Oesophagus Anatomy and Pathology Quiz

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Questions and Answers

What characteristic of Barrett oesophagus is primarily related to its increased risk of cancer?

Eosinophil recruitment

Mucosal hyperemia

Basal zone hyperplasia

Intestinal metaplasia (correct)

At what age does Barrett oesophagus typically present?

40 to 60 years (correct)

60 to 80 years

30 to 40 years

20 to 30 years

What distinguishes the gross morphology of Barrett oesophagus?

Uniform hyperemic mucosa

Pale, smooth mucosa throughout

Red, velvety mucosa that extends upward from the gastroesophageal junction (correct)

Rugged patches of black mucosa

Which cell type is typically recruited as the disease worsens in reflux oesophagitis?

Neutrophils Signup and view all the answers

Which demographic is predominantly affected by Barrett oesophagus?

White males Signup and view all the answers

What condition is characterized by high-amplitude contractions and can cause periodic short-lived oesophageal obstruction?

Nutcracker oesophagus Signup and view all the answers

What is the most common cause of oesophageal stenosis?

Chronic gastroesophageal reflux Signup and view all the answers

Which group is most commonly affected by oesophageal mucosal webs?

Women over 40 years Signup and view all the answers

What symptom is most commonly associated with oesophageal webs?

Dysphagia with incompletely chewed food Signup and view all the answers

Oesophageal rings, or Schatzki rings, differ from webs in that they are:

Circumferential and thicker Signup and view all the answers

What is a potential complication of diffuse oesophageal spasm?

Formation of diverticulae Signup and view all the answers

The narrowing of the oesophageal lumen caused by fibrous thickening is referred to as:

Stenosis Signup and view all the answers

Which condition involves motility disorders resulting in functional obstruction in the oesophagus?

Diffuse oesophageal spasm Signup and view all the answers

What is oesophageal atresia primarily characterized by?

Absence or closure of a natural passage Signup and view all the answers

Which of the following is NOT a complication associated with fistulae in oesophageal atresia?

Esophageal varices Signup and view all the answers

Which condition involves a protrusion of the stomach into the thorax?

Hiatal hernia Signup and view all the answers

Congenital disorders of the gastrointestinal tract should prompt evaluation of what?

Other organs Signup and view all the answers

Which statement accurately describes the anatomical positioning of the epiglottis in relation to the gastroesophageal junction?

It is located above the esophagus. Signup and view all the answers

What are proximal and distal blind pouches in oesophageal atresia typically connected to?

The pharynx and stomach Signup and view all the answers

Which congenital condition is recognized in infants and children but is often acquired later in life?

Hiatal hernia Signup and view all the answers

What is the most common anatomical site for tracheoesophageal fistula in infants with oesophageal atresia?

Tracheal bifurcation Signup and view all the answers

What is the most common cause of esophagitis?

Reflux of gastric contents Signup and view all the answers

Which symptom is NOT typically associated with reflux esophagitis?

Severe chest pain Signup and view all the answers

What complication is associated with gastroesophageal reflux disease (GORD)?

Barrett esophagus Signup and view all the answers

Which of the following factors can contribute to decreased lower esophageal sphincter tone?

Pregnancy Signup and view all the answers

Which statement regarding herpetic ulcers is accurate?

Ulceration is often accompanied by necrosis and granulation tissue. Signup and view all the answers

Which condition is least likely to increase abdominal pressure and contribute to GERD?

Regular physical activity Signup and view all the answers

What is the effect of oesophageal irradiation on blood vessels?

Intimal proliferation Signup and view all the answers

What type of epithelium lines the esophagus, making it resistant to abrasion but sensitive to acid?

Stratified squamous epithelium Signup and view all the answers

Which condition is most commonly associated with the development of esophageal varices?

Alcoholic liver disease Signup and view all the answers

What treatment method is typically used for achalasia-like disease?

Laparoscopic myotomy and pneumatic balloon dilatation Signup and view all the answers

Which of the following individuals is most likely to develop infectious esophagitis?

A patient undergoing chemotherapy Signup and view all the answers

What is the primary characteristic of Mallory-Weiss tears?

