GORD Flashcards
Tell me what you can about mr Mueller?
- Belongs to private club where he drinks with clients- maybe he overdrinks
- finding it difficult to sleep, hence his girlfriend gave him a book on sleep solution
- he struggles to stop smoking
- his diet consists of takeaway
- his job is quite stressful; as he takes a lot of coffee a day but he has been promoted.

What is the length of the oesophagus ? What is the function?
25cm.
it acts as a conduit for food (water and mucus) from pharynx into stomach
What is the origin and end of the oesophagus ?
It originates at the inferior border of the cricoid cartilage (C6).
it ends at the cardiac orifice of the stomach (T11)
At the origin of the oesophagus, what is it continuous supeirorly with?
It is continuously superiority with the laryngeal part of the pharynx ( the laryngopharynx )
What portion of the thorax does the oesophagus enter? Where is the Oesophagus positioned in the thorax
It descends downwards into the superior mediastinum of the thorax.
It is positioned between the trachea and the vertebral bodies of T1 to T4.
How does the oesophagus enter the abdomn
Via the oesophageal hiatus (an opening in the right crus of the diaphragm) at T10
What is the length of the abdominal portion of the Oesophagus?
1.25 cm
What are the layers of the oesophagus
Adventitia / serosa
muscularis externa
submucosa
mucosa
What is Adventitia ? What part of the Oesophagus has serosa instead of Adventitia
Adventitia - outer layer of connective tissue.
it is the very distal and intraperitoneal part of the Oesophagus that has serosa instead of Adventitia.
What are the layers of the muscularis externae and how do they differ in muscle type as you go down the Oesophagus
Outer longitudinal and inner circular .
Superior third of Oesophagus = voluntary striated muscle.
middle third - voluntary striated and smooth muscle.
inferior third - smooth muscle
What does the mucosa of the Oesophagus contain
Non- keratinised stratified squamous epithelium ( it is continuous with columnar epithelium of the stomach)
lamina propria .
muscularis mucosa.
How is food transported down through Oesophagus ?
Peristalsis- a rhythmic contractions of the muscles, which propagates down the Oesophagus.
What can hardening of the muscular layers of Oesophagus lead to?
It can interfere with peristalsis and cause difficulty in swallowing (dysphagia)
What are the oesophageal sphincters and their respective functions?
Upper and lower.
They act to prevent entry of air (upper) and reflux of gastric contents (lower)
What are the features and functions of the upper oesophageal sphincters.
It is an anatomical, striated muscle sphincter at the junction between the pharynx and Oesophagus.
It is produced by the cricopharyngeus muscle.
Under normal conditions it is constricted to prevent entry of air into the Oesophagus
What are the features of the lower oesophageal sphincters?
Physiological (functional ) sphincter located in gastro-oesophageal junction. The junction is situated to the left of the T11 vertebra.
The sphincter does not have any specific sphincteric muscle
Where the location of the gastro-oesophageal junction and what marks it?
Situated at the left of the T11 vertebra.
Marked by change from oesophageal (stratified) to gastric mucosa (columnar epithelium)
What are the 4 phenomena which forms the Lower oesophageal sphincter?
- The oesophagus enters stomach at an acute angle
- The walls of the intra-abdominal section of the oesophagus are compressed when there is a positive intra-abdominal pressure.
- The folds of mucosa present aid in occluding the lumen at the gastro-oesophageal junction.
- The right crus of the diaphragm has a “pinch-cock” effect.
What situaitons are the sphincters relaxed or constricted?
It is relaxed during oesophageal peristalsis to allow food to enter stomach.
Otherwise it is constricted- what are the 2 functions?
what is barretts oesophagus?
metaplasia (from stratified squamous to columnar epithelium) of lower oesophageal squamous epithelium
What causes barretts oesophagus?
It is usually caused by chronic acid exposure as a result of a malfunctioning lower oepshageal sphincter.
The acid irritates the oesophageal epithelium, leading to a metaplastic change
What is the most common symptoms for Barretts oesophagus ?
How can it be detected ?
Symptoms- long-term burning sensation of indigestion
it can be detected via endoscopy of the oesophagus (OGD). Patients who are found to have it will be monitored for any cancerous changes.
What is the prevalence of oesophageal carcinomas
Around 2% of malignancies in the uk are oesophageal carcinomas.
What are the clinical features of oesophageal carcinomas ?
Dysphagia- it becomes progressively worse over time as tumour increases in size, restricting the passage of food.
Weight loss.

























