Oesophagus

Question 0

Vertebral levels of the oesophagus?

Answer 0

C6-T11

Question 1

How long and wide is the oesophagus?

Answer 1

25cm long

2cm wide

Question 2

Where does it begin and end?

Answer 2

Inferior border of the cricoid cartilage - continuous with pharynx
Cardiac orifice of the stomach

Question 3

What ligament connects the oesophagus to oesophageal hiatus in the diaphragm? What does this allow?

Answer 3

Phrenicoesophageal ligament

Independent movement of diaphragm and oesophagus during eating and breathing

Question 4

Structure of the muscular layers of the oesophagus?

Answer 4

Inner circular layer

Outer longitudinal layer

Question 5

What are the types of muscle found in the longitudinal layer of the oesophagus?

Answer 5

Superior third - voluntary striated
Middle third - voluntary striated and smooth
Inferior third - smooth muscle

Question 6

Function of oesophageal sphincters?

Answer 6

Prevent entry of air and reflux of gastric contents

Question 7

Describe the structure of the upper oesophageal sphincter

Answer 7

Anatomical

Striated muscle produced by cricopharyngeus muscle

Question 8

Where is the upper oesophageal sphincter found?

Answer 8

Between pharynx and oesophagus

Question 9

Vertebral level of lower oesophageal sphincter? Where is it located?

Answer 9

T11

In gastro-oesophageal junction

Question 10

What factors allow the lower oesophageal sphincter to be a physiological one?

Answer 10

Oesophagus enters stomach at an acute angle
Walls of intra-abdominal section of oesophagus are compressed when there is positive intra-abdominal pressure
Folds of mucosa aid in occluding the lumen

Question 11

Arterial supply of the oesophagus?

Answer 11

Thoracic - arterial blood from thoracic aorta and inferior thyroid artery

Abdominal - left gastric artery and left inferior phrenic artery

Question 12

Venosus drainage of the oesophagus?

Answer 12

Thoracic - azygous and inferior thyroid veins

Abdominal

• into portal circulation via left gastric vein
• in systemic circulation via azygous vein

PORTO-SYSTEMIC ANASTAMOSIS a

Question 13

What is Barrett’s oesophagus?

Answer 13

Metaplasia of the lower oesophageal squamous epithelium to gastric columnar epithelium

Question 14

What is Barrett’s oesophagus caused by?

Answer 14

Chronic exposure to acid due to a malfunctioning lower oesophageal sphincter

Question 15

Symptoms and investigation of Barrett’s oesophagus?

Answer 15

Long-term burning sensation

Endoscopy

Question 16

Main types of oesophageal carcinoma? Where do they occur?

Answer 16

Squamous cell carcinoma - at any level

Adenocarcinoma - lower third

Question 17

What are oesophageal varices?

Answer 17

Dilated sub-mucosal veins in wall of oesophagus that lie in the portosystemic anastamosis
Happens in portal hypertension

Question 18

What does oesophageal varices commonly occur secondary to?

Answer 18

Chronic liver disease