general anatomy of gastro-intestinal system the teeth ...anat.lf1.cuni.cz/souhrny/aofa9.pdf ·...
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General Anatomy
of Gastro-IntesTinal
System The teeth, Oral cavity,
Tongue, Salivary glands,
Pharynx. Their vessels and innervation
Ivo Klepáček IK
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Primordium of the alimentary
canal (GastroInTestinal Canal) GIT devel– systema gastropulmonale –
it develops from the embryonal intestine (entoderm) ; lower respiratory structurses are splitted from intewstine as a tracheobronchial pouch
Ventral (head) intestine part is added to ectodermal pouch
called stomodeum, caudal part of the intestine is added to
ectodermal pouch called proctodeum
Division of the alimentary tract:
1) oral ectodermal segment 2) main entodermal segment 3) caudal ectodermal segment
děivision of the main segment:
ventral gut (foregut – to biliary duct opening) middle gut (midgut – to 2/3 colon) dorsal gut (hindgut – to upper part of the anal canal IK
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Digestive System: Oral cavity (ectodermal origin)
The gut and ist derivatives
(entodermal origin) is
devided in four sections:
1. Pharyngeal gut or pharynx
2. Foregut - esophagus,
stomach, ¼ of duodenum,
liver and gallblader,
pancreas
3. Midgut – ¾ of duodenum,
jejujnum, ilium, colon
caecum, colon ascendens
and 2/3 of colon transversum
4. Hindgut – 1/3 of colon
transversum, colon
descendens, colon
sigmoideum, colon rectum,
canalis analis IK
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Alimentary tube
(canal) - general
structure
– tunica mucosa (mucous membrane 1
• epithelium
• lamina propria mucosae (lymph tissue)
• lamina muscularis mucosae
– tunica submucosa (submucous
layer) – vessels, erves (plexus submucosus Meissneri)
– tunica muscularis externa 7
(outer muscular layer) – longitudinal, circular even plexiform; vessels, nerves (plexus myentericus Auerbachi)
– tunica serosa (serous layer) or
tunica adventitia (fibrous layer)
14
salivary glands (glandulae salivares)
pancreas
liver (hepar)
gall bladder and bile ducts (vesica
fellea, ductus choledochus) IK
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Development of the facial skeleton,
formation of the nasal and oral
cavities Primitive lips:
week 6 - ectoderm ingrowth to mesenchyme in developing
jaw – formation of the labiogingival lamina
lamina splits into two layers separated by groove
central part of upper lip (known as a philtrum develops
from the intermaxillary segment
Primitive oral cavity - stomodeum depression lined by ectoderm and oropharyngeal
membrane
margines:
lower processes from the 1. pharyngeal arch -
mandible
laterally of them upper processes of the 1.
pharyngeal arch - maxilla
superiorly frontonasal process where nasal
placodes appear(pits, sacs and later are
opened to primitive nasal cavity), medial and
lateral nasal processes. IK
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Frontonasal
maxillary
et
mandibular
processes
Face formation
48 day
35 day
14 week
28 day
Philtrum,
nasolacrim
al groove,
cheeks,
maxillae,
nose IK
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The border between the lips and the surrounding skin is
referred to as the vermilion
Labium + mentum
Lip
Chin IK
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Lp – lamina
propria
mucosae
Sm –
submucosa
Gl –
glandulae
labiales
Gl
Keratinizing epithelial layer continues dorsally as a multilayered cuboid non-keratizing
epithelial layer; Lamina propria mucosae continues as a submucous layer
containing numerous small salivary or mucous glands (compare with soft palate) IK
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c - frenulum
linguae sup.
