Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2A - Alimentary System > Oesophageal Disorders > Flashcards

Oesophageal Disorders Flashcards

1
Q

What is the length of the oesophagus?

A

25cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where does the oesophagus begin and end?

A

Begins at lower level of cricoid cartilage (C6)

Terminates at T11-T12 where it enters the stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What kind of muscle is present in the oesophagus?

A

Upper 1/3 is skeletal muscle

Lower 2/3 is smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the classification of the epithelium in the oesophagus?

A

Stratified squamous non-keratinised epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the function of the oesophagus?

A

Transport food/liquid from the mouth to the stomach which is an active process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What propels swallowed materials into the stomach?

A

Oesophageal peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What produces oesophageal peristalsis?

A

Oesophageal circular muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What must the oesophageal circular muscles coordinate with so that food can enter the stomach?

A

Lower oesophageal sphincter (LOS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What must the LOS do to allow food to enter the stomach?

A

Relax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is contraction in the oesophageal body (peristalsis) and relaxation of the LOS mediated by?

A

Vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What forms the LOS?

A

Striated muscle of the right crus of diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is formed by the acute angle of His at gastro-oesophageal junction?

A

Mucosal rosette (Redundant mucosal folds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does GOJ stand for?

A

Gastro-oesophageal junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the resting pressure like in distal smooth muscle of oesophagus?

A

High resting pressure due to LOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are key symptoms of oesophageal disease?

A

Heartburn

Dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is heartburn?

A

Retrosternal discomfort or burning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can heartburn be associated with?

A

Waterbrash (sudden flow of saliva)

Cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a sudden flow of saliva called?

A

Waterbrash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is heartburn a consequence of?

A

Reflux of acidic and/or bilious gastric contents into oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do things that reduce LOS pressure result in?

A

Increased reflux/heartburn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are examples of things that can reduce LOS pressure?

A

Drugs (dietary xanthines, alcohol, nicotine)

Food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does persistent reflux and heartburn lead to?

A

Gastro-oesophageal Reflux disease (GORD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does GORD stand for?

A

Gastro-oesophageal reflex disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is dysphagia?

A

Subjective sensation of difficulty in swallowing foods and/or liquids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What often accompanies dysphagia?

A

Odynophagia (pain when swallowing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is pain when swallowing called?

A

Odynophagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What should you enquire about when a patient presents with dysphagia?

A

Type of food (solid v liquid)

Pattern (progressive, intermittent)

Associated features (weight loss, regurgitation, cough)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where can the location of dysphagia be?

A

Oropharyngeal (part of throat behind the mouth)

Oesophageal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the part of the throat behind the mouth called?

A

Oropharyngeal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are some possible causes of dysphagia?

A

Benign stricture

Malignant stricture (oesophageal cancer)

Motility disorders

Eosinophilic oesophagitis

Extrinsic compression (such as lung cancer0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is eosinophilic oesophagitis?

A

Allergic inflammatory condition of the oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are examples of motility disorders?

A

Achalasia

Presbyoesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the main investigations done for oesophageal disease?

A

Endoscopy

Contrast radiology

Oesophageal pH and manometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is an endoscopy?

A

Procedure where the inside of the body is examined using an endoscope (long, thin, flexible tube) that has a light source and camcer at one end

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are examples of different endoscopies that can examine the oesophagus?

A

Oesophago-gastro-duodenoscopy (OGD)

Upper GI endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What does OGD stand for?

A

Oesophageal-gastro-duodenalscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What does UGIE stand for?

A

Upper GI endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is an exampe of a contrast radiology that can be used to examine the oesophagus?

A

Barium swallow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is an oesophageal pH and manometry?

A

Naso-gastric catheter containing pressure and pH sensors placed in oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Where are the probs for a oesophageal pH and manometry placed?

A

At both UOS and LOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Why is manometry used in investigations of dysphagia?

A

To assess sphincter tonicity, relaxation of sphincters and oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What does manometry messure?

A

Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are pH studies of the oesophagus used to investigate?

A

Refractory hearburn/reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is manometry of the oesophagus used to investigate?

A

Dysphagia/suspected motility disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are the 2 categories of motility disorders?

A

Hypermotility

Hypomotility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is an example of hypermotility disorder?

A

Diffuse oesophageal spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What can be seen on a barium swallow for oesophageal spasm?

A

Corkscrew appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the common presentation of oesophageal spasms?

A

Severe, episodic chest pain with or without dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is oesophageal spasm often confused with?

A

Angina/MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What does a manometry for oesophageal spasms show?

A

Exaggerated, uncoordinated, hypertonic contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are hypermotility disorders?

A

Abnormal or excessive movement of the oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are hypomotility disorders?

A

Abnormal deficiency of movement of the oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are hypomobility disorders associated with?

A

Connective tissue disease

Diabetes

Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What do hypomobility disorders lead to?

