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oesophagus Flashcards

1
Q

what does pharynx contain

A
  • naso
  • oro
  • larynx
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2
Q

what connects throat to oesophagus

A

laryngeal pharnyx

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3
Q

what does oesophagus connect

A

pharynx to stomach

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4
Q

what is oesophagus function

A

to transport food from mouth to stomach

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5
Q

what is oesophagus lined with

A

stratified squamous epithelium

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6
Q

how is oesophagus separated from pharynx

A

by upper oesophageal sphincter

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7
Q

what is lower oesophageal sphincter responsible for

A

prevention of gastric reflux

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8
Q

what is smooth muscle of oesophagus and the LOS supplied by

A

vagal autonomic motor nerves

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9
Q

what are major oesophageal symptoms

A
  • dysphagia
  • odynophagia
  • heartburn
  • regurgitation
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10
Q

what is dysphagia

A

difficulty swallowing liquid or solid

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11
Q

what does dysphagia for solid and liquids suggest

A

achalasia

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12
Q

what is odynophagia

A

pain whilst swallowing

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13
Q

what is odynophagia suggestive of

A

oesophagitis

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14
Q

what is heartburn a common symptom of

A

reflux of gastric contents into oesophagus

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15
Q

when is heartburn worse

A

lying down at night

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16
Q

what is regurgitation

A

effortless reflex of oesophageal contents into mouth and pharynx

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17
Q

what are investigations for oesophageal disorders

A
  • barium swallow
  • gastroscopy 1st line
  • manometry
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18
Q

how does GORD occur

A

failure of lower oesophageal sphincter

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19
Q

what usually buffers acid in cells

A

bicarbonate

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20
Q

factors associated with GORD

A
  • pregnancy
  • obesity
  • fat
  • smoking
  • drugs
  • hiatus hernia
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21
Q

how is diagnosis made for GORD

A

usually clinical

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22
Q

treatment of GORD

A
  • diet
  • lose weight
  • raise head of bed at night
  • reduce alcohol and coffee - stop smoking
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23
Q

example of H2 receptor antagonist

A

ranitidine

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24
Q

PPI example

A

omeprazole

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25
Q

SE of omeprazole

A
  • osteoporosis

- increase in GI infections e.g. c.diff

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26
Q

what can you do if PPI doesn’t work

A

surgery

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27
Q

what are complications of GORD

A
  • peptic stricture

- barretts oesophagus

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28
Q

symptom of peptic stricture

A
  • intermittent dysphagia for solids
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29
Q

what is Barretts oesophagus

A

change from stratified squamous epithelium to simple columnar

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30
Q

what is always replaced in Barretts oesophagus

A

hiatus hernia

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31
Q

how is diagnosis of Barretts oesophagus made

A

endoscopy

32
Q

who is most likely to get Barretts oesophagus

A

middle-aged obese men

33
Q

what does Barretts oesophagus increase chance of

A

oesophageal adenocarcinoma

34
Q

what is treatment for endoscopic treatment of dysplasia

A

radiofrequency ablation

35
Q

what is achalasia characterised by

A

oesophageal aperistalsis and imparted relaxation fo lower oesophageal sphincter

36
Q

when does regurgitation usually occur in achalasia

A

at night

37
Q

what is a complication of achalasia

A

aspiration pneumonia

38
Q

what does histology show in achalasia

A
  • inflammation of myenteric plexus of oesophagus

- reduction of ganglion cell numbers

39
Q

differential diagnosis of achalasia

A
  • genetic syndromes
  • infectious diseases
  • neoplasms
  • chronic inflammatory conditions
40
Q

investigations for achalasia

A
  • xray
  • barium swallow
  • oesophagoscopy
  • CT
  • manometry
41
Q

what does X-ray of achalasia show

A
  • dilated oesophagus
  • fluid behind heart
  • fundal gas shadow absent
42
Q

what does barium swallow in achalasia show

A
  • lack of peristalsis

- ‘birds beak’ appearance due to failure of sphincter to relax

43
Q

why is oesophagoscopy done

A

to exclude carcinoma at lower oesophagus

44
Q

what are all forms of achalasia treatment

A

palliative

45
Q

what are drug treatments of achalasia

A
  • nifedipine
46
Q

what is there an increase of in achalasia

A

squamous carcinoma of oesophagus

47
Q

what is diffuse oesophageal spasm

A

severe form of oesophageal dysmotility the can sometimes produce retrosternal chest pain and dysphagia

48
Q

what can oesophageal spams accompany

A

GORD

49
Q

what is oesophageal spasm on barium swallow show

A

corkscrew appearance

50
Q

when are PPI successful i. oesophageal spam

A

when there is reflux

51
Q

what is last resort treatment for oesophageal spasm

A

balloon dilatation or even longitudinal oesophageal myotomy

52
Q

where do oesophageal diverticulum occur

A
  • immediately above the upper oesophageal sphincter
  • near the middle of the oesophagus
  • just above the lower oesophageal sphincter
53
Q

when is oesophageal diverticulum detected

A

incidentally on a barium swallow

54
Q

what is an oesophageal web

A

thin, membranous tissue flap covered with squamous epithelium

55
Q

where are most oesophageal webs located

A

anteriorly in postcricoid region

56
Q

symptom of oesophageal web

A

dysphagia

57
Q

what is Plummer-vision syndrome associated with

A

a web associated with chronic iron deficiency anaemia, glossitis and angular stomatitis

58
Q

who does Plummer vision usually affect

A

women

59
Q

what are 2 types of oesophageal rings

A
  • mucosal

- muscular

60
Q

where is mucosal oesophageal ring located

A

squamocolumnar mucosal junction

61
Q

what is mucosal oesophageal ring associated with

A

history of intermittent bolus obstruction

62
Q

where is muscular oesophageal ring located

A

proximal to the mucosal ring

63
Q

what is muscular oesophageal ring covered by

A

squamous epithelium

may cause dysphagia

64
Q

what is management of oesophageal ring

A

reasurrance and dietary advice

65
Q

what can oesophageal ring respond to

A

PPI

66
Q

what is most common cause of benign oesophageal stricture

A

peptic stricture secondary to reflux

67
Q

what kind of ulceration does TB cause

A

deep ulceration with associated mediastinal lympadenopathy

68
Q

when are eosinophils seen in oesophageal mucosa

A
  • eosinophilic oesophagitis

- GORD

69
Q

what do patients with eosinophilic oesophagitis present with

A
  • dysphagia
  • heart burn
  • oesophageal pain
70
Q

1st line treatment for eosinophilic oesophagitis

A

topical steroids

71
Q

where do adenocarcinoma arise

A

in columnar lined epithelium in lower oesophagus

72
Q

what age do people get carcinoma

A

60-70

73
Q

what are most common physical signs of carcinoma

A
  • weight loss
  • anorexia
  • lymphadenopathy
74
Q

investigations for carcinoma

A
  • endoscopy

- barium swallow

75
Q

treatment for carcinoma

A

surgery

GI (50 decks)

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