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CRC: ANATOMY OF THE GASTROINTESTINAL TRACT Slides last updated: March 2015 The wall of the GI tract is composed of four layers1 GI tract wall 1. Mucosa 2. Submucosa Lumen 3. Muscularis 4. Serosa 1. Tortora GJ, et al. Principles of Anatomy and Physiology. 11th Ed. Hoboken: John Wiley & Sons;2006:895-946. The wall of the GI tract is composed of four layers1 1. Mucosa • Mucous membrane that lines the lumen of the GI tract • Further divided into the epithelium, lamina propria and muscularis mucosa 2. Submucosa • Areolar connective tissue that binds the mucosa to the muscularis • Contains blood and lymphatic vessels that receive the absorbed nutrients • Also contains glands, lymphatic tissue and an extensive network of neurons 1. Tortora GJ, et al. Principles of Anatomy and Physiology. 11th Ed. Hoboken: John Wiley & Sons;2006:895-946. The wall of the GI tract is composed of four layers1 3. Muscularis • Contains either skeletal muscle for voluntary control of movement, or smooth muscle organised in two sheets of perpendicular fibres to generate involuntary contractions 4. Serosa • Superficial layer of the GI tracts segments that are suspended in the abdominopelvic cavity • Also called the visceral peritoneum • Composed of areolar connective tissue and simple squamous epithelium 1. Tortora GJ, et al. Principles of Anatomy and Physiology. 11th Ed. Hoboken: John Wiley & Sons;2006:895-946. Stage is determined by how far the cancer has spread1 Cancer progression Stage 0 Cancer is in the mucosa only Stage IA-B Stage IIA-C Stage IIIA-C Stage IVA-B Cancer has grown through the muscularis mucosa or submucosa Cancer has grown through the muscularis propria, serosa, or through the colon or rectum wall Cancer has grown through at least the muscularis mucosa, and has been found in nearby lymph nodes Cancer has grown through at least the muscularis mucosa and has spread to distant organs (metastasised) 1. American Cancer Society. Colorectal Cancer Detailed Guide, 2014. Available online from http://www.cancer.org/acs/groups/cid/documents/webcontent/003096-pdf.pdf, last accessed on 17/03/2015.