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oesophagus Flashcards

(75 cards)

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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
SE of omeprazole
- osteoporosis | - increase in GI infections e.g. c.diff
26
what can you do if PPI doesn't work
surgery
27
what are complications of GORD
- peptic stricture | - barretts oesophagus
28
symptom of peptic stricture
- intermittent dysphagia for solids
29
what is Barretts oesophagus
change from stratified squamous epithelium to simple columnar
30
what is always replaced in Barretts oesophagus
hiatus hernia
31
how is diagnosis of Barretts oesophagus made
endoscopy
32
who is most likely to get Barretts oesophagus
middle-aged obese men
33
what does Barretts oesophagus increase chance of
oesophageal adenocarcinoma
34
what is treatment for endoscopic treatment of dysplasia
radiofrequency ablation
35
what is achalasia characterised by
oesophageal aperistalsis and imparted relaxation fo lower oesophageal sphincter
36
when does regurgitation usually occur in achalasia
at night
37
what is a complication of achalasia
aspiration pneumonia
38
what does histology show in achalasia
- inflammation of myenteric plexus of oesophagus | - reduction of ganglion cell numbers
39
differential diagnosis of achalasia
- genetic syndromes - infectious diseases - neoplasms - chronic inflammatory conditions
40
investigations for achalasia
- xray - barium swallow - oesophagoscopy - CT - manometry
41
what does X-ray of achalasia show
- dilated oesophagus - fluid behind heart - fundal gas shadow absent
42
what does barium swallow in achalasia show
- lack of peristalsis | - 'birds beak' appearance due to failure of sphincter to relax
43
why is oesophagoscopy done
to exclude carcinoma at lower oesophagus
44
what are all forms of achalasia treatment
palliative
45
what are drug treatments of achalasia
- nifedipine
46
what is there an increase of in achalasia
squamous carcinoma of oesophagus
47
what is diffuse oesophageal spasm
severe form of oesophageal dysmotility the can sometimes produce retrosternal chest pain and dysphagia
48
what can oesophageal spams accompany
GORD
49
what is oesophageal spasm on barium swallow show
corkscrew appearance
50
when are PPI successful i. oesophageal spam
when there is reflux
51
what is last resort treatment for oesophageal spasm
balloon dilatation or even longitudinal oesophageal myotomy
52
where do oesophageal diverticulum occur
- immediately above the upper oesophageal sphincter - near the middle of the oesophagus - just above the lower oesophageal sphincter
53
when is oesophageal diverticulum detected
incidentally on a barium swallow
54
what is an oesophageal web
thin, membranous tissue flap covered with squamous epithelium
55
where are most oesophageal webs located
anteriorly in postcricoid region
56
symptom of oesophageal web
dysphagia
57
what is Plummer-vision syndrome associated with
a web associated with chronic iron deficiency anaemia, glossitis and angular stomatitis
58
who does Plummer vision usually affect
women
59
what are 2 types of oesophageal rings
- mucosal | - muscular
60
where is mucosal oesophageal ring located
squamocolumnar mucosal junction
61
what is mucosal oesophageal ring associated with
history of intermittent bolus obstruction
62
where is muscular oesophageal ring located
proximal to the mucosal ring
63
what is muscular oesophageal ring covered by
squamous epithelium may cause dysphagia
64
what is management of oesophageal ring
reasurrance and dietary advice
65
what can oesophageal ring respond to
PPI
66
what is most common cause of benign oesophageal stricture
peptic stricture secondary to reflux
67
what kind of ulceration does TB cause
deep ulceration with associated mediastinal lympadenopathy
68
when are eosinophils seen in oesophageal mucosa
- eosinophilic oesophagitis | - GORD
69
what do patients with eosinophilic oesophagitis present with
- dysphagia - heart burn - oesophageal pain
70
1st line treatment for eosinophilic oesophagitis
topical steroids
71
where do adenocarcinoma arise
in columnar lined epithelium in lower oesophagus
72
what age do people get carcinoma
60-70
73
what are most common physical signs of carcinoma
- weight loss - anorexia - lymphadenopathy
74
investigations for carcinoma
- endoscopy | - barium swallow
75
treatment for carcinoma
surgery

GI (50 decks)

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