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Gastroenterology 1 usmle rx bricks
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Anatomy and Histologyof the Gastrointestinal
Tract
Last Updated: May 26, 2021
access_time23 min
Learning Objectives (3)
After completing this brick, you will be able to:
● Describe the mesenteries, ligaments, and omental layers of the
peritoneum.
● Distinguish regions of the digestive tract as retroperitoneal or with
mesentery.
● Identify and describe the anatomy, primary functions, and histology of
the esophagus, stomach, duodenum, jejunum, ileum, and large
intestines.
CASE CONNECTION
TY is a 52-year-old woman seeing you in follow-up for the evaluation
of fatigue. “I know everybody says they’re tired these days, but I
really am. Normally, I am a go-getter but now, I’m always looking to
sit down or take a nap,” she tells you. You order some screening
bloodwork, and these results, along with TY’s old records, are
available to you on her follow-up visit: her WBC count is normal,
hemoglobin low, and mean corpuscular volume high. Five years ago,
she had weight loss surgery, a sleeve gastrectomy, in which 70%-80%
of the greater curvature of the stomach was removed.
,How will you explain the cause of TY’s anemia? What treatment will
you recommend? Consider your answers as you read, and we’ll revisit
at the end of the brick.
What Are the Anatomy and Histology
of the Gastrointestinal Tract?
There’s certainly a lot to cover, and that is exactly where we will start;
the abdominal cavity has a sort of “covering” of its own, involving
most all of the organs within the gastrointestinal (GI) tract. After
exploring this covering in detail, we’ll progress systematically, organ
by organ down along the GI tract, stopping at each structure to discuss
its function and histology. Figure 1 provides an overview of GI tract
anatomy.
,What Is the Peritoneum?
The covering mentioned above is known as the peritoneum, and in
addition to the stability and support it provides to the GI tract, it also
allows us to classify organs anatomically. For example, organs
completely within in the peritoneum, such as the stomach, are referred
to as intraperitoneal, whereas organs within the abdominal cavity that
are not involved in the peritoneum are called retroperitoneal, such as
the kidneys.
The peritoneum has two layers, visceral and parietal, and the space
between the two layers is known as the peritoneal cavity. The
peritoneal cavity is a potential space that is normally filled with
, serous fluid, which can be thought of as a bit of lubrication for the
abdominal organs, to prevent friction as they move.
Parietal Peritoneum
The parietal peritoneum lines the abdominal wall. The most
superficial aspect is composed of connective tissue, and it adheres
tightly to the deepest layer of abdominal muscle fascia.
Visceral Peritoneum
Visceral peritoneum is a thin membrane that lines the surfaces of
abdominal organs. However, the visceral peritoneum also takes on
different forms to aid the normal function of the abdominal cavity.
Think about it as the abdominal cavity’s support system.
The different forms of visceral peritoneum are mesenteries, omenta,
and ligaments. These structures are collectively known as peritoneal
reflections.
Mesenteries. A mesentery is a double layer of visceral peritoneum
that envelopes an organ and connects it to the posterior abdominal
wall. Mesenteries provide a highly absorptive surface, have important
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