36 Questions
What is the primary symptom of dysphagia?
Something sticking in the throat or chest during swallowing or immediately after
Which type of tumor is most commonly associated with dysphagia?
Squamous cell carcinoma
What is the primary cause of oesophageal spasms leading to dysphagia?
Atypical achalasia
What is the term for a fibrous stricture that forms at the upper end of the oesophagus due to mucosal atrophy?
Web
What is the primary treatment for a soft food bolus causing dysphagia?
Muscle relaxants
What is the complication of a tumor spreading to the trachea in dysphagia?
Tracheo-oesophageal fistulation
What is the risk of iron deficiency due to chronic inflammation?
Glossitis and microcytic anemia
What is the age group where carcinoma of the oesophagus is most common?
Over 50s
What is a risk factor for carcinoma of the oesophagus?
Heavy alcohol use
What is a symptom of carcinoma of the oesophagus?
All of the above
What is the primary complication of retained oesophageal contents?
Respiratory problems
What is the main reason for oesophagitis?
Inflammation of the oesophagus due to acid reflux
What is a local spread effect of carcinoma of the oesophagus?
Fistulae to the trachea
What is the characteristic feature of Globus hystericus?
Intermittent sensation of a lump in the throat
What is the most common type of carcinoma present in oesophagus carcinoma?
Squamous cell Carcinoma
What type of muscle coats the inner and outer layers of the oesophagus?
Circular and longitudinal muscle coats
How can the oesophagus spread to the liver?
Through direct invasion
What is the weak point of the oesophagus?
Meeting point of the two parts of the inferior constrictor
What is a diagnostic test for carcinoma of the oesophagus?
All of the above
What type of epithelium lines the mucosal layer of the oesophagus?
Stratified squamous non-keratinising epithelium
What is pyloric stenosis?
A condition where the pyloric sphincter is always closed
What is haematemesis?
Vomiting of blood
What is the main reason for pharyngeal pouch disease?
Herniation of mucosa through a weakness in the pharyngeal constrictor muscles
What is achalasia of the cardia?
Loss of ganglia from the intramural plexus
What is the function of the vagus nerve in the oesophagus?
Innervates the motor and sensory nerves in the oesophageal plexus
What is the consequence of retained oesophageal contents?
All of the above
What is the primary result of achalasia of the cardia?
Functional obstruction to oesophageal emptying
What is the main difference between peptic and gastric ulcers in terms of areas affected?
Peptic ulcers affect the oesophagus, stomach, and duodenum, while gastric ulcers affect only the stomach
What is the primary cause of peptic ulcer disease?
Mucosal inflammation due to acid and pepsin destruction of lining mucosal
What is the purpose of quadruple therapy in treating peptic ulcers?
To treat Helicobacter pylori infection
What is the result of chronic duodenal ulceration?
Penetration of the ulcer into the submucosa and muscular wall
What is the primary symptom of peptic ulcer disease?
Pain
What is the purpose of controlling predisposing factors in treating peptic ulcers?
To prevent further mucosal damage
What is the result of an oesophageal spasm?
Dysphagia and pain
What is the primary treatment for oesophageal webs?
All of the above
What is the primary difference between an acute and chronic duodenal ulcer?
Chronic ulcers penetrate the submucosa and muscular wall, while acute ulcers do not
Study Notes
Dysphagia
- Dysphagia is difficulty in swallowing
- Symptom: something sticking in throat/chest during or after swallowing
- 9 oesophageal reasons for dysphagia:
- Tumours (SCC, adenocarcinoma)
- Inflammation (acid reflux, drugs, chemical burn)
- Stricture (radiation, acid reflux)
- Foreign body (soft food bolus, impacted coins, bones)
- Trauma (bones, surgery)
- Web (mucosa becomes atrophic, fibrous stricture forms)
- Goitre, enlarged left atrium, mediastinal glands
- Oesophageal spasms (atypical achalasia, acid reflux, neuromuscular disorders, cardia obstruction)
Pharyngeal and Oral Causes of Dysphagia
- 10 oral and pharyngeal reasons for dysphagia:
- Tumours (SCC)
- Inflammation (severe candidiasis, herpes, tonsillitis, glossitis)
- Fibrosis (scleroderma)
- Trauma (bones, surgery)
- Pouch (herniation of mucosa, food collects in pouch)
- Deformity of cervical spine
- Xerostomia (Sjogren's, drugs)
- Stroke, Parkinson's, MS, MG, Bulbar Palsy
- Globus hystericus (perceived lump in throat, worse with saliva, less with food/liquids)
GI Disease Symptoms
- 9 symptoms of GI disease:
- Abdominal pain
- Dysphagia
- Heartburn
- Dyspepsia
- Flatulence
- Vomiting
- Constipation
- Diarrhoea
- Steatorrhoea
Oesophagus
- The oesophagus is a musculotendinous tube connecting the pharynx to the stomach
- 4 symptoms associated with the oesophagus:
- Dysphagia
- Pain (acid reflux)
- Cough or vomiting (food/liquids refluxing back to pharynx)
- Bleeding (haematemesis)
- 6 diseases associated with the oesophagus:
- Pharyngeal pouch
- Achalasia
- Oesophageal spasm
- Oesophageal web
- Peptic ulcer disease/reflux
- Carcinoma
Oesophageal Anatomy and Function
- The oesophagus consists of 3 muscles: superior, middle, and inferior constrictor muscles (striated)
- Weak point of the oesophagus: Killian's dehiscence, where Zeneker's diverticulum can form
- Innervation: vagus nerve (X)
- Epithelium lining the mucosal layer: stratified squamous non-keratinising epithelium
- Swallowing occurs through peristalsis: a peristaltic wave triggers, food bolus is pushed into the stomach, and the gut stretches, causing depolarisation and action potential, leading to waves of muscle relaxation and contraction.
This quiz covers the definition, symptoms, and oesophageal reasons for dysphagia, including tumors, inflammation, and other causes.
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