Esophagus and Swallowing Quiz

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Questions and Answers

What is the primary function of the lower esophageal sphincter (LES)?

To regulate the secretion of digestive enzymes

To aid in the ingestion of food

To facilitate the propulsion of bolus

To provide a pressure barrier between the esophagus and stomach (correct)

Secondary peristalsis is more common than previously thought.

False

What may occur following a cerebrovascular accident regarding swallowing?

Coordinated outflow of swallowing may be altered.

The maximum weight that can be overcome when attempting to swallow a bolus attached by a string is ______.

5 to 10 g Signup and view all the answers

Match the following terms with their definitions:

Secondary peristalsis = Not as common as once thought Cricopharyngeus = Striated muscle in the esophagus Cerebrovascular accident = May disrupt coordinated outflow LES = Acts as a valve between esophagus and stomach Signup and view all the answers

What does the retrocricoid portion of the inferior constrictor serve as?

The upper sphincter of the esophagus Signup and view all the answers

The cervical portion of the esophagus is shorter than the thoracic portion.

True Signup and view all the answers

Which nerve plexus lies on the muscular wall of the esophagus?

Esophageal nerve plexus Signup and view all the answers

The thoracic duct passes through the diaphragm on the anterior surface of the _____ column.

vertebral Signup and view all the answers

Match the following parts of the esophagus with their functions:

Retrothyroid portion = Contracts to force the bolus into the esophagus Thoracic duct = Lymphatic drainage Cricopharyngeus = Part of the inferior constrictor muscle Vagal nerves = Control involuntary functions of the esophagus Signup and view all the answers

At which thoracic vertebra does the esophagus begin to move vertically away from the spine?

8th thoracic vertebra Signup and view all the answers

The descending thoracic aorta is located on the right side of the esophagus.

False Signup and view all the answers

Who showed that the retrocricoid and retrothyroid portions of the inferior constrictor serve different functions?

Keith Signup and view all the answers

What happens to the abdominal pressure in the upright position compared to atmospheric pressure?

It is negative Signup and view all the answers

In the supine position, the gastroesophageal pressure gradient increases, preventing reflux into the esophagus.

False Signup and view all the answers

What maintains the intrinsic myogenic tone of the lower esophageal sphincter (LES)?

Neural and hormonal mechanisms Signup and view all the answers

The hormones _ and _ have been shown to increase LES pressure.

gastrin, motilin Signup and view all the answers

Which neurotransmitters are involved in regulating LES pressure?

α-Adrenergic and β-blockers Signup and view all the answers

Match the factors with their roles in relation to the lower esophageal sphincter (LES):

Gastrin = Increases LES pressure Cholecystokinin = Decreases LES pressure Vagus nerve = Carries both excitatory and inhibitory fibers α-blockers = Decrease LES pressure Signup and view all the answers

Relaxation of the LES coincides with peristaltic waves in the esophagus.

True Signup and view all the answers

What is a potential cause of gastroesophageal reflux disease (GERD)?

Spontaneous lower esophageal relaxation Signup and view all the answers

How long does the whole course of rise and fall of occlusive pressure occupy in the esophagus?

3 to 5 seconds Signup and view all the answers

The peak of a primary peristaltic contraction reaches the distal esophagus approximately 5 seconds after swallowing starts.

False Signup and view all the answers

What is the speed range at which the primary peristaltic wave moves down the esophagus?

2 to 4 cm/s Signup and view all the answers

The peak of a peristaltic contraction lasts about ______ seconds.

0.5 Signup and view all the answers

What happens when the act of swallowing is rapidly repeated?

The esophagus remains relaxed Signup and view all the answers

Efficient contraction of the esophagus is solely governed by gravity.

False Signup and view all the answers

What is the resting level of intraluminal esophageal pressure mentioned in the text?

30 mmHg Signup and view all the answers

What is more common during wakefulness and the upright position in healthy individuals?

Physiologic gastroesophageal reflux Signup and view all the answers

Normal subjects can rapidly clear gastric juice from the esophagus regardless of their position.

True Signup and view all the answers

What is the primary reason for increased reflux episodes in healthy individuals when they are upright?

Transient losses of the gastroesophageal barrier Signup and view all the answers

Gastroesophageal reflux is typically observed when the lower esophageal sphincter (LES) _____ or when intra-gastric pressure overcomes sphincter pressure.

relaxes Signup and view all the answers

Match the terms with their descriptions:

LES = Lower esophageal sphincter Intra-gastric pressure = Pressure within the stomach Gastroesophageal reflux = Backward flow of gastric contents into the esophagus Healthy individuals = People with normal physiological functions Signup and view all the answers

Which of the following statements is accurate regarding esophageal reflux mechanisms?

Reflux happens mainly during transient losses of the gastroesophageal barrier. Signup and view all the answers

Physiological reflux occurs more frequently during sleep than when awake.

False Signup and view all the answers

What is the role of the cricopharyngeus in relation to the pharyngeal muscles?

To relax Signup and view all the answers

What condition is characterized by the lining of the esophagus being made up of columnar epithelium instead of normal squamous epithelium?

Barrett’s esophagus Signup and view all the answers

Gastroesophageal reflux is always associated with visible mucosal abnormalities.

False Signup and view all the answers

What diagnostic technique is used to observe coordinated esophageal peristalsis?

Barium swallow Signup and view all the answers

A small hiatal hernia is usually not associated with ______________.

gastroesophageal reflux symptoms Signup and view all the answers

What is the appearance of Barrett’s esophagus when viewed during an endoscopy?

Redder, salmon-colored mucosa Signup and view all the answers

Histologically, Barrett’s esophagus appears as intestinal metaplasia.

True Signup and view all the answers

What is essential for confirming the presence of Barrett's esophagus?

