HIATUS HERNIAS Flashcards
What is a hiatus hernia?
Protrusion of upper part of stomach into the thorax through a weakness or tear in the diaphragmatic hiatus.
What are the different types of hiatus hernia?
Sliding hiatal hernia
Paraoesophageal (rolling) hernia
What is a sliding hiatus hernia?
The cardiac sphincter moves up into the thorax through the diaphragmatic hiatus along with the upper part of the stomach.
What is a paraoesophageal (or rolling) hiatus hernia?
The cardiac sphincter doesn’t necessarily come through the diaphragm but part of the upper stomach makes its way into the thorax next the oesaphagus through the diaphragmatic hiatus.
What are the risk factors for developing a hiatus hernia?
Increased pressure within the abdomen caused by: Heavy lifting or bending over Frequent or hard coughing Hard sneezing Violent vomiting Straining Pregnancy Obesity
Diaphragmatic laxity caused by:
Previous surgery
Connective tissue disorders
Which type of hiatus hernia is more common, rolling or sliding?
Sliding hiatal hernias make up 95% of hiatal hernias
Are rolling hiatal hernias more common in males or females?
Females
Which cells are responsible for the secretion of gastric acid?
Parietal cells
What are the three receptors involved in increasing gastric acid secretion?
Gastrin receptor
H2 (Histamine receptor)
Muscarinic (ACh) receptor
What is the receptor involved in reducing gastric acid secretion and how does it work?
Prostaglandin receptors
Block signals from H2 receptors
What do alginates do?
Alginates protect the lining of the oesopaghus
How does the oesophagus react to chronic exposure to gastric acid?
Intraepithelial build up of eosinophils and lymphocytes
Basal layer hyperplasia
Congestion and oedema
Columnar metaplasia (Barrett’s oesophagus)
