Term
| Why do malignant esophageal cancers metastasize very easily |
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Definition
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|
Term
| What are the components of the Upper esophageal sphincter |
|
Definition
Cricopharyngeus Muscle
Inferior Pharyngeal Constrictors
Upper Esophageal Constrictors
Cricoid Cartilage |
|
|
Term
| What are the barriers to gastro-esophogeal reflux |
|
Definition
LES tone
Crural Diaphragm
Angle of His |
|
|
Term
| What are the muscle type of the muscularis propria in the esophogus |
|
Definition
Proximal 1/3: Skeletal
Middle 1/3: Mixed
Distal 1/3: Smooth |
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Term
| What are the physiological mechanisms of Peristalsis |
|
Definition
Extrinsic Vagal imput from Medullary swallowing center
NO, Substance P and Ach Enteric Ganglia
Myogenic Cl-dependant Hyperpolarization |
|
|
Term
| How can you tell the difference between a functional versus mechanical achalasia |
|
Definition
Mechanical: Solids only
Function: Solids and Liquids |
|
|
Term
| Neurotransmitters used to relax the LES |
|
Definition
|
|
Term
| What is the presentation, physiological causes, and diagnosis of achalasia |
|
Definition
Presentation:
Dysphagia
Chest Pain
Nocturnal cough*
Causes:
Incomplete LES relaxation
Hypertonic LES
Aperistalsis
Dx: Manometry
Radiologic-Bird's beak, Air fluid level |
|
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Term
| What is the diagnosis of Diffuse Esophogeal spasm |
|
Definition
Manometric(Measures Pressure): Simultaneous sponataneous high Amp contractions
Radiologic: Cockscrew Appearance |
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|
Term
| What are the complications of GERD |
|
Definition
Esophagitis
Bleeding
Obstruction
Barrett's Metaplasia |
|
|
Term
| What is the most common cause of Iron deficiency anemia |
|
Definition
|
|
Term
| If diffuse esophogeal spasms progress to achalasia what does it suggest about the cause? |
|
Definition
| Neuropathic processes are responsible |
|
|
Term
What is the diagnostic techniques for GERD
What is the mainstay of treatment? |
|
Definition
Symptom Characterization
24hr Esophogeal pH: Most sensitive
Endoscopy
Tx: High Dose PPI's
|
|
|
Term
| What is the treatment of Barrett's esophogus and which is the most effective? |
|
Definition
Behavior modification
Antacids/H2 Antagonists
Cholinergics/prokinetics
PPI's-Best
Surgery |
|
|
Term
| What are the mechanisms causing GERD |
|
Definition
Hypotonic Sphincter
Transient Intermittent LES Relaxation
Stress Reflux: situations increasing Ab pressure |
|
|
Term
| What structure provides the most protection for the esophogus when swallowing? |
|
Definition
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|
Term
| What areas of the GI tract provide viscerotropic sensory imput to the brain |
|
Definition
|
|
Term
What is transfer dysphasia?
What are some causes? |
|
Definition
Difficulty initiating swallowing
Causes
CNS Disorders
PNS Disorders
MG
UES Problems |
|
|
Term
| What are the major causes of problems in esophogeal motility? |
|
Definition
Achalasia
Diffuse Esophogeal Spasms |
|
|
Term
| Where does pill esophogitis most commonly occur? |
|
Definition
SM and Skeletal interdigitation
Above LES |
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