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Oesophagus Anatomy and Pathology
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Oesophagus Anatomy and Pathology

Created by
@JollyFern

Questions and Answers

What defines A rings in the distal esophagus?

  • Located above the gastroesophageal junction with columnar mucosa.
  • Present in the distal esophagus above the gastroesophageal junction and covered by squamous mucosa. (correct)
  • Located at the squamocolumnar junction with gastric cardia-type mucosa.
  • Covered by squamous mucosa and located below the gastroesophageal junction.

    • Which neurotransmitters contribute to the relaxation of the lower esophageal sphincter (LES) during swallowing?

  • Serotonin and acetylcholine.
  • Histamine and dopamine.
  • GABA and substance P.
  • Nitric oxide and vasoactive intestinal polypeptide. (correct)

    • What is a characteristic of primary achalasia?

  • Aperistalsis of the esophagus. (correct)
  • Overactivity of cholinergic signaling.
  • No change in LES tone.
  • Complete relaxation of the LES.

    • Which condition is classified as secondary achalasia?

    <p>Chagas disease.</p> Signup and view all the answers

    What is NOT part of the characteristic triad of primary achalasia?

    <p>Esophageal narrowing.</p> Signup and view all the answers

    Which condition can lead to achalasia-like disease?

    <p>Diabetic autonomic neuropathy</p> Signup and view all the answers

    What is one of the main causes of oesophageal varices?

    <p>Chronic liver disease</p> Signup and view all the answers

    Which statement about Mallory-Weiss tears is correct?

    <p>They occur due to severe retching or vomiting.</p> Signup and view all the answers

    What is a potential cause of infectious oesophagitis in immunocompromised patients?

    <p>Candida species</p> Signup and view all the answers

    What is the primary morphological finding in patients with oesophageal varices?

    <p>Tortuous dilated veins</p> Signup and view all the answers

    What therapy is commonly used to treat achalasia?

    <p>Laparoscopic myotomy</p> Signup and view all the answers

    Which complication is associated with the rupture of varices?

    <p>Massive hematemesis</p> Signup and view all the answers

    Which of the following is a cause of chemical oesophagitis?

    <p>Heavy smoking</p> Signup and view all the answers

    In what manner do oesophageal varices develop?

    <p>Due to portal hypertension leading to collateral veins forming</p> Signup and view all the answers

    What is the role of botulinum neurotoxin (Botox) in managing achalasia?

    <p>Inhibits LES cholinergic neurons</p> Signup and view all the answers

    What is oesophageal atresia primarily characterized by?

    <p>Absence of a segment of the oesophagus</p> Signup and view all the answers

    What are the potential complications associated with fistulas in oesophageal atresia?

    <p>Aspiration and pneumonia</p> Signup and view all the answers

    What is a characteristic feature of a hiatal hernia?

    <p>Protrusion of the stomach into the thorax</p> Signup and view all the answers

    What associated issues should be investigated when a congenital GI disorder is present?

    <p>Other organ abnormalities</p> Signup and view all the answers

    Which of the following correctly describes oesophageal atresia?

    <p>A non-canalized segment that creates mechanical obstruction</p> Signup and view all the answers

    Which of the following statements is true regarding congenital heart defects and oesophageal atresia?

    <p>They are often associated with other congenital malformations.</p> Signup and view all the answers

    Which age group is most likely to experience congenital hiatal hernias?

    <p>Young children and infants</p> Signup and view all the answers

    What defines atresia in a medical context?

    <p>Absence or closure of a natural passage</p> Signup and view all the answers

    What is the most frequent cause of oesophagitis?

    <p>Reflux of gastric contents</p> Signup and view all the answers

    Which condition is associated with an increase in abdominal pressure that can contribute to GERD?

    <p>Alcohol use</p> Signup and view all the answers

    Which complication is NOT associated with reflux oesophagitis?

    <p>Pseudomembranous colitis</p> Signup and view all the answers

    Which of the following symptoms is commonly associated with gastroesophageal reflux disease (GERD)?

    <p>Dysphagia</p> Signup and view all the answers

    What type of epithelium is found in the oesophagus, which is resistant to abrasion but sensitive to acid?

    <p>Stratified squamous epithelium</p> Signup and view all the answers

    What kind of damage can occur in the oesophagus due to chemical injury following exposure to substances like lye or acids?

    <p>Necrosis of the oesophageal wall</p> Signup and view all the answers

    Which of the following conditions is least likely to contribute to GERD?

    <p>Chronic allergy</p> Signup and view all the answers

    What is a common clinical feature of reflux oesophagitis in adults over 40?