A

Failure of LOS leading to heartburn and reflux symptoms

55
Q

What is achalasia?

A

Functional loss of myenteric plexus ganglion cells in distal oesophagus and LOS

56
Q

What is the incidence of achalasia?

A

1-2/100000

57
Q

What is the male:female incidence of achalasia?

58
Q

What age does achalasia usually onset?

59
Q

How does achalasia affect the LOS?

A

Causes failure of the LOS to relax, resulting in obstruction of the distal oesophagus

60
Q

What are symptoms of achalasia?

A

Progressive dysphagia for solids and liquids

Weight loss

Chest pain

Regurgitation and chest infection

61
Q

What investigations are done for achalasia?

62
Q

What does a manometry show for achalasia?

A

High pressure at LOS (usually 45mmHg above normal, normal being 10mmHg)

Failure of LOS to relax after swallowing

Absence of peristaltic contractions in lower oesophagus

63
Q

What is the normal pressure of the LOS?

64
Q

What is the treatment for achalasia?

A

Pharmacological - nitrates, calcium channel blockers

Endoscopic - botulinum toxin, pneumatic balloon dilation

Radiological - pneumatic balloon dilatin

Surgical - myotomy

65
Q

What is a myotomy?

A

Cut away outer layers of tissue from lower oesophagus

66
Q

What are possible complications of achalasia>

A

Aspiration pneumonia and lung disease

Increased risk of squamous cell oesophageal carcinoma

67
Q

What causes GORD?

A

Pathological acid and bile exposure in lower oesophagus

68
Q

What are symptoms of GORD?

A

Heartburn

Cough

Water brash

Sleep disturbances

69
Q

What are risk factors for GORD?

A

Pregnancy

Obesity

Drugs lowering LOS pressure

Smoking

Alcoholism

Hypomotility

70
Q

What is the male:female ratio for GORD?

A

Men are affected more than woman

71
Q

How does ethnicity change risk of GORD?

A

Caucasians more than black more than asian

72
Q

What can GORD be diagnosed on?

A

Basis of characteristic symptoms without diagnosed testing

73
Q

What can be said about endoscopies and diagnosing GORD?

A

Poor diagnostic test due to >50% having no visible evidence of oesophageal abnormalities

But it must be performed in presence of alarming features suggesting malignancy

74
Q

What are alarming features that could suggest malignancy and so an endoscopy must be performed?

A

Dysphagia

Weight loss

Vomiting

75
Q

What is GORD aeitology?

A

Increase in transient relaxations of LOS

Hypotensive LOS

Delayed gastric emptying

Delayed oesophageal emptying

Decreased oesophageal acid clearance

Decreased tissue resistance to acid/bile

Anatomical distortion of the OGJ

76
Q

What are the 2 types of hiatus hernia?

A

Sliding

Para-oesophageal

77
Q

What happens in a hiatus hernia?

A

Stomach moves proximally through the diaphragmatic hiatus

78
Q

What does a hiatus hernia likely occur due to?

A

Obesity and aging

79
Q

Explain GORD pathophysiology?

A

Mucosa exposed to acid-pepsin and bile

Increased cell loss and regenerative ability (ie inflammation)

Erosive oesophagitis

80
Q

What are examples of GORD complications?

A

Ulceration (5%)

Stricture (8-15%)

Glandular metaplasia (Barrett’s oesophagus)

Carcinoma

82
Q

Does treatment occur with or without investigation for GORD in the absence of alarming features?

A

Without investigation

83
Q

What is the treatment for GORD?

A

Lifestyle measures

Pharmacological - alginates (gaviscon), H2RA (Ranitidine), proton pump inhibitor (such as omeprazole or lansoprazole)

Surgery - anti reflux surgery (fundoplication)

84
Q

What is fundoplication?

A

Full or partial wrap of stomach around the oesophagus

85
Q

What is Barrett’s oesophagus?

A

Metaplasia related to prolonged acid exposure in distal oesophagus

86
Q

What changes in Barrett’s oesophagus?

A

Stratified squamous epithelium of oesophagus changes to glandular

87
Q

What is Barrett’s oesophagus a precurser for?

A

Dysplasia/adenocarcinoma

88
Q

What is the male:female ratio of Barrett’s oesophagus?

A

Males are affected more than females

89
Q

What is the treatment for Barrett’s oesophagus?

A

Endoscopic mucosal resection (EMR)

Radio-frequency ablation (RFA)

Oesophagectomy rarely

90
Q

What is endoscopic mucosal resection (EMR)?

A

Procedure to remove early stage cancer from lining of digestive tract

91
Q

What does EMR stand for?

A

Endoscopic mucosa resection

92
Q

What is radio-frequency ablation?

A

Tumour is ablated using the heat generated from medium frequency alternating current

93
Q

What does RFA stand for?

A

Radiofrequency ablation

94
Q

What is the procedure called where part or all of the oesophagus is removed?

