1F-Esophagus & DEglutition

Question 1

Between swallows the esophagus is ________ but the lumen can distend to approximately ____ in the anterior- posterior dimension and up to ___ laterally to accommodate a swallowed bolus.

Answer 1

collapsed…2 cm…3 cm

Question 2

Where in relation to the cervical vertebrae is the pharynxgoesophageal junction?

Answer 2

C5-C6

Question 3

What important digestive structure is at approximately the T10 vertebral level?

Answer 3

The Diaphragmatic Hiatus

Question 4

Which vertebral level is the cardia of the stomach located?

Answer 4

T11

Question 5

What type of epithelium is in the esophagus?

Answer 5

Non-Keratinized Stratified Squamous Epithelium

Question 6

A breach in the esophageal epithelium creates an ____.

Answer 6

ulcer

Question 7

_________ provide mucus for lubricating the passage of food down the esophagus, augmenting the role of salivary glands.

Answer 7

Esophageal glands

Question 8

Which layer of the esophagus houses the esophageal glands?

Answer 8

The submucosa

Question 9

What is unique about the layers of the esophagus?

Answer 9

NO true Serosal outer layer, just a thin and poorly defined layer of Connective Tissue

Question 10

Which layer does most of the venous drainage occur in the esophagus?

Answer 10

the Submucosal layer

Question 11

Collaterals of the _______ vein, a branch of the _____ vein, receive venous drainage from the mid and lower esophagus, plus from the submucosal venous plexus.

Answer 11

left gastric….portal

Question 12

The submucosal venous spaces, along with all of the other “draining” veins of the mid to lower esophagus may enlarge into _________.

Answer 12

ESOPHAGEAL VARICES

Question 13

What is the main reason for esophageal varices?

Answer 13

PORTAL hypertension caused by CIRRHOSIS

Question 14

What is another name for the esophageal varicose manifestations?

Answer 14

Red Wale Spots

Question 15

What are the three phases of swallowing(deglutition)?

Answer 15

1.Oral/voluntary phase 2.Pharyngeal Phase 3.Esophageal Phase

Question 16

What happens in the pharyngeal phase?

Answer 16

the UpperEsophagealSphinter (UES) relaxes and opens

Question 17

Swallowing is difficult if not impossible when the ________.

Answer 17

mouth is open (dental office!)

Question 18

What marks the esophageal phase?

Answer 18

When esophageal peristalsis takes over

Question 19

Does there have to be food for esophageal peristalsis to occur?

Answer 19

Nope, but food intensifies it!

Question 20

What is the condition where the LES (Lower Esophageal Sphinter) FAILS to relax? What is the main danger?

Answer 20

“AK-AH-LAY-SHA” —–Achalasia…Main danger is aspiration into the lungs when the person lies down

Question 21

What is the result of decreased closing strength of the LES and therefore permitting acidic gastric contents into the esophagus?

Answer 21

GERD-GastroEsophageal Reflux Disease

Question 22

What two things does GERD cause?

Answer 22

Heartburn and Esophagitis

Question 23

What type of cancer is related to GERD?

Answer 23

Esophageal AdenoCarCinoma

Question 24

What do all of these have in common? Fatty foods, chocolate, ethanol, caffeine, peppermint, “spicy” foods, citrus fruits and juices, smoking, and steroidal based oral contraceptives.

Answer 24

They can diminish the LES closing strength and cause GERD

Question 25

What is the result of persistent/chronic reflux leading to edema and erosion to the luminal surface?

Answer 25

Barrett’s Esophagus

Question 26

________ in Barrett’s Esophagus are caused by a combination of scar tissue, spasm and edema. What is the result?

Answer 26

Strictures…result is Dysphagia (difficulty swallowing)

Question 27

What is PAINFUL swallowing?

Answer 27

ODYN-O-PHAGIA

Question 28

What is the physical sign of Barrett’s Esophagus?

Answer 28

RED epithelium

Question 29

What is the hallmark of Barrett’s Esophagus on a cellular level?

Answer 29

Metaplasia of Squamous Epithelium to Columnar Epithelium