GI 1 - Basics + Common diseases Flashcards

1
Q

What is the approx. length of the oesophagus?

A

~ 25 cm

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2
Q

What are the 4 mechanisms which prevent reflux from the lower oesophageal sphincter?

A

1) Right crus of diaphragm acts as a pinch-cock
2) Acute angle from oesophagus to stomach
3) Mucosal folds of oesophagogastric junction acts as a valve
4) Abdominal pressure is higher than thoracic pressure

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3
Q

Name the 5 regions of the stomach:

A
  • Cardia
  • Fundus
  • Body
  • Antrum
  • Pylorus
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4
Q

Behind which laryngeal cartilage does the upper oesophageal sphincter lie?

A

Cricoid cartilage

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5
Q

In which part of the GI tract is the majority of fluid absorbed?

A

Small intestine

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6
Q

Which parts of the GI tract are not controlled by autonomic nerves?

A
  • Mouth
  • 1st 1/3rd of Oesophagus
  • External anal sphincter
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7
Q

Name the 2 main nerve plexuses of the enteric nervous system, which control GI motility:

A

1) Auerbach’s myenteric plexus

2) Meissner’s submucosal plexus

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8
Q

Where is Auerbach’s myenteric plexus located?

A

Between the inner circular and outer longitudinal layers of muscularis externa, surrounding the GI tract

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9
Q

Where is Meissner’s submucosal plexus located?

A

Beneath muscularis externa, on top of the submucosa, surrounding the GI tract

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10
Q

Name the nerve plexus which lies between the inner circular and outer longitudinal layers of muscularis externa, surrounding the GI tract:

A

Auerbach’s myenteric plexus

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11
Q

Name the nerve plexus which lies beneath muscularis externa, on top of the submucosa, surrounding the GI tract:

A

Meissner’s submucosal plexus

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12
Q

Name the common complications of chronic acid reflux:

A
  • Oesophagitis
  • Barrett’s oesophagus
  • Oesophageal cancer
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13
Q

What causes Barrett’s oesophagus usually?

A

Chronic acid reflux

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14
Q

Describe the pathology of Barrett’s oesophagus:

A

Metaplasia of normal non-keratinised stratified squamous epithelia of lower oesophagus, into simple columnar gastric epithelium

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15
Q

Name the 2 most common types of oesophageal cancer:

A
  • Squamous cell carcinoma

- Adenocarcinoma

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16
Q

What are the main risk factors predisposing someone to oesophageal cancer?

A
  • Male sex
  • Age
  • Smoking
  • Heavy drinking
  • Obesity
  • Acid reflux
17
Q

What are oesophageal varices?

A

Abnormally enlarged veins in oesophagus, prone to rupturing and bleeding

18
Q

What causes oesophageal varices?

A

Portal hypertension, commonly dues to:

  • Liver cirrhosis
  • Thrombosis
  • Schistosomiasis
19
Q

List some sites of portosystemic anastamoses:

A
  • Lower oesophagus
  • Anal canal
  • Umbilical area
20
Q

Portal hypertension can result in caput medusae. What is this?

A

Abnormally enlarged and dilated veins radiating from the umbilicus across the abdomen.

21
Q

What are the 2 main types of dysphagia?

A

1) Oropharyngeal dysphagia

2) Oesophageal dysphagia

22
Q

What is dysphagia?

A

Difficulty swallowing

23
Q

What is oropharyngeal dysphagia?

A

Difficulty swallowing - cannot initiate the swallow

24
Q

What is oesophageal dysphagia?

A

Food sticking in the oesophagus AFTER swallowing

25
Q

List some common causes of dysphagia:

A
  • Stroke
  • GERD
  • Dementia
  • Benign/malignant tumours
  • Scar tissue
26
Q

What is odynophagia?

A

Painful swallowing

27
Q

What is achalasia?

A

Dysphagia in which the lower oesophageal sphincter doesn’t relax properly, so food cannot pass into the stomach

28
Q

How will dysphagia caused by a malignancy often present?

A
  • Coughing
  • Hoarse voice
  • Haematemesis
  • Acid reflux
  • Progressively harder to swallow
29
Q

What are the common causes of peptic ulceration?

A
  • Helicobacter pylori
  • Aspirin/NSAIDs/Steroids (chronic use)
  • Stress
  • Alcohol
  • Smoking
30
Q

How does the chronic use of aspirin/NSAIDs/steroids lead to peptic ulceration?

A
  • These drugs reduce prostaglandin secretion
  • Prostaglandins maintain the gastric mucosal defence system, by regulating bicarbonate and mucous secretion, and inhibiting acid secretion