HISTOLOGY OF THE DIGESTIVE

SYSTEM
 Histology of the Digestive system
• The digestive system proper is a long hollow
tube or tract that starts at the oral cavity
and terminates at the anus.
• It includes the;
1. Oral cavity 2. Oesophagus
3. Stomach
4. Small intestine (duodenum, jejunum, ileum)
5. Large intestine (colon)
6. Rectum
7. Anal canal.
 ORAL CAVITY
• Consists of the lips, cheeks, tongue, gingiva
(gum), teeth, and palate.
• Specialized for food ingestion, mastication, and
lubrication by saliva for swallowing.
• The mucosa consists of a stratified squamous
epithelium and a dense lamina propria.
• The submucosa may be present in some regions
of the oral cavity.
 LIP
• Covered by skin (keratinized stratified squamous
epithelium), sweat glands, hair follicle and sebaceous
glands externally
• Nonkeratinized, wet, stratified squamous epithelium
containing papillae internally.
• At the vermilion border, it is covered by a
nonkeratinized, translucent, stratified squamous
epithelium that lacks hair follicles and glands
• Projection of its lamina propria into the overlying
epithelium forms numerous tall connective tissue
papillae that contain abundant capillaries impacting a
red colour to the lip.
• Skeletal muscle fibres of the orbicularis oris muscle
• The ducts of numerous mixed mucoserous
tubuloacinar, labial glands in the submucosa empty
onto the internal surface of the lip
• Adipose cells are present in the underlying connective
tissue of the lip.
 TONGUE
• Submucosa is absent hence the mucous membrane of
the tongue is firmly bound to a core of skeletal muscle.
• The dorsal surface shows numerous small
protuberances called papillae.
• Papillae are indented by the lamina propria and
responsible for the roughness of the dorsum of the
tongue.
• The tongue are covered by stratified squamous
epithelium that shows partial or incomplete
keratinization.
• The posterior one-third lacks papillae but there is
presence of underlying lymphatic tissue of the lingual
tonsils.
 Papillae
Four types of papillae include;
1. Filiform papillae: are 2-3 mm long and conical in
shape.
2. Fungiform papillae: are mushroom-shaped,
scattered singly between the filiform type.
• Most numerous near the tip of the tongue and
are associated with taste buds
3. Circumvallate papillae: The largest of the papillae
located along the V-shaped sulcus terminalis that
divides the tongue into anterior and posterior
regions.
• The epithelium covering the lateral surfaces of
these papillae contains numerous taste buds that
may number 250 or more per papillae.
• Serous glands, lingual minor salivary glands, lie in
the propria and open into the bottom of the
furrows.
4. Foliate papillae: are rudimentary in humans but in
species such as the rabbit are well developed and
contain many taste buds.
 Taste buds
• Taste buds are present in fungiform, circumvallate, and
foliate papillae and may be scattered in the epithelium of
the soft palate, glossopharyngeal arches, pharynx, and
epiglottis.
• They appear as lightly stained, oval structures that extend
from the basement membrane almost to the surface of
the lining epithelium.
• They consist of supporting/sustentacular (type 1) cells,
between which are neuroepithelial (type 2) cells both
having microvilli/taste hairs projecting into the taste pore.
• Peripheral and basal cells, also associated with taste buds,
are thought to represent undifferentiated progenitors of
the supporting and neuroepithelial cells.
 Teeth
• Has a crown and a root separated by the neck.
• The root fits into a socket/alveolus of the mandible
or maxilla.
• Teeth has small pulp cavity that communicates with
the alveolar cavity and periodontal membrane
through the apical foramen, a small opening at the
tip of the root.
• Soft tissues of the tooth are the pulp, periodontal
membrane, and gingiva.
• The hard tissues of the tooth consists of the enamel,
dentin, and cementum.
 Dentin
• forms the bulk of the tooth and surrounds the pulp
chamber.
• Consists of 80% inorganic material (hydroxyapatite
crystals) and 20% organic substance (mostly collagen).
• Presence of radially striated appearance due to
numerous minute canals called dentinal tubules.
