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GI and Nutrition > 2.1.3 GI Motility and Dysmotility II > Flashcards

2.1.3 GI Motility and Dysmotility II Flashcards

1
Q

What is secondary peristalsis?

A

If residual food in the esophagus, this is initiated by nervous system and vaso-vagal responses

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2
Q

Increased intraabdominal pressure will to what to the LES pressure?

A

Increase it

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3
Q

Spasms of the esophagus can have what appearance?

A

Corkscrew

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4
Q

Describe the signals that occur for the bolus to travel down the esophagus?

A

The bolus will send a signal via the vagal afferent. This will travel to the dorsal vagal complex. This will cause a signal to be sent to the vagal efferent, then to the myenteric nerves. The myenteric nerve in front of the bolus will release NO to relax the esophagus, and the nerve behind the bolus will release acetylcholine to cause orad contraction to move the bolus down.

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5
Q

Patient comes in with problem swallowing of solids and liquids. Hands a tight and taught, and displays Raynaud’s phenomenom. Barium swallow study reveals no peristalsis. Manometry is attached. What do they have?

A

Scleroderma - anti centromere antibody

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6
Q

Describe the inhibitory signals that occur in the esophagus.

A

NO - lower end signal will last longer than at upper end

Acetylcholine - activating signal

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7
Q

What are the excitatory and inhibitory signals for the LES?

A

Excitatory cholinergic nerves (ACh) and the tonic myogenic property of the LES favor contraction, whereas the inhibitory nitrergic (NO) pathway favors inhibition.

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8
Q

The proximal 1/3rd of the esophagus consists of what type of muscle?

A

Circular striated muscle

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9
Q

What is diffuse esophageal spasm?

A
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10
Q

Describe the manometric of peristalsis in the esophagus.

A
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11
Q

This manometry is indicative of what?

A

Diffuse esophageal spasm

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12
Q

What is a hypotensive peristaltic wave?

A

Contractions have decreased strength leading to decreased esophageal transit

Main symptoms are dysphagia and some reflux symptoms

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13
Q

What are the diseases that fit these motility patterns?

A
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14
Q

The distal 1/3rd of the esophagus is made up of what muscle?

A

Longitudinal smooth muscle

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15
Q

What are the characteristics of achalasia?

A

Results from damage to imhibitory nerves

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16
Q

What are the localized and diffuse esophageal motor diseases?

A
17
Q

What are the characteristics of the lower esophageal sphincter?

A
18
Q

What can be a result of refluxed gastric acid into the esophagus?

A
19
Q

This manometric reading is characteristic of?

A

Achalasia

Incomplete relaxation of the LES

Intraesophageal pressure is higher than intragastric

Insufficienct activity of inhibitory nerve

20
Q

Relaxation of the LES without swallow is in place for?

A

Gas venting - suppressed in horizontal position

21
Q

What is hiatial hernia?

A

Displacement of the stomach into the thoracic cavity via diaphragmativ esophageal hiatus.

22
Q

What are the controlling mechanisms of the Upper esophagus vs the lower esophagus?

A

Upper - striated - central mechanisms

Lower - smooth muscle - intrinsic mechanisms and central

23
Q

Describe the importance of deglutitive inhibiton.

A

There is a delay in peristalsis when there is rapid swallowing. This is to avoid “bumping” of the bolus into the peristaltic contraction and aspiration

24
Q

What is Schatzki’s ring?

A

Ring forms at the junction which may limit entry of poorly chewed food into the stomach

25
Q

What are the characteristics of hypotensive LES?

A
26
Q

What are the longitudinal muscles thought to do?

A

Causes shortening of the esophagus, which may facilitate transit and help with relaxation of the lower esphageal sphincter

27
Q

These manometric and fluoroscopy are indicative of what?

A

Hypotensive peristalsis

28
Q

What is primary peristalsis?

A

Continued peristaltic wave that started in the pharynx

29
Q

nNOS-deficient mice lose the ability for?

A

LES relaxation

30
Q

What is hypertensive peristalsis?

A

Normal sequence of peristalsis on barium swallow. But, smooth muscle contractions are excessive in amplitude or duration

GI and Nutrition (57 decks)

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