Section 1F Flashcards
What do esophageal glands do?
Provide mucus for lubricating the passage of food down the Esophagus. Found in the esophageal submucosa
What type of epithlieum is found in the esophagus
Non-keratinized stratified squamos.
Wall of the esophagus is made of what three layers
- Mucosa
- Submucosa
- Muscularis
Where do the vascular plexus veins drain into from the esophagus?
The left gastric vein –> drains into the portal vein
In what people are esophageal varices found?
In cases of portal hypertension (an increase in pressure in the portal vein, usually due to cirrhosis).
Swallowing consists of what three phases?
Oral or voluntary phase
Pharyngeal phase
Esophageal phase
How does the histology of the esophagus differ from the rest of the GI tract?
Esophagus has no true serosal outer layer but is covered by a thin and poorly defined layer of connective tissue
In cases of portal hypertension, the submucosal venous spaces along with all of the other “draining” veins of the mid to lower esophagus may do what?
Enlarge into esophageal varices with prominent red wale spots.
How is swallowing initiated? This is the oral phase
By the voluntary action of collecting the oral contents on the tongue and propelling them backward to the pharynx (oral phase).
After swallowing is initiated what occurs especially in the pharyngeal muscles? This is the pharyngeal phase.
A wave of involuntary contraction in the pharyngeal muscles that pushes the material into the esophagus, as the upper esophageal sphincter (UES) relaxes and opens (pharyngeal phase)
How does the epiglottis close the airway during swallowing?
The material tilts the epiglottis backward and down over the closed glottis as further protection from food entering the respiratory airways.
Is swallowing possible when the mouth is open?
It is difficult if not impossible when mouth is open, as anyone has spent time in the dentist’s chair feeling saliva collect in the throat is aware.
What happens once food enters the esophagus? This is the esophageal phase
Peristalsis takes over. Esophageal peristalsis involves a progressive wave of ring-like smooth contractions that propels food down to the lower esophageal sphincter (LES)
Does peristalsis occur if food is not present?
Esophageal peristalsis will occur whether or not food is present, although the presence of food will intensify the peristaltic contractions.
What occurs if the primary peristaltic wave fails to move food into the stomach?
The persistence of the food bolus in the esophagus will set off secondary peristaltic waves to complete the job.
How is the LES contracted?
Like most sphincters, it is tonically contracted
What occurs to the LES during achalasia?
The LES fails to relax; food that has been swallowed has difficulty passing into the stomach, and the esophagus above the LES becomes enlarged.
What occurs when LES pressure decreases?
Decreases it’s closing strength. this permits reflux of acidic gastric contents into the esophagus (GERD - gastroesophageal reflux disease)
Other than a decrease in LES pressure, What also may contribute to reflux?
Delayed gastric emptying also may contribute to reflux by increasing gastric volume and pressure with greater chance for reflux.
GERD causes what two things?
Causes heartburn and esophagitis
These can lead to ulceration and stricture of the esophagus due to scarring.
T or F, Research has found no relationship between GERD and esophageal adenocarcinoma
False, There is a strong causal relationship between GERD and esophageal adenocarcinoma
Nine agents that have been demonstrated to diminish the closing strength of the LES
- Fatty food
- Chocolate
- Ethanol
- Caffeine
- Peppermint
- Spicy foods
- Citrus fruits and juices
- Smoking
- Steroidal based oral contraceptives
What causes complications of Barrett’s esophagus
Complications result from persistent reflux, producing a cycle of mucosal damage that causes edema and erosion of the luminal surface.
What causes the strictures in Barrett’s esophagus?
Caused by a combination of scar tissue, spasm and edema
What do strictures cause in Barrett’s esophagus?
They produce narrowing of the esophagus and cause dysphagia when the lumen becomes sufficiently constricted
Patients with dysphagia usually complain of what?
Choking
Coughing
Abnormal sensation of food sticking in the back of the throat or upper chest when they swallow.
What is it called if swallowing is painful?
Odynophagia
What characterizes Barrett’s Esophagus?
Characterized by a repair process in which the squamous mucosa that normally lines the esophagus is gradually replaced by columnar epithelium resembling that in the stomach and intestines. It is associated with increased risk of developing esophageal cancer.
How long is the esophagus?
18 to 26 cm from upper sphincter to the lower sphincter
Esophagus connects what to things?
Pharynx to the stomach