• Some areas of dentin remain incompletely calcified
and form the interglobular spaces.
• Dentin is sensitive to cold, pain, touch, and hydrogen
ion concentration. Sensation is thought to be
perceived by the processes of odontoblasts, which in
turn transmit the sensory stimulation to adjacent
nerves in the pulp chamber.
 Enamel
• It covers the dentin of the crown and is the
hardest substance of the body.
• It is acellular and consists primarily of calcium
salts in the form of apatite crystals. Only 1% of
the enamel substance is organic material.
• Enamel consists of thin rods called enamel
prisms that lie perpendicular to the surface of
the dentin and extend from the dentinoenamel
junction to the surface of the tooth.
• Enamel is absent at the root of the tooth.
 Cementum
• The cementum covers the
dentin of the tooth root.
• Nearest the neck of the
tooth, the cementum is thin
and lacks cells, forming the
acellular cementum.
• The remainder cellular
cementum, which covers the
apex of the tooth root,
contains cells, the
cementocytes, that lie in
lacunae and are surrounded
by a calcified matrix similar
to that of bone.
 Pulp cavity
• In living persons, the pulp cavity and root canal
are filled with Pulp (fine connective tissue),
stellate fibroblasts (most prominent cells),
histiocytes, and dentin-forming cells
(odontoblasts).
• Mesenchymal cells, macrophages, and
lymphocytes are found in limited numbers.
• Blood capillaries and nerves enter the pulp cavity
through the apical foramen at the tip of each
root.
 Basic organization
The morphology of the different
layers of the digestive tract show
variation due to their different
functions.
However four layers describe the
basic histologic organization.
The layers includes;
1. Mucosa
2. Submucosa
3. Muscularis externa
4. Serosa or adventitia
 Basic organization…
1. The mucosa
• The innermost layer of the digestive tube
consisting of a covering epithelium and glands
• The glands extend into the underlying. layer of
loose connective tissue called lamina propria.
• Muscularis mucosae (an inner circular and outer
longitudinal layer of smooth muscle) separates
the mucosa from the submucosa. It is found only
in tubular portion of the tracts.
2. The submucosa
• It consists of dense irregular connective tissue
with numerous blood and lymph vessels and a
submucosal (Meissner’s) nerve plexus.
• The nerve plexus contains postganglionic
parasympathetic neurons responsible for the
control of the motility of the mucosa and
secretory activities of associated mucosal glands.
3. The muscularis externa
• It is composed of an inner layer of circular
smooth muscle and outer layer of longitudinal
smooth muscle .
• Between the two smooth muscle layers of the
muscularis externa is connective tissue and
another nerve plexus called the myenteric
(Auerbach’s) nerve plexus.
• The nerve plexus also contains some
postganglionic parasympathetic neurons that
controls the motility of smooth muscles in the
muscularis externa.
4. The Serosa/ Adventitia
• The visceral organs is surrounded by a thin layer
of loose connective tissue that may or may not be
covered by a thin outer layer of squamous
epithelium called mesothelium.
• If mesothelium is present it is called a serosa.
• In the absence of mesothelium it is called
adventitia.
• Visceral organs surrounded by serosa are
intraperitoneal. Organs covered by adventitia are
retroperitoneal lying outside of the peritoneal
cavity
 ESOPHAGUS
• It is relatively straight muscular tube about 25 cm (10
inches) long extending from the pharynx in the thoracic
cavity to the stomach in the abdominal cavity and located
posterior to the trachea.
• When empty exhibits numerous but temporary
longitudinal folds

MUCOSA
• Lined with moist, non keratinized stratified squamous.
• The lamina propria is a loose areolar connective tissue
with diffuse nodular lymphatic tissue scattered throughout
its length.
• The muscularis mucosae consists of longitudinally
arranged smooth muscle cells and sometimes circularly
arranged smooth muscle cells also may be present.
Submucosa
• Contains small oesophageal glands (compound tubuloacinar
glands of mucous type).
• Both glands (including the cardiac oesophageal gland)
secrete mucus that protect the mucosa and facilitate the
passage of food material through the oesophagus.
