Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BDS2 HHD - Human Disease > 16. Gastroenterology I: Dysphagia, oesophagus & peptic ulceration > Flashcards

16. Gastroenterology I: Dysphagia, oesophagus & peptic ulceration Flashcards

(39 cards)

Start Studying
1
Q

symptoms of gastrointestinal disease

A
  • abdominal pain
  • dysphagia
  • heartburn
  • dyspepsia
  • flatulence
  • vomiting
  • constipation
  • diarrhoea
  • steatorrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is dysphagia?

A
  • difficulty is swallowing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is heartburn?

A
  • retrosternal discomfort, spreads up towards throat
  • common system of heartburn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is dyspepsia?

A
  • discomfort in upper GI tract
  • used to describe range of symptoms EG.
    ~ nausea
    ~ heartburn
    ~ acidity
  • patients usu call it indigestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is steatorrhoea?

A
  • passage of pale bulky stools that contain fat
  • often indicative of pancratic + billiary disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

upper digestive tract passage

A
  • lips
  • oral cavity
  • oropharynx
  • pharynx
  • oesophagus
  • stomach
  • first part of duodenum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

OESOPHAGUS

  1. what is the oesophagus?
  2. what do it’s symptoms include?
A

1
- Musculotendinous tube connecting
pharynx to the stomach

2
– Dysphagia
– Pain
– Cough or vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

OESOPHAGUS

important diseases to consider?

A

– Pharyngeal pouch
– Achalasia (difficulty swallowing)
– Oesophageal spasm
– Oesophageal web
– Peptic ulcer disease/reflux
– Carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ANATOMY OF OESOPHAGUS

  1. what is it/ what does it connect?
  2. what does it pass through?
  3. where does it lie?
A

1
- 25cm musculotendinous tube connecting
pharynx to the stomach

2
- passes through the chest via the mediastinum

3
- lies posterior to the trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ANATOMY OF OESOPHAGUS

what constrictor muscles does the pharynx overlap

A
  • pharynx has 3 overlapping constrictor muscles to consider
    1. superior
    2. middle
    3. inferior

(each inside each other)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ANATOMY OF OESOPHAGUS?

  • potential weakness?
A
  • killian’s dehiscence = meeting point of 2 parts of inferior constrictor
    1. thyropharyngeus
    2. cricopharyngeus
  • this is a point where the weakness can be exploited and outpouching can be created = zenekers diverticulum
  • zenekers diverticulum passes through killian’s dehiscence
  • during swallowing thyropharyngeus is populsive and cricopharyngeus is sphincteric
  • if cricopharyngeus fails to relax, a posterior mucosal herniation may take place via Killian’s dehiscence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ANATOMY OF OESOPHAGUS?

  1. outer muscle
  2. inner muscle
  3. upper and lower oesophagus muscle type (striated, non-striated)
  4. motor and sensory nerves?
  5. where do the nerves lie?
A

1
outer longitudinal muscle coat

2
inner circular muscle coat

3
- upper 2/3 oesophagus = striated muscle
- lower 2/3 oesophagus = non striated muscle
- middle 1/3 = mixed

4
come from X (vagus) —> oesophageal plexus

5
- nerve plexi lie between outer longitudinal and inner circular muscle planes & also submucosally

6
- lining mucosal = stratified squamous non keratinising epithelium
BUT
- lower part CAN be lined by ectopic gastric (columnar) muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PHYSIOLOGY OF THE OESOPHAGUS

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

symptoms of oesophageal disorders?

(what they are, what may be the result?

A
  1. DYSPHAGIA
    - sensation of difficulty in swallowing
    - true dysphagia should cause weight loss if persistent
  2. PAIN
    - may result from acid reflux or spasm
    - cardiac pain may be impossible to distinguish clinically (ECG & cardiac enzymes)
  3. COUGH OR VOMIT
    - if food or liquids do not pass normally to the stomach they may reflux back to the pharynx
    - overflow into the lungs may present as a cough
  4. BLEEDING - haematemesis
    = NB anti emetic for stopping nausea/ vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

possible causes of dysphagia

A
  • intrinsic lesion
  • neuromuscular disorders
  • motility disorders
  • extrinsic pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Main diseases to consider?

Study These Flashcards
A
  1. pharyngeal pouch
  2. achalasia
  3. oesophageal spasm
  4. oesophageal web
  5. peptic ulcer disease reflux
  6. carcinoma
17
Q

PHARYNGEAL POUCH
1. what is pharyngeal pouch?
2. possible symptoms?

Study These Flashcards
A
  • herniation of mucosa through weakness in pharyngeal constrictor muscles (killian’s dehiscence passing through zenker’s diverticulum)
  • undigested food can get stuck in this pouch

-

18
Q

what is oesophagitis?

