DIGESTIVE SYSTEM:

ALIMENTARY CANAL
dr. Dewi Suryani, MInfectDiS
 LEARNING OBJECTIVE

Understand the histologic structure of the alimentary canal

Understand the correlation between histologic structure and
function of the alimentary canal
 COMPULSARY READING

Gartner, L.P, Hiatt, J.L, 2007, Colour Text Book of Histology third
edition, Saunders Elseiver, New York
Chapter 17
 GENERAL PLAN OF THE ALIMENTARY
CANAL

Hollow Organs of the

Digestive System

Esophagus
Stomach
Small Intestines
Large Intestines
 GENERAL PLAN OF THE
ALIMENTARY CANAL
LAYERS DESCRIPTION

MUCOSA Epithelium (columnar epith. except: esophagus & distal of anus)

Lamina propria (loose connective tissue, vasularization, lymph
vessel, lymphoid nodule (MALT)
Muscularis mucosa (inner: circular; outer: longitudinal) smooth
muscel (excpet for upper espohagus & lower anal)

SUBMUCOSA Irregular fibroelastic connectve tissue layer

Houses no glands except: esophagus and duodenum
Contains: blood, lymph node, enteric nervous system (Meisner
submucosal plexus: postganglionic parasympatic nerve cell
bodies: motility of mucose, secretory activity of glands

MUSCULARIS Compose of : inner circular and outer longtudinal smooth muscle,

EXTERNA Auerbachs myenteric plexus(peristaltic activity)
blood and lymph vessel
SEROSA AND structure that envelopes the muscularis externa:
ADVENTITIA - Tunica serosa: covering of GIT intrapertoneal (simple squamous
epithelium mesothelium)
- Tunica adventitia: covering of GIT retroperitoneal
GENERAL PLAN OF THE
ALIMENTARY CANAL
INNERVATION
ENTERIC
ESOPHAGUS
 ESOPHAGUS

STRUKTUR FUNGSI
Function Transport food mouth
stomach
T. mukosa Epithel
- Non keratinized
squamous ep.
Submucosa Esophageal gland
T. Muscularis Proximal : striated muscle
Middle: mix
Distal: smooth muscle
T. m. adventitia
Serosa/advan
titia
 ESOPHAGUS AND
GASTRIC JUNCTION
transitiongland
mucous
l.p:lymphoid
fromin
stratified
 ESOPHAGEAL HISTOPHYSIOLOGY

The esophagus have 2

functional spincter
(note: NOT an Function: prevent reflux
anatomical spincter) Rate of bolus from
1. pharyngoesophageal esophagus to gaster: 50
spincter mm/sec
2. Internal and external
gastroesophageal
spincter
 CLINICAL CORRELATION

HIATAL HERNIA
Herniation of the stomach to
the thoracic
Weakens the
gastroesophageal spincter
reflux
 CLINICAL CORRELATION

BARRETS ESOPHAGUS
Premalignant condition due
to gastroesphageal reflux
Part esophagus:epith
squamous simple
columnar
GASTER
 GENERAL OVERVIEW

Average adult voulme : 50 ml expand to 1500 ml

Hormon Ghrelin:
- maintain intraluminal pressure
- induce sensation of hunger
- relaxation of the smooth muscle fiber
Rugae
- longitudinal folds in the T. mucosa and T. submucosa
- disapear in distended stomach
Gastric pit
- invagination of the epithelial linning in the mucosa
 GASTER

Pylorus (junction with duodenum)

corpus
fundus
Cardia
 CARDIA

T. mucosa - Simple columnar

- lamina propria: cardiac gland,
tubular gland & shallow gastric
pit (P)
- Surface lining cells, mucous
neck cells, regeneratif cells,
DNES cells, parietal cells
(Oxyntic cells)
- MM: circular-longitudinal-
cicular
T. - No glands
submucos
a
T. - Inner: oblique
muscularis - middle: circular
- ouetrmost: longitudinal
T. serosa/ serosa
adventitia
 FUNDUS