Muscularis externa
• The muscularis externa of the oesophagus contains a mixture
of different types of muscle fibres.
• Striated skeletal muscle fibres in the upper third
• Smooth muscle fibres in the lower third
• Both skeletal and smooth muscle fibres in the middle third
Serosa/Adventitia
• In the thoracic cavity, the oesophagus is surrounded by
adventitia while in the abdominal cavity, it is surrounded by
serosa.
 STOMACH
• The stomach is an expanded hollow organ
situated between the oesophagus and small
intestine.
• Histologically the stomach is divided into 3
regions; the cardia, the fundus and body, and the
pylorus.
• The fundus and the body comprise about 2/3 of
the stomach and have identical histology.
• The glands in their mucosa are deep and produce
most of the gastric secretions for digestion.
Mucosa
• Stomach is made up of simple columnar
epithelium
• The luminal/gastric epithelium has a similar
structure throughout the stomach and has
secretory columnar cells that continuously
produces a neutral mucin that helps protect the
mucosa and lubricate the surface.
• Scattered, stubby microvilli are present on the
apical surfaces.
• The luminal epithelium invaginates the
underlying connective tissue lamina propria to
form gastric pits with numerous tiny openings to
the mucosa.
• Tubular gastric glands are located below the
luminal epithelium and open directly into the
gastric pits to deliver their secretions into the
stomach lumen.
• The gastric glands descend through the lamina
propria to the muscularis mucosae.
Submucosa
• Has dense connective tissue containing large blood vessels
and nerves.
Muscularis externa
• Exhibits three muscle layers (an inner oblique, a middle
circular, and an outer longitudinal) instead of the two that
are normally seen
Serosa/Adventitia
• The outer layer of the stomach is covered by the serosa.
NOTE
• The stomach is made up of mucosal glands and no
submucosal glands
 Three types of glands occur in the gastric mucosa:
1. Cardiac gland in the cardia region
2. Fundic (Oxyntic) gland in the fundus and body
3. Pyloric gland in the pyloric region
 CARDIAC
• Cardiac region has simple branched tubular
glands that open into the overlying gastric pits.
• Has shallow gastric pits with depth
approximately equal to the length of the cardiac
gland
• The secretory units consist mainly of mucous
cells, but occasional parietal cells are present
and appear to be identical to those of gastric
glands.
• The cardiac glands have similar histology with
that of the pylorus and predominantly
mucus-secreting cells.
CARDIAC GLANDS
 FUNDUS AND BODY OF THE STOMACH
The mucosa
• Surface epithelium is mucus secreting simple columnar
epithelium
• Lamina propria separates adjacent gastric pits.
• Cell types in the gastric glands: the large polygonal acidophilic
parietal (oxyntic) cells in the upper portions of the glands,
which produces HCl and the cuboidal basophilic chief
(zymogenic) cells in the lower regions which secrete
pepsinogen and precursors of renin and lipase.
• Some mucous neck cells interspersed between parietal cells
which secrete acid mucus. Some enteroendocrine cells that
secrete endocrine molecules such as serotonin, gastrin,
histamine.
• Muscularis mucosae (inner circular and an outer longitudinal
layer).
The Submucosa contains lymph vessels, capillaries, large
arterioles, and venules, Isolated clusters of parasympathetic
ganglia of the submucosal (Meissner’s) nerve plexus.
The Muscularis externa: an inner oblique, a middle circular,
and an outer longitudinal smooth muscle layer. Myenteric
(Auerbach’s) nerve plexus between the circular and
longitudinal layer.
The Serosa can contain adipose cells.
Fundic region
• Body region of the stomach
• Unlike the mucous cells that line the gastric surface
and gastric pits, mucous neck cells produce an acidic
mucin.
• Parietal cells produce hydrochloric acid, the major
component of gastric juice and gastric intrinsic
factor, a glycoprotein that is necessary for
absorption of vitamin B12 from the small intestine.
• Chief or zymogenic cells are filled with secretory
granules that contain the proenzyme pepsinogen,
an inactive precursor of pepsin for the break down
of protein.
