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Samenvatting "Histologie" - Abdomen 1 partim spijsverteringsorganen
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  • Course
  • Abdomen 1 partim spijsverteringsorganen
  • Institution
  • Universiteit Antwerpen (UA)

Samenvatting van de hoorcolleges over "Histologie" gegeven door prof. Driessen A. Onderdeel van het vak 'Abdomen 1 partim spijsverteringsorganen' gegeven in de 2e Bachelor Geneeskunde aan de UA. Samenvatting gebaseerd op slides, lesnotities én cursus.

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Document information

  • September 4, 2024
  • 57
  • 2023/2024
  • Summary

Subjects

  • sinusoïden
  • kupffer cellen
  • stellaire cellen
  • lobulus van hiernan
  • acinus van rappaport
  • pancreatitis
  • portavelden
  • centrilobulair
  • periportaal

Written for

  • Universiteit Antwerpen (UA)
  • Geneeskunde
  • Abdomen 1 partim spijsverteringsorganen
All documents for this subject (15)

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Inhoudsopgave
Histologie van lever....................................................................................................................................... 3
Anatomie.................................................................................................................................................... 3
4 lobben................................................................................................................................................3
8 segmenten (volgens Couinaud)........................................................................................................ 3
Histologie................................................................................................................................................... 4
Lobulus van Kiernan.............................................................................................................................4
Acinus van Rappaport.......................................................................................................................... 4
Portale lobulus......................................................................................................................................5
Architectuur van de lever........................................................................................................................... 6
Portaveld.............................................................................................................................................. 6
Leverparenchym...................................................................................................................................6
Lymfeafvoer..........................................................................................................................................7
Sinusoïden................................................................................................................................................. 8
Sinusoïdale endotheelcellen................................................................................................................ 8
Kupffer cellen (1876)............................................................................................................................ 8
Stellaire cellen (1876)...........................................................................................................................9
Intrasinusoïdale lymfocyten................................................................................................................10
Extracellulaire matrix................................................................................................................................ 10
Leverpathologie.................................................................................................................................. 11
Leverpathologie........................................................................................................................................12
Alcohol................................................................................................................................................13
Levercirrose........................................................................................................................................15
Complicaties.......................................................................................................................................16

Histologie van galblaas............................................................................................................................... 17
Gal............................................................................................................................................................17
Galwegsysteem........................................................................................................................................17
Galcanaliculus.................................................................................................................................... 18
Kanaal van Hering = galductulus....................................................................................................... 18
Galductus........................................................................................................................................... 19
Galblaas............................................................................................................................................. 19
Extrahepatisch systeem..................................................................................................................... 20

Histologie van de gastro-intestinale tractus............................................................................................. 22
Mondholte................................................................................................................................................ 22
Lippen.................................................................................................................................................22
Tanden................................................................................................................................................22
Gingiva = tandvlees............................................................................................................................23
Tong....................................................................................................................................................24
Mond.................................................................................................................................................. 25
Pharynx.............................................................................................................................................. 25
Gastro-intestinale tractus......................................................................................................................... 26
Mucosa...............................................................................................................................................26
Submucosa........................................................................................................................................ 26
Muscularis propria.............................................................................................................................. 27
1

, Serosa/adventitia................................................................................................................................27
Bezenuwing........................................................................................................................................27
Onderdelen.........................................................................................................................................28
Slokdarm.................................................................................................................................................. 28
Mucosa...............................................................................................................................................29
Submucosa........................................................................................................................................ 29
Muscularis propria.............................................................................................................................. 29
(Dys)functie........................................................................................................................................ 30
Maag........................................................................................................................................................ 31
Mucosa...............................................................................................................................................32
Celtypes............................................................................................................................................. 34
Bescherming tegen maagzuur........................................................................................................... 35
Gastritis.............................................................................................................................................. 36
Dunne darm............................................................................................................................................. 37
Mucosa...............................................................................................................................................38
Submucosa........................................................................................................................................ 41
3 delen van de dunne darm................................................................................................................42
Coeliakie.............................................................................................................................................43
Dikke darm............................................................................................................................................... 43
Mucosa...............................................................................................................................................44
Appendix............................................................................................................................................ 45
Rectum............................................................................................................................................... 46
Acute zelf-limiterende colitis = infectieuze colitis............................................................................... 46
Examenvragen......................................................................................................................................... 47

Histologie van de spijsverteringsklieren................................................................................................... 48
Spijsverteringsklieren............................................................................................................................... 48
Speekselklieren........................................................................................................................................48
Tubuloalveolaire klieren..................................................................................................................... 48
Acini....................................................................................................................................................49
Afvoergangen..................................................................................................................................... 50
Speeksel.............................................................................................................................................52
Pancreas.................................................................................................................................................. 53
Afvoersysteem....................................................................................................................................53
Sereuze exocriene klier......................................................................................................................54
Endocriene klier..................................................................................................................................54
Dubbele bloedvoorziening..................................................................................................................55
Pathologie: acute pancreatitis............................................................................................................ 56
Pathologie: chronische pancreatitis....................................................................................................57




2

,Histologie van lever
Anatomie
● grootste klier van het lichaam
● grootste parenchymateus abdominaal orgaan: 1200-1500 g
● locatie: van rechter fossa hypochondriaca tot fossa epigastrica
● vrijwel volledig omgeven door peritoneum

vorm
● pyramide: basis thv rechter flank, top thv linker flank
● beweegt met de ademhaling en houding

oppervlakken
● diafragmatisch oppervlak: in de koepel van het diafragma
● visceraal oppervlak
○ in contact met diverse organen: maag, dunne darm, galblaas …
○ porta hepatis (hilus): bloedvaten gaan lever binnen en galwegen treden naar buiten


4 lobben
→ scheidt de bloedvoorziening en galafvoer

rechter lob (grootste): gescheiden van linker lob door …
● ventraal: ligamentum falciforme
● interior/posterior: ligamentum teres en ligamentum venosum

linker lob: bevat 2 lobus
● lobus caudatus: tegen vena porta
● lobus quadratus: tegen galblaas




8 segmenten (volgens Couinaud)
● verdeeld op basis van bloedtoevoer
● segment 2-8: anterior
● segment 1 = lobus caudatus

⇒ voordeel: kleinere resercties (segmentectomies)




3

, Histologie
classificatie op basis van de morfologische of functionele architectuur
● morfologie
○ lobulus van Kiernan (1)
● functie
○ acinus van Rappaport (3)
○ portale lobulus (2)




Lobulus van Kiernan
6-hoekige structuur
● centraal: terminale hepatische venule = vena centrilobularis
● hoeken: portale tractus = portavelden

vaatmarker (CD34)(rechts): vena centrilobularis beter in beeld brengen
→ zowel portavelden als vena centrilobularis kleuren bruin aan

praktijk
● biopt: de lobulus is een grote structuur die enkel kan gezien worden bij
biopten in een resectiestuk van 2 op 1 cm
● leverpunctiecilinder: cilinder van 2 cm lang met 2 mm diameter, waardoor
de lobulus niet zichtbaar is




Acinus van Rappaport
functionele eenheid op basis van dubbele bloedvoorziening
● a. hepatica (25%)
● v. portae (75%)

⇒ belangrijke structurele eenheid ter beoordeling van het leverbiopt

portaveld (v. portae + a. hepatica) → sinusoïde → v. centrolobularis → hepatische venen → v. cava inferior




4

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