LAYER DESCRIPTION
T. Mucosa - Ep. Simple columnar
- Deep gastric pit
- lamina propria: fundus
glands
- cells of glands: Surface
lining cells, mucous neck
cells, regeneratif cells,
DNES cells, parietal cell
- MM: circular-longitudinal-
circular

T. Submucosa -No glands:

T. Muscularis obligue-circular-longitudinal

T. serosa/ T. serosa
adventitia
 Distribution of cell
type
Isthmus
- Surface linning cell
- DNES
Neck
- Mucous neck cell
- parietal Cell
- Regeneratif cell
- DNES
Base
-Chief Cless
- Parietal Cells
- DNES

DNES= Diffuse Neurendocrine

System
APUD = Amin Precursor Uptake
Decarboxylase
 Different Cell of the Gaster

Type of cell Location charachteristic Function

Stem Cell Neck region - Low columnar cell, - Produce neutral mucous
nucleus basal
Mucous Neck region - Single cells - Produce acid mocous
Neck cell Between parietal cells
Parietal cell/ Base region -rounded/pyramid -Hydrochloride Acid
Oxyntic Cell shaped cells - Intrinsic factor:
- NC: spherical/central Glucoprotein that binds with
-Cytoplasma Vit B12
eosinophilic
Chief Cell/ Lower region of the NS - Produce: pepsinogen,
Zymogenic tubulus amilase, lipase
Cell
Argentaffin - Among the chief NS - Produce serotonin
Cell nearcellhe bases
APUD cells/ - All region NS - Glucagon
DNES - Somatostatin
- Gastrin
 PYLORUS
HAS DEEP GASTRIC
PITS

BRANCHED,TUB.PYLO
RIC GLAND
-LONGER PITS AND
SHORTER COILED

PRODUCE:LYSOZYM
 SUBMUCOSA GASTER
DENSE C.T:

BLOOD AND LYMPH VESSELS

LYMPHOID CELL

MACROPHAGE AND MAST CELLS

 MUSCULARIS GASTER

SMOOTH MUSCLE FIBERS

LONGITUDINAL:EXTERNAL
CIRCULAR :MIDDLE
OBLIQUE :INTERNAL
PYLORUS:MIDDLE LAYER.TO FORM THE PYLORIC
SPHINCTER.

SEROSA :THIN ,COVERED BY MESOTHELIUM

 GASTRIC HISTOPHYSIOLOGY

Sufficient: Over abundance

- Acidity of chyme of fat, proteins,
- caloric and fat content increase
- osmolality of chyme osmolaritas and
- degree of distention acidity in the
Gastrin: duodenum
-Contraction - feedback
of musc.
Pyloric and Release
relaxation of Stomach emptying cholecystokinin
counteract
pyloric
gastrin stimulate
spincter release of gastric
inhibitory peptide
inhibits gastric
contraction
 ACTIVATION AND INHIBITION OF HCL
PRODUCTION

ACTIVATION INHIBITION
1. Cephalic 1. Stomatostatin
physiological gactor 2. Prostaglandin
(smell, sight of food, 3. Urogastrone
stress) parasimpatic
impulse n. vagus
release Ach
2. Gastric secretion:
food in the stomach
gastrin, histamin
CLINICAL SIGNFICANCE
ANEMIA PERNICOUSA
Absence of gastric intrinsic
factor (glycoprotein)
Absorbtion of vitamin B12
GASTRIC ULCERS
Drug induced = NSAID
inhibit manufacture of
prostaglandin precluding
their protective function of
the stomach
Non drug induced: H. pylori
SMALL INTESTINE
 SMALL INTESTINE

