Al-Mehdi: Motility Disorders Flashcards
difficulty swallowing food or liquid (fx impaired)
dysphagia
painful swallowing due to mucosal ulceration
odynophagia
inability to swallow due to complete esophageal obstruction by food bolus or foreign body
Aphagia
CN X, CN V, CN VII, and CNXII innervate what
UES
what autonomics constrict the sphincters
sympathetics
what autonomics relax the sphincters
parasympathetics
proximal esophagus innervated by _____ to regulate peristalsis
CN X
distal esophagus innervated by _____ to regulate peristalsis
myenteric plexus neurons in ENS
excitatory neurons in ENS (myenteric plexus)
Ach, substance P
inhibitory neurons in ENS (myenteric plexus)
VIP, NO
liquid + solid dysphagia
motility disorder (motor)
only solid food dysphagia
structural dysphagia
hoarseness 1st then dysphagia
vocal cord tumor
dysphagia 1st then hoarseness
recurrent laryngeal n. damage
episodic dysphagia to solids unchanged over years
Schatzki ring
eosinophilic esophagitis
pathogenesis of this includes:
autoimmine myenteric plexopathy——loss of ganglion cells to loss of esophageal peristalsis
Achalasia
another cause of this includes loss of NO——insufficient relaxation of LES
Achalasia
to dx Achalasia
esophageal manometry
barium radiography
drug contraindicated in Achalasia
anti-D2 metoclopramide
_____causes Chagas disease (prevalent in south america)
Trypanosoma cruzi
chronic phase of this disease after many years of infection has destruction of autonomic ganglion cells
Chagas disease
most common cause of death in Chagas disease
Chronic cardiomyopathy
organs most affected in Chagas disease
esophagus, duodenum, colon
Rx of Achalasia
surgery
marker for ICC (pacemaker of stomach)
KIT