Oesophagus Flashcards
In which layers of the oesophagus are the glands that secrete lubricating mucous located?
Submucosa
What cell types makes up the muscosa layer of the oesophagus
Non-keratinized stratified squamous epithelium
What is the location of the oesophagus
Connects the inferior laryngopharynx to the sup portion of the stomach. Found posteriorly to the trachea and anteriorly to the vertebral column. Runs through the mediastinum.
Runs from C6 - T11
What is the superficial layer of the oesophagus called and what is its function?
Adventitia - connects the oesophagus to surrounding structures in the mediastinum due to its collapsible tube nature.
What is the name of the areola connective tissue found in the mucosa layer of the oesophagus?
Lamina Propria
What is another name for swallowing and what is it?
Deglutition - movement of food/drink from the oral cavity to the stomach
What are the functions of the upper and lower oesophageal sphincter?
Upper - allows passage of food from the pharynx to the oesophagus
Lower - allows passage of food from the oesophagus to the stomach
What occurs during the voluntary and pharyngeal phases of swallowing?
Voluntary - tongue pushes food/drink to back of oral cavity and into the oralpharnyx
Pharyngeal - nasopharynx is closed off by rising of the soft palate and uvula, epiglottis closes the entry to the larynx, upper oesophageal sphincter relaxes and bolus passes through to the oesophagus from the laryngopharynx
What are the names of the 3 stages of swallowing?
Voluntary stage
Pharyngeal stage
Oesophageal stage
Describe the process of peristalsis within the oesophageal stage of swallowing
Bolus enters the oeophagus
Circular muscalris sup to bolus contracts constricting the oephagus narrowing the walls pushing food toward the stomach. Longitudinal muscles inf to bolus also contract shortening and widening the walls allowing space for bolus to move into.
What is achalasia
Failure of lower oesophageal sphincter to relax normally causing slow passage of food into the stomach. Food gets lodged.
Roughly how long does it take for food to travel from the oral cavity to the stomach
4-8 seconds.
What is GORD
GORD is where there is failure of the lower oesophageal sphincter to contract and close properly after food has entered the stomach causing the stomach acid to reflux back into the oesophagus causing a burning sensation.
Give 3 preventable risk factors of oesophageal cancer
Alcohol
Tobacco
Obesity
Name a condition of the oesophagus that increases the risk of oesophageal cancer
Barrett’s oesophagus
What is Barrett’s oesophagus?
A condition where over time the stratified epithelium lining the mucosa are replaced with columnar epithelium. This change of cell type increases the risk of cancer forming.
What is dyplasia?
Abnormal cell presence within a tissue or organ
Name 5 common signs/symptoms of oesophageal cancer
Dysphagia
Unexplained weight loss
Regurgitation
Haematemesis
Coughing
Name 3 observations that may be undertook during a clinical examination of oesophageal cancer
Englarged nodes in the cervival/supraclavicular region
Enlarged liver (heptomegaly)
Ascites (build up of fluid in the abdomen)
What is a gastroscopy?
Type of endoscopy for the oesophagus -
Sticks a camera down the gullet to visualise tumour/cancerous cells. Can take a biopsy
What is the most common type of oesophageal cancer and where does this occur?
Adenocarcinoma
Lower 3rd (where the glandular tissue is present)
What are common sites for metastatic spread of oesophageal cancer?
Liver
Lungs
What is the process called for surgical removal of part of the oesophagus?
Oesophagectomy
In what scenarios is Radiotherapy given to treat oesophageal cancer
Alone for palliative treatment
Post surgery
Pre surgery with concomitant chemotherapy (as a radiosensitiser)
Give 5 common side effects of radiotherapy of the oesophagus
- Oesophagitis (after 30Gy)
- Coughing
- Pain when swallowing
- Dysphagia
- Regurgitation
What is the standard prescription for radical oesophageal radiotherapy?
50Gy in 25#
What is a palliative prescription for oesophageal radiotherapy?
8-10Gy in 1#
20-30Gy in 5-10#
What technique is used for radical vs palliative radiotherapy of the oesophagus?
Radical - VMAT
Palliative - parallel opposed pairs
What are the margins added to the GTV for oesophageal cancer to make up the CTV?
Additional 1cm laterally, ant and post
Additional 2cm sup and inf
What is the % survival in oesophageal cancer for 10 years?
12%
