DIGESTIVE TRACT

CHAIRUL ANWAR

THE ORAL CAVITY

IT IS LINED WITH STRATIFIED NON KERATINIZEDSQUAMOUS EPITHELIUM

THE LIP

COMPOSED OF 3 COMPONENTS :

1. PARS CUTANEA INDENTIC WITH THIN SKIN

2. PARS INTERMEDIA ( THE RED PART OF LIP )

- BORDER PART OF SKIN TO THE MUCOSA - EPITHEL : KERATOHYALIN CONSENTRATION IS HIGH

- STRATUM LUCIDUM IS THICK AND TRANSPARANT.

- DERMIS : - DERMAL PAPILLA IS HIGH - THERE ARE MANY BLOOD VESSELS - THERE IS NOT HAIR FOLLICLE, CEBACEOUS GLAND, SUDORIFERA GLAND AND CONTAIN MANY SENSORIC NERVES ENDING

3. PARS MUCOSAE : EPITHEL : SQUAMOUS STRATIFIED NON

KERATINIZED CAN FOUND LABIALIS GLAND WITH MUCOUS

CHARACTER.

THE TONGUE

BIG PART OF TONGUE CONSIST OF SKELETAL MUSCLE WHICH SALING TEGAK LURUS IN THREE DIRECTION.

DORSAL PART OF THE TONGUE IS DIVIDED BY SULCUS TERMINALIS INTO :

- 2/3 ANTERIOR PART, WHICH CONTAIN LINGUAL PAPILL.- 1/3 DORSAL PART, WHICH CONTAIN LYMPHONODULI NAMELY TONSILLA LINGUALIS

VENTRAL PART OF TONGUE HAVE SLIPERLY SURFACE

TONGUE PAPILL ( PAPILLA LINGUALIS )

ARE PROCESSES OF PROPRIA PAPILL WHICH IT’S SURFACE LINED BY SIMPLE SQUAMOUS EPITHELIUM.

1. PAPILLA FILIFORMIS - THE SHAPE LIKE A THREAD - THE EPITHEL WITH KERATINIZED - HAVE PRIMAIR AND SECUNDAIR PAPILL - THE NUMBER IS GREATER AND SPREAD OUT ON THE DORSAL SURFACE OF TONGUE. - THERE IS NOT TASTE BUD

2. PAPILLA FUNGIFORMIS

- FUNGI SHAPE, LOCATED IS INSERT OF FILIFORMIS PAPILL. - THE EPITHEL IS NON KERATINIZED - THE NUMBER OF TASTE BUD IS A LITTLE

3. PAPILLA CIRCUMVALATA

- IS THE GREATEST OF PAPILL AT TONGUE - THE NUMBER IS 7 – 12 - LOCATED ARE ALONG SULCUS TERMINALIS - HAVE MANY TASTE BUD IN THE MARGIN OF PAPILL. - THERE IS VON EBNER GLAND IN BASED OF SULCUS, IN BENEATH OF THE PAPILL.

4. PAPILLA FOLIATA

- THE APPEARANCE LIKE A LEAF - THERE ARE THREE SECUNDARY PROPRIA PAPILLS : - ONE IN THE MIDDLE CONTAIN BLOOD VESSELS. - TWO IN THE MARGIN CONTAIN NERVE FIBERS - HAVE TASTE BUD - THE POSITION OF THIS PAPILL IS AT THE

POSTERO-LATERAL SIDE, NEAR TERMINALLY SULCUS.

GLAND IN THE TONGUE

1. VON EBNER GLAND : THE CHARACTER OF SECRET IS PURE SEROUS, POSITION IS NEAR FROM PAPILLA CIRCUM VALATA.

2. WEBER GLAND : THE CHARACTER OF SECRET IS PURE MUCOUS, THE POSITION IS NEAR TONSILLA LINGUALIS.

3. BLANDIN NUHN : THE CHARACTER OF SECRET IS SEROMUCOUS AND THE POSITION IN 1/3

THE ANTERIOR PART OF TONGUE.

