dysphagia

Question 1

two phases of swallowing

Answer 1

Oro-pharyngeal ( mainly neuromuscular ) and esophageal ( mechanical anatomical problems)

Question 2

Oro-phayngeal dysphagia sx

Answer 2

coughing, sticking of food, RTIs, wheezing, regurgitation, halitosis , aspiration and chest infections if in throat

Question 3

oEsophageal sx

Answer 3

heartburn, odynophagia, regurgitation, weight loss, debility

Question 4

most freqeuent cause of orphayngeal swallowing problems

Answer 4

stroke

Question 5

ix for orophaygneal swallowing problems

Answer 5

Laryngoscopy
Esophageal - initially OGC ( barium swallow)
Monomety /ph study
Imaging CX CT thorax

Question 6

what muscle lifts up epiglottis over vocal cords

Answer 6

crycopharyngeus

Question 7

Water soluble contrast can be used if unsure whether to use a barium swallow especially if risk of oro-pharyngeal problem because then risk of

Answer 7

aspiration

Question 8

Pharyngeal pouch - cricopharyngeus - two parts

Answer 8

circular and oblique part creating a triangle which can weaken over time causing a weekend structure just above the entrance to the oesophagus

Question 9

risk factos for SCC oesophageal ca

Answer 9

smoking, alcohol, thermal injury , poor nutrition and immunosuppression - cancer of poverty and bad habits - aerophagic tract - if have one SCC in mouth for example likely to get it further down tract or higher up

Question 10

RF for adenocarcinoma oesophageal ca

Answer 10

commonest in UK - increased transient lower esophageal sphincter relaxations : GORD, obesity, hiatus hernia, diet , reduced esophageal clearance such as recumbency

Question 11

two out of 4 most common types of hiatus hernia

Answer 11

Type 1 - sliding hiatus hernia
Type 2 - stomach herniated alongside the junction - rolling hiatus hernia

can get both together

Question 12

Barrets oesophagus pre cursor to

Answer 12

adenocarcinoma

Get more glandular mucosa above the junction then get glandular tissue above junction - oGJ called barrerts metaplasia
Intestinal type that looks like cancer and is the risk factor

Question 13

Esophageal motility measured how

Answer 13

manometry

Pressure measured along esophageal body and at lower esophageal sphincter - at rest and after wet adn dry swallows

Question 14

what is achalasia

Answer 14

failure of lower esophageal sphincter to relax - failure of lower neural tissue