Facultate: Medicină Număr capitol: 5

An: IV, Serie Engleză Nume capitol: Surgical diseases of the esophagus
Examen: Chirurgie generală

1 The following about innervation of the esophagus are true

a. Inervation is based on the autonomic nervous system with sympathetic and parasympathetic fibers True
exerting opposing effects
b. The proximal esophagus receives its nerve fibres through the recurrent laryngeal nerves of the vagus True
nerve and cervical sympathetic chain
c. Damage of the recurrent nerve disrupts not only the vocal cords but also the swallowing mechanism of True
the upper esophagus, increasing the risk of aspiration
d. The mid- and distal esophagus receives autonomic innervations from the vagus and thoracic sympathetic True
chain
e. The myenteric plexus controls peristaltic activity of the esophagus and, when damaged, can lead to True
achalasia – failure of the LES muscle to relax along with esophageal body aperistalsis
f. The myenteric plexus controls peristaltic activity of the esophagus and, when damaged, can lead to False
achalasia – failure of the LES muscle to contract along with esophageal body aperistalsis
g. The mid- and distal esophagus receives autonomic innervations from the vagus and thoracic False
parasympathetic chain
h. Damage of the recurrent nerve disrupts only the vocal cords but also the swallowing mechanism of the False
upper esophagus, decreasing the risk of aspiration
i. The proximal esophagus receives its nerve fibres through the long thoracic nerve of the vagus nerve and False
cervical parasympathetic chain
j. Inervation is based on the somatic nervous system with sympathetic and parasympathetic fibers exerting False
opposing effects
Facultate: Medicină Număr capitol: 5
An: IV, Serie Engleză Nume capitol: Surgical diseases of the esophagus
Examen: Chirurgie generală

2 Venous and arterial supply to the esophagus

a. Cervical esophagus – inferior thyroid artery True
b. Thoracic esophagus – bronchial arteries & smaller esophageal arteries from thoracic aorta True
c. Distal esophagus – branches of left gastric artery True
d. Cervical esophagus – inferior thyroid vein True
e. Thoracic esophagus – azygos vein & hemiazygos vein True
f. Distal esophagus – coronary & right gastric vein False
g. Thoracic esophagus – azygos artery & hemiazygos artery False
h. Cervical esophagus – superior thyroid artery False
i. Distal esophagus – branches of right gastric artery False
j. Cervical esophagus – superior thyroid vein False
Facultate: Medicină Număr capitol: 5
An: IV, Serie Engleză Nume capitol: Surgical diseases of the esophagus
Examen: Chirurgie generală

_2022_Medicina_EN_AN IV_Cap 2_F1

3 The correct associations are:
a. figure “A” corresponds to Type I, often associated with gastroesophageal reflux disease True
b. figure “A” corresponds to Type I – the gastroesophageal junction and proximal stomach slide into True
the chest beacause of the weakening of the esophageal hiatus
c. figure “B” corresponds to Type II – the gastroesophageal junction remains anchored in the True
abdomen and a weakening in the phrenoesophageal ligament allows the stomach
d. figure “C” corresponds to Type III – the gastroesophageal junction and the stomach migrate into True
the chest
e. figure “D” corresponds to Type IV – is type III with other intra-abdominal vicera in the chest True
f. figure “B” corresponds to Type I – often associated with gastroesophageal reflux disease False
g. figure “B” corresponds to Type I – the gastroesophageal junction and proximal stomach slide into False
the chest beacause of the weakening of the esophageal hiatus
h. figure “A” corresponds to Type II – the gastroesophageal junction remains anchored in the False
abdomen and a weakening in the phrenoesophageal ligament allows the stomach
i. figure “D” corresponds to Type III – the gastroesophageal junction and the stomach migrate into False
the chest
j. figure “C” corresponds to Type IV – is type III with other intra-abdominal vicera in the chest False

Notă: Aceasta este imaginea ataşată întrebării nr. 3 care este salvată în fişierul identificat prin numele _2022_Medicina_EN_AN IV_Cap 2_F3.
Facultate: Medicină Număr capitol: 5
An: IV, Serie Engleză Nume capitol: Surgical diseases of the esophagus
Examen: Chirurgie generală

4 Esophageal histology
a. The wall consists of four main layers True
b. On endoscopic ultrasound imaging, the esophagus is seen as five discrete boundaries True
c. The third layer seen on EUS is submucosa True
d. The muscularis propria layer of the esophagus transitions from striated muscle fibres to smooth muscle fibres True
e. The entire length of the esophagus is normally lined with nonkeratinizing stratified squamous epithelium True
f. The wall consists of five main layers False
g. On endoscopic ultrasound imaging, the esophagus is seen as four discrete boundaries False
h. The third layer seen on EUS is adventia False
i. The muscularis propria layer of the esophagus transitions from skeletal muscle fibres to smooth muscle fibres False
j. The entire length of the esophagus is normally lined with keratinizing stratified squamous epithelium False

5 Recurrent episodes of bronchitis or pneumonia may be signs of recurrent aspiration of esophageal or gastric
contents beacause of
a. Esophageal obstruction True
b. Congenital malformation True
c. Diverticula True
d. Large hiatal hernias True
e. Esophageal motility disorders True
f. Heartburn False
g. Small hiatal hernia False
h. Esophageal ulceration False
i. All type of hiatal hernia False
j. BRGE False