组胚学英文版Digestive-Gland.ppt

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Digestive gland,Small gland:fundis gland,small intestinal gland,Large gland:salivary gland,pancreas,liver,Salivary glands,Parotid gland,Submandibular gland,Sublingual gland,1,Salivary Glands,1)General structure of exocrine gland,-Capsule:CT,-lobule:acinus;ducts,acinus:,a.serous acinus:,structure:,pyramidal or cuboidal;round basally-located N,apical:zymogen granule-acidophilic,basal:basophilic-RER,ribosome,function:secret salivary amylase,b.mucous acinus:,structure:,pale-stained,slight-blue,flattened N against the basal membrane,mucinogen granule,Golgi,RER,mitochondria,c.mixed acinus:several serous cell attached to mucous acinus serous demilune,Comparision of different acinus,serous acinus mucous acinus mixed acinus,2)structural feature of each salivary gland,a.,parotid gland,:,-serous,-long intercalated duct,short striated duct,c.,sublingual gland,:,-mixed(mainly mucous,more serous and mixed),-more demilunes,no intercalated duct,under-developed striated duct,大唾液腺,（二）三种唾液腺的结构特点,腮腺,(,纯浆液性腺,),颌下腺（混合腺，浆液为主）,舌下腺（混合腺，黏液为主）,1),exocrine pancreas,-acinus:serous,*centroacinar cell:small,pale cell with round or ovoid N,derived from epithelial cell of intercalated duct,-duct:long intercalated duct,-function:secret pancreatic liquid,1-2L/D,PH 7.8-8.4,Digestive enzymes:trypsinogen,chymotrypsinogen,amylase and lipase,Acute pancreatitis,is an acute inammatory disease of the pancreas characterized by pathologic changes include interstitial and peripancreatic edema,fat necrosis with saponication,inammatory inltration of neutrophils,and necrosis of the pancreatic parenchyma.This image shows acute pancreatitis with fat necrosis,an acute inammatory inltrate consisting of neutrophils,and inamed pancreatic parenchyma.,Acute pancreatitis is an acute inammatory disease of the pancreas characterized by severe upper abdominal pain,nausea and vomiting,and elevated serum pancreatic enzymes,amylase and lipase.Acute pancreatitis may be caused by hypertriglyceridemia,alcohol ingestion,infections,trauma,drugs,and gallstones.Gallstones may block the pan-creatic duct,resulting in autodigestion of the pancreatic parenchyma by enzymes released because of disrupted cell membranes.Pathologic changes include interstitial and peripancreatic edema,fat necrosis with saponication,in ammatory inltration of neutrophils,and necrosis of the pancreatic parenchyma.Based on the severity of the disease,treat-ment includes pain control,intravenous uids,nasogastric suction,and reduction of food intake.In very severe cases,surgical removal of the damaged tissue may be necessary.This image shows acute pancreatitis with fat necrosis,an acute inammatory inltrate consisting of neutro-phils,and inamed pancreatic parenchyma.,Endocrine Pancreas,(pancreas islet),-170.000-200.000,constitute about 1%of total pancreas volume,-75-500 um,-HE:cells arranged into cord with CT rich in fenestrated cap.,-EM:,a.,A cell,:,20%.Large polygonal in shaped,peripheral-distributed,EM:secretory G:large,190-310 nm,round with dense core,function:secret glucogon-29 amino acid residues protein ,glycogen glucose,b.,B cell:,75%,small,centrally-distributed,EM:secretory G:different diameter,225-375 nm with one or several dense core,function:secret insulin-51 amino-acid residues,c.,D cell:,5%,ovoid,fusiform,peripheral-distributed,between A,B cells,EM:,-gap junction with A,B cell,-secretory G:large,190-370nm,low-density core,function:secrete somatostatin to inhibit the secreting of A,B,PP cell,Liver,components,hepatic lobule,portal area,A:,hepatic lobule:basic structural unit,-500.000-1.000.000,-2 mm long,1 mm in across D,-polygonal prism(irregular),一、,hepatic lobule(structure),(central vein+hepatocyte+hepatic sinusoid+bile canaliculus),1.,Central vein,:,small vein:endothelium+CT/45 um/receive the blood from sinusoids,2.,Hepatic plates,-formed by,single layer of hepatocytes,a.hepatocyte:,LM:,polygonal,20-30 um,eosinophilic,N:-large,pale,round,centrally-located,-1/4 binuclear,EM:,mitochondria:1000-2000,20%total volume,RER:involve in the synthesis of albumin,fibrinogen,clotting factor,lipoprotein and complement protein,SER:contain enzymes-oxidoreductase(oxidase,reductase),hydrolase,transterase,synthetase,involve in the formation of bile and the metabolism of adipose,glucose and hormones,Golgi apparatus:involve in,-formation of bile,-process,condense and storage of proteins,-formation of lysosome,Lysosome:involve in phagocytosis activity and metabolism of bilirubin,microbody:,-round,0.2-1.0 um,-contain catalase and peroxidase,inclusions:glycogen,lipid droplet,pigment,。