• Enteroendocrine cells secrete the hormone gastrin
• The secretory activities of the cells are controlled by
the autonomic nervous system
 Pyloric-duodenal junction
• The pylorus of the stomach is separated from the
duodenum of the small intestine by the thickened smooth
muscle circular layer of the muscularis externa of the
stomach called the pyloric sphincter
• The mucosal ridges become broader and more irregular
and variable in shape.
• Lymphatic nodules are seen between the stomach and the
duodenum.
• The mucus-secreting stomach epithelium changes to
intestinal epithelium in the duodenum.
• The intestinal epithelium consists of goblet cells and
columnar cells with microvilli that are present throughout
the length of the small intestine
Pyloric region of the stomach
 Small intestine
• It is divided into the duodenum, jejunum, and
ileum.
• Minor microscopic differences among these
subdivisions exists however, all have the same
basic organization as the rest of the digestive
tube - mucosa, submucosa, muscularis externa,
and serosa or adventitia.
• Its primary function is digestion of gastric
contents and absorption of nutrients into blood
capillaries and lymphatic lacteals (assist in the
digestion of long chain fatty acids).
Surface Modifications of Small Intestine for Absorption
• The Mucosa exhibits specialized structural modifications
(plicae circulares, villi, and microvilli) that increase the
cellular surface areas for absorption of nutrients and fluids.
• The plicae circulares are permanent spiral folds or elevations
of the mucosa extending into the intestinal lumen and are
most prominent in the proximal portion, where most
absorption takes place.
• Villi are permanent finger-like projections of lamina propria
of the mucosa extending into the intestinal lumen. They are
covered by simple columnar epithelium and are also more
prominent in the proximal portion with the height
decreasing toward the ileum of the small intestine.
• The connective tissue core of each villus contains a lymphatic
capillary called a lacteal, blood capillaries, and individual
strands of smooth muscles.
• Microvilli cover the apices of the intestinal absorptive
cells.
• Intestinal glands are located between the villi
throughout the small intestine and open into the
intestinal lumen at the base of the villi.
• The glands measure 0.3 to 0.5 mm in depth and extend
through the mucosa to the level of the muscularis
mucosae.
• Asides producing secretions that aid digestion, they are
the sites of renewal of intestinal epithelial cells as they
are shed at the tips of the villi.
• The simple columnar epithelium that lines the villi is
continuous with that of the intestinal glands.
All epithelial cells that line the intestinal surface arise
from cells in the intestinal glands.
Absorptive cells (Enterocytes)-most common cell types in
the intestinal epithelium, tall and columnar with microvilli.
Goblet cells-are interspersed among the columnar
absorptive cells. They increase in number toward the distal
region of the small intestine. They secrete mucus that
lubricate and protect the intestinal walls.
Enteroendocrine cells- scattered throughout the
epithelium of the villi and intestinal glands far fewer in
number than goblet cells.
Undifferentiated cells-exhibit mitotic activity and
functions as stem cells to replace worn-out columnar
absorptive, goblet and intestinal gland cells. Located in the
base of intestinal glands.
Paneth cells-located at the base of intestinal glands
primarily in the ileum. They are characterized by the
presence of deep-staining eosinophilic granules in their
cytoplasm. They contain lysozyme and secrete substances
called defensins, which protect against infection.
M cells -highly specialized epithelial cells that cover the
Peyer’s patches and large lymphatic nodules; they are not
found anywhere else in the intestine. M cells phagocytose
luminal antigens and present them to the lymphocytes
and macrophages in the lamina propria, which are then
stimulated to produce specific antibodies against the
antigens.
Epithelial Lining-Enterocytes, goblet cells, endocrine cells.
1-villus, 2-lamina propria, 3-lymph node, 4-goblet cell,
5-muscularis mucosae, 6-enterocytes, 7-intestinal gland
 DUODENUM
• The shortest segment of the small intestine.
• The villi are broad, tall, and numerous, with fewer goblet
cells in the epithelium.
• Presence of branched duodenal (Brunner’s) glands with
mucus-secreting cells in the submucosa characterize this
region.
