Which of the following mechanism can not prevent Gastroesophageal reflux -
Ans is 'c' ie Circular muscle fibres of GE I am not really sure of the answer. When this question was asked, 22/e, of Bailey was in circulation. According to it, among all the given options, circular muscle fibres of GE sphincter appears to be least contributory in preventing reflux. Read these lines of Bailey 22nd ed. " There is a functional intrinsic physiological sphinctre at the cardia. This is expressed as a zone of relatively high intraluminal pressure which prevents regurgitation from the stomach. This impoant function is augmented by five factors : 1. The valvular effects of oesophagogastric angle. 2. The pinchcock action of the right crus. 3. The 'rosette-like' folds of the gastric mucous membrane at the cardia. 4. The presence of a length of intra abdominal oesophagus. 5. A band of muscles on the fundus of the stomach, acting as a sling, which accentuates the esophagogastric angle."
Looping fibres of crus of diaphragm
Mucosal folds at gastroesophageal junction
Circular muscle fibres of GE sphincter
Angle made by the oesophagus with stomach