    <p>Regurgitation of sour-tasting gastric contents</p> Signup and view all the answers

    What is a common symptom of oesophageal obstruction?

    <p>Dysphagia</p> Signup and view all the answers

    What condition is characterized by high-amplitude contractions in the oesophagus?

    <p>Nutcracker oesophagus</p> Signup and view all the answers

    What is one potential cause of oesophageal stenosis?

    <p>Chronic gastroesophageal reflux</p> Signup and view all the answers

    Which demographic is most commonly affected by oesophageal mucosal webs?

    <p>Women over 40</p> Signup and view all the answers

    What is the main symptom associated with oesophageal mucosal webs?

    <p>Dysphagia</p> Signup and view all the answers

    Which structure is most commonly associated with the formation of diverticulae due to increased wall stress?

    <p>Diffuse oesophageal spasm</p> Signup and view all the answers

    What distinguishes oesophageal rings from mucosal webs?

    <p>Rings are thicker and circumferential</p> Signup and view all the answers

    What is a probable characteristic of the oesophageal mucosal webs?

    <p>Associated with iron-deficiency anemia</p> Signup and view all the answers

    Study Notes

    Congenital Abnormalities

    • Various developmental anomalies can impact the gastrointestinal (GI) tract, necessitating evaluation of other organs.
    • Oesophageal atresia is the absence of a natural passage, commonly associated with congenital heart defects and neurologic diseases.

    Oesophageal Atresia

    • Characterized by mechanical obstruction and the presence of proximal and distal blind pouches.
    • Most frequently occurs at tracheal bifurcation, with potential for fistula formation leading to complications like aspiration.

    Hiatal Hernia

    • Defined as protrusion of the stomach into the thorax through a gap created by separation of the diaphragmatic crura.
    • Congenital forms appear in infants; acquired forms are prevalent in older adults, often presenting similar symptoms to GERD.

    Oesophageal Obstruction

    • Requires coordinated peristalsis; dysmotility can manifest as conditions such as nutcracker oesophagus or diffuse oesophageal spasm.
    • Oesophageal stenosis involves fibrous thickening often due to chronic gastroesophageal reflux or caustic injury, leading to progressive dysphagia.

    Oesophageal Mucosal Webs and Rings

    • Mucosal webs are ledge-like protrusions common in women over 40, associated with iron-deficiency anemia and other conditions.
    • Schatzki rings are thicker, circumferential structures located at the lower esophagus, potentially causing obstruction.

    Achalasia

    • Increased lower oesophageal sphincter (LES) tone and impaired relaxation result in oesophageal obstruction, with primary achalasia being idiopathic.
    • Secondary achalasia can occur due to Chagas disease or other conditions affecting peristalsis; treated with laparoscopic myotomy or Botox injection.

    Oesophageal Varices

    • Develop from collateral channels due to portal hypertension, often seen in cirrhosis, particularly with alcohol-related liver disease.
    • Asymptomatic until a rupture occurs, leading to massive hematemesis—a medical emergency requiring immediate attention.

    Oesophageal Lacerations

    • Mallory-Weiss tears arise near the gastroesophageal junction, often due to retching or alcohol intoxication, presenting as haematemesis.
    • Generally self-limiting with rapid healing; represent up to 10% of upper GI bleeding cases.

    Causes of Haematemesis

    • Common causes include Mallory-Weiss syndrome, oesophageal varices, chemical and infectious oesophagitis, benign strictures, and malignancies.

    Oesophagitis Overview

    • Chemical Oesophagitis: Damage from irritants (alcohol, corrosives) and pill lodgment leads to mucosal injury, potentially causing dysphagia, bleeding, or strictures.
    • Infectious Oesophagitis: More prevalent in immunocompromised individuals, caused by herpes, CMV, or fungal organisms like Candida.

    Reflux Oesophagitis

    • The most frequent cause of oesophagitis, linked to gastroesophageal reflux disease (GERD), common in individuals over 40.
    • Symptoms include dysphagia, heartburn, and regurgitation, with complications such as ulcers and Barrett esophagus.

    Reflux Pathogenesis

    • Contributing factors to decreased LES tone and increased abdominal pressure include obesity, alcohol consumption, pregnancy, and hiatal hernia.
    • Many cases lack a definitive cause, complicating diagnosis and management.

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    Description

    This quiz covers the anatomy and pathology of the oesophagus, focusing on congenital abnormalities, conditions such as achalasia and oesophagitis, and the anatomy of the foregut. Test your knowledge on the various disorders and structural aspects related to the oesophagus.

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