• The duodenal glands are the only submucosal glands
present in the gastrointestinal tract aside the oesophageal
glands.
 JEJUNUM
• The histology of the lower duodenum, jejunum,
and ileum is similar to that of the upper
duodenum except the presence of the duodenal
(Brunner’s) glands usually limited to the
submucosa in the upper part of the duodenum.
• Exhibits shorter, narrower, and fewer villi and
more goblet cells than the duodenum.
 ILEUM
• Characterized with few villi that are narrow and
short with more goblet cells in the epithelium
than in the duodenum or jejunum.
• Contains the Peyer’s patches, large and numerous
aggregated lymphatic nodules in the lamina
propria and submucosa.
• The lymphatic nodules originate in the diffuse
lymphatic tissue of the lamina propria and extend
into the submucosa disrupt the muscularis
mucosae, and spread out in the loose connective
tissue of the submucosa.
 Large intestine
• Approximately 180 cm long and is divided into
several regions with the same features histologically.
• The cecum bearing the appendix, ascending,
transverse, descending and sigmoid, rectum an anal
canal.
Mucosa
• Similar to the small intestine but lacks villi and has a
smooth interior surface.
• The lumen is lined by a simple columnar epithelium
consisting of intestinal absorptive cells (enterocytes)
and goblet cells. The goblet cells increase in number
toward the rectum so that in the distal region of the
colon the epithelium consists mainly of goblet cells.
• Intestinal glands of the colon are longer and more
closely packed than those in the small intestine, and
they increase in length distally to reach their
maximum depth (0.7 mm) in the rectum.
• The glands contain numerous goblet cells,
endocrine cells (which does not secrete enzymes)
and in the basal half of the glands, proliferating and
undifferentiated epithelial cells. Paneth cells usually
are absent.
Submucosa
• It is similar to that of the small intestine and
contains the larger blood vessels and the
submucosal nerve plexus. Glands are not present.
Muscularis Externa
• The outer, longitudinal coat of the muscularis
externa of the cecum and colon differs from that of
the small intestine. It forms three longitudinal bands
called the taeniae coli.
• The inner circular layer is complete and appears
similar to that of the small intestine.
• Due to the tonus of the taeniae coli, the wall of the
colon is gathered into outwardly bulging pockets,
the haustra.
• Crescentic folds called plicae semilunares project
into the lumen of the colon between the haustra.
Serosa
• The serosa is incomplete in the colon, as the
ascending and descending portions of the colon are
retroperitoneal. Here the muscular wall of the colon
is attached to adjacent structures by an adventitia.
• Where a serosa is present, it may contain large,
pendulous lobules of fat called appendices
epiploicae.
colon
 Appendix
• The structure of the appendix resembles that of
the colon, but in miniature.
• The lumen is small and irregular
• Taeniae coli are absent.
• Lamina propria is extensively infiltrated with
lymphocytes
• Details of the mucosa often are obscured by the
many lymphatic nodules that may fill the mucosa
and submucosa.
 Rectum and Anorectal junction
• The mucosa of the first part of the rectum is similar to that
of the colon except that the intestinal glands are slightly
longer and the lining epithelium is composed primarily of
goblet cells.
• The distal 2 to 3 cm of the rectum forms the anal canal,
which ends at the anus.
• At the pectinate line, the simple columnar intestinal
epithelium becomes non-cornified stratified squamous
epithelium which also becomes continuous with the
keratinized stratified squamous epithelium of the skin at
the level of the external anal sphincter.
• The intestinal glands of the distal rectum are
somewhat shorter and spaced farther apart.
• The lamina propria of the rectum is replaced by
the dense irregular connective tissue of the
lamina propria of the anal canal.
• The muscularis mucosae and the intestinal glands
of the digestive tract disappear at the anorectal
junction.
• The submucosa of the rectum merges with the
connective tissue in the lamina propria of the
anal canal, a region that is highly vascular.
• The submucosa of the anal canal contains numerous
veins that form a large hemorrhoidal plexus. When
distended (varicosed), these vessels protrude into the
overlying mucosa and form internal hemorrhoids (piles).
