Chapter 17: GIT- Esophagus Obstruction Flashcards
For food and fluids to be delivered efficiently from the esophagus to the stomach, swallowing
must be accompanied by a coordinated waveofperistaltic contractions.
Esophageal dysmotility
interferes with this process and can take several forms.
What is nutcracker esophagus?
High-amplitude esophageal
contractions in which the outer longitudinal layer of smooth muscle contracts before the inner
circular layer occur in some patients.
Such lack of coordination results in a syndrome termed
nutcracker esophagus that can cause periodic short-lived esophageal obstruction.
What is diffuse esophageal spasm?
motor disorders of the esophagus which can also result in functional obstruction.
Because it increases esophageal wall stress, diffuse esophageal spasm can cause small diverticulae to form.
These small mucosal outpouchings, which are more
accurately described as pseudo-diverticulaebecausethey lack a true muscularis, are
uncommon, probably because of the dense and continuous esophageal musculature.
Where is the Zenker diverticulum (pharyngoesophageal diverticulum) located?
is located immediately above the upper
esophageal sphincter
What’s ZUp?
The traction diverticulum occurs near where?
midpoint of the esophagus;
TM
Epiphrenic diverticulum is located where?
immediately above the lower esophageal sphincter.
Mnemonic: Elow
Why does Zenker diverticulae may produce symptoms that include regurgitation and producing a mass ?
may reach several centimeters in size and accumulate significant amounts of food
Passage of food can also be impeded by esophageal stenosis, or narrowing of the lumen, what is the general cause of this?
. This is generally caused by fibrous thickening of the submucosa and is associated with atrophy of
the muscularis propria as well as secondary epithelial damage.
Although occasionallycongenital, stenosis is most often due to what?
- inflammation and scarring that may be caused by:
- chronic gastroesophageal reflux,
- irradiation, or
- caustic injury.
The course of dysphagia is associated with
stenosis is usuailly what?
progressive, first affecting the ability to eat solids and only later interfering with ingestion of liquids.
Because obstruction develops slowly, patients may subconsciously modify their diet to favor soft foods and liquids and be unaware of their condition until the
obstruction is nearly complete.
What is an Esophageal mucosal webs?
are uncommon ledge-like protrusions of mucosa that may causeobstruction.
The pathogenesis is unknown, but webs are encountered most frequently in
women over age 40.
Esophageal mucosal webs encountered most frequently in what sex and age?
women over age 40.
Webs are often associated with what?
- gastroesophageal reflux,
- chronic graftversus- host disease
- , or blistering skin diseases
Upper esophageal webs accompanied by .what?
- irondeficiency anemia,
- glossitis, and cheilosis are part of the Paterson-Brown-Kelly or Plummer- Vinson syndrome
Esophageal webs are most common where?
in the upper esophagus