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Y1 - Gatrointestinal > Pharynx and Oesophagus > Flashcards

Pharynx and Oesophagus Flashcards

1
Q

What is the pharynx?

A

The part of the throat that connects to the oesophagus

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2
Q

What is the difference between the upper 1/3 and lower 2/3 of the oesophagus?

A

Upper 1/3 is striated, skeletal muscle

Lowe 2/3 are composed of smooth muscle

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3
Q

What type of epithelium is the oesophagus lined by?

A

Stratified squamous

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4
Q

Is the upper oesophageal sphincter normally contracted or relaxed?

A

Contracted

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5
Q

What is the function of the lower oesophageal sphincter?

A

Prevention of gastric reflux

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6
Q

What are the three phases of swallowing?

A

The swallowing centre causes initial relaxation
Primary peristalsis
Secondary peristalsis, stimulated by the presence of the food bolus in the lumen

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7
Q

What are tertiary contractions in swallowing?

A

Pathological, non-peristaltic contractions

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8
Q

What are common symptoms of oesophageal disorders?

A

Dysphagia
Odynophagia
Heartburn
Regurgitation

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9
Q

How is dysphagia defined?

A

A sensation of obstruction during the passage of liquid or solid through the pharynx or oesophagus

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10
Q

What does a slow progression of dysphagia with a history of heartburn suggest?

A

Benign peptic stricture

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11
Q

What does relentless progression of dysphagia over a few weeks suggest?

A

Malignancy

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12
Q

What does the slow onset of dysphagia for solids and liquids at the same time suggest?

A

A motility disorder, e.g. achalasia

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13
Q

What are the categories of causes of dysphagia?

A 
Disease of mouth and tongue
Neuromuscular disorder
Oesophageal motility disorder
Extrinsic pressure cause
Intrinsic lesion cause
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14
Q

What is an example of a disease of the mouth and tongue that can cause dysphagia?

A

Candidiasis

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15
Q

What are examples of neuromuscular disorders that can cause dysphagia?

A

Pharyngeal
Bulbular palsy
Myasthenia gravis

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16
Q

What are examples of oesophageal motility disorders that can cause dysphagia?

A 
Achalasia
Scleroderma
Diffuse oesophageal spasm
Presbyoesophagus
Diabetes mellitus
17
Q

What is achalasia?

A

The lower oesophageal sphincter fails to open causing food and drink to be unable to pass into the stomach. They are often regurgitated

18
Q

What are examples of extrinsic pressures that can cause dysphagia?

A

Mediastinal glands
Goitre
Enlarged left atrium

19
Q

What are examples of intrinsic pressures that can cause dysphagia?

A 
Foreign body
Stricture (peptic, carcinoma)
Lower oesophageal ring
Oesophageal web
Pharyngeal pouch
20
Q

What is odynophagia?

A

Pain during swallowing

21
Q

What is odynophagia suggestive of>

A

Oesophagitis

22
Q

What are causes of odynophagia?

A

Reflux
Infection
Chemical oesophagitis
Oesophageal stenosis

23
Q

What is heartburn a common symptom of?

A

Reflux of gastric contents into the oesophagus

24
Q

How is heartburn felt?

A

Retrosternal burning pain that can spread to the neck and across the chest

25
Q

When is heartburn often worse?

A

When lying down, bending or stooping

26
Q

What is regurgitation?

A

Effortless reflux of oesophageal contents into the mouth and pharynx

27
Q

In which conditions is regurgitation common?

A

GORD

Organic stenosis

28
Q

What investigations can be done for oesophageal disorders?

A 
Barium swallow/meal
Gastroscopy
Manometry
Ambulatory pH monitoring
Impedance
29
Q

What is a barium swallow/meal

A

Radiological contrast study of the oesophagus

30
Q

When is a barium swallow used?

A

To give anatomical and functional information but has been superseded by gastroscopy as initial investigation of choice

31
Q

When is a gastroscopy used?

A

As the usual first line investigation for suspected oesophageal disorders

32
Q

How is a manometry study performed?

A

A catheter is passed through the nose to measure the pressures generated within the oesophagus

33
Q

When is a manometry study used?

A

To assess oesophageal motility and measure pressures within the sphincters.
Not a primary investigation, only used when diagnosis has not been achieved by history, imaging or endoscopy
Gold standard for motility disorders

34
Q

Which is preferred, high-resolution or conventional manometry?

A

High-resolution

35
Q

What is involved in a ambulatory pH monitoring?

A

A pH sensitive probe is placed in the lower oesophagus to measure the pH of acid reflux episodes
Catheter and implantable sensors are in place for 24-96 hours

36
Q

When is ambulatory pH monitoring useful?

A

To correlate episodes of acid reflux with a patient’s symptoms

37
Q

What is impedance?

A

A catheter is used to measure the resistance to flow of alternating current in the contents of the oesophagus

38
Q

When is impedance helpful?

A

Combined with a measurement go pH to assess acid, alkaline and gaseous reflux to understand symptoms produced by non-acid reflux, particularly in those continuing to have symptoms while on PPIs

Y1 - Gatrointestinal (31 decks)

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