1F Esophagus and Deglutition

Question 1

Describe the esophagus

Answer 1

Flattened muscular tube of 18 to 26 cm from upper sphincter to lower sphincter

Question 2

What is the shape of the esophagus between swallows?

Answer 2

Collapsed

Question 3

What does the esophagus connect?

Answer 3

Pharynx to stomach

Question 4

Where is the esophagus relative to the vertebral column?

Answer 4

Anterior of the vertebral column

Question 5

Where does the esophagus begin relative to the vertebral column?

Answer 5

C5-C6

Question 6

At what vertebral level does the esophagus traverse the diaphragm?

Answer 6

T10

Question 7

At what vertebral level does the esophagus end at the cardia of the stomach?

Answer 7

T11

Question 8

What kind of tissue lines the esophagus?

Answer 8

Non-keratinized stratified squamous epithelium

Question 9

Why is epithelia continuity critical for normal function?

Answer 9

A breach in the epithelium creates ulcers

Question 10

Where are the esophageal glands found?

Answer 10

Scattered in the esophageal submucosa

Question 11

What do esophageal glands provide?

Answer 11

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

Question 12

What layers does the wall of the esophagus have?

Answer 12

All like the GI tract except the serosal outer layer. That is mucosa, submucosa, and muscularis

Question 13

What does the esophagus have instead of the serosal layer?

Answer 13

Thin and poorly defined layer of CT

Question 14

What does the submucosal vascular plexus of the esophagus include?

Answer 14

Especially large venous spaces

Question 15

What veins receive venous drainage from the mid and lower esophagus and the submucosal venous plexus?

Answer 15

Collaterals of the left gastric vein, a branch of the portal vein

Question 16

What are esophageal varices?

Answer 16

When submucosal venous spaces along w/ all the other draining veins of the mid to lower esophagus enlarge

Question 17

Why would esophageal varices occur?

Answer 17

Due to portal hypertension (usually due to cirrhosis)

Question 18

What are the risks of esophageal varices?

Answer 18

May rupture with fatal bleeding into the esophageal lumen

Question 19

What demographic commonly has esophageal varices?

Answer 19

alcoholics, but can also occur with liver cancer

Question 20

What is the position of the epiglottis when the upper esophageal sphincter (UES) opens?

Answer 20

The epiglottis covers the trachea

Question 21

What is the oral phase of swallowing?

Answer 21

Voluntary action of collecting the oral contents on the tongue and propelling them backward to the pharynx

Question 22

What is the pharyngeal phase of swallowing?

Answer 22

Wave of involuntary contraction in the pharyngeal muscles that pushes the material into the esophagus, as the UES relaxes and opens

Question 23

What happens to respiration when someone is swallowing?

Answer 23

It is inhibited

Question 24

What is the esophageal phase of swallowing?

Answer 24

Once food enters the esophagus, peristalsis takes over

Question 25

Swallowing triggers esophageal peristalsis whether or not what is present?

Answer 25

Whether or not food is present. Though presence of food will intensify the peristaltic contractions

Question 26

What would happen if the primary peristaltic wave fails to move food into the stomach?

Answer 26

The persistence of food in the esophagus will set off secondary peristaltic waves to complete the job

Question 27

How is the LES contracted?

Answer 27

It is tonically contracted like most sphincters are

Question 28

What can the tonic contraction be influenced to do?

Answer 28

either relax or contract further

Question 29

What is achalasia?

Answer 29

the LES fails to relax - food that has been swallowed has difficulty passing into the stomach, and the esophagus above the LES becomes enlarged

Question 30

What is the danger of achalasia?

Answer 30

A person may aspirate the esophageal contents into the lungs when the person lies down

Question 31

What is GERD?

Answer 31

When the LES does not close completely after swallowing

Question 32

What is the common term for GERD?

Answer 32

heartburn or esophigitis

Question 33

What can esophigitis lead to?

Answer 33

Ulceration and stricture of the esophagus due to scarring

Question 34

GERD has a strong causal relationship with what?

Answer 34

Esophageal adenocarcinoma

Question 35

What agents have been shown to diminish the closing strength of the LES, leading to GERD?

Answer 35

Fatty foods, chocolate, ethanol, caffeine, peppermint, spicy foods, citrus fruits and juices, smoking, steroidal based oral contraceptives

Question 36

What complications can occur from persistent reflux?

Answer 36

mucosal damage that causes edema and erosion of the luminal surface

Question 37

What is Barrett’s esophagus?

Answer 37

Stricture of the esophagus caused by scar tissue, spasm, and edema. May experience dysphagia and/or odynophagia.

Question 38

What is the difference b/w dysphasia and odynophasia?

Answer 38

Dysphagia is a difficulty in swallowing and odynophagia is when swallowing is painful

Question 39

What is Barret’s esophagus characterized by?

Answer 39

a repair process in which squamous mucosa that normally lines the esophagus is gradually replaced by columnar epithelium (metaplasia) - resembling that in the stomach and intestines

Question 40

What is Barret’s esophagus associated with?

Answer 40

Increased risk of developing esophageal cancer