Esophageal Physiology Quiz

A muscular tube connecting the pharynx to the stomach, about 23-25 cm long. It has two sphincters and is lined by squamous epithelium.

The upper esophageal sphincter (UES) is composed of the cricopharyngeus muscle and is located at the top of the esophagus. It helps prevent food from going back up into the throat.

The lower esophageal sphincter (LES) is located at the bottom of the esophagus, below the diaphragm. It acts as a valve to prevent stomach acid from backing up into the esophagus.

The esophagus is innervated by the vagus nerve, which controls smooth muscle contraction and peristalsis. The myenteric plexus controls peristalsis, while the Meissner's plexus controls secretions.

The primary function of the esophagus is to propel food from the pharynx to the stomach through muscle contractions called peristalsis.

Secondary peristalsis occurs in response to esophageal distention, such as food remaining in the esophagus or acid reflux.

Tertiary contractions are nonperistaltic contractions that propel food in a backward direction towards the proximal esophagus.

Endoscopy is a procedure where a thin, flexible tube with a camera is used to visualize the lining of the esophagus. It can be used for both diagnosis and treatment.

A procedure that measures the pressure inside the esophagus and the coordination of the muscles that control the flow of food. It is used to diagnose conditions like achalasia and Scleroderma.

A sensation of food being stuck or delayed as it travels from the mouth to the stomach.

Pain while swallowing.

A condition where a person vomits against a closed airway, causing a rapid increase in pressure in the esophagus, which can lead to a tear or rupture.

A tear or hole in the lining of the esophagus.

The most common cause of a foreign object stuck in the esophagus, which usually suggests an underlying condition.

A procedure used to remove foreign objects from the esophagus using a flexible or rigid tube.

A type of battery that can be extremely dangerous if swallowed, especially if it gets stuck in the esophagus.

A condition where air or gas enters the space between the lungs and the chest wall (pleural space), causing the lung to collapse.

A condition that occurs when there is a buildup of pressure around the heart, usually due to an injury that causes air to get into the chest cavity.

Injury to the lungs or other organs caused by changes in pressure, often from diving or flying.

A tear or rupture in the esophagus, often caused by forceful vomiting.

An abnormal connection between the esophagus and another structure, such as the trachea or the bronchus.

The most common cause of esophageal perforation. It occurs when instruments are used to examine or treat the esophagus.

A perforation in the esophagus caused by swallowed foreign objects, often occurring when these objects are not retrieved in time.

Gastroesophageal reflux is a common condition where stomach acid backs up into the esophagus, causing burning pain and discomfort.

Increased gastric volume after meals can put pressure on the lower esophageal sphincter (LES), causing acid to flow back up into the esophagus.

Bending over or lying down can also increase pressure on the LES, leading to acid reflux. Gravity plays a role.

Obesity and tight clothing can increase pressure in the abdomen, squeezing the stomach and forcing acid up into the esophagus.

A hiatal hernia occurs when a part of the stomach protrudes through the diaphragm, weakening the LES and allowing acid to reflux.

Erosive esophagitis, also known as acid reflux esophagitis, is a condition where the lining of the esophagus gets irritated by stomach acid, leading to damage and ulcers.

Esophageal strictures are narrowings in the esophagus that can develop as a result of healing from erosive esophagitis. This can cause difficulty swallowing.

Barrett's esophagus is a condition where cells lining the esophagus change in response to chronic acid reflux. This can increase the risk of developing esophageal cancer.

Lifestyle interventions to manage GERD, including dietary changes, weight management, and positioning strategies.

Medications used to decrease acid production in the stomach. They work by blocking histamine receptors. Examples include cimetidine, ranitidine, famotidine, and nizatidine.

Medications that suppress gastric acid secretion. They are highly effective for GERD. Examples include omeprazole and lansoprazole.

Medications that accelerate stomach emptying and esophageal clearance. They improve GERD symptoms by promoting faster food movement.

Surgical procedure to wrap the upper part of the stomach around the lower esophagus, tightening the lower esophageal sphincter to prevent reflux.

A surgical technique for GERD using stitches placed through the mouth rather than an incision.

A minimally invasive procedure using radiofrequency energy to tighten the LES. Works by heat-treating muscle tissue.

A group of new, minimally invasive treatments for GERD.

Alkalis are more likely to be ingested in larger quantities as they are generally tasteless and odorless. They cause liquefaction, saponification of fats, dehydration, and thrombosis of blood vessels.

Acids cause coagulative necrosis, leading to eschar formation, which can limit their penetration into deeper layers of the esophagus. They also cause more gastric damage than alkalis due to intense pylorospasm.

The most effective method for assessing stricture development after ingestion of corrosive substances is regular endoscopic examinations. This is recommended because significant stricture formation occurs in about half of patients with extensive mucosal damage.

Early endoscopy performed by an experienced endoscopist is crucial for managing corrosive ingestion cases. It allows for a comprehensive inspection of the entire esophagus and stomach.

Gastroesophageal reflux disease (GERD) is defined by either symptoms or mucosal damage caused by abnormal reflux of gastric contents into the esophagus. It often presents chronically and may involve complications in patients with atypical symptoms.

Physiologic GERD is postprandial (after meals), short-lived, asymptomatic, and lacks nocturnal symptoms. Pathologic GERD, however, is associated with symptoms, mucosal injury, nocturnal symptoms, and is often a chronic condition.

The lower esophageal sphincter (LES) acts as the primary barrier against gastroesophageal reflux. It works in conjunction with the diaphragm to prevent acid reflux. A disruption in this barrier allows stomach acid to backflow into the esophagus.

Gastroesophageal reflux results from either transient relaxation or incompetence of the LES or increased pressure within the stomach. These factors contribute to the reflux of gastric contents into the esophagus.