GENERAL STRUCTURES OF OESOPHAGUS UNTIL

ANUS :

CONSIST OF 4 MAIN LAYERS, FROM THE SURFACE :

A. MUCOSA LAYER

B. SUBMUCOSA LAYER

C. EXTERNAL MUSCULARIS LAYER

D. ADVENTITIA / SEROSA LAYER

A.TUNICA MUCOSA

CONSIST OF THREE LAYERS :

1. EPITHEL 2. LAMINA PROPRIA 3. MUSCULARIS MUCOSAE

1. EPITHEL

DEPEND OF THE FUNCTION :

- PROTECTIVE : STRATIFIED SQUAMOUS EPITHELIUM NON KERATINIZED OESOPHAGUS AND ANUS.

- SECRETORIC / ABSORBTIF : SIMPLE COLUMNAR EPITHELIUM FROM CARDIA UNTIL RECTUM.

2. LAMINA PROPRIA IS A LOOSE CONNECTIVE TISSUE, WHICH CONTAIN : - BLOOD / LYMPHATIC VESSEL - GLAND : - KRYPTA LIEBERKUHN - OESOPHAGEAL-CARDIAC GLAND - SMOOTH MUSCLE IN VILLI INTESTINALIS

3. MUSCULARIS MUCOSAE TWO LAYERS OF SMOOTH MUSCLE, WHICH IN INNER LAYER IS CIRCULAR AN IN OUTER IS LONGITUDIAL

EXCEPT : - IN OESOPHAGUS, ONE LAYER, THE DIRECTION IS LONGITUDINAL.

- IN STOMACH : THERE ARE THREE LAYER, THE DIRECTION ARE CIRCULAR, LONGITUDINAL AND CIRCULAR.

B. TUNICA SUBMUCOSA

IS A DENSE CONNECTIVE TISSUE, THAT CONTAIN : - BLOOD VESSELS ( PLEXUS HELLER ) - PLEXUS SUBMUCOUS OF MEISSNER - PARASYMPHATETIC GANGLION - GLANDS : - OESOPHAGEAL GLAND PROPER - BRUNNER – GLANDS.

C. TUNICA MUSCULARIS EXTERNA CONSIST OF TWO LAYERS OF SMOOTH MUSCLE TISSUE WHICH THE DIRECTION IS CIRCULAR AND LONGITUDINAL, EXCEPT ON STOMACH, THERE ARE THREE LAYERS. THERE IS AUTONOM GANGLON BETWEEN TWO

LAYERS OF SMOOTH MUSCLE TISSUE, NAMELY IS PLEXUS AURBACH

D.TUNICA ADVENTITIA / SEROSA

FILL WITH LOOSE CONNECTIVE TISSUE, IF COVERED BY MESOTHEL ( SIMPLE SQUAMOUS OF EPITHELIAL ) ARE CALLED SEROSA

FUNCTION : FIXATION

GLANDS IN DIGESTIVE TRACK

AT THE WALL :USUALLY THE LOCATED AT LAMINA PROPRIA :

- CRYPTA OF LIEBERKUHN IN SMALL INTESTINE AND LARGE INTESTINE

- OESOPHAGEAL-CARDIAC GLAND IN POSTERIOR REGION OF OESOPHAGUS NEAR FROM CARDIA.

AT SUBMUCOSA :

- OESOPHAGEAL GLAND PROPER - BRUNNER GLAND ( IN SUBMUCOUS OF INTESTINE )

B. AT OUTSIDER OF DIGESTIVE TRACT : SALIVARY GLANDS, PANCREAS AND LIVER

FUNCTION : HAVE IMPORTANCE ROLES IN DIGESTION PROCESS

SPECIAL STRUCTURE :

OSOPHAGUS.

EPITHEL : STRATIFIED SQUAMOUS OF EPITHELIUM NON KERATINIZED.MUSCULARIS MUCOSAE : 1 LAYER, THICK WITH LONGITUDINAL DIRECTION.GLANDS : - OSOPHAGEAL GLAND PROPER, MUCOUS CHARACTER LOCATED IN SUBMUCOUS.

- OSOPHAGEAL-CARDIAC GLAND IN LAMINA PROPRIA OF POSTERIOR REGION OF OSOPHAGUS.

TUNICA MUSCULARIS EXTERNA :

1/3 UPPER REGION : THE OUTER LAYER IS SKELETAL MUSCLE AND THE INNER IS ALSO SKELETAL MUSCLE.

