Lesson 2

Question 1

Oropharyngeal dysphagia causes

Answer 1

• Altered bolus impulse towards the hypopharynx, due to neurological problems that affect chewing
• Alterations in saliva production
• Oral lesions (candidiasis and infections)
• Altered contraction of the hypopharynx due to neurological problems or traffic obstruction: tumours or abscess in the pharynx area.

Question 2

Causes of esophageal dysphagia - stenosis

Answer 2

Stenosis: mechanical obstruction of oesophageal lumen

• Intraluminal: swallowed foreign bodies
• Parietal: neoplasms, retractable scars etc.
• Extra-parietal: Mediastinal tumours, aortic aneurism,
  Zenker’s esophageal pouches (diverticula), vertebral osteophytes

Question 3

Causes of oesophageal dysphagia: motor impairment

Answer 3

Primary or myopathic:
- Oesophageal wall becomes rigid and loses peristaltic movement in sclerodermia due to muscle fiber atrophy and connective tissue substitution (achalasia, diffuse oesophageal spasm, nutcracker oesophagus)

Secondary or neuropathic,
- Chagas disease where intra-oesophageal plexuses are destroyed, or pathologic esophageal dilation