Abdomen Flashcards
Barrett’s oesophagus:
Squamous epithelium of lower oesophagus may be replaced by columnar epithelium in certain clinical conditions.
The abnormal type of epithelium present in oesophagus is referred as Barrett’s epithelium.
achalasia cadia.
due to neuromuscular incoordination it may fail to dilate leading to difficulty in passage of food or dysphagia.
oesophageal stenosis.
The lumen of oesophagus may not be canalised at all
the oesophagus shows 4 constrictions at the
following levels.
1 At its beginning, 15 cm/ 6 inch from the incisor teeth,
where it is crossed by cricopharyngeus muscle.
2 where it is crossed by the aortic arch, 22.5 cm/9-inch
from the incisor teeth.
3 Where it is crossed by the left bronchus, 27 .5 cm / 17-
inch from the incisor teeth.
4 where it pierces the diaphragm37 .5 cm/15-inch from
the incisor teeth.
The distance from the incisor teeth are important in passing instruments like endoscope into the oesophagus.
The cervical part of oesophagus is supplied by
The cervical part including the segment up to the arch
of aorta is supplied by the inferior thyroid arteries.
Nerve supply of oesophagus
Parasympathetic nerves: The upper half of the oesophagus is supplied by the recurrent laryngeal nerves, and the lower half by the oesophageal plexus formed mainly by the two vagi. Parasympathetic nerves are sensory, motor and secretomotor to the oesophagus.
2 Sympa.thetic neroes: For upper half of oesophagus, the fibres come from middle cervical ganglion and run with inferior thyroid arteries. For lower half, the fibres come directly from upper four thoracic ganglia, to form oesophageal plexus before supplying the oesophagus. Sympathetic nerves are vasomotor.
Left atrial enlargement as in mitral stenosis can also be visualised by barium swallow.
The enlarged atrium causes a shallow depression on the front of the oesophagus. Barium swallow also helps in the diagnosis of oesophageal strictures, carcinoma and achalasia cardia.
