Session 1 - Clinical Flashcards
What is the normal epithelium of the oesophagus?
Non-keratinized stratified squamous epithelium
Approximately how long is the oesophagus?
25cm
What is the distance from the incisor teeth to the oesophago gastric junction? Why is this clinically important?
38-40cm
Useful for diagnosis and endoscopy (nasogastric tubes)
What is Barret’s oesophagus?
Metaplasia of non-keratinized stratified squamous epithelium of oesophagus to simple columnar gastric epithelium
Caused by repeated exposure to gastric acid
Is Barret’s oesophagus a direct indication of cancer?
No, but can be considered pre-cancerous
Name two possible types of cancer that can arise in the oesophagus
Adenocell carcinoma
Squamous cell carcinoma
Deifne dysphagia
Difficulty swallowing
Name three things that may cause dysphagia
Tumours
Problems with musculature
Neural problems (achalasia)
What are oesophageal varicies?
Swollen and ruptured veins in the oesophagus, which can cause potentially fatal haemorrhage
What are oesophageal varicies caused by?
Portal hypertension (drains into oesophageal veins)
Name three mechanisms that help to prevent stomach contents refluxing into oesophagus
Pinch valve - angle of entry of oesophagus into stomach
Mucosal folds at the oesophagogastric junction
You’re going on a journey through the stomach. Outline the 6 landmarks you will see
Cardia Fundus Body Antrum Pyloris Pyloric sphincter
Define peptic ulceration
Muscular erosions of greater the 5cm in stomach and duodenum
Why is the first part of the duodenum prone to ulceration?
Acidity of chyme and leakage of stomach acid, due to lack of protection - no bicarbonate or bile
What is delivered through the duodenal papilla?
Water
Bile, hepatic and pancreatic secretions
Where does the 14liters of fluid in the gut come from?
1.5l saliva
2.5l of gastric secretions
9l water + alkali
Which part of the GI system absorbs the majority of fluid?
The small intestine (12.5l)
If a person had their entire SI removed, what changes would be present in their faeces?
Watery
Steatorrhea
Name two conditions affection the SI which potentially result in malabsorption
Chrohn’s disease
Coeliac disease
What is Meckel’s diverticulum?
A congenital disorder where part of the SI bulges out and is a vestigal remnant of omphalo-mesenteric duct
Outline the cool rule surround Meckel’s diverticulum
2% (of the population). 2 feet (proximal to the ileocecal valve). 2 inches (in length). 2 types of common ectopic tissue (gastric and pancreatic). 2 years is the most common age at clinical presentation. 2:1 Male:Female ratio
What condition can Meckel’s diveritculum be mistaken for?
Acute appendicitis, presents with similar symptoms if inflamed
How will someone present clinically if they have a blocked small intestine?
Nausea
Constipation
Vomit
Loss of appetite
Give two common causes of appendicitis
Faecolith
Intestinal worms
Where is pain initially felt in appendicitis?
Umbilical pain
Where is McBurney’s point, and what is it significant for?
1/3 up from illiac fossa, 2/3 water to umbilicus
Appendix location
What are diverticula and how do they develop?
Formation of pouches which extend outwards from large hollow organs
Embryonic remmenant
Develop in sigmoid colon, as it experiences highest pressure
What is a result of the variable mobility of different parts of the large bowel?
Twists
Blood blockage
Where is the dentate line?
1/3 up anus
Saw toothed pattern
What cancers occur above dentate line?
Adenocarcinoma
What cancers occur below dentate line?
Squamous cell carcinoma
What are haemorrhoids?
Dilated vascular structures which help with stool control
Vascular cushion which surround rectum
What are the symptoms of piles? (bad haemorrhoids)
Rectal bleeding
Pain
