What are the accessory GI organs?

List the 3 pairs of large salivary

glands.

Salivary glands
Pancreas
Liver
Gallbladder

Parotid
Submandibular
Sublingual

Xerostomia
What is dry mouth called? What are
4 potential causes?

Which 3 cell types comprise the

salivary secretory unit?

Describe the structure of serous

cells.

Mumps, viral infection, radiation of

the glands, normal side effect of
drugs (such as antihistamines)

Serous cells
Mucous cells
Myoepithelial cells

Polarized, protein-secreting, pyramidshaped cells with rounded nuceli, wellstained RER, and apical secretory
granules; joined apically by tight
junctions; form an acinus with a very
small central lumen; secrete enzymes
and other proteins

Describe the structure of mucous

cells.

Describe the location and structure

of myoepithelial cells.

More columnar in shape with more

compressed basal nuclei
Apical granules with hydrophilic mucins
Organized as cylindrical tubules rather
than acini

Located in the basal lamina surrounding acini,

tubules, and proximal ends of duct system
Small, flattened cells that extend contractile
processes around associated secretory cells;
help move secretory products into and
through the ducts

Sialorrhea
What is excessive saliva production
called? What are potential causes?

Describe the intralobular duct

system of salivary glands.

Describe the epithelium of the

intercalated ducts.

Nausea
Inflammation within the oral cavity
Rabies viral infection

Secretory acini and tubules empty

into short intercalated ducts.
Several intercalated ducts join to
form a striated duct.

Simple cuboidal epithelium

Columnar

Describe the cells of the striated

ducts.

Many infoldings of the basolateral membrane that are

all aligned with numerous mitochondria that, by light
microscopy, appear as faint basal striations radiating
toward the nuclei
Mitochondria --> energy for active transport
Infoldings --> more surface area for ion transport

Describe the interlobular excretory

ducts of salivary glands.

Multiple epithelium types:

simple/stratified/pseudostratified
columnar/cuboidal
Diverse functions of cells: ion reabsorption, mucin and protein
secretion, enteroendocrine cells, basal stem cells
Right before opening onto oral cavity = nonkeratinized stratified
squamous epithelium

Describe the location and histology

of the parotid glands.

Describe the histology of the

submandibular glands.

Describe the histology of the

sublingual glands.

Location = in each cheek near the ear

Branched acinar glands
Exclusively serous acini
Serous cells secrete abundant alphaamylase and antimicrobial proteins

Produce 2/3 of all saliva

Branched tubuloacinar glands
Primarily serous acini but with many mixed
tubuloacinar secretory units
Serous cells of mixed units are in peripheral cresentshaped groups (serous demilunes)
Serous cells secrete alpha-amylase, antimicrobial
peptides, lysozyme, and other enzymes

Branched tubuloacinar glands

Secretory tubules of mucous cells
predominate
Main product of gland is mucus
Few serous cells are present in
demilunes and add alpha-amylase and
lysozyme

Describe the secretory acini of the

exocrine pancreas.

Polarized serous acinar cells (round

basal nuclei and apical zymogen
granules) surround a very small
lumen
No myoepithelial cells

Describe the route of fluid

drainage from the exocrine
pancreas.

Acinus --> intercalated duct -->

merges with intralobular ducts and
larger interlobular ducts
(increasingly columnar epithelium)
--> main pancreatic duct

Describe the histology of

intercalated ducts of the pancreas.

Each acinus drains into a short intercalated

duct of simple squamous epithelium.
Initial cells = centroacinar cells = small, palestaining; extend into the lumen of the acinus
Secretion of a large volume of bicarbonaterich fluid

What are 3 ways in which the

pancreas is protected from autodigestion?

1. Trypsin inhibitor is copackaged in secretory

granules with trypsinogen
2. Low pH in the cells of the acini and duct system
(due to HCO3- secretion by centroacinar and
intercalated duct cells) keeps the enzymes inactive
3. Enteropeptidase that activates trypsinogen to
trypsin is present in the duodenal brush border and
not in the pancreas

Describe blood supply to the liver.

Hepatic portal vein = 75% of blood

flow to liver; deoxygenated,
nutrient-rich blood
Hepatic artery = 25% of blood flow
to liver; oxygen-rich blood

List 9 functions of cells in the liver.

Describe the histology of

hepatocytes.

Describe the structure of a hepatic

lobule.

1. Secretion of bile
2. Synthesis and endocrine secretion into the blood of the major plasma
proteins (albumin, fibrinogen, clotting factors, apolipoproteins, transferrin,
complement system, etc.)
3. Gluconeogenesis
4. Detoxification and conjugation of ingested toxins and drugs
5. Amino acid deamination and urea production
6. Storage of glycogen and triglycerides
7. Storage of Vitamin A (in hepatic stellate cells) and other fat soluble
vitamins (D, E, K)
8. Storage of iron in complexes with ferritin
9. Removal of effete RBCs (by Kupffer cells)

Large cuboidal or polyhedral epithelial cells

Large, rounded central nuclei
Eosinophilic cytoplasm rich in mitochondria
Frequently binucleated
About 50% are polyploid with 2-8 times the
normal chromosomal number

Hepatocytes form hundreds of irregular plates arranged radially

around a small central vein. Plates are supported by a delicate
stroma of reticulin fibers. Peripherally each lobule has 3-6 portal
areas with more fibrous connective tissue, and each portal ares
contains a portal triad.

What are the 3 components of the

portal triad in a portal area next to
a hepatic lobule?

1. Venule branch of the portal vein

2. Arteriole branch of the hepatic
artery
3. One or two small bile ductules of
cuboidal epithelium

Besides the portal triad, what do

most peripheral portal areas
contain?

