6: Path Of Esophagus And Stomach Flashcards
four layers of the alimentary canal
Mucosa, submucosa, muscularis, serosa
Three layers of the mucosa of the gut
- Epithelium
- Lamina propria
- Muscularis mucosa
VACTERL Association parts
- V: vertebral
- A: anal anomalies (missing an anus)
- C: Cardiac
- TE: tracheo-esophageal fistula
- R: Renal anomalies
- L: limb anomalies
Two plexuses for intrinsic innervation and their location
- Myenteric: in muscularis layer
2. Submucosal plexus: in submucosal layer
What do the two plexuses for intrinsic innervation do?
- Myenteric: motility, esp the rhythm and force of contractions of muscularis
- Submucosal: regulating digestive secretions, reacts to presence of food
What part of the embryonic gut does the esophagus form from?
Cranial portion of the foregut
When in gestation is the esophagus recognizable?
Third week
Blood supply to the upper, middle, and lower 1/3 of the esophagus
- Upper: inferior thyroid artery
- Middle: branches of thoracic aorta
- Lower: left gastric A
How much more common are UGIBs vs LGIBs?
UGIBs 4x more common
Atopy
The genetic tendency to develop allergic disease such as allergic rhinitis, asthma, and atopic dermatitis
Most common outpatient GI dx
GERD
What three things allow the LES to relax during swallowing
- NO
- Vasoactive intestinal polypeptide
- Interruption of nl cholinergic signaling
Most common tumor of the esophagus
Smooth muscle tumors
Mutation that causes Tylosis
RHBDF2 mutation
What portion of the stomach are G cells in?
Antrum (bottom)
G cells secrete what?
Gastrin
What does gastrin do
Stimulates luminal acid secretion by parietal cells
Where in the stomach are parietal cells located?
Fundus and body
What cell type in the stomach secretes pepsin?
Chief cells
What hormone inhibits gastrin release?
Somatostatin
What cell type is present that qualifies a gastritis as “acute”
Neutrophils
How to name a gastritis with no/rare inflammatory cells
Gastropathy
What do prostaglandins do in the stomach? 4 Things
- Inhibit acid secretion
- Stimulate mucus and bicarb
- Alter mucosal blood flow
- Provide protection against many agents that may cause mucosal damage
H. Pylori is associated with what factors in the US?
Poverty, household crowding, limited education, rural areas
Likely transmission of H pylori
Fecal oral
Three tests that test for H pylori
- Serologic Ab tests
- fecal bacterial Ag detection
- Urea breath test
Combo of drugs to treat H pylori
Abx + PPI
What does autoimmune gastritis turn into in 2-3 decades?
Gastric atrophy
Type of gastritis related to celiac disease
Lymphocytic gastritis
Three things that can cause granulomatous gastritis
- Chron disease (most common)
- Sarcoidosis
- Infection
description of a typical peptic ulcer
Solitary, round/oval sharply punched out defect with slight overhang of mucosa at the base
Heaped up margin of an ulcer is indicative of what?
Cancers
Hypertrophic gastropathy: describe
Giant cerebriform enlargement of rugae folds due to epithelial hyperplasia without inflammation
Example of a hypertrophic gastropathy
Menetrier Disease
Two most powerful prognostic indicators in gastric CA
- Depth of invasion
2. Extent of nodal and distant metastases
Three factors that determine prognosis of neuroendocrine carcinoma
- Degree of Histo differentiation
- Mitotic rate
- II-67
Three ways on histo to differentiate a neuroendocrine tumor
- Synaptophysin
- Chromogranin
- NSE
Three indicators of prognosis for GIST
- Size
- Mitotic index
- Location
