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Lawrence > Esofag > Flashcards

Esofag Flashcards

1
Q

Lungime esofag

A

25 cm

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2
Q

Structuri in stransa vecinatate cu esofagul

A
  1. Trahee
  2. AS
  3. Aorta desc toracica
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3
Q

Zone de ingustare esofagiana

A
  1. Proximal - m cricofaringian
  2. Mijl - arcul aortic
  3. Distal - diafragm
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4
Q

Esofagul cervical - a, v, l, n

A
  1. A. tiroidiana inf
  2. V. tiroidiana inf
  3. Ggl jugulari (cervicali profunzi)
  4. Nv laringieni recurenti + lant sy cervical
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5
Q

Esofagul toracic - a, v, l, n

A
  1. A. bronsice + esofagiene (aorta)
  2. V. azygos + hemiazygos
  3. Ggl paratraheali, hilari pulm (med post)
  4. Vag, lantul sy toracic
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6
Q

Esofagul distal - a, v, l, n

A
  1. A. gastrica stg
  2. V. gastrica stg + coronariana gastrica
  3. Ggl celiaci, gastrici stg, parahiatali
  4. Vag + lant sy toracic
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7
Q

Zonele esofagului la EUS

A
  1. Mucoasa superf
  2. Mucoasa profunda
  3. Submucoasa
  4. Musculara proprie
  5. Adventice
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8
Q

Localizari carcinoame esofag

A

CSC - 1/3 prox, 1/3 medie, rar distal

AC - distal

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9
Q

Adenocarcinomul este asociat cu

A

BRGE

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10
Q

Primul test folosit pt evaluarea disfagiei

A

Tranzit baritat

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11
Q

Imagistica in cancerul esofagian

A

EUS - T, N

CT + PET - M

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12
Q

Cancerul esofagian metastazeaza cel mai frecv in

A

Ficat

Plamani

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13
Q

Substitute folosite pt reconstructie

A

Stomac
Colon stg
Jejun

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14
Q

Avantaje si dezavantaje ale folosirii stomacului ca grefon

A

Avantaje: - Vascularizatie bogata
- Mobilizare chir facila
- Necesar redus de anastomoze
Dezav: - Risc de ischemie fornix
- Reflux

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15
Q

Artere si nerv sectionat in folosirea stomacului ca grefon

A

A. gastrica stg + gastrice scurte

Nv vag

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16
Q

Avantaje si dezav a;e folosirii colonului ca grefon

A

Av: - Lungime mare
- Anatomie favorabila, dim similare esofagului
- Ascensiune facila la niv cervical
Dezav: - + 2 anastomoze
- experiente tehnice
- colonoscopie preop + angio

17
Q

Principalul avantaj al abordului transhiatal

A

Evitarea toracotomiei

18
Q

Cel mai comun abord chir in efectuarea unei toracotomii

A

Ivor Lewis

19
Q

Tehnica McKeon. Cand, cum

A
  • Tumori esofag proximal / mediotoracic

- Triplu abord: toracotomie dr, abd, cervical

20
Q

Abordul transhiatal este ideal pt tumori situate in …

A

Esofagul distal

21
Q

Terapia neoadjuvanta in cancerul esofagian

A

5 FU + Cisplatin

Iradiere ext 45 Gy 6-7 sapt

22
Q

Metode paliative

A
  1. Dilatatia endoscopica
  2. Stenturi esofagiene
  3. Terapie laser / fotodinamica
  4. Radio-chimio
23
Q

Simptome initiale in lezarea esof cervical

A
  1. Odinofagie

2. Durere la flexie

24
Q

Tratament in lez esof cervical

A
  • Atb iv
  • Debridare
  • Drenaj
25
Q

Sd Boerhaave

A

Ruptura esof distal spontana dupa eructatii si varsaturi violente

26
Q

HH de alunecare:

  • Cea mai comuna
  • Asociata BRGE
  • Jonct gastro-esof in torace
A

!!!

27
Q

Gold std in dg HH

A

Tranzit baritat sup cu subst de contrast

28
Q

Etapele operatorii in HH

A
  1. Reducere sac de hernie
  2. Mobilizare esof toracic -> 2-3 cm intraabd
  3. Inchidere defect diafragm fara tensiune
  4. Fundoplicatura
29
Q

Simptomatologia princ in achalazie

A

Disfagie progresiva la solide apoi lichide

30
Q

Semnul clasic la tranzitul baritat in achalazie

A

Cioc de pasare

31
Q

Trat med + chir in achalazie

A

Med: - nitriti po/sl, Ca blocante
Chir: - Dilatare cu balon (nechir)
- Miotomie - Heller transtoracic/transabd
- Laparoscopic
- POEM

32
Q

Tulburari majore si minore ale persitaltismului esof

A
  1. MEI (asimpt)
  2. Spasm esofagian distal
  3. Jackhammer = esofag hipercontractil
    (ambele cu distagie si dureri toracice)
33
Q

Care sunt diverticulii de pulsiune

A

Zenker (cervical)

Epifrenic (distal)

34
Q

Tumori benigne si localizare

A
  1. Leiomiom - cel mai frecv
    - str muscular
  2. Chist - adventice
  3. T cu cel granulare + polip fibrovasc - mucoasa / submucoasa
35
Q

Gradele in ingestia subst caustice si descrierea lor

A

I - hiperemie, eroziuni superf
II - ulceratii superf, benzi albe
III - ulceratii prof

Lawrence (9 decks)

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