b,a - plicae
bucco-
alveolares
(buccales) IK
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Palatum durum
Palatum molle
Hard palate
Soft palate
Premaxilla
Maxilla
Os palatinum
Papilla,
rugae (folds)
pits (foveolae)
Lines (crests) IK
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Palate – surface features
Lacey
Incisive papilla
Palatine rugae
Median raphe IK
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Palatal relief with rugae, foveolae and incisal papila IK
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Palate – surface features
Lacey
Hard palate
Soft palate
Median raphe
Fatty zone
Openings of
palatine glands A
H
Hauptmayer line - hard and soft palate connection IK
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Dilates tube Opens tubal orifice
after Petrovicky 2002 IK
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Soft palate
– dorsal view
– ventral view IK
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Chrápání Snoring IK
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Mobile musculoepithelial organ;
Located in the oral cavity and pharynx
Mastication,
Deglutition,
Speech
Squeezing food into pharynx during
swallowing;
Forming words during speaking
Lingua,
tongue,
glossa IK
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Papillae
filiformes
fungiformes
vallatae
Foliatae
Week 6 - 7 IK
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Palatoglossal arch
Palatopharyngeal arch
Triangular fold (plica) (there is r. tonsillaris) IK
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bitter
salty
sour
sweet IK
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Innervation IK
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Floor of the oral cavity lingual frenulum,
sublingual folds,
carunculae
Paralingual
canal =
between
hyoglossus
and
genioglossus IK
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f – plica fimbriata
e – frenulum linguae
g – vena lingualis
profunda
b – caruncula
sublingualis
a – openings of the
sublingual duct on
plica sublingualis
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Styloglossus
Palatoglossus
Hyoglossus
Genioglossus
Extrinsic
lingual
muscles
alter the
position of
the tongue IK
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Intrinsic lingual muscles
alter lingual shape
Superior and inferior longitudinal,
transverse, vertical muscles IK
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Musculi genioglossi are separated by the
lingual septum
Between hyoglossus and genioglossus muscles there is
lingual canal
Lingual septum can be
defibered;
after this abscess cavity
appears IK
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Abscess inside
septum IK
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Salivary glands • Serous cells
• pyramidal, acinous,
• Secerned proteins
• bazofilic, ER, GA
• Apically have
microvili, secretory
granula
• Mucinous cells
• Cuboidal, cylindric,
form tubules
• Secerned mucus
pale granula (fused)
• Viscous secret
distally located inside
ducts IK
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Salivary glands
• Cells of intercalate
ducts
• One-layered
epithelium (flat)
• Lactoferin,, lysozymes
• Intralobular ducts
• Cells of striateed
ducts
• Radially organised,
waved, transport ionts
and participate in
formation of
hypotonic saliva IK
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Salivary glands IK
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after Schumacher 2002 IK
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Glandula parotidea
Sublingualis
Sublingualis anterior
Submandibularis
1:1
3:2 1:3
Relation between serous
and mucous parts IK
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Mucous and serous small
glands
Ebner gl.
serous Weber gl.
mucinous
Anterior
Lingual gl. IK
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Glandula parotis Superficial part
Deep part (processus pharyngeus
Serous tissue
Ductus parotideus (of Stensen) IK
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Glandula
submandibularis
mucoserous tissue
Ductus submandibularis
(of Wharton) IK
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Glandula
sublingualis
Seromucinous tissue
Ductus sublingualis major et
minores (of Santorini) IK
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Pharynx general
arrangement
Nasopharynx (epi-)
Oropharynx (meso-)
Laryngopharynx (hypo-) IK
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Piriform
recess
Pharyngeal recess IK
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* m. stylopharyngeus
** Nervus et vasa laryngea
superiora CN X
Piriform recess
Recessus piriformis
(piriform recess, pouch)
is bordered by aryepiglottic fold
and pharyngoepiglottic fold
Nervus can be irritated through difficult
swallowing or tumor growth IK
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Superior constrictor SC
1 Pars pterygopharyngea
2 Pars buccopharyngea
3 Pars mylopharyngea
4 Pars glossopharyngea
Medius constrictor MC
5 Pars chondropharyngea
6 Pars ceratopharyngea
7 Pars desmopharyngea
Inferior constrictor IC
8 Pars thyropharyngea
9 Pars cricopharyngea
1 2 3
4 5
6
7
8
9
SC: raphe – mandible and hamulus
MC: raphe – hyoid bone and stylohyoid lig.
IC: raphe – cricoid and thyroid cartilages and cricothyroid lig. IK
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Eustachian tube
(auditive tube, salpinx)
relates to
tensor veli palatini (torus
tubarius)
levator veli palatini (torus
levatorius)
and salpingopharyngeus
(from palatopharyngeus)
muscles IK
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Esophageal
(Zenker´s)
diverticle IK
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Spatia around pharynx
lamina prevertebralis fasciae cervicalis + septum styloideum
spatium previscerale
spatium retropharyngeum
spatium parapharyngeum 1. sp. prestyloideum 2. sp. retrostyloideum
spatium paraviscerale IK
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Anulus lymphoideus pharyngis /Waldeyeri/
First barrier protecting body against antigens
in food
Tonsilla pharyngea /1/
Tonsilla tubaria /Gerlachi/ /2/
Tonsilla palatina /2/
Tonsilla lingualis /1/ IK
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Tonsillar lymph circle of Waldeyer
Heinrich Wilhelm
Gottfried
Waldeyer
1836-1921 IK
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Tonsilary system
Tonsills + lymph nodes
IK
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Incomplete capsule
Only efferent lymph vessels
Modified epithelium in
crypts (lymphoepithel or
FAE follicle-associated
epithelium)
Intraepithelial vascularization
Free, T, B lymphocytes,
active immunocompetitive
cells, macrophages,
Langerhans cells, fibrous
stroma
IK
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tonsillectomy IK
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Pharynx
IK
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END IK