1/3 MIDDLE REGION : THE OUTER LAYER IS SKELETAL MUSCLE AND THE INNER LAYER IS SMOOTH MUSCLE.

1/3 DISTAL REGION : THE OUTER LAYER IS SMOOTH MUSCLE AND THE INNER IS ALSO SMOOTH MUSCLE TOO.

OESOPHAGEAL-CARDIAC JUNCTION

IN CROSS SECTION, THE FORM OF OSOPHAGUS LUMEN IS LIKE AS STAR, BECAUSE THERE ARE MUCOUS AND SUBMUCOUS FOLD.

STOMACH

IS A DILATED SEGMENT OF DIGESTIVE TRACK WHICH THE INGESTED FOOD IS RECEIVED AND DIGESTED BY CHEMICAL AND MECHANICAL PROCESS.

IN GROSS ANATOMY, THERE ARE : - LONGITUDINAL FOLD, NAMELY IS RUGAE. - CAVITY ( INWARD ), NAMELY IS FOVEOLAE GASTRICAE ( GASTRIC PITS ).

TUNICA MUCOUSA

- EPITHEL IS SIMPLE COLUMMNAR, THE FUNCTION IS PROTECTING, NAMELY IS SURFACE EPITHELIUM, CYTOPLASM APPEARANCE IS CLEAR, THERE ISN’T GOBLET CELL IN THIS EPITHEL.

- LAMINA PRORIA : FULL OF GLANDS.

- MUSCULARIS MUCOUSAE : THERE ARE THREE LAYERS, THE DIRECTIONS ARE CIRCULAIR, LONGITUDINAL AND CIRCULAIR.

TUNICA SUBMUCOUS : THERE ISN’T GLAND IN THIS LAYER.

TUNICA MUSCULARIS EXTERNA : CONSIST OF THREE LAYERS OF SMOOTH MUSCLE THE DIRECTION ARE CIRCULAIR - LONGITUDINAL – CIRCULAIR.

TUNICA ADVENTITIA : CONSIST OF SEROSA.

STOMACH ARE DIVIDED INTO :

- CARDIAC REGION- CORPUS / FUNDUS- PYLORUS

CARDIAC REGION

- FOVEOLAE GASTRICAE LIKE AS V LETTER- GLAND IS DOUBLE COMPOUND, WITH BRANCH, ESPECIALLY IN UPPER PORTION OF GLANDS NAMELY IS CARDIAC GLAND.

CORPUS / FUNDUS REGION

- FOVEOLAE GASTRICAE LIKE AS U LETTER- TUBULAR GLANDS, ARRANGED AS STAND ERECTLY TO THE SURFACE AND ALSO PARAREL FUNDIC GLAND

THE CELLS IN FUNDIC GLAND :

- CHIEF CELL : IS MAIN CELL, CONTAIN ZYMOGEN GRANULES IN CYTOPLASM AND PRODUCE PEPSINOGEN ------------------- PEPSIN, INFLUENCED BY HCL

- PARIETAL CELL : IS BIG MEASUREMENT, PROTUDE TO THE LUMEN, CYTOPLASM HAVE STRONG STAINED WITH H.E. STAIN ( RED ) AND PRODUCE FREE HCL.

- MUCOUS NECK CELL : IS DIFFICULT TO DIFFER WITH CHIEFF CELL.

- ARGENTAFFINE CELL : WITH Ag IMPREGNATION STAIN, THE COLOR IS DARK BROWN.

PYLORUS

PRESENT DEEP OF GASTRIC PITSPYLORIC GLAND : RAMIFIED TUBULAR AND SHORT COILED GLANDS, SO NEVER SLICED LONGITUDINAL DIRECTION.

SMALL INTESTINE

FUNCTION : DIGEST AND ABSORB

IMPORTANCE STRUCTURES, THAT IS NEEDED TO EXPEND THE SURFACE OF ABSORBTION PROCESS ARE :

FUNDUS

PYLORUS

1. PLICAE SEMICIRCULARIS OF KERKRINGI :

MUCOSAL AND SUBMUCOSAL FOLD CIRCULAIRLY, WHICH CONSIST OF : - LAMINA PROPRIA

- MUSCULARIES MUCOSAE

- SUBMUCOSAE TO ANAL DIRECTION, THE NUMBER IS LESS AND

WILL DISAPPEAR IN THE MIDDLE OF ILEUM.

