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ANAT + PHYS (9610) > UNIT 6: Esophagus and Gastro Tract > Flashcards

UNIT 6: Esophagus and Gastro Tract Flashcards

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1
Q

what is the goal of the digestive system

A

obtain nutrients to support energy needs, growth, and cell repair

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2
Q

what are the 5 functions of the digestive system

A

ingestion
propulsion
digestion
absorption
defecation

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3
Q

ingestion

A

brought into the body

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4
Q

propulsion

A

moved along the digestive tract

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5
Q

digestion (2 types)

A

broken down into simpler forms

mechanical and chemical

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6
Q

absorption

A

nutrients pass into blood stream

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7
Q

defecation

A

waste is removed from the body

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8
Q

6 organs of the digestive sys

A

mouth and pharynx
esophagus
stomach
small intestine
large intestine
anus

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9
Q

4 accessory organs of the digestive sys

A

salivary glands
liver
gallbladder
pancreas

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10
Q

mouth has 4 functions

A

ingestion - food brought into oral cavity
propulsion - tongue propels bolus into pharynx
mechanical digestion
chemical digestion

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11
Q

mechanical digestion in the mouth ….

A

mastication by teeth and mixing movements by tongue (voluntary)

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12
Q

chemical digestion in the mouth…

A

salivary amylase and lipase begins breakdown of starches and fats

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13
Q

parotid contributes…

A

the most saliva during chewing and swallowing

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14
Q

pharynx propulsion is….

A

peristaltic wave like - positive pressure on bolus tail moves bolus from pharynx to esophagus

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15
Q

esophagus propulsion is…

A

true peristaltic wave moves bolus (pos pressure on bolus tail) from pharyngoesophageal segment (PES) to the gastoesophageal junction

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16
Q

describe the esophagus

A

collapsible, muscular tube of approx 25cm in length

posterior to trachea, anterior to vert column

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17
Q

the esophagus runs from the _____ and passes through the _______ and pierces the _____ through the _______

A

laryngopharynx
mediastinum
diaphragm
esophageal hiatus

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18
Q

hiatal hernia

A

when a portion of the stomach protrudes into the thoracic cavity

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19
Q

the pharyngoesophageal segment (PES) contains the

A

upper esophageal sphincter (UES)

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20
Q

PES is comprised of ____ and ____ tissues, the UES is comprised of the _______ muscle

A

pharyngeal and esophageal tissues
cricopharyngeus muscle

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21
Q

UES is ______ at rest due to contraction of the CP muscle

A

closed

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22
Q

UES opens by

A

tissue compliance

relaxation of CP muscle

traction of the ascending larynx (hyolaryngeal complex)

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23
Q

traction of the ascending larynx (hyolaryngeal complex) works to open the UES by

A

cricoid cartilage is pulled anterosuperiorly and thus pulls the anterior esophageal wall away from the posterior esophageal wall