• The inner circular layer of the muscularis externa
increases in thickness and ends as the internal anal
sphincter.
• In the distal rectum the taeniae coli come together to
invest the rectum as a thin complete outer longitudinal
layer which blends with the surrounding connective
tissue and muscle of the pelvic diaphragm.
• Lower in the anal canal, the internal anal sphincter is
replaced by skeletal muscles of the external anal
sphincter.
Rectum
Anorectal junction
 Accessory digestive organs
Accessory organs are organs of the digestive system
located outside of the digestive tract
• Usually they are responsible for the production of
digestive enzyme
They include;
• Liver
• Gallbladder
• Pancreas
 Liver
• The cells of the liver are called Hepatocytes
• The liver is divided in hexagonal units called hepatic
lobules by interlobular septa of connective tissue.
• It has the central vein located at the centre of each
lobules
• Hepatocytes and sinusoids radiates from the centre
to the periphery.
• In each lobules, about 6 portal areas or canals
(containing branches of the hepatic artery, hepatic
portal vein, bile duct, and lymph vessels) are
contained in the interlobular septa of connective
tissue.
 Hepatic sinusoids
• Dilated blood channels lined by a discontinuous layer of
fenestrated endothelial cells and discontinuous basal lamina
• They are separated from the underlying hepatocytes by a
subendothelial perisinusoidal space
• The nature of the sinusoids allows for direct access through the
discontinuous endothelial wall with the hepatocytes and
efficient exchange of materials between the hepatocytes and
blood
• Sinusoids are made up of endothelial cells, macrophages and fat
cells
• Macrophages are called Kupffer cells, located on the luminal
side of the endothelial cells
• Arterial and venous blood mixes in the hepatic sinusoids before
flowing toward the central vein of each lobule
 Gall bladder
• A small, hollow organ attached to the inferior
surface of the liver.
• Responsible for storing and concentrating bile
produced by hepatocytes of the liver
• Bile leaves the gallbladder via the cystic duct and
enters the duodenum via the common bile duct
through the major duodenal papilla
• Its wall consists of mucosa, muscularis, and
adventitia or serosa. It is devoid of muscularis
mucosae or submucosa.
• The mucosa- consists of a simple columnar epithelium,
lamina propria that contains loose connective tissue, some
diffuse lymphatic tissue, and blood vessels, venule and
arteriole.
• The gallbladder is devoid of glands except in its neck
region
• The muscularis has randomly oriented smooth muscle
fibers (that do not show distinct layers) and interlacing
elastic fibers. A thick layer of dense connective tissue that
contains large blood vessels, artery and vein, lymphatics,
and nerves surrounds the smooth muscles
• The serosa covers the entire unattached gallbladder
surface and adventitia where it is attached to the liver
surface
 Pancreas
• The pancreas is a soft, elongated organ located
posterior to the stomach.
• Most of the pancreas is an exocrine gland but it is also
an endocrine organ.
• The exocrine which makes up the majority has secretory
units (acini) that contains pyramid-shaped acinar cells,
whose apices are filled with secretory granules It also
contains zymogenic cells
• The secretory acini are subdivided into lobules and
bound together by loose connective tissue.
• The excretory ducts in the exocrine pancreas start from
within the center of individual acini as pale-staining
centroacinar cells, which continue into the short
intercalated ducts.
• The endocrine units of the pancreas are scattered
among the exocrine acini as isolated, pale-staining
vascularized units called pancreatic islets, arranged in
cords and clumps.
• Each islet is surrounded by fine fibers of reticular
connective tissue.
Cell types identified in each pancreatic islet includes;
• Alpha cells- makes up about 20% responsible for
producing glucagon
• Beta cells- makes up about 70% located in the centre
• Delta cells
• Pancreatic polypeptide (PP) cells
 Clinical correlations
• Gastro-esophagial reflux disease
• Gastric ulcer
• Colon polyps
• Colorectal cancer
• Meckel diverticulum
• Hemorrhoids
• Ulcerative colitis
• Crohn disease
• Alcoholic fatty liver (steatosis)
• Hepatitis
• gallstones