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Published byBeverley Casey Modified over 9 years ago
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HISTOLOGY OF ESOPHAGUS &gastro esophageal junction
By Dr. Sobia Ibrahim Assistant Professor Anatomy, KEMU
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ESOPHAGUS Is muscular tube Extends from pharynx to stomach
Wall has four layers: Mucosa Epithelium Lamina propria Muscularis interna or muscularis mucosae Submucosa Muscularis externa Adventitia / Serosa
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UPPER 1/3 OF ESOPHAGUS MUCOSA SUB-MUCOSA MUSCULARIS EXTERNA ADVENTITIA
Epithelium: Stratified squamous non-keratinized Lamina propria: scattered lymphocytes, few lymphatic nodules, mucous glands, blood vessels Muscularis mucosae: Thick, smooth muscles longitudinally arranged SUB-MUCOSA Collagen & elastic fibres, mucous glands, blood vessels, nerves MUSCULARIS EXTERNA Skeletal (striated) muscles ADVENTITIA Collagen & elastic fibers, blood vessels
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MIDDLE 1/3 OF ESOPHAGUS MUCOSA
Epithelium: stratified squamos non- keratinized Lamina propria: : scattered lymphocytes, few lymphatic nodules, mucous glands, blood vessels Muscularis mucosae: thick, smooth muscles longitudinally arranged SUB-MUCOSA Collagen & elastic fibres, mucous glands, blood vessels, nerves MUSCULARIS EXTERNA Skeletal (striated) muscles, Smooth muscles ADVENTITIA Collagen & elastic fibers, blood & lymphatic vessels
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LOWER 1/3 OF ESOPHAGUS MUCOSA Epithelium: Simple columnar
Lamina propria: scattered lymphocytes, few lymphatic nodules, mucous glands, blood vessels Muscularis mucosae: thick, smooth muscles longitudinally arranged SUB-MUCOSA Collagen & elastic fibres, mucous glands, blood vessels, nerves MUSCULARIS EXTERNA Smooth muscles ADVENTITIA/ SEROSA Collagen & elastic fibers, blood & lymphatic vessels
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GASTROESOPHAGEAL REFLUX DISEASE
It is associated with incompetent barriers at this junction; caused by hiatal hernia, decrease in lower esophageal sphincter tone. Results in reflux esophagitis as mucosal barriers are not sufficient to protect esophagus from acids, pepsin & bile causing heart burns/atypical chest pain
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BARRETT’S ESOPHAGUS Reflux of gastric contents throu lower esophageal sphincter Gastric acid in esophagus Heart burn With time, metaplasia of epithelium (protective) Barrett’s esophagus High risk for carcinoma
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STOMACH PARTS OF STOMACH Rugae Three histological zones Cardia Fundus
Body Pylorus Rugae Three histological zones
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CARDIOESOPHAGEAL JUNCTION
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Esophageal cardiac junction
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MUCOSA: 1:Epithelium changes from: Startified squamous non keratinised into simple columnar. 2: Lamina propria: esophageal cardiac glands but in stomach (cardiac, fundic and pyloric glands). They are tubular and deep. 3:Muscularis mucosae: thick longitudinal in esophagus but thin and two layered in stomach. Submucosa: esophageal glands proper disappear. No glands in submucosa of stomach. Muscularis externa: three layered in stomach an additional oblique layer is there
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GASTROESOPHAGEAL REFLUX DISEASE
It is associated with incompetent barriers at this junction; caused by hiatal hernia, decrease in lower esophageal sphincter tone. Results in reflux esophagitis as mucosal barriers are not sufficient to protect esophagus from acids, pepsin & bile causing heart burns/atypical chest pain
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