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IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder
Slide 154: Pancreas, H&E
the pancreas , located adjacent to the duodenum, is a mixed exocrine and endocrine gland; it is usually readily
identifiable by the presence of the interspersed endocrine pancreatic islets ( islets of Langerhans ); a thin
capsule and septa divide the gland into lobules (not readily seen); the exocrine pancreas is a compound acinar
gland of serous acini; large amounts of adipose may be present in the septa or within the thin CT surrounding the
acini; interlobular ducts are lined by simple columnar epithelium and are surrounded by connective tissue
IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder
serous acini of the exocrine pancreas drain into small intercalated ducts which have centroacinar cells that
penetrate into the acini (these are a distinguishing feature of the pancreas but are often difficult to see); the
intercalated ducts converge into larger intralobular ducts (there are no striated ducts within the pancreas)
which converge into the larger interlobular ducts , within the CT septa and lined by columnar epithelium; the
interlobular ducts finally drain into the main pancreatic duct which empties into the duodenum
Slide 154: Pancreas, H&E
serous acinus of 5-10 cells
facing a central lumen;
apical ends of the cells are
eosinophilic due to the
secretory granules; the
basal ends are basophilic
due to the displaced
nucleus and rER
intralobular duct lined
by simple cuboidal
epithelium and a small
amount of surrounding
connective tissue
IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder
Slide 29: Liver, H&E
the liver is easily distinguished by the presence of the stromal portal tracts containing portal triads (branches
of the hepatic artery proper, hepatic portal vein, and bile ducts); the bulk of the parenchyma of the liver is
hepatocytes organized into plates of cells radiating from central veins ( venules ); the central veins which merge
into larger hepatic veins and eventually drain into the inferior vena cava
IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder
Slide 55 (464): Pig Liver, H&E
the liver parenchyma is divided into polygonal hepatic lobules (generally hexagonal); in pigs, the lobules are
demarcated by connective tissue septa providing nice visualization of the liver architecture; in humans, however,
connective tissue in the liver is primarily confined to the portal tracts so lobules are visualized by finding a
central vein and then identifying the surrounding portal tracts containing the portal triads
septum
(not seen in humans)
central vein
IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder
central vein
hepatic plates
hepatic plates are cords of hepatocytes (one or two cells thick) radiating from the central vein ; the plates are
maintained by a meshwork of reticular fibers (type III collagen) and separated from each other by hepatic
sinusoids ; the sinusoids carry combined blood from the branches of the hepatic portal vein and the hepatic
artery in the portal tracts to the central vein
Slide 55 (464): Pig Liver, H&E
IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder
hepatic sinusoids are situated between hepatic plates and receive combined blood from the hepatic artery and
hepatic portal vein branches within the portal tracts; the sinusoids drain into the central veins/venules
( terminal hepatic venules ); between the sinusoids and hepatocytes is a narrow space (generally seen in EMs)
called the space of Disse into which the hepatocytes project microvilli from their basal surfaces for increased
surface area contact with the vascular contents (plasma) that leave the sinusoids into the space of Disse
Slide 24: Liver & Gallbladder, Trichrome
central
vein
IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder
Slide 141: Liver, H&E
hepatocytes are large, polygonal epithelial cells; their microvilli-lined basal surface face the sinusoids and their
microvilli-lined apical surface form the bile canaliculi into which they secrete bile; they are abundant cells – not
only in number – but in cytoplasmic contents: they have abundant rough ER and free ribosomes, abundant
smooth ER and Golgi, abundant mitochondria, abundant glycogen, abundant peroxisomes, abundant lipofuscin,
and may have abundant lipids
hepatic sinusoids
hepatocyte
with a large, spherical
nucleus (can be bi-nucleated)
and prominent nucleolus; the
cytoplasm is generally
eosinophilic but mottled
IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder
Slide 24: Liver & Gallbladder, Trichrome
look here to see
the gallbladder
IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder
Common Confusion: Parotid Gland vs. Pancreas
Parotid gland
Parotid Gland: major salivary gland located anterior to the ear; composed almost exclusively of serous acini that produce a thin watery secretion rich in enzymes Look for: (1) striated (intralobular) ducts are readily visible; (2) surrounded by CT capsule with defined septa
Pancreas: exocrine and endocrine gland located in upper left posterior of abdomen; exocrine portion is purely serous and empties into the duodenum
Look for: (1) pale-staining pancreatic islets (endocrine); (2) intralobular ducts are fewer and less readily seen; (3) surrounded by loose CT or very thin capsule with delicate septa; (4) at higher magnification, pale-staining centroacinar cells (where duct inserts into acinus) may be seen
Pancreas
IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder
Common Confusion: Pancreas vs. Spleen
Pancreas
Pancreas: exocrine and endocrine gland located in the upper abdomen; exocrine portion is purely serous and empties into the duodenum Look for: (1) exocrine gland, so ducts are present; (2) pale- staining pancreatic islets (endocrine) have homochromatic appearance; (3) at higher magnification, cells arranged in acinar configuration
Spleen: highly-vascular abdominal organ with abundant lymphoid tissue; filters the blood, providing immune functions and removal/destruction of old or faulty red blood cells Look for: (1) no exocrine tissue, so lacks ducts; (2) white pulp has heterochromatic staining, e.g., pale germinal centers surrounded by dark mantle zone; (3) no acini present; (4) numerous trabeculae throughout
Spleen
CChharacteristics of Segments of the Gastrointestinal Tract Small Intestine General Layer Specific Layer Esophagus^ Stomach^ Duodenum^ Jejunum^ Ileum^ Large Intestine Mucosa Epithelium
Lamina propria
Muscularis mucosae
Submucosa (w/ Meissner’s plexus)
Muscularis (w/ Auerbach’s plexus)
Innermost oblique Inner circular Outer longitudinal
Serosa/Adventitia
IUSM – 2016
I. Introduction II. Keywords III. Slides A. Oral Cavity
- Lip
- Soft palate
- Tongue
- Tooth B. Gastrointestinal Tract
- Esophagus
- Stomach
- Small Intestine a. Duodenum b. Jejunum c. Ileum
- Colon and Appendix
- Rectum and Anal Canal C. Accessory Organs
- Salivary Glands a. Sublingual b. Submandibular c. Parotid
- Pancreas
- Liver
- Gallbladder