Longitudinal linear tears in the esophagus Signup and view all the answers

Which factor does NOT contribute to chemical esophagitis?

Overeating spicy foods Signup and view all the answers

What is the most immediate danger associated with the rupture of esophageal varices?

Massive hematemesis Signup and view all the answers

What is the role of botulinum neurotoxin in treating achalasia-like disease?

To relax the lower esophageal sphincter Signup and view all the answers

Which of the following is NOT a common source of upper gastrointestinal bleeding?

Pulmonary embolism Signup and view all the answers

What is a significant clinical feature of esophageal varices?

Tortuous dilated veins on venogram Signup and view all the answers

What is a potential complication of chemical/esophageal injury from pills?

Stricture or perforation Signup and view all the answers

Study Notes

Congenital Abnormalities

Congenital GI disorders often necessitate evaluation of associated organ abnormalities.
Oesophageal atresia involves the absence or closure of a natural passage, commonly leading to feeding regurgitation after birth.
Associated conditions include congenital heart defects, genitourinary malformations, and neurologic diseases.
Oesophageal atresia results in mechanical obstruction with proximal and distal pouches connecting to the pharynx and stomach.
Fistula complications may include aspiration, suffocation, pneumonia, and severe fluid imbalances.
Hiatal hernias may present as congenital in infants or acquired later in life, causing symptoms akin to gastroesophageal reflux disease (GERD).

Oesophageal Obstruction

Proper swallowing involves coordinated peristaltic contractions; dysmotility can disrupt this.
Nutcracker oesophagus presents as high-amplitude contractions leading to potential obstruction.
Diffuse oesophageal spasm causes functional obstruction and may lead to diverticula formation.
Oesophageal stenosis often results from inflammatory scarring, commonly due to chronic reflux or irradiation.
Dysphagia due to stenosis progresses from solids to liquids, often leading to dietary modifications.

Oesophageal Mucosal Webs and Rings

Mucosal webs are uncommon projections often seen in women over 40, associated with conditions like gastroesophageal reflux and iron-deficiency anemia.
Most commonly found in the upper oesophagus, webs cause dysphagia with incompletely chewed food.
Schatzki rings are thicker, circumferential lesions that may lead to obstruction, treated with myotomy or balloon dilation.

Oesophageal Varices

Oesophageal varices arise from portal hypertension, caused by liver diseases such as cirrhosis, particularly related to alcohol use.
Varices develop from collateral channels due to impaired blood flow, leading to a venous plexus in the distal oesophagus.
Ruptured varices cause massive hematemesis, presenting a medical emergency.

Oesophageal Lacerations

Mallory-Weiss tears are longitudinal lacerations near the gastroesophageal junction, often related to severe vomiting or alcohol intoxication.
These lacerations account for up to 10% of upper GI bleeding; they usually heal quickly without surgical intervention.

Oesophagitis

Chemical oesophagitis results from irritation by substances like alcohol, hot fluids, or medicines lodging in the oesophagus.
Infectious oesophagitis can occur in immunocompromised individuals, commonly caused by herpes simplex, CMV, or fungi.

Reflux Oesophagitis

Reflux oesophagitis is mainly caused by gastroesophageal reflux disease (GERD), affecting adults over 40 and presenting with dysphagia, heartburn, and regurgitation.
Contributing factors include decreased lower oesophageal sphincter tone and increased abdominal pressure from obesity, pregnancy, or hiatal hernias.
Barrett oesophagus, a complication of chronic GERD, presents intestinal metaplasia, which raises adenocarcinoma risk, predominantly in white males aged 40-60.

Barrett Oesophagus Morphology

Recognizable by red, velvety mucosa patches extending from the gastroesophageal junction, alternating metaplastic and normal mucosa.
Sub-classified as long segment (>3 cm) or short segment based on the extent of the affected area.

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Description

Test your knowledge on the anatomy and various pathologies related to the oesophagus. This quiz covers congenital abnormalities, common conditions such as achalasia and oesophageal varices, and structural details of the oesophagus. Perfect for students in the field of Anatomical Pathology.