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GIT - Anatomy > Esophagus > Flashcards

Esophagus Flashcards

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1
Q

What is the esophagus?

A

A tube that carries food, liquid, & saliva from the pharynx to stomach

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2
Q

Esophagus anatomical course?
#1

A
  1. Begins at C6 (cricoid cartilage inferior border) in neck (continuous with laryngopharynx superiorly)
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3
Q

Esophagus anatomical course?
#2

A
  1. Descends downwards into sup. mediastinum of thorax, b/w trachea and vertebral bodies of T1 - T4
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4
Q

Esophagus anatomical course?
#3

A
  1. Enters abdomen via esophageal hiatus (opening in right crus of diaphragm) at T10
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5
Q

Esophagus anatomical course?
#4

A
  1. It terminates in the abdominal portion at T11 by joining the cardiac orifice
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6
Q

Label its anatomical structure from innermost to outermost

A
  1. Mucosa
  2. Submucosa ( along w Meissner’s/submucosal plexus)
  3. Muscular layer (externa)
    (Inner circular layer, auerbach’s / myenteric plexus, outer longitudinal)
  4. Adventitia / Serosa
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7
Q

What sort of epithelium does its mucosa have?

A

Stratified Squamous (non-keratinised)

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8
Q

What sort of muscles are present in the 3 divisions of longitudinal muscle (sup, middle, inf)?

A

Sup: voluntary striated muscle

Middle: voluntary striated muscle + smooth muscle

Inf: smooth muscle

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9
Q

Is it entirely adventitia or serosa too?

A

It has both, but the outer distal & intraperitoneal region is serosa

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10
Q

In what week is the esophagus developed?

A

4th week

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11
Q

What layer of the gut is it formed by?

A

Foregut

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12
Q

Explain the embryological development of the esophagus

A
  1. In the 4th week, the foregut forms the oesophagus (dorsally) and trachea (ventrally) by the tracheoesophageal folds, which in turn fuse to form the tracheoesophageal septum
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13
Q

What layer is the epithelium formed by

A

Endoderm

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14
Q

What layer forms the glands

A

Endoderm

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15
Q

What forms the striated muscle

A

Mesenchyme of caudal pharyngeal arches

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16
Q

Which layer forms the smooth muscle

A

Splanchnic mesenchyme (mesoderm)

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17
Q

How does the oesophagus grow embryologically?

A

With the descent of heart and lungs it also extends

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18
Q

Food is transported via?

A

Peristalsis

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19
Q

What is peristalsis

A

Rhythmic contractions of muscles which propagate food downwards

20
Q

If peristaltic muscles harden or get damaged, it would lead to?

A

Difficulty in swallowing = Dysphagia

21
Q

How many oesophageal sphincters are there and name them

A

2, upper and lower

22
Q

What do the oesophageal sphincters do?

A

Prevent air entry and gastric acid reflux via upper and lower respectively

23
Q

Location, muscle type, function and muscle name, as well as normal muscle state and why of Upper Oesophageal sphincter

A

At junction between pharynx and oesophagus
Striated muscle
Prevents air entry
Via cricopharyngeus
Normally, constricted to prevent air entrance into oesophagus

24
Q

Location, muscle type, and function of Lower Oesophageal sphincter at rest and

A

Located at gastro-oesophageal junction (Left to T11 vertebra)
Not muscle type but rather a physiological sphincter
At rest, prevents gastric acid reflux and during peristalsis, allowed to relax to let food enter stomach

25
Q

How is the change of the LES marked?

A

By changing from oesophageal to gastric mucosa
(Stratified Squamaous -> Simple Columnar)

26
Q

Since the LES is physiological, how many factors is it maintained by and name them
(ACMP)

A

4 factors

  1. Oesophagus enters stomach at an acute angle
  2. Walls of intra-abdominal sections of oesophagus are compressed when there is a positive intra-abdominal pressure
  3. Prominent mucosal folds at gastro-oesophageal junction aid in occluding lumen.
  4. Right crus of diaphragm has a pinch-cock effect
27
Q

How many anatomical relations lead to physiological constrictions in its lumen and name them

(ABCD)

A

4 relations

  1. Arch of Aorta
  2. Bronchus (Left main stem)
  3. Cricoid Cartilage
  4. Diaphragmatic hiatus
28
Q

Arterially, Thoracic supply of oesophagus is done by:

A
  1. Branches of Thoracic Aorta
  2. Inferior Thyroid Artery ( branch of thyrocervical trunk)
29
Q

Venius drainage of thoracic region is done by and what do they drain into

A
  1. Azygous Vein
  2. Inferior Thyroid Vein

They drain into systemic circulation

30
Q

Arterial abdominal supply?

A
  1. Left gastric artery
  2. Left inferior phrenic artery
31
Q

Venous abdominal supply and drainage into?

A
  1. Into portal circulation via left gastric artery
  2. Into systemic circulation via azygous vein
32
Q

Portal and systemic circulation drainage form a:

A

Porto-systemic anastomosis

33
Q

Innervation of it is done by which plexus

A

Oesophageal plexus

34
Q

Oesophageal plexus is formed by union of what?
( OP = PVT + Sym from C & T Sts)

A
  1. Parasympathetic vagal trunks
  2. Sympathetic fibers from:
    A. Cervical
    B. Thoracic sympathetic trunks
35
Q

How many types of sympathetic fibers do the vagal trunks have?

A

2 different types

36
Q

Upper oesophageal sphincter + upper striated muscles supplied by what nerve/cell fibers?

A

Nucleus Ambiguus

37
Q

Upper oesophageal sphincter + upper striated muscles supplied by what nucleus?

A

Nucleus Ambiguus

38
Q

Lower Oesophageal Sphincter and Lower smooth muscles supplied by what nucleus?

A

Dorsal Motor Nucleus

39
Q

Lymphatic drainage of sup 1/3?

A

Deep cervical lymph nodes

40
Q

Lymphatic drainage of mid 1/3?

A

Superior & Posterior Mediastinal nodes

41
Q

Lymphatic drainage of inferior 1/3?

A

Left gastric & Celiac Nodes

42
Q

Disorders of the oesophagus? (3)

A
  1. Barrett’s
  2. Oesophageal carcinoma
  3. Oesophageal varices
43
Q

What is barretts oesophagus and how is it caused and how is it detected?

A

Metaplasia of the LES’s stratified squamous epithelium to gastric columnar epithelium

Caused by chronic acid exposure due to malfunctioning LES

Detected via endoscopy

44
Q

Features and types of Oesophageal carcinoma?

A

Features:
1. Dysphagia
2. Weight loss

Types:
1. Squamous Cell Carcinoma - common and occurs at any level
2. Adenocarcinoma - only in inferior 1/3, associated with Barrett’s

45
Q

What are Oesophageal varices, why do they occur, what is it also known as, and what do most patients present it with?

A

When the abdominal oesophagus drains into portosystemic circulation and leads to abnormally dilated submucosal veins

Occurs due to pressure increase beyond normal in portal system and secondary to chronic liver disease such as cirrhosis and portal vein obstruction

Aka Portal Hypertension

Patients present with Haematemesis
(Puking blood)

GIT - Anatomy (1 decks)

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