A

Oesophagectomy

95
Q

How common are benign tumours for oesophageal cancer?

A

Rare, are usually malignant

96
Q

What are the two histological types of oesophageal cancer?

A

Squamous cell carcinoma

Adenocarcinoma

97
Q

Where is oesophageal cancer in the world cancer mortality rankings?

98
Q

What is the male:female ratio of oesophageal cancer?

99
Q

What is more common out of adenocarcinoma and squamous cell carcinoma?

A

Adenocarcinoma in Western Europe and USA, squamous cell carcinoma everywhere else

100
Q

What is the presentation of oesophageal cancer?

A

Progressive dysphagia (90%)

Anorexia and weight loss (75%)

Odynophagia

Chest pain

Cough

Pneumonia (due to trachea-oesophageal fistula)

Vocal cord paralysis

Haematemesis

101
Q

Where in the oesophagus do squamous cell carcinomas usually occur?

A

Proximal and middle third of oesophagus

102
Q

What are squamous cell carcinomas preceded by?

A

Dysplasia and carcinoma in situ

103
Q

What is carcinoma in situ?

A

Group of abnormal cells that are considered to be pre-cancer

104
Q

What are significant risk factors for squamous cell carcinoma?

A

Tobacco

Alcohol use

Diet is potentially related (vitamin deficiencys

105
Q

What is squamous cell carcinoma associated with?

A

Achalasia

Caustic strictures

Plummer-Vinson syndrome

106
Q

Where do adenocarcinoma usually occur?

A

Distal oeophagus

107
Q

What is adenocarcinoma associated with?

A

Barrett’s oesophagus

108
Q

What are risk factors for adenocarcinoma?

A

Obesity

Male sex

Middle age

Caucasian

109
Q

What is the physical appearance of squamous cell carcinomas normally?

A

Large exophytic (grows outwards) occluding tumour

110
Q

Where do tumours of oesophageal cancer commonly spread to?

A

Regional lymph nodes (due to lamina propria having rich lymphatic supply)

Liver

111
Q

Why does oesophageal invasion to the heart, trachea or aorta often limit surgery?

A

No peritoneal (serosal) linking in mediastinum

112
Q

What does no serosal layer make more likely in terms of cancer?

A

Tumour invasion into adjacent structures occur more easily

113
Q

Where are metastatis of oesophageal cancer common?

A

Liver

Brain

Pulmonary

Bone

114
Q

What is the prognosis of oesophageal cancer?

A

Very poor with 5 year survival less than 10%

115
Q

What investigations are done for oesophageal cancer?

A

Diagnosis by endoscopy and biopsy

Staging by CT scan, endoscopic ultrasound, PET scan, bone scan

116
Q

What is required for the diagnosis of oesophageal cancer?

A

Endoscopy and biopsy

117
Q

What classification is used for staging of oesophageal cancer?

A

TNM classification

118
Q

What are treatments for oesophageal cancer?

A

Oesophagectomy with or without adjuvant or neoadjuvant chemotherapy

Combined chemotherapy and radiotherapy

119
Q

What does adjuvant mean?

120
Q

What does neoadjuvant mean?

121
Q

Who is oesophagectomy limited to?

A

Patients with local disease, without comorbid disease who are usually <70 years old

122
Q

What is the morbidity and mortality of oesophagectomy like?

A

Significant, moraltity is 10%

123
Q

What do people who recieve an oesophagectomy require post-operation?

A

Nutritional support

124
Q

What does treatment of oesophageal cancer usually aim to do?

A

Provide palliative care as most people present with incurable disease

125
Q

What are some symptom palliation options for oesophageal cancer?

A

Endoscopic (stent, laser, PEG)

Chemotherapy

Radiotherapy

Brachytherapy

126
Q

What is brachytherapy?

A

Kind of radiation treatment where a sealed radiation source is placed next to the area requiring treatment

127
Q

What is eosinophillic oesophagitis?

A

Chronic immune/allergen mediated condition defined clinically by symptoms of oesophageal dysfunction and pathologically by eosinophillic infiltration of the eosophageal epithelium in the absence of secondary causes of local or systemic eosinophilia

128
Q

What eosinophil count is required to pathologically be consider eosinophillic oesophagitis?

A

More than or equal to 15 eosinophils per high power microscopic fields on oesophageal biopsy

129
Q

How is the incidence and prevalence of eosinophillic oesophagitis changing?

A

Both are rising

130
Q

What is the male:female ratio of eosinophillic oesophagitis?

A

Males affected more than females

131
Q

What is the presentation of eosinophillic oesophagitis?

A

Dysphagia

Food bolus obstruction

132
Q

What is the treatment of eosinophillic oesophagitis?

A

Topical/swallowed corticosteroids

Dietary elimination

Endoscopic dilation

133
Q

What is endoscopic dilation?

A

Procedure that inflates a region of the oesophagus

2A - Alimentary System (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions