Term
| what are the 3 phases of deglutition? |
|
Definition
oral
pharangeal
oesophageal |
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Term
| time from oral cavity to stomach is no more than 20 seconds. what can affect this? |
|
Definition
poor salivary gland fx i.e less lubrication
other things that can affect include not intact dentition, surgical defects and neurological disorders. |
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Term
| in oral phase the bolus is in the middle of the tongue, voluntary contractions of tongue and striated muscle press bolus against tonsillar pillar and this triggers pharyngeal phase. the cerebellum controls motor nuclei of cranial nerves. which ones are involved? |
|
Definition
TRIGEMINAL
FACIAL
HYPOGLOSSAL |
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Term
| pharyngeal phase of swallowing is the most shortes but complex. what happens in this phase? |
|
Definition
soft palate elevates.
this is to close of nasopharynx and prevent nasopharyngeal regurg |
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Term
| contraction of which muscle begins pharyngeal peristalsis? |
|
Definition
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|
Term
how is bolus propulsion enhanced?
which muscle is a part of the apparatus involved? |
|
Definition
by passive and active dilatation of the upper oesophageal sphincter.
The cricopharyngeus is a part of UOS. |
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Term
| which two need to relax in order to allow food to pass into the upper oesophagus? |
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Definition
| cricopharyngeal and inferior constrictor must relax in order to allow food to pass into the upper oesophagus |
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Term
| pharyngeal phase of swallowing is involuntary and doesnt occur unless the swallowing reflex is triggered. which motor and sensory tracts does this involve? |
|
Definition
Glossopharyngeal and
Vagus |
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Term
| in dysphagia, solids which 'stick' most likely due to? |
|
Definition
stricture and carcinoma.
solids that do not stick may be due to pharyngeal pouch, globus hystericus, |
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Term
| post cricoid web...whats the name of the syndrome? |
|
Definition
| patterson-brown kelly syndrome |
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Term
| how can strictures be managed? |
|
Definition
endoscopic dilatation.
using bougies or inflatable balloons |
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|
Term
palliative relief of dysphagia in oesophageal cancer
4 methods |
|
Definition
repeated dilation
stent replacement
laser photocoagulation
injection of sclerosants |
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Term
| pt presents with dysphagia, he has barrats, smokes, GORD and drinks a lot of alcohol. Also weight loss, anorexia, vomiting during eating |
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Definition
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Term
| what would you suspect if someone is systematically well with a hx for heartburn. they have odonophagia |
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Definition
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Term
| HIV and steroid inhaler user presents with odonophagia? |
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Definition
|
|
Term
dysphagia of solids and liquids from the start
heartburn.
there may be regurg of food. this can lead to cough, heartburn, aspiration pneumonia etc. |
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Definition
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Term
| features of a pharyngeal pouch |
|
Definition
more common in older men
if it big then there is a lump that gurgles on palpation
it is due to a posteromedial herniation between thyropharyngeus and cricopharyngeus
symptoms: dysphagia, regurg, aspiration and chronic cough
there may also be halitosis |
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|
Term
CREST what does it stand for?
what happens to the pressure of the LOS? |
|
Definition
calcinosis
raynauds
esophageal dysmotility
sclerodactly
telangiectasia
as well as oesophageal dysmotility the pressure of the LOS is decreased. |
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Term
| what happens to the pressure of the LOS in achalasia? |
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Definition
|
|
Term
dysphagia with solids and liquids from the start
extraocular muscle weakness and ptosis. what are you thinking? |
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Definition
|
|
Term
history of anxiety
feeling of lump in throat that is made better with swallowing.
it is usually painless. what is it? |
|
Definition
Globus hystericus.
if there is pain then further ix should be done to exclude organic cause. |
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Term
| neurological causes of dysphagia |
|
Definition
CVA
MG
MS
PD
brainstem pathology |
|
|
Term
| intrinsic causes of dysphagia |
|
Definition
tumours
strictures
oesophageal webs
schatzki rings |
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|
Term
| oesophageal wall causes of dysphagia |
|
Definition
achalasia
diffuse oesophageal spasm
hypertensive lower oesophageal sphincter |
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|
Term
how does barium swallow differentiate between achalasia and oesophageal cancer?
if you plan to endoscopy and barium swallow which one comes first? |
|
Definition
achalasia looks like a birds beak on barium swallow
cancer with look like a rats tail
if you are planning to do barium and endoscopy for cancer for example do barium swallow first as you can perf the gullet with the endoscope if you poke too hard through a stricture. |
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|
Term
| gold standard for diagnosing achalasia? |
|
Definition
manometry .. it shows
high resting pressure in cardiac sphincter
incomplete relaxation on swallowing
absent peristalsis |
|
|
Term
|
Definition
medical: calcium channel blockers and nitrates
surgical: Heller's cardiomyotomy
for older unfit pts: pneumatic dilatation
endoscopic injection of botulinum injection |
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|
Term
a pt presents with dysphagia and you ask ' it is difficult to make a swallowing movement?'
they say yes.
what are you thinking? |
|
Definition
bulbar palsy.
especially if the pt coughs on swallowing |
|
|
Term
true or false
long standing achalasia may cause oesophageal cancer |
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Definition
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|
Term
| two anti emetics that are anti H1 |
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Definition
|
|
Term
|
Definition
metoclopromide
domperidone
prochloorimazine
haloperidol |
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|
Term
|
Definition
|
|
Term
hyoscine hydrobromide
dexamethasone
midazolam can all be used in which purpose? |
|
Definition
|
|
Term
|
Definition
anemia
loss of weight
anorexia
recent onset, progressive symptoms
maleana |
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|
Term
when can GORD be diagnosed?
what can prolonged GORD cause? |
|
Definition
when there have been 2 or more episodes of heartburn/reflux in the week
prolonged GORD can cause oesophagi tis |
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|
Term
|
Definition
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|
Term
|
Definition
weight loss
progressive dysphagia for solids then liquids |
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