(lower panel). The anus has anal valves and an absence of the muscularis
mucosa. The esophageal-cardiac junction also represents a junction
between stratified squamous and simple columnar epithelium, but the car-
diac portion of the stomach forms the mucus-secreting cardiac glands with
nogoblet cells (answer b). The junction of the stomach (pylorus) and duo-
denum represents the juncture of two simple columnar epithelia, the
pylorus containing the short (compared with fundus) pyloric glands and the
duodenum with crypts and villi as well as the submucosal Brunner’s glands
(answer d). Skin is keratinized (answer c).The cervical mucosa contains
extensive cervical glands, and the vaginal epithelium is keratinized. In
vagina and cervix, the GI tract pattern [epithelium, connective tissue (CT),
muscle, CT, muscle, CT] is notpresent (answer e).
213.The answer is b.(Young, p 261. Junqueira, pp 290–295, 298–300.)
The patient in the scenario is suffering from celiac disease, an allergic
response to gliadin. The result is villous atrophy and crypt and Brunner
gland (the structures labeled with the asterisks in the photomicrograph)
hyperplasia. The presence of the mucus and bicarbonate (HCO 3 −) secreting
Brunner’s glands in the submucosal layer of the small intestine is an identi-
fying feature of the duodenum. The Brunner’s gland secretions function to
neutralize the acidic pH of the stomach and establish the appropriate pH
for function of the enzymes in the pancreatic juice. Parietal cells are unique
to the stomach and synthesize acid (answer a) and intrinsic factor
(required for vitamin B 12 absorption from the small intestine). Chief cells in
the fundic glands produce pepsinogen (answer c)that is activated by acid
to form pepsin. Paneth cells in the base of the crypts make lysozyme
(answer d)and modulate the flora of the small intestine. Enterokinase
(answer e)is made by the duodenal mucosa and is instrumental in the con-
version of pancreatic zymogens to their active form (e.g., trypsinogen to
trypsin).
214.The answer is a.(Young, p 282. Junqueira, p 337.Moore and Dalley,
pp 232–235.)The photomicrograph illustrates the structure of the gallblad-
der that stores and concentrates the bile. Gallbladder inflammation can
lead to pain referred to the top of the right shoulder. Diaphragmatic prob-
lems may be felt in the neck (answer b), stomach problems may refer to
the spine between the scapulae (answer c), kidney pain may be felt in the
334 Anatomy, Histology, and Cell Biology