Chapter 10 Flashcards
Cause of cleft lip and palate
Failure of facial prominences to fuse
Aphthous Ulcer
painful, superficial ulceration of the oral mucosa that arise due to stress.
Behçet Syndrome
Recurrent aphthous ulcers + genital ulcers + uveitis. Due to immune complex vasculitis. Etiology unknown, but can follow viral infection.
Precursors of Squamous Cell Carcinoma of the oral cavity
- Leukoplakia (cannot be scraped off, so not thrush, and not on sides of tongue in immunocompromised, which is hairy leukoplakia)
- Erythroplakia- vascularized leukoplakia. More likely to be SCC….
Mumps infection
See bilateral inflamed parotid glands, orchitis (in older than 10 boys), pancreatitis (but Amylases elevated regardless), and aseptic meningitis.
Sialadenitis
inflammation of the salivary gland due to obstructing stone (sialolithiasis) leading to Staph aureus infection.
Pleomorphic Adenoma (histology and location)
Benign tumor of stromal (cartilage) and epithelial tissue most often in parotid.
Recurrence of pleomorphic adenoma (cause)
Incomplete resection, due to extension of small islands of tumor through capsule. Rarely can progress to carcinoma (often see facial nerve involvement).
Warthin Tumor (histology and location)
Benign cystic tumor with abundant lymphocytes and germinal centers, often seen in parotid.
Mucoepidermoid Carcinoma (histology and location)
Malignant tumor of mucinous and squamous cells, most often in parotid involving facial nerve.
Symptoms of tracheoesophogeal fistula
Vomiting, polyhydramnios, abdominal distention (from air) and aspiration.
Zenker diverticulum
outpouching of pharyngeal mucosa (false diverticulum) due to acquired defect in muscular wall. Presents with dysphagia, obstruction, and halitosis (bad breath)
Mallory-Weiss Syndrome
Longitudinal laceration of mucosa at GE junction. Presents with PAINFUL hematemisis. Due to excessive vomiting (alcoholism/bulimia)
Boerhaave Syndrome
Rupture of esophagus leading to air in the mediastinum and subcutaneous emphysema (air bubbles in skin that crackle!)
Esophageal Varices
Due to portal hypertension (via left gastric vein). When rupture, cause PAINLESS hematemisis (most common cause of death in cirrhosis)
Achalasia
Disordered esophageal motility with inability to relax LES. Due to damaged myenteric plexus. Often due to Chagas Disease!
Symptoms of achalasia
Dysphasia for BOTH SOLIDS AND LIQUIDS
- putrid breath
- High LES pressure of esophageal manometry
- bird beak sign of barium swallow
Sliding hiatal hernia
Hourglass- GE junction moves up into esophagus. Increased risk for GERD (LES bypassed)
Paraesophageal hiatal hernia
stomach perforates the diaphragm. Here bowel sounds in lung fields and lung hyperplasia.
Clinical features of GERD
- Heartburn
- Adult onset asthma and cough
- Tooth enamal damage
Histology of Barrett Esophagus
Metaplasia from stratified squamous epithelium to nonciliated columnar epithelium with goblet cells.
Adenocarcinoma of the esophagus (most common cause and location)
Barrett esophagus. Lower 1/3 of esophagus.
Squamous Cell carcinoma of the esophagus (cause)
IRRITATION.
- Alcohol/tobacco
- Very hot tea
- Achalasia (from rotting food)
- Esophageal web (from rotting food)
- lye ingestion…
Spread of esophageal carcinoma
If upper 1/3 –> Cervical nodes
middle 1/3 –> mediastinal or tracheobronchial nodes
lower 1/3 –> celiac and gastric nodes