TERMINAL FOOD
DIGESTION
NUTRIENT
ABSORPTION
ENDOCRINE
SECRETION
APPROXYMATELY 5 M
CONSIST OF:
DUODENUM
JEJENUM
ILEUM
 MODIFICATION OF THE LUMINAL
SURFACE
TYPE DESCRIPTION
OF
MODIF.
Plica Tarnsverse fold of the T. mucosa and
circularis submucose
kerkringi
Villi Finger like protrusion of the lamina
propria into the lumen
Microvilli Modification of the plasmalemma of the
eipthelial cell
Crupte of Invagination of the epithelial into the
liberkuhn lamina propria
Houses various intestinal glands
INTESTINAL MUCOSE:
EPTHELIUM
 DISTRIBUTION OF DIFFERENT TYPE
OF CELL
TYPE OF CELL FUNCTION
Surface absorptive tall coumnar cell
cell Acts as terminal digestion,
absorbtion water and nutrient
Goblet cell unicelular gland
produce mucus (protective
layer lining the lumen)
less in the duodenum
more towards the ileum
Enteroendocrine cell like in the stomach
Regeneratif Cell stem cell that repopulate the
epithelium
Paneth Cell produce lysozym
 INTESTINAL MUCOSE:
LAMINA PROPRIA
COMPOSED OF:
-LOOSE C.T
-BLOOD AND LYMPH
VESSELS
-NERVE FIBERS
-SMOOTH MUSCLE CELLS
-AGGREGATES OF LYMPHOID
NODULES.PEYERS
PATCHES(ILEUM)
 INTESINAL: SUBMUCOSA

Composed of dense, irreguler

fibroelastic connective tissue
Rich lymphatic and vasculer
supply
houses: submucosal (Meissner
plexus) and Brunner glands
(duodenum)
Brunner glands produce:
- mucous
- urogastrone
1. human epidermal growth
2. inhibits production of HCl
(directly inhibiting parietal cells)
 SMALL INTESTINE:
T. MUSCULARIS & T. SEROSA
SMOOTH MUSCLE CELLS:
-INTERNAL:CIRCULAR LAYER
-EXTERNAL:LONGITUDINAL LAYER

SEROSA: MESOTHELIUM
 REGIONAL DIFFERENCES
SMALL INTESTINE

DIFFERENCES Duodenum Jejeunum Ileum

T. Mucosa Epith columnar simplex Epith columnar Epith columnar
- Epith with goblet cell simplex with goblet cell simplex with goblet cell
- Lamina propria Crypte of liberkuhn Crypte of liberkuhn Crypte of liberkuhn
Patch of payer
T. Submucosa Brunner gland No gland Patch of peyer
T, Muscularis Circular - longitudinal Circular - longitudinal Circular - longitudinal
T. Serosa T. serosa T. serosa T. serosa
LARGE INTESTINE
 LARGE INTESTINE

NO FOLDS (PLICAE CIRC

KERCKRING)
NO VILLI
GREAT ABUNDANCE OF
GOBLET CELLS
FUNCTION:
- ABSORPTION OF WATER
- FORMATION OF THE FECAL
MASS
- PRODUCTION OF MUCUS
 LARGE INTESTINE

RICH IN LYMPHOID CELLS EXTEND INTO THE SUBMUC.

MUSCULARIS:
- LONGITUDINAL
- CIRCULAR
FIBERS OF THE OUTER LONG.LAYER CONGREGATE IN 3
THICK LONG.BANDSTENIAE COLI
 ANAL-RECTUM JUNCTION

MUCOUS MEMBRANE
FORMS :SERIES OF
LONGITUDINAL FOLDS.
RECTAL COLUMNS OF
MORGAGNI.
DISTAL OF THE ANAL
COVERED BY STRTIFIED
SQ.EP
L.P CONTAIN A PLEXUS OF
LARGE VEINS(EXCESSIVELY
DILATED AND
VARICOSE..HEMORRHOIDS
 APPENDIX

EVAGINATION OF THE
CECUM

LUMEN:SMALL,NARROW
,IRREGULAR

ABUNDANT LYMPHOID
FOLLICLES

INTESTINAL GLANDS:FEWER
NO TENIAE COLI.