,3.,bile canaliculus,:,-cell membrane of adjacent hepatocytes depress to form a tubular system between hepatocytes,-structure:,silver preparation:dark-brown colored network,0.5-1um,Microvilli,tight junction,desmosome,4.Hepatic sinusoid,-space between hepatic plates,LM:9-12 um/endothelial cell:fenestrated,gap,plasmalemmal vesicles/RF/cavity:,-liver macrophage(Kupffer cell),-large granular lymphocyte:NK cell,EM:,Perisinusoidal space,:Disse space-narrow space between endothelial cell and hepatocytes,0.4 um width,blood plasma,microvilli,RF,fat-storing cell:,*,fat-storing cell,:,-irregular,with processes,-EM:large lipid droplets,RER,mito,Golgi,-function:storage of vitamin A(E,K),synthesis of collagen,*The three kinds of different surfaces of hepatocytes,-face adjacent cell each other:55%,-face the sinusoids:35%,-form bile canaliculus:10%,B:,portal area,-areas(triangle-shaped or irregular-shaped)where adjacent hepatic lobules meet,-contains CT and several ducts,a,.,interlobular arteries:,branches of hepatic A,small A:endothelium+3-4 layers of SM,b,.,interlobular vein,:,branches of portal vein,small vein:endothelium+less CT and single SM,c,.,interlobular bile duct,:,simple cuboidal or low columnar epi.,C:Blood circulation of liver,hepatic A interlobular A terminal hepatic arteriole,portal Vinterlobular Vterminal portal venule,hepatic sinusoicentral veinsublobular Vhepatic Vinferior vena cava,D:,Passage of bile,Hepatitis C,is an infectious liver disease caused by the hepatitis C virus,which may result in chronic hepatitis and cirrhosisThis image shows a portal area and adjacent hepatocytes with portal brosis and a lymphocytic inammatory inltrate along with periportal hepatitis(or“piecemeal”necrosis)and scattered necrotic hepatocytes.,Hepatitis C is an infectious liver disease caused by the hepatitis C virus,which may result in chronic hepatitis and cirrhosis.The hepatitis C virus is spread primarily by blood-to-blood contact.Common signs and symptoms may include fatigue,nausea,poor appetite,muscle and joint pains,jaundice,low fever,and tenderness in the liver.In some patients,the disease is self-limiting,but in others it becomes chronic with serious consequences.In the later stages of the disease,cirrhosis may ensue with resultant liver failure and ascites.Pathologic changes to the liver include portal tract expansion with lymphocytes,portal brosis,periportal hepatitis,steatosis(fatty change),and lobular parenchymal inammation.In time,brosis becomes marked,surrounding nodules of regenerating hepatocytes to produce hepatic cirrhosis.Treatment options include injections of pegylated interferon-a,the antiviral drug ribavirin,and liver transplantation.This image shows a portal area and adjacent hepatocytes with portal brosis and a lymphocytic inammatory inltrate along with periportal hepatitis(or“piecemeal”necrosis)and scattered necrotic hepatocytes.,Alcoholic fatty liver,or steatosis,is usually an asymptomatic and reversible liver condition associated with mild to moderate alcohol use in which lipid accumulates within hepatocytes.Histologic features of alcoholic hepatitis include a neutrophilic inltrate,hepatocyte edema and necrosis,and the presence of Mallory bodies,which are cellular accumulations of cytokeratin intermediate laments.,Alcoholic fatty liver,or steatosis,is usually an asymptomatic and reversible liver condition associated with mild to moderate alcohol use in which lipid accumulates within hepatocytes.Severe steatosis may lead to hepatomegaly and mildly elevated serum bilirubin and alkaline phosphatase levels.Grossly,a fatty liver appears yel-low and greasy compared to the normal red-brown appearance of liver tissues.Chronic alcohol abuse,particularly heavy binge drinking,may lead to alcoholic hepatitis,an in ammatory condition of the liver characterized by abdominal dis-comfort,malaise,hepatomegaly,and abnormal liver tests.Severe cases may result in fulminant hepatic failure.Histologic features of alcoholic hepatitis include a neutrophilic in ltrate,hepatocyte edema and necrosis,and the presence of Mallory bodies,which are cellular accumulations of cytokeratin intermediate laments.Some patients will progress to alcoholic cirrhosis characterized by regenerating nodules of hepatocytes with intervening brous septae.This image shows portal brosis,in ltration by neutrophils,fatty change,and Mallory bodies.,Gallstones,are a condition in which stones are formed in the gallbladder or in the bile ducts.There are two major types of gallstones:cholesterol stones and pigment stones.The size of gallstones can range from that of a grain of sand to a golf ball.Cholesterol stones are pale yellow,radiolucent,and large(13 cm),whereas pigment stones are black,radiopaque,and smaller(1 cm).This gross photograph shows a fresh cholecystectomy specimen containing multiple cholesterol stones.,Gallstones are a condition in which stones are formed in the gallbladder or in the bile ducts.There are two major types of gallstones:cholesterol stones and pigment stones.Cholesterol stones are far more common than pigment stones in Western countries and the United States.Risk factors for gallstones include female gender,obesity,oral contraceptives,and being of Northern European,Mexican American,or Native American descent.Most patients are asymptomatic until stones obstruct the cystic or common bile ducts,causing severe pain,called biliary colic,because of smooth muscle contraction of the duct against the stone.The pain is colicky(wavelike)because of the intermittent nature of the contrac-tion.Gallstones can cause acute or chronic cholecystitis,and blockage of the hepatopancreatic ampulla(ampulla of Vater)may lead to acute pancreatitis.The size of gallstones can range from that of a grain of sand to a golf ball.Cholesterol stones are pale yellow,radiolucent,and large(13 cm),whereas pigment stones are black,radiopaque,and smaller(1 cm).Open surgical or laparoscopic removal of the gall-bladder is the most common treatment for gallstones.This gross photograph shows a fresh cholecystectomy specimen containing multiple cholesterol stones.,