Lymphatics
Nerve fibers

Describe the hepatic sinusoids.

What do the discontinuities and

fenestrations of the hepatic
sinusoid lining allow for?

What are 2 functionally important

cells found in hepatic sinusoids or
perisinusoidal spaces (apart from
the endothelial cells)?

Emerge from portal venules and hepatic

arterioles
Converge on the lobule's central vein
Mixture of venous and arterial blood
Lining = thin, discontinuous, fenestrated
endothelial cells

Allow plasma to fill a narrow

perisinusoidal space (or space of
Disse) and directly bathe the many
irregular microvilli projecting from
the hepatocytes into this space

Kupffer cells (stellate

macrophages)
Hepatic stellate cells (Ito cells)

Where are Kupffer cells found?

What are their functions?

Location = sinusoidal lining

Functions =
1. Recognize and phagocytose aged RBCs,
freeing heme and iron for reuse or storage in
ferritin complexes
2. Antigen presentation and removal of
bacteria or debris present in the portal blood

Where are hepatic stellate cells

found? What are their functions?

Location = in the perisinusoidal space

Functions =
1. Store fat-soluble vitamins in small lipid
droplets
2. Produce extracellular matrix components
3. Produce cytokines that help regulate
Kupffer cell activity

Where does blood in the central

veins drain?

How do the functions of periportal

vs. central hepatocytes differ?

Into larger veins that eventually

form 2 or more hepatic veins that
empty into the inferior vena cava

Periportal hepatocytes = near portal area;

receive nutrient- and oxygen-rich blood; aerobic
metabolism and protein synthesis
Central hepatocytes = exposed to lower nutrient
and oxygen concentrations; more involved with
detoxification and glycogen metabolism

Juxtaposed grooves in the apical surfaces of two

adjacent hepatocytes that are sealed by tight junctions

Describe bile canaliculi.

Elongated spaces (total length > 1 km) with tiny

diameters and large surface areas due to the short
microvilli from the constituent hepatocytes
Form an anastomosing network of channels through the
hepatocyte plates that end near the portal tracts

What do bile canaliculi drain into?

Fibrosis (characteristic of cirrhosis)

has what effect on histological
structure?

Bile canaliculi --> canals of Hering that

are composed of cuboidal epithelial cells
(cholangiocytes) --> bile ductules lined
by cuboidal or columnar cholangiocytes
and covered by a connective tissue
sheath --> right and left hepatic ducts -> common hepatic duct
Connective tissue fills the perisinusoidal
space and interferes with metabolic
exchange between hepatocytes and the
sinusoids. Blockage of hepatocyte
secretion into the blood can result in
clotting disorders, hypoalbuminemia,
etc.

What occurs during fatty liver

disease? What are common
causes?

Reversible condition
Large triglyceride-containing lipid droplets
accumulate abnormally in hepatocytes
(steatosis)
Common causes = alcoholism and obesity
Accumulation of fat in hepatocytes may produce
a progressive inflammation of the liver
(steatohepatitis)

What are the 3 ways of considering

liver lobule structure?

Classic hepatic lobule

Portal lobules
Heaptic acinus

What does the classic hepatic

lobule model emphasize?

What does the portal lobule model

emphasize?

What does the hepatic acinus

model emphasize?

Blood flowing past hepatocytes from

portal areas to a central vein
Emphasizes the endocrine function of
the structure producing factors for
uptake by plasma
Emphasizes exocrine function (bile
secretion)
Portal area at the center; includes
surrounding hepatocytes that drain bile
into that portal area; triangular in shape
with the central veins of 3 classic lobules
at its angles
Emphasizes the nature of the blood supply to the hepatocytes
and the oxygen gradient from the hepatic artery to the central
vein; diamond shaped area extending from 2 portal triads to the 2
closest central veins
Zone I = periportal hepatocytes; get the most oxygen and
nutrients; functions requiring oxidative metabolism such as
protein synthesis
Zone II = near the central vein; get the least oxygen and nutrients;
preferential sites of glycolysis, lipid formation, and drug detox

Which hepatocytes are the first to

undergo fatty accumulation and
ischemic necrosis?

Hepatocytes nearest to the central

veins

What is a treatment for jaundice in

newborns?

Exposure to blue light from ordinary

fluorescent tubes
Transforms unconjugated bilirubin into
a water-soluble photoisomer that can be
excreted by the kidneys

What is the liver's potential for

tissue regeneration?

Strong capacity for regeneration (unlike

salivary glands or pancreas)
Hepatocyte loss from exposure to toxins or
surgical removal of a lobe triggers mitosis of
remaining healthy hepatocytes in a process of
compensatory hyperplasia that works to
maintain the original tissue mass.

Where are liver stem cells located?

What are they often called?

Describe the histology of the

hepatic, cystic, and common bile
ducts.

Oval cells
Location = present among
cholangiocytes of the bile canals near
portal areas; produce progenitor cells
for both hepatocytes and
cholangiocytes
Simple cuboidal or low columnar epithelium of
cholangiocytes
Lamina propria and submucosa are thin with
mucous glands in some areas of the cystic duct
Thin muscularis becomes thicker near the
duodenum and duodenal papilla and finally forms
the sphincter of Oddi

Describe the histology of the

gallbladder.

Wall of gallbladder = simple columnar epithelium, lamina propria,

thin muscularis, external adventitia (against liver) or serosa
(where exposed)
Mucosa has numerous folds (esp. evident when gallbladder is
empty)
Epithelial cells have prominent mitochondria, microvilli, and large
intercellular spaces --> indicative of active transport of water

What is the process of gallstone

formation called?

Cholelithiasis

What is inflammation of the

gallbladder called?

Cholecystitis