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oesophagus imp points for AIPGE
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03.11.06 (2 years ago)
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The oesophagus
• The oesophagus is a fibromuscular tube that is about 25 cm in length and which connects the pharynx to the stomach. It enters the abdomen through the diaphragm at the level of T10.
• The upper third of the oesophagus contains striated muscle and the lower third contains smooth muscle. The middle third is made up of both types of muscle.
• The oesophageal mucosa is lined by non-keratinised, stratified squamous epithelium.
• Oesophageal atresia and fistula occur together in 90% of cases. The most common form involves a blind ending in the upper part of the oesophagus and a fistulous opening into the trachea at the lower end.
• In gastro-oesophageal reflux disease (GORD), reflux causes injury to and desquamation of the squamous oesophageal cells. Increased loss of the cells is compensated by basal cell proliferation (hyperplasia).
• Barrett's oesophagus is a premalignant disorder in which the normal squamous epithelium is subjected to prolonged injury and undergoes a metaplastic change to be replaced by columnar epithelium. People with Barrett's oesophagus are 30-40 times more likely to develop adenocarcinoma than normal.
• Achalasia involves the loss of coordinated peristalsis of the lower oesophageal sphincter. This prevents the passage of food and liquid into the stomach. It can be caused by damage to the oesophageal innervation, as in Chagas' disease.
• A hiatus hernia is the herniation of part of the stomach through the diaphragm. They can be described as sliding or rolling hernias.
• Oesophageal varices are dilated veins at the gastro-oesophageal junction. They are seen most commonly in patients with liver cirrhosis and portal hypertension. The enlarged veins are at risk of tearing, resulting in haematemesis - a medical emergency.
• Mallory-Weiss syndrome is haematemesis as a result of a tear at the gastro-oesophageal junction. It is caused by prolonged retching or coughing, which causes a sudden increase in intra-abdominal pressure.
please enter more important points so we can get all imp for oesophagus here.
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