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Gastroenterology > Upper GI Tract > Flashcards

Upper GI Tract Flashcards

1
Q

what vertrebal level does the oesophagus start and end?

A

c6-t10

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2
Q

What makes up the LOS (4)?

A

3-4cm of oesophagus
diaphragm
phrenoesophageal ligament
angle of his

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3
Q

Describe the stages of swallowing

A

Stage 0: chewing and saliva bolus
Stage 1: pharyngeal musculature guides bolus towards oesophageus UOS opens
Stage 2: UOS closes and LOS dilates more
Stage 3: LOS closes to prevent reflux

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4
Q

What neuron allows oesophageal relaxation? What neural structure do they stem from?

A

inhibitory noncholinergic nonadrenergic (NCNA) neurons from myenteric plexus

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5
Q

What is Achalasia (functional disorder) and what is its pathophysiology?

A

Hypermotility due to the loss of ganglion cells in myenteric plexus = decreased activity of NCNA neurones and LOS does not relax = muscles constantly contracted = food cannot pass through

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6
Q

What are some secondary causes of achalasia? what is the most common treatment line?

A

Chagas disease
Protozoa (infection)
Sarcoma/eosinophilic oesophagitis
Hellers myotomy

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7
Q

What is Scleroderma (functional disorder) and what is its pathophysiology? What condition is it normally associated with

A

Hypomotility and dilated LOS
increased reflux
associated with CREST syndrome: Calcinosis, Raynauds, Esophageal disturbance, Sclerodactyly (thickening of skin in hands) Telangiectasis (dilation of vessles causing red marks on skin)

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8
Q

What 3 areas are oesophageal perforations most common in?

A

Cricopharyngeal constriction
Aortic and bronchial constriction
Diaphragmatic constriction (narrowing)

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9
Q

What is the most common cause of oesophageal perforations? what other perforations are seen?

A

OGD- oesophagogastroduodenoscapy
Latrogenic
booerhaves
foreign body
trauma
intraoperative

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10
Q

What does the LOS protect us from? what are 3 mechanisms does the oesophagus have to also protect us from this?

A

Reflux
Peristalsis keeps food going down rather than up
saliva is slightly alkaline- coats oesophaus
epithelieum has barrier properties

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11
Q

What does failure of reflux mechanisms cause?

A

GORD-gastro-oesophageal reflux disease
Sliding Hiatus hernias and Rolling hiatus hernias

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12
Q

What do each parts of the stomach produce?

A

Cardia and Pylori: Mucus
Body and Fundus: Mucus HCL Pepsinogen
Antrum: Gastrin

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13
Q

What vertebral level does oesophagus enter the diaphragm?
What level does the vena cava and aorta pierce the diaphragm

A

T10
Vena C- T8
Aorta- T12

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14
Q

What ligament surrounds the oesophagus at the LOS?
What organ does It also bind it to?

A

Phrenooesophageal ligament
The diaphragm

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15
Q

What reflex opens the oesophageal sphincter?

A

Vasovagal reflex

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16
Q

What is the difference between reflux and regurgitation?

A

Reflux is when oesophageal contents return from above an obstruction
Regurgitation is when gastroduodenal contents return to mouth

17
Q

How do you treat scleroderma?
What must you exclude?

A

Improve peristalsis with prokinetics
Exclude obstructions

18
Q

What is an example of disordered coordination?
What muscle do you see hypertrophy in this condition?
What are its symptoms?
How do you treat it?

A

Corkscrew oesophagus- oesophageal spasms causing a corkscrew appearance
Smooth muscle
Dysphasia and chest pain
Pneumatic dilation of cardia

19
Q

What type of hernia causes GORD?

A

Sliding hiatus hernia

20
Q

What are the two types of hernias? What are their differences?

A

Rolling hernia: stomach rolls up with oesophagus to the chest
Sliding hernia: stomach and oesophagus move up and down

21
Q

What are the medical and surgical treatments for GORD?

A

OGD- oesophageal gastro duodenoscopy
Manometry
Strictures

22
Q

What are the 4 types of gastritis and what causes them each?

A

Erosive and haemorrhagic- E&H (acute ulcer)
Non erosive chronic- H.Pylori
Atrophic-autoantibodies
Reactive-Alcohol and steroids

23
Q

What stimulates and inhibits gastric secretion?
Where do they stimulators come from?

A

Acetylcholine from brain
Gastrin from endocrine
Histamine from paracrine

Inhibit: Secretin, somatostatin, prostaglandin, TGF-alpha

24
Q

What are the three mechanisms for repairing epithelial damage in ulcers?

A

Migration of epithelial cells, cell growth via TGF, acute wound healing

25
Q

How do you test for H.Pylori?

A

CLO test: Clarythromycin Like Organism test

Gastroenterology (10 decks)

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