2. INTESTINAL VILLI : THE PROPRIA PROTRUSION WHICH THE SHAPE

LIKE AS A LEAF, TO ANAL DIRECTION THE NUMBER IS LESS AND SHORTER, AND WILL DISAPPEAR IN THE END OF ILLEUM.

3. MICROVILLI CYTOPLASM PROTRUSION WHICH THE SHAPE IS

LIKE A HAIR, VISIBLE ONLY WITH E.M.

PLICAE KERKRINGI

VILLI INTESTINALIS

FOR PERFORMING THE GOOD FUNCTION OF DIGESTION, THERE ARE SOME STRUCTURES :

1. GOBLET CELLS LOCATED ARE BETWEEN SURFACE CELLS,

PRODUCE MUCOUS MATERIALS FOR PROTECTING EPITHEL SURFACE.

2. GLANDS IN LAMINA PROPRIA CRYPTA OF LIBERKUHN,

WHICH TO ANAL DIRECTION THE NUMBER IS GREATER.

3. PANETH CELLS AT BASE OF CRYPT, IN CYTOPLASM CAN BE

FOUND EOSINOPHLILIC GRANULES

4. ARGENTAFFINE CELLS CYTOPLASM STAINED WITH Ag / CHROMIUM IMPREGNATION. THE COLOR IS BLACK.

5. ABSORBTIF CELLS ARE SURFACE EPITHELIUM CELLS WHICH HAVE

HIGH COLUMNAR AND MICROVILLI ( STRIATED BORDER ).

6. LOW COLUMNAR CELLS IN UPPER PART OF CRYPT, AS A REPLACEMENT

OF ABSORBTIF AND GOBLET CELLS. MANY MITOSIS PROCESS HAPPENED IN THIS PLACE.

LOCAL STRUCTURES

DOUDENUM- VILLI SHAPE IS WIDE LIKE A LEAF- AT MUCOSA , THERE IS BRUNNER GLAND, ON MIDDLE PART THERE IS ORIFICE OF CHOLEDUCTUS DUCT AND PANCREATICUS DUCT.

JEJUNUM-VILLI SHAPE LIKE A FINGER / TONGUE

ILLEUM- PLICAE KERKRINGI IS RARE, DISAPPEAR ON MIDDLE PART OF ILLEUM, VILLI IS SHORT AND ATHROPY, AND FINNALY IS DISAPPEAR, CRYPTA UNCLEAR BECAUSE IS CLOSED BY PEYER’S PATCH.

DEUDENUM

BERUNNER GLAND

ILLEUM

PAYER’S PATCH

LARGE INTESTINE

THE DIFFERENCES BETWEEN SMALL INTESTINE :

- THERE ISN’T PLICA KERKRINGI- THERE IS PLICAE SEMILUNARIS IS PROTRUTION OF MUCOSA, SUBMUCOSA AND MUSCULARIS CIRCULARIS.- THERE ISN’T VILLI- A LOT OF NUMBER OF DEEP CRYPT AND ALSO A LOT OF NUMBER OF GOBLET CELLS.

LOCAL STRUCTURES :

APPENDIX OF VERMIFORMIS

- THE LUMEN SHAPE IS TRIANGGLE

- PROPRIA CONTAIN A LOT OF LYMPHNODE- CRYPT OF LIEBERKUHN’S SHAPE IS NOT STANDART.- MUSCULARIS MUCOSAE IS NOT CONTINUE

COLON

- THERE IS TINEA COLI OUTER PART OF MUSCULARIS EXTERNA IS ASEMBLE INTO THREE GROUPS.- APPENDICES EPIPLOICAE ( +) SEROSA, WHICH CONTAIN ADIPOUSE TISSUE.

RECTUM

- TINEA COLI IS SPREAD AGAIN- APPENDICES EPIPLOICAE ( + ).- MUCOSA FORMS LONGITUDINAL FOLD, NAMELY COLUMNAE RECTALIS MORGAGNI.

ANUS

- EPITHEL : STRATIFIED SQUAMOUS EPITHELIUM.- CIRCUM ANALIS RECTI GLAND ( + ).

RECTO-ANAL JUNCTION

THANKS