Esophagus Flashcards
Numerate the anatomic and motor disorders of oesophagus?
1)Hiatal hernia include: A-Axial or sliding hernia B-paraesophageal or rolling hernia 2)Achalasia include Primary and secondary achalasia 3)Lacerations (Mallory-Weiss Syndrome) 4)Varices
Which type of hiatal hernia cause barrett oesophagus ?
Axial or sliding hernia
Rolling hernia is constitutes 95% of hiatal hernia cases True/False?
False .The correct is
Axial hernia
In which type of hiatal hernia a bell-shaped dilation forms?
Sliding hernia
The cause of paraesophageal hernia is congenital True /False?
False .The correct is
The cause of this deranged anatomy is obscure
What is meaning of achalasia ?
It means incomplete relaxation of lower oesophageal sphincter in response to swallowing
Primary Achalasia occurs in Chagas Disease True/False?
False .The correct is
Secondary achalasia occurs in Chagas disease which is caused by Trypanosoma cruzi
Explain how Trypanosoma cruzi cause secondary achalasia ?
By destruction of myenteric nerve plexus in oesophageal wall
Laceration are longitudinal tears in pharyngoesophageal junction ?And why?
False .The correct is
In gastroesophageal junction
The presumed pathogenesis is inadequate relaxation in lower oesophageal sphincter during vomiting with stretching and tearing the esophagogastric junction at the moment of propulsive expulsion of gastric content
Lacerations ,The tears always involve the Musclusa of gastroesophageal wall ?
False
Tears may involve the mucosa or may penetrate the wall
NSAIDs therapy is given to stop bleeding in case of lacerations ?
False .The correct is
Supportive therapy and vasoconstrictive medications are given
When varices does occur?
When portal venous blood flow in liver is impeded by cirrhosis
Why Collateral bypass channels are formations ?
To provide a communication between portal and systemic systems
In case of varices the portal venous blood is drain into IVC True/False?
False .The correct is
SVC
Explain the collateral bypass mechanism
The portal blood flow is drain into coronary veins of stomach then into oesophageal plexus of sub-epithelial and sub-mucosal veins then to azygos vein and finally in SVC
Varices appear as straight thin vessel True/False ?
False
are appeared as tortuous dilated veins
Numerate the causes of Oesophagi-tis?
1) Prolonged gastric intubation
2) Ingestion of corrosive and irritant substances
3) Radiation and chemotherap
4) In some cases attributable to gastric reflux
Oesophagi-tis include …..&…..
Simple hyperaemia &
Sever oesophagi-tis
Barrett oesophagus is defined as replacement of oesophageal mucosa by gastric mucosa ?
False .The correct is Intestinal mucosa (metaplastic columnar epithelium with goblet cell)
How does healing of Barrett oesophagus does occur?
Healing is occur by re-epithelialisation of stem cell that present in wall.In the microenvironment of an abnormally low ph in distal part of oesophagus caused by acid reflux ,the cell differentiated in to columnar epithelium
Why re-epithelialisation does occur ?
Due to the newly formed tissue is more resistant to injury caused by gastric contents reflux
The parietal cell clinical significances of Barrett oesophagus is related to the development of adenocarcinoma True/False?
False .The correct is
Chief cell
Describe the morphology of Barrett oesophagus ?
It may exists as an irregular dark pink colour tongues that extending up from gastro oesophageal junction
Oesophageal carcinoma include …..&…..
1) squamous cell carcinoma (mostly in middle and upper two thirds)
2) Adenocarcinoma (distal third )
What are the causes of Oesophageal carcinoma ?
Smoking,Alcohol abuse,hot and spicy food and drinks
Also there is strong association with human papilloma virus is noted in high-incidence areas
Numerate the forms of oesophageal carcinoma tumour
1) Polypoid exudate masses that protrude into the lumen
2) Necrotising Cancerous Ulcerations that may extend deeply and sometimes erode into the respiratory tree or aorta
3) Diffusible infiltrative neoplasms that impart thickening and rigidity to the wall and narrowing the lumen
Where Adenocarcinoma appear?
In the distal part(lower third)of oesophagus and may invade the gastric cardia
Describe the form of Adenocarcinoma
Initially it appear as flat and raised patch on an otherwise intact mucosa ,they may latter develop into large nodular masses or exhibit deeply ulcerative or diffusely infiltrative features
Who can we diagnose the cancer of oesophagus ?
By using imaging techniques and endoscopic biopsy
Oesophageal cancer when is detected ?
When confined the mucosa or submucosa is amenable to surgical treatment