Biopsy Signup and view all the answers

Match the esophageal conditions with their descriptions:

Barrett’s esophagus = Lining replaced by columnar epithelium Hiatal hernia = Displacement of esophagogastric junction Gastroesophageal reflux = Reflux that may not show mucosal abnormalities Esophageal strictures = Narrowing of the esophagus Signup and view all the answers

Study Notes

Surgical Anatomy

The esophagus is a muscular tube, beginning as a continuation of the pharynx and ending at the cardia of the stomach
During swallowing, the esophagus's proximal points of fixation move craniad.
The esophagus generally stays in the midline, but has a slight deviation to the left in the neck and upper thorax, returning to the midline in the mid-thorax near the trachea's bifurcation.
In the lower thorax, the esophagus deviates to the left and anterior to pass through the diaphragmatic hiatus.

Physiology

Alimentation requires transporting food and drink from the mouth to the stomach.
The esophagus and pharynx are divided into 3 parts: mouth/hypopharynx, and esophagus.
Swallowing involves the tongue and pharynx acting as piston pumps, the esophagus and cardia acting as worm-drive pumps, and 3 pharyngeal valves(soft palate, epiglottis, and cricopharyngeus) and one esophageal valve (lower esophageal sphincter): LES).
Swallowing is a reflex action initiating with the tongue pushing a bolus into the pharynx, which closes off the nasopharynx using the soft palate.
The hyoid bone moves upward and forward as the larynx and epiglottis are elevated, protecting the larynx from aspiration.

Tests to Detect Functional Abnormalities

Endoscopic evaluation is the initial diagnostic procedure to test the esophagus for disease.
Los Angeles grading system is used to categorize and quantify esophagitis.
Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disease requiring treatment.
Barrett's esophagus is the transformation of distal esophageal epithelium from squamous to specialized columnar epithelium.
Radiographic analysis is used for evaluating anatomy and motility.
High-resolution manometry provides detailed evaluation of esophageal motor function using pressure-sensitive transducers positioned along the esophageal canal.
Esophageal impedance recordings give information about esophageal function and gastroesophageal reflux.
Esophageal transit scintigraphy records the transit of a water-based or nonacidic bolus through the esophagus.
Video- and cineradiography used for evaluating the pharyngeal phase of swallowing.

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Description

Test your knowledge on the anatomy and functions of the esophagus and its relation to swallowing. This quiz covers crucial terms, definitions, and physiological aspects of the lower esophageal sphincter and related structures. Perfect for students and professionals in the medical field.

Esophagus and Swallowing Quiz

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Podcast

Questions and Answers

What is the primary function of the lower esophageal sphincter (LES)?

Secondary peristalsis is more common than previously thought.

What may occur following a cerebrovascular accident regarding swallowing?

The maximum weight that can be overcome when attempting to swallow a bolus attached by a string is ______.

Match the following terms with their definitions:

What does the retrocricoid portion of the inferior constrictor serve as?

The cervical portion of the esophagus is shorter than the thoracic portion.

Which nerve plexus lies on the muscular wall of the esophagus?

The thoracic duct passes through the diaphragm on the anterior surface of the _____ column.

Match the following parts of the esophagus with their functions:

At which thoracic vertebra does the esophagus begin to move vertically away from the spine?

The descending thoracic aorta is located on the right side of the esophagus.

Who showed that the retrocricoid and retrothyroid portions of the inferior constrictor serve different functions?

What happens to the abdominal pressure in the upright position compared to atmospheric pressure?

In the supine position, the gastroesophageal pressure gradient increases, preventing reflux into the esophagus.

What maintains the intrinsic myogenic tone of the lower esophageal sphincter (LES)?

The hormones _____ and _____ have been shown to increase LES pressure.

Which neurotransmitters are involved in regulating LES pressure?

Match the factors with their roles in relation to the lower esophageal sphincter (LES):

Relaxation of the LES coincides with peristaltic waves in the esophagus.

What is a potential cause of gastroesophageal reflux disease (GERD)?

How long does the whole course of rise and fall of occlusive pressure occupy in the esophagus?

The peak of a primary peristaltic contraction reaches the distal esophagus approximately 5 seconds after swallowing starts.

What is the speed range at which the primary peristaltic wave moves down the esophagus?

The peak of a peristaltic contraction lasts about ______ seconds.

What happens when the act of swallowing is rapidly repeated?

Efficient contraction of the esophagus is solely governed by gravity.

What is the resting level of intraluminal esophageal pressure mentioned in the text?

What is more common during wakefulness and the upright position in healthy individuals?

Normal subjects can rapidly clear gastric juice from the esophagus regardless of their position.

What is the primary reason for increased reflux episodes in healthy individuals when they are upright?

Gastroesophageal reflux is typically observed when the lower esophageal sphincter (LES) _____ or when intra-gastric pressure overcomes sphincter pressure.

Match the terms with their descriptions:

Which of the following statements is accurate regarding esophageal reflux mechanisms?

Physiological reflux occurs more frequently during sleep than when awake.

What is the role of the cricopharyngeus in relation to the pharyngeal muscles?

What condition is characterized by the lining of the esophagus being made up of columnar epithelium instead of normal squamous epithelium?

Gastroesophageal reflux is always associated with visible mucosal abnormalities.

What diagnostic technique is used to observe coordinated esophageal peristalsis?

A small hiatal hernia is usually not associated with ______________.

What is the appearance of Barrett’s esophagus when viewed during an endoscopy?

Histologically, Barrett’s esophagus appears as intestinal metaplasia.

What is essential for confirming the presence of Barrett's esophagus?

Match the esophageal conditions with their descriptions:

Study Notes

Surgical Anatomy

Physiology

Tests to Detect Functional Abnormalities

Studying That Suits You

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