Chapter 14 - Oral Cavity - Parts 4 Flashcards
The esophagus is located posterior to what?
trachea
The esophagus is noted as the beginning of what? What is the end?
GI tract
anus
The esophagus runs from the ______ to the _____ _____.
epiglottis
gastroesophageal junction
The esophagus is lined by what?
Esophageal mucosa
What are the 4 types of obstructive and vascular lesions of the esophagus?
Mechanical
Functional
Ectopic
Esophageal varices
When a thin, noncanalized cord replaced a segment of esophagus.
atresia
Artesia is an example of what kind of obstructive of the esophagus?
mechanical
Atresia is usually associated with what?
A fistula
What is it called where there is a connection btw esophagus and trachea?
Tracheal fistula
Besides atresia and tracheal fistula what else can cause a mechanical obstruction of the esophagus?
stenosis (fibrosis)
Uncoordinated peristalsis is called what?
aperistalsis
Aperistalsis is what kind of obstruction of the esophagus?
functional
Achalasia is what kind of esophageal obstruction?
functional
What does achalasia mean?
“failure to relax”
What is characterized by a triad of things?
achalasia
What is the triad associated with Achalasia?
- Incomplete LES relaxation
- Increased LES tone
- Esophageal aperistalsis
What are some things that can happen with people with Achalasia?
dysphagia, regurgitation, chest pain (heartburn), weight loss
Achalasia can cause dilation of the esophagus where?
Proximal area
What are some treatments for Achalasia?
botulinum toxin
Pneumatic dilation
What are the two types of Achalasia?
Primary and secondary
Is primary or secondary Achalasia MC?
primary
What is primary Achalasia?
Los of INHIBITORY innervation to the LES
What is secondary Achalasia?
Co-morbidity impairs esophageal functioning.
What are some things that can cause secondary Achalasia?
Chagas disease
Irradiation
Diabetes
polio
specifically distinctive or characteristic of a disease or pathologic condition; a sign or symptom on which a diagnosis can be made.
pathognomonic
What is the pathognomonic characteristic of secondary Achalasia?
Inflammation near Aeurbach’s plexus
Infection of what in Chagas disease will cause secondary Achalasia?
trypanosoma cruzi
Ectopia affects what part of the esophagus?
Upper 1/3
Ectopia is aka
Ectopic gastric mucosa
What are the MC symptoms of ectopic gastric mucosa?
MC are AYSMPTOMATIC
Is ectopic gastric mucosa a risk of cancer?
yes
Portal venous congestion can lead to what?
Portal HTN
Esophageal varices develop in what area of the esophagus?
Distal 1/3
What are esophageal varices?
Dilated and tortuous esophageal vessels
Esophageal varices are secondary to what?
Liver cirrhosis
Liver cirrhosis is most commonly associated with what?
Alcoholic liver disease
What percentage of patients with liver cirrhosis will develop esophageal varices?
90%
Why is esophageal varices known as the “silent killer”
b/c it is asymptomatic and a risk for hemorrhage
1st time bleed of esophageal varices are lethal what percent of the time?
50%
Bleeds from esophageal varices can lead to what?
hypovolemic shock
Advanced cirrhosis of liver can lead to what?
Hepatic encephalopathy (hepatic coma)
With liver failure what can happen?
Toxins accumulate in CNS
What is esophageal inflammation called? Is this a common condition?
esophagitis
yes
Esophagitis occurs secondary to what?
Injury of esophageal mucosa
Do symptoms of esophagitis correlate well with the degree of inflammation?
no
a dysphagia in which swallowing causes pain.
odynophagia
What two things happen with esophagitis?
Odynophagia and dysphagia
What is the MC cause of esophagitis?
Reflux esophagitis (GERD)
GERD means
gastroesophageal reflux disease
What percentage of adults have GERD?
25-40%
What is the cause of GERD?
idiopathic
What are some things that can lead to GERD?
LES dysfunction Increase gastric volume Obesity hiatal hernia Pregnancy Smoking alcohol
What are the 3 types of esophagitis?
- GERD
- Chemical
- Infectious
Esophagitis that is acute and self-limited is what kind?
chemical
What are the irritants that can damage the squamous mucosa of the esophagus?
Tobacco Alcohol Pills Hot fluids Acidic/alkaline foods Irradiation chemotherapy
Infectious esophagitis is MC what?
Secondary to ulcer
Infectious esophagitis is MC in what types of patients?
Debilitate or immunosupressed
What can cause infectious esophagitis?
Fungal (Candida esophagitis)
HSV
CMV