Oesophagus

OESOPHAGUS

Q. 1 Corkscrew oesophagus is seen in: 
 A Achalasia cardia 
 B Diffuse esophageal spasm
 C Carcinoma esophagus
 D Reflux oesophagitis
Q. 1 Corkscrew oesophagus is seen in: 
 A Achalasia cardia 
 B Diffuse esophageal spasm
 C Carcinoma esophagus
 D Reflux oesophagitis
Ans. B

Explanation:

Diffuse esophageal spasm 


Q. 2

All of the following structures press over the oesophagus, except:

 A

Aortic arch

 B

Left atrium

 C

Left bronchus

 D

Right bronchus

Q. 2

All of the following structures press over the oesophagus, except:

 A

Aortic arch

 B

Left atrium

 C

Left bronchus

 D

Right bronchus

Ans. D

Explanation:

Right bronchus


Q. 3

All of the following structures press over the oesophagus, EXCEPT?

 A

Aortic arch

 B

Left atrium

 C

Left bronchus

 D

Right bronchus

Q. 3

All of the following structures press over the oesophagus, EXCEPT?

 A

Aortic arch

 B

Left atrium

 C

Left bronchus

 D

Right bronchus

Ans. D

Explanation:

Anteriorly the normal esophagus is indended from above downwards by three important structures that cross it, the arch of aorta, left bronchus and left atrium.

 
Various structures that may press on the oesophagus and cause obstruction are:
  • Enlarged left atrium
  • Bronchial carcinoma
  • Enlarged lymph nodes at the hilum of lung
  • Dilated aorta
  • Congenital abnormalities of the main thoracic arteries
The 4 constrictions of the oesophagus are:
  • First constriction is at the pharyngoesophageal junction
  • Second constriction is produced by the arch of aorta as it crosses the anterior and lateral aspects of oesophagus
  • Third constriction is produced by the left bronchus as it crosses the oesophagus
  • Fourth constriction is at the oesophageal opening in the diaphragm.

Q. 4

Oesophagus crosses the diaphragm at the level of ?

 A

T8

 B

T10

 C

T12

 D

T2

Q. 4

Oesophagus crosses the diaphragm at the level of ?

 A

T8

 B

T10

 C

T12

 D

T2

Ans. B

Explanation:

The distal end of the esophagus enters the abdominal cavity in the upper left quadrant by traversing the diaphragm at the T10 vertebral level. The esophagus immediately transitions into the stomach, with the cardiac sphincter serving as the transition boundary. Coursing parallel to the esophagus are the anterior and posterior vagal trunks. 


Q. 5

Oesophagus receives supply from all of the following except :

 A

Bronchial artery

 B

Internal mammary artery

 C

Inferior phrenic artery

 D

Inferior thyroid artery

Q. 5

Oesophagus receives supply from all of the following except :

 A

Bronchial artery

 B

Internal mammary artery

 C

Inferior phrenic artery

 D

Inferior thyroid artery

Ans. B

Explanation:

B i.e. Internal mammary artery


Q. 6

Ilnd constriction in oesophagus is seen at the following site :

 A

Where it crosses left main bronchus

 B

Crossing of aorta

 C

At pharyngoesophageal junction

 D

Where it pierces the diaphragm

Q. 6

Ilnd constriction in oesophagus is seen at the following site :

 A

Where it crosses left main bronchus

 B

Crossing of aorta

 C

At pharyngoesophageal junction

 D

Where it pierces the diaphragm

Ans. B

Explanation:

B i.e. Crossing of Aorta


Q. 7

Barrett’s oesophagus is :

 A

Lower oesophagus lined by columnar epithelium

 B

Upper oesophagus lined by columnar epithelium

 C

Lower oesophagus lined by ciliated epithelium

 D

Lower oesophagus lined by pseudostratified epithelium

Q. 7

Barrett’s oesophagus is :

 A

Lower oesophagus lined by columnar epithelium

 B

Upper oesophagus lined by columnar epithelium

 C

Lower oesophagus lined by ciliated epithelium

 D

Lower oesophagus lined by pseudostratified epithelium

Ans. A

Explanation:

Ans. is ‘a’ i.e., Lower esophagus lined by columnar ephithelium

Barrett’s esophagus

  • Is metaplastic change of distal esophageal mucosa from normal squamous epithelium to columnar epithelium, in response to chronic gastro-esophageal reflux.
  • The junction between squamous esophageal mucosa and gastric mucosa moves proximally.
  • Three types of columnar epithelium have been described in Barrett’s esophagus:

i)        intestinal type – the most common type

ii)      the junctional type and

iii)    the gastric fundic type

  • Barrett’s esophagus is a premalignant condition for adenocarcinoma esophagus
  • “The definition of Barrett’s esophagus (BE) has evolved considerably over the past decade. Traditionally, BE was identified by the presence of columnar mucosa extending at least 3 cm into the esophagus. It is now recognized that the specialized intestinal type epithelium found in the Barrett’s mucosa is the only tissue predisposed to malignant degeneration. Consequently, the diagnosis of BE is presently made given any length of endoscopically indentifiable columnar mucosa that proves on biopsy to show intestinal metaplasia.” – Schwartz 9/e p831 (8/e, p868)

Also remember

The hallmark of intestinal metaplasia is the presence of intestinal goblet cells.


Q. 8

3rd constriction of the oesophagus is at the level of‑

 A

Left brunchus crossing the aorta

 B

Where it pierces the diaphragm

 C

Junction of the oesophagus and stomach

 D

Cricopharynx

Q. 8

3rd constriction of the oesophagus is at the level of‑

 A

Left brunchus crossing the aorta

 B

Where it pierces the diaphragm

 C

Junction of the oesophagus and stomach

 D

Cricopharynx

Ans. B

Explanation:

Ans. is ‘b’ i.e., Where it pierces the diapharm 



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