Mucosa surface

Forms of local anesthesia. Local anesthetics are applied via different routes, including infiltration of the tissue (infiltration anesthesia] or injection next to the nerve branch carrying fibers from the region to be anesthetized (conduction anesthesia of the nerve, spinal anesthesia of segmental dorsal roots), or by application to the surface of the skin or mucosa (surface anesthesia]. In each case, the local anesthetic drug is required to diffuse to the nerves concerned from a depot placed in the tissue or on the skin. 

The pathways of drug absorption are transcellular and paracellular. Moreover, absorption can be due to the vesicular- or receptor-mediated transport or it can occur through the aqueous pores on the mucosa surface. 

In vivo drug absorption is influenced not only by the hydrophilic/lipophilic properties, charge, and volume, but also by the metabolic stability of the drug. Resorption from the mucosa of the intestine is favored compared with the resorption from the stomach. The reason for this is the unique construction of the luminal cell membrane, which results in an enlarged mucosa surface of the intestine. 

In TL 102 M, the drug exists on the mucosa surface and the distribution spread to CT and ML. The distribution pattern of the solution does not change from the 10-min sample. However, the drug on the mucosa has already disappeared. 

The use of a bioadhesive, polymeric dosage form for sustained dehvery raises questions about swallowing or aspirating the device. The surface area is small, and patient comfort should be addressed by designing a small (less than 2 cm ), thin (less than 0.1 mm (4 mil) thick) device that conforms to the mucosal surface. The buccal route may prove useful for peptide or protein dehvery because of the absence of protease activity in the sahva. However, the epithelium is relatively tight, based on its electrophysiological properties. An average conductance in the dog is 1 mS/cm (57) as compared to conductances of about 27 and 10 mS/cm in the small intestine and nasal mucosa, respectively (58,59) these may be classified as leaky epitheha. 

It has the ability to cross the placenta and therefore provides a major line of defence against infection for the newborn. This can be reinforced by transfer ofcolostral IgG across the gut mucosa of the neonate. It diffuses readily into the extravascular spaces where it can act in the neutralization of bacterial toxins and can bind to microorganisms enhancing the process of phagocytosis (opsonization). This is due to the presence on the phagocytic cell surface of a receptor for Fc. 

The mucosa of the GIT represents an interface between the external and internal environments. The expansive surface area is necessary for the efficient hydrolysis of foodstuffs and the absorption of energy and nutrients. The mucosa also influences the systemic availability of non-nutrient compounds in the diet, both beneficial and detrimental. Digestion and absorption of glucosinolates are critical determinants of health benefits (see Chapter 4) Similarly, the bioavailability and health benefits of phytoestrogens, such as genistein (see Chapters 5 and 10) are at least partly dependent on the carrier-mediated processes of absorption associated with the GIT (Oitate et al, 2001). Moreover, the metabolic activities of the mucosa can influence the systemic concentrations and forms of dietary phytochemicals, as exemplified by research with soy isoflavones (Andlauer et al., 2000). 

Petechiae are very small (usually less than 3 mm) pinpoint flat red spots beneath the skin surface caused by microhem-orrhaging. They occur in 20% to 40% of chronic IE, often found on the buccal mucosa, conjunctivae (Fig. 71-3A) and extremities1 (Fig. 71-3B). 

Diffuse erythema on the surface of buccal mucosa, throat, tongue, and gums... 

Four major tissue layers, from the lumen outward, form the large intestine the mucosa, submucosa, muscularis externa, and serosa (Fig. 88-2). Complete replacement of surface epithelial cells occurs approximately weekly, with the total number of epithelial cells remaining constant in normal colonic tissue. As patients age, abnormal cells accumulate on the surface epithelium and protrude into the stream of fecal matter their contact with fecal mutagens can lead to further cell mutations and eventual adenoma formation.4... 

Structurally, the large intestine is similar to the small intestine, although the luminal surface epithelium of the former lacks villi. The muscularis mucosa, as in the small intestine, consists of inner circular and outer longitudinal layers. Figure 6 illustrates a photomicrograph and diagrammatic sketches of this region. 

Mucosa. The innermost layer of the wall is the mucosa, which consists of a mucous membrane, the lamina propria, and the muscularis mucosa. The mucous membrane provides important protective and absorptive functions for the digestive tract. The nature of the epithelial cells lining the tract varies from one region to the next. Rapidly dividing stem cells continually produce new cells to replace worn out epithelial cells. The average life span of these epithelial cells is only a few days. The lamina propria is a thin middle layer of connective tissue. This region contains the capillaries and small lymphatic vessels that take up the digested nutrient molecules. The muscularis mucosa is a thin layer of smooth muscle. Contraction of this muscle may alter the effective surface area for absorption in the lumen. 

Mucus is produced by the mucus neck cells and by the surface epithelial cells of the stomach wall. A thick layer of mucus adheres to the wall of the stomach, forming the gastric mucosal barrier. The function of this barrier is to protect the gastric mucosa from injury — specifically, from the corrosive actions of HCl and pepsin. Together with bicarbonate ion released into the lumen of the stomach, mucus neutralizes the acid and maintains the mucosal surface at a nearly neutral pH. 

The plicae circulares, or circular folds, form internal rings around the circumference of the small intestine that are found along the length of the small intestine. They are formed from inward foldings of the mucosal and submucosal layers of the intestinal wall. The plicae circulares are particularly well developed in the duodenum and jejunum and increase the absorptive surface area of the mucosa about threefold. Each plica is covered with millions of smaller projections of mucosa referred to as villi. Two types of epithelial cells cover the villi ... 

Microvilli are microscopic projections found on the luminal surface of the absorptive cells. Each absorptive cell may have literally thousands of microvilli forming the brush border. These structures increase the surface area for absorption another 20-fold. Together, these three anatomical adaptations of the intestinal mucosa — plicae circulares, villi, and microvilli — increase the surface area as much as 600-fold, which has a profound positive effect on the absorptive process. 

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