Study These Flashcards
A
  • inflammation of oesophagus
  • many causes - most common = refluxed acid coming up
19
Q

candida oesophagitis

Study These Flashcards
A
  • oesophagitis can also be infective
  • infected by candida (can also be infected by diff bacteria)

why may a person be infected??
Must consider why –
Immunocompromised –
transplant, chemotherapy HIV infection etc

20
Q

ACHALASIA (of the cardia)

what is it?

treatment?

Study These Flashcards
A
  • ## if you can’t relax the sphincter, food tends to get stuck
21
Q

how can the oesophagus dilate

22
Q

oesophageal dialtion methods

23
Q

OESOPHAGEAL SPASM

what?
causes?

24
Q

what is corkscrew oesophagus?

how to manage?

  1. how is it diagnosed?
Study These Flashcards
A
  • Oesophageal spasm often leads to this odd shape
  • Pain can resemble reflux and heartburn
  • Manage with muscle relaxants

3
- by radiographical appearance
~ eg. barium swallow looks like a corkscrew
- oesophageal manometry

25
OESOPHAGEAL WEB (paterson-kelly syndrome) 1. most common in M or F 2. consists of? 3. what happens 4. treatment
- although rare it is important as it is premalignant - Koilonychia = spoon shaped fingernail deformity = bowl shaped 3 - mucosa becomes atrophic - fibrous structure forms at the upper end of the oesophagus - structure described as form 'web' on barium swallow 4 - dilation of structure + correction of iron deficiency
26
post cricoid web
27
Reflection 1
* Review Upper GI presentation symptoms * Review anatomy of upper GI tract – relate to BDS1 anatomy * Be aware that first part of the duodenum is the regurgitation limit –(bile can be vomited) – ie defines the limits of haemoptysis * Reflect upon the conditions that adversely affect the oesophagus
28
PEPTIC ULCER DISEASE (REFLUX) 1. what is it and what may it cause? 2. common aetiology? 3. what may cause removal of mucous protection coat 4. incidence, age, gender, geography, promoter factors
-
29
Peptic Ulcer Disease & Oesophageal Reflux (make q)
* Acid reflux into the oesophagus can cause pain, ulceration and spasm * Peptic ulcers (oesophagus, stomach or duodenum) – Commonly due to mucosal inflammation caused by acid and pepsin, with Helicobacter pylori infection and stress * Dental relevance: - avoid NSAIDs…. - Steroid complications?
30
acute vs chronic ulcer diff
ACUTE - relatively small - perhaps penetrated muscularis mucosae - but submucosa and muscular wall of gut (peritoneum = intact) CHRONIC - larger - further through it has penetrated = weaker wall becomes - increases risk of rupturing and periotonitis
31
UPPER GI BLEEDING ULCER 1. sites 2. microscopic sites 3. signs + symptoms
32
ULCER 1. healing 2. prognosis 3. investigations 4. treatment
33
Consequences of inflamed stomach - gastritis
* Chronic inflammation / irritation risks erosion, ulceration, bleeding & ultimately malignant conversion * Inflammation reduces function – reduced parietal cell function induces – Reduced acid production (achlorhydria) reduced potential ferric to ferrous conversion of iron – only ferrous Fe can be absorbed effectively. – risk iron deficiency – eg glossitis & microcytic anaemia (also risk of long term antacid therapies eg PPI – omeprazole etc) – Reduced Intrinsic factor production – cant bind Vitamin B12 – therefore cant reabsorb the complexed B12 in the terminal ileum macrocytic anaemia & sore mouth etc. Gastric parietal cell antibody production can mimic this.
34
BARRETT'S OESOPHAGUS what is it?
1 - condition where long-standing stomach acid reflux has caused change / inflammation in lower oesophageal lining (stratified squamous non keratinising epithelium) - this is because if repeatedly exposed to acid it can metaplase (changes lining to a diff type) - histologically looking normal BUT in the wrong place - gastric metaplasia in lower oesophagus is a pre-malignant condition - image = endoscopic view = redder more inflamed mucosa
35
CARCINOMA (CANCER) OF THE OESOPHAGUS 1. incidence in uk 2. age 3. sex 4. geography 5. promoting 6. macroscopic 7. effects of local tumour spread 8. what you see microscopically
5. coeliac = malabsorption = low iron = can cause pharyngeal web
36
CARCINOMA (CANCER) OF THE OESOPHAGUS 1. note 2. what happens when the tumour spreads
37
CARCINOMA (CANCER) OF THE OESOPHAGUS 1. survival 2. how to diagnose 3. cure or palliate (make comfortable for what time they have left)
- has late presentation
38
Oesophageal Carcinoma
2nd image = wire mesh stent - screening x-ray
39
what is Pyloric stenosis
- manifests as Paediatric projectile vomiting - can go into spasm

BDS2 HHD - Human Disease (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions