of the stomach to decrease the pH, while the dissociated
HCO3- enters the blood to raise its pH.
The SMALL INTESTINE is the main segment of the gastrointestinal tract involved in re-
absorption. The small intestine is folded into a series of ridges known as the
PLICAE -CIRCULARIS to increase the surface area for re-absorption. A
covering of tall finger-like projections of mucosa, known as VILLI, further
increases the surface area. Between these villi are CRYPTS of
LIEBERKUHN. The epithelium of the small intestine is made up of
absorptive simple columnar cell that increase the surface area, and secretory
goblet cells. The small intestine consists of five types of cells:
ENTEROCYTES are the most abundant cells and are tall columnar cells
involved in the absorption of many substances. Their nucleuses are basely
placed and contains between 2000-3000 microvilli on their cell surface that
are coated with enzyme-containing glycoproteins.
GOBLET CELLS are involved in the secretion of mucus and are very numerous in the small intestine.
PANETH CELLS are found in the lower part of the crypts and also have basely placed nuclei.
However, they are not involved in absorption like the Enterocytes, but are in fact involved in the release
of digestive enzymes, immunoglobulins, and lysozyme that help to destroy
bacteria and parasites. Due to the secretory function of the paneth cells,
granules are prominent in the appearance of paneth cells.
ENDOCRINE CELLS, are also found in the lower part of the crypts and also
have a secretory function. Endocrine cells secrete hormones for many
purposes, such as the regulation of water and electrolyte metabolism; enzyme
secretion; mucosal growth; the stimulation of other hormones and the
regulation of gastrointestinal motility (how fast peristalsis is).
The small intestine consists of three parts: the duodenum, the jejunem, and the
ileum. The DUODENUM is identified due to its submucosal BRUNNER
GLANDS, which aid in neutralising the acidic chyme from the stomach by
raising the pH. This is achieved by the secretion of bile salts. The brunner
glands slowly diminish along the length of the duodenum.
The JEJUNUM is identified due to having the tallest villi and no Brunner
Glands. It is distinguished from the ileum by having few lymphoid follicles.
The ILEUM is identified due to its aggregation of lymphoid tissue, known as
PEYER’S PATCHS. Peyer’s Patches contain a germinal centre of IgA positive
B cells and a dome of B lymphocytes covered by M Cells. Peyer’s patches are
easily visible in the submucosa of the ileum as balls of lymphoid tissue.
The COLON is involved in the re-absorption of water and electrolytes
from the bolus and the secretion of mucus to lubricate the passage of the bolus towards the anus. The
colon is easily distinguished from the small intestine by the absence of villi. Absorptive Surface cells,
which take water and electrolytes, are columnar with crypts containing large quantities of mucus-
secreting goblet cells. These goblet cells are easily identified by Pas staining, which stains them very
darkly compared to the enterocytes.