aka when this structure moves up when we swallow it pulls open the UES

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24
Q

inferior border of the esophagus forms the

A

lower esophageal sphincter - LES

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25
LES is a
muscular junction bw esophagus and stomach at level of the diaphragm
26
how is the LES a physiological sphincter
physiological sphincter bc no sphincteric muscle present smooth muscle of esophagus and crura of diaphragm maintain closure prevents gastroesophageal reflux
27
along the length of the esophagus, transitions from ____ muscle to ____ muscle
striated to smooth
28
upper 1/3 of esophagus is
cervical esophagus skeletal muscle
29
intermediate 1/3 of the esophagus is
skeletal and smooth muscle
30
lower 1/3 of esophagus is
smooth muscle
31
cervical esophagus is
a muscular wall comprised on 2 muscle groups w fibres perpendicular to each other circular muscle fibres and longitudinal muscle fibres
32
what is primary peristalsis
muscle contraction triggered by arrival of bolus at UES; contraction wave propagates the length of the esophagus
33
what is secondary peristalsis
if residue remains in esophagus, second peristaltic wave is triggered
34
esophagus is innervated/controlled by
esophageal branch of CN X
35
UES =
a muscular sphincter (cricopharyngeus m) w/i the PES tonic contraction of the CP muscle keeps the UES closed at rest .... prevents gastric contents from re-entering pharynx (i.e. prevents retrograde flow)
36
LES =
An anatomical sphincter (where esophagus passes thru crura of diaphragm)
37
resting pressure of LES is ____ of the UES resting pressure ... created by....prevents...
1/3 circular muscle layer and the crura of the diaphragm prevents gastric contents from re-entering esophagus (i.e. prevents retrograde flow)
38
as bolus approaches LES releases _____ posture and bolus enters stomach.... ______ on tail of bolus, brief supra-resting level of contraction
resting closure
39
what are the 3 functions of the stomach
mechanical digestion and propulsion chemical digestion absorption
40
mechanical digestion and propulsion in the stomach
peristaltic waves mix food w gastric juice and propel it into the duodenum (small intestine)
41
chemical digestion in the stomach
pepsin in gastric acid begins digestion of proteins, produces chyme proteins --> large polypeptides --> small polypeptides --> aminoacids
42
absoprtion in the stomach
few fat soluble substances absorded (ex. aspirin, alcohol, some drugs)
43
part of the stomach that often causes hiatal hernias
fundus
44
what is gastroesophageal reflux GER
spontaneous movement of gastric contents into the esophagus
45
what is GERD
Gastroesophageal reflux disease chronic symptoms or mucosal damage due to the reflux of gastric contents
46
GER is ______ in western society .... caused by.... estimated at ___% symptoms daily, ___% symptoms monthly
extremely common dietary habits, stress, obesity 10%, 20-30%
47
clinical symptoms of GER include
heart burn, regurgitation, chest pain
48
less typical symptoms of GER related to acid damage
sore throat, globus sensation, chronic cough, vocal changes (Hoarseness), poor dentition, persistent throat clearning, asthma, aspiration laryngopharyngeal reflex LPR
49
what is the common mechanism behind GER
Transient lower esophageal sphincter relaxation (TLESR) LES relaxes inappropriately, creating backflow into esophagus
50
other than the common mechanism behind GER, what are the two other mechanisms
hypotensive LES = weak tonic contractile state hiatal hernia = stomach herniates thru diaphragmatic hiatus, LES no longer receives structural support from the diaphragm
51
Gastric reflux is _____ to the esophagus and other structures in the upper digestive tract because of -____
destructive pepsin aka stomach acid
52
patients w GER are often prescribed .... alternatively could use ....
proton pump inhibitors - typically proton pump (in stomach) pulls protons into cells to create HCI - PPIs inhibit creation of HCI H2 blockers, histamine 2 receptor agonists, gastric acids suppressors raises pH of stomach after acid has already been produced
53
3 parts of small intestine and the order of them
duodenum jejunum ileum
54
mechanical digestion and propulsion in the small intestine
smooth muscle segmentation mixes contents w digestive juices, produces short distance peristaltic waves
55
chemical digestion in small intestine
enzymes delivered from pancreas and gallbladder complete digestion of all food classes
56
absorption in small intestine
products of carbohydrate, protein, fat, and nuclei acid digestions, plus vitamins, electrolytes, and water are absorbed
57
segmentation vs peristalsis
peristalsis = adjacent segments of alimentary tract organs alternately contract an relax which move food along the tract distally segmentation = nonadjacent segments of alimentary tract organs alternately contract and relax, moving the food forward then backward - food mixing and slow food propulsion occurs
58
chemical digestion in large intestine
remaining food residues digested by enteric bacteria
59
absorption in large intestine
remaining water, electrolytes (NaCl), and vitamins produced by bacteria (organic compounds)
60
propulsion in the large intestine
feces propelled toward rectum by haustral churning and mass movements
61
defecation of large intestine
reflex triggered by rectal distension; eliminates feces from body
62
2 functions of swallowing
supportive function = transports ingested material from mouth to stomach protective function = protects respiratory sys from entry of foreign material
63
why is swallowing necessary: in the adult human the upper respiratory and digestive paths are _____, crossroads is called the _____
crossed upper aerodigestive tract
64
4 phases of swallowing
oral preparatory oral (transport) pharyngeal esophageal
65
describe the oral preparatory phase of swallowing... voluntary or involuntary?
ingested material is broken down mechanically and chemically, forming a bolus a voluntary phase - actions vary w the properties of the food/liquid
66
describe the oral (transport) phase of swallowing
bolus is moved posteriorly over the tongue surface
67
describe the pharyngeal phase of swallowing... voluntary or involuntary?
phase is triggered when a moving bolus excites oropharyngeal sensory receptors bolus transported from mouth to esophagus involuntary -patterned motor response
68
describe the esophageal phase of swallowing
bolus is transported to stomach
69
swallowing events tend to occur in a _____ patter, although there is _____ subject and ____ subject variability
predictable intra inter
70
how is the epiglottis deflecting during swallowing?
in 2 stages first = upright, once the bolus comes along the hyolaryngeal complex moves up, base of epi comes up becoming a horizontal structure second = to get it to tip the rest of the way the tongue base, pharyngeal wall, and bolus itself push the epi down to flip it the rest of the way
71
describe the path of the bolus
bolus flows lateral to the larynx w/i the pyriform sinuses 1 pyriform sinus on each side - bw larynx and the pharyngeal wall
72
during the esophageal phase, the ____ of the esophagus is relaxed in basal state; ____ and ____ are normally contracted, _____ on demand
body UES and LES Relaxed
73
UES opens during the esophageal phase bc of
CP m relaxes, traction from HLAE, compliant segment, intrabolus pressure
74
describe the peristalsis of the esophagus
progressive, normal/constant amplitude, non-repetitive, non-spontaneous = motility
75
3 parts of esophagus contraction
primary peristalsis = distally progressive wave initiated by the act of swallowing secondary peristalsis = distally progressive wave initiated by esophageal distension tertiary contraction = non peristaltic (non-progressive) contraction of the body of the esophagus
76
what causes residue/material in the pharynx?
weakness in pharyngeal constrictor muscles inability to open UES sufficiently gastroesophaeal reflux - incomplete closure of LES/UES at rest
77
cervical osteophytes is....
bone spurs that grow on the cervical spine narrow the pharynx and esophagus making it more difficult to get a bolus through leads to residue
78
what is hypertonicity in inferior pharyngeal constrictor
incomplete/inadequate relaxation during swallowing leads to herniation of pharyngeal wall - at level of UES, this is called a zenker's diverticulum ... at triangle of killian
79
what is triangle of killian .... what is pharyngoesophageal diverticulum ... what does it result from?
triangle of killian = area of weakness bw oblique fibres of thyropharyngeus m and transverse fibres of CP posterior hypopharyngeal mucosa protrudes bw two components of inferior pharyngeal constrictor results from repetitive high hypopharyngeal pressures due to poor compliance of the UES
80
clinical symptoms of zenker's diverticulum
dysphagia with both solids and liquids reguritation of undigested foods coughing/aspiration halitosis (bad breath bc of food stuck)
81
how is zenker's diverticulum diagnosed
use barium swallow can use endoscopy but risk a perforation of the esophagus
82
treatment of zenker's diverticulum
diverticulectomy and or CP myotomy

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