Oral Cavity and Oesophagus

Question 1

what are the 4 main functions of the GI tract

Answer 1

motility
secretion
digestion
absorption

Question 2

what allows the slow wave activity to be passed through the entire GI tract

Answer 2

gap junctions

Question 3

each slow wave triggers a contraction true/false

Answer 3

false - slow wave must reach a certain threshold to initiate a contraction and this is dependent on neuronal and hormonal stimuli

Question 4

what are the two types of muscle throughout the GI tract

Answer 4

circular and longitudinal

Question 5

during smooth muscle contraction, circular muscle becomes

Answer 5

longer and narrower

Question 6

during smooth muscle contraction, longitudinal muscle becomes

Answer 6

shorter and fatter

Question 7

what drives the slow wave contraction and where are they located

Answer 7

interstitial cells of Cajal - pacemaker cells

located between the circular and longitudinal muscle layers

Question 8

what is the effect of the parasympathetic NS on GI tract

Answer 8

increases gastric secretions, motility and blood flow

relaxes stomach and sphincters

Question 9

what nerves supply the parasympathetic NS in GI tract

Answer 9

vagus nerve supplies until the descending colon then spinal nerves 2, 3, 4 supply distal part of the tract

Question 10

what is the effect of the sympathetic NS on GI tract

Answer 10

decreases motility, secretions and blood flow

increases sphincter tone

Question 11

what is the function of the enteric nervous system

Answer 11

governs the function of the GI tract
myenteric plexus - sphincters and motility
submucous plexus - epithelia and blood vessels

Question 12

define peristalsis

Answer 12

wave of relaxation followed by contraction to move a food bolus along the tract. triggered by gut distension

Question 13

describe segmentation

Answer 13

rhythmic contraction of circular muscle layers which work to mix and churn the chyme dividing luminal contents

Question 14

what are the spincters of the GI tract and their function

Answer 14

upper oesophageal sphincter - swallowing
lower oesophageal sphincter - travels food to stomach
pyloric sphincter - for gastric emptying regulation
ileo-caecal - regulates flow
internal and external anal sphincter for defaecation

Question 15

how many teeth does an adult have

Answer 15

32

Question 16

where is saliva first formed and then where is it modified

Answer 16

formed in the acinar cells

modified by duct cells

Question 17

name the 3 salivary glands

Answer 17

parotid
submandibular
sublingual

Question 18

where does the parotid gland secrete saliva into and which nerve innervates it

Answer 18

secretes saliva into the mouth via upper second molar

innervated by glossopharyngeal nerve

Question 19

where does the submandibular gland secrete saliva into and how much

Answer 19

secreted into the floor of the mouth - 70% of total saliva

Question 20

what nerve supplies the submandibular and sublingual glands

Answer 20

facial nerve

Question 21

at what point does the laryngopharynx become the oesophagus

Answer 21

C6

Question 22

where does the oesophagus terminate at the cardia of the stomach

Answer 22

T10

Question 23

the upper oesophageal sphincter is physiological only true/false

Answer 23

false UOS is anatomical

lower is physiological

Question 24

what are the 4 physiological restrictions at the oesophagus

Answer 24

A - arch of the aorta
B - bronchus (left main stem)
C- cricoid cartilage
D - diaphragmatic hiatus

Question 25

what are papillae and what is within them

Answer 25

bumps on the tongue - taste buds are located within them.

Question 26

name the 3 types of papillae that contain taste buds

Answer 26

vallate, fungiform, fusiform | filiform doesnt contain taste buds

Question 27

what are the main causes of acute oesophagitis

Answer 27

ingestion of chemicals | infection in immunocompromised patients (candidiasis, herpes, CMV)

Question 28

what are the symptoms associated with oesophagitis

Answer 28

dysphagia odynophagia chest pain

Question 29

what treatment is used for acute oesophagitis

Answer 29

antibiotics/antivirals if required | corticosteroid to reduce inflammation

Question 30

what is the main causes of chronic oesophagitis

Answer 30

reflux disease (GORD)

Question 31

what are the causes of GORD

Answer 31

increased intra-abdominal pressure eg obesity, pregnancy gastric acid hypersection LOS dysfunction

Question 32

what are the symptoms of GORD

Answer 32

``` dysphagia odynophagia heart burn water brash chest pain - after eating/at night ```

Question 33

what is the treatment for GORD

Answer 33

PPIs eg omeprazole antacid tablets lifestyle advice to reduce incidence

Question 34

what are 3 complications of chronic oesophagitis

Answer 34

ulceration/bleeding stricture Barretts Oesophagus

Question 35

define Barretts Oesophagus

Answer 35

replacement of stratified squamous epithelium with simple columnar epithelium reduce to persistent abuse from acid and bile

Question 36

why can Barretts Oesophagus be described as pre-malignant tissue

Answer 36

form of metaplasia because mature cells are differentiating and growing abnormally

Question 37

what is allergic oesophagitis

Answer 37

chronic type of oesophagitis

Question 38

who typically develops allergic oesophagitis

Answer 38

those with personal/family history of asthma and other allergies males > females

Question 39

what investigations are done for those with allergic oesophagitis

Answer 39

blood tests for eosinophilia | pH probs to exclude acid reflux

Question 40

what is the treatment for allergic oesophagitis

Answer 40

corticosteroids such as prednisolone - can be used alongside monkelukast

Question 41

benign oesophageal tumours are more common than malignant tumours true/false

Answer 41

false - malignant more common

Question 42

what is the most common type of benign oesophageal tumour and what is it associated with

Answer 42

squamous cell papilloma | associated with HPV 16 and 18 - usually asymptomatic

Question 43

what are the two types of malignant tumours that can develop in the oesophagus

Answer 43

adenocarcinoma | squamous cell carcinoma

Question 44

what is the aetiology of oesophageal malignancies

Answer 44

``` caucasian smoking males obesity genetics ```

Question 45

Barretts Oesophagus increases likelihood of which cancer? where in the oesophagus is it most likely to develop

Answer 45

adenocarcinoma | lower 1/3 of oesophagus because thats where is most likely to develop Barretts from GORD

Question 46

what are the symptoms of oesophageal cancer

Answer 46

``` progressively worsening dysphagia odynophagia haematemesis weight loss anaemia stricture lymphadenopathy ```

Question 47

what is the best treatment for oesophageal cancer

Answer 47

surgical resection - dependent on co-morbidities with neo-adjuvant chemotherapy if localised treat with radical chemo