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esoph Flashcards

1
Q

dysphagia

A

diff swalllowing

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2
Q

odynophagia

A

painful swallowing

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3
Q

globus

A

sensation of fullness in upper throat–improvse w/ swallowing

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4
Q

pyrosis

A

heart burn; substernal pain

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5
Q

regurgitation

A

return of sour gastric content

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6
Q

watre brash

A

sponaneous salivation from reflux

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7
Q

rumination

A

chewing ones cud

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8
Q

c6

A

begin upper eso spincter

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9
Q

t3

A

aortic arch presses on eso

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10
Q

t10

A

passes through diaphragmatic hiatus to reach te stomach

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11
Q

UES inn

A

pharyn branch vagus

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12
Q

inhib NT

A

NO

vip

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13
Q

excit nt

A

ach

sub p

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14
Q

swallowing

A

bolus masticated–>food pushed backwards–> soft palate elevates, vocal cords close, epiglottis tipped forward–>UES opens, LES opens, pharynx contracts–>peristalisis

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15
Q

layers of esoph

A

mucosa
submucosa
muscularis propia
adventitia

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16
Q

the esoph has no

A

serosal lining

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17
Q

upper esoph blood supply

A

inf thyroid artery

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18
Q

middle esoph blood supply

A

R and L bronchial arteries

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19
Q

mid distal and distal blood supply

A

direct branches from thoracic aorta and esoph branch of L gastric artery

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20
Q

sensory receptors and eso

A

chemo in mucosa and submucosa- chemical irritants

mechanoR- submucosa–>adventitia; distention but not tearing

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21
Q

primray peristatliss

A

initiated by swallow

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22
Q

2nd peri

A

luminal distention

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23
Q

sensory input swallowing

A

pharynx via CN5, 10,11

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24
Q

motor output swallowing

A

CN 5,7,9,10,12

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25
ddx globus
UES issue- spasm, incomplete relax., hypertensive UES GERD visceral hypersensitivity
26
ddx odynophagia
injury to mucosal lining by viral infx meds gerd
27
oropharyngael dysphagia
difficulty initiating a swallow or transferring food from mouth to esoph-- food "sticks in throat"
28
ddx OD
neuro skeleal muscle srucural
29
best test for OD
cineradiography--frame by frame analysis of pt swallowing
30
tx OD
work w/ speech pathologist + entubation if aspiration riskt oo high
31
esoph dysphagia
food sticks in throat--usually lower than what pt thinks but due to intra-luminal obstuction
32
achlasia patho
inflamm injury to myenteric plexus--> loss of NO producing cells-->LES fails to relax-->change in peristalisis/aper
33
gold standard dx achalasia
esoph mamomry--ess before surgery/dilation incomplete relax- achlasia no change in motor fx- vigorous ach
34
tx achalasia
drugs- nitrates, ca channel blockers, botox pneumatic dilation surg myotomy POEM
35
diffuse esoph spasm manometry
increase in repetitive and high amplitude contractions--incomplete LES relax
36
CREST pathophys
vascular oblit--> fibrosis in SM--> weak LES, poor eso contract, delayed gastric emptying
37
barium swallow adenocarcinoma
shelf
38
spiculated barium swallow
candidia (aids!)
39
A rings
muscular
40
B rings
schazskis (mucosal)
41
ddx gred
transient LES relax ineffective esoph motility gastric acid hypresec delayed stomach emptying (gastroparesis)
42
gold standard dx GERD
impdece eso catheter
43
meds for people w/ delayed gastric emptying
domperidone--prokinetic
44
barretts metaplasia
metaplasia normal esophageal stratified squamous epithelium to intestinal columnar epithelium goblet cells, surface maturation (dec N:C ratio) -->intestinal type metaplasia suspceted by endo, confirmed by biopsy
45
tzanck test
scrape herpes lesion and lok for multinodular giant cells under oil immersion smudy/steel grey inclusions
46
aspergillus vs mucor
aspergillus-45 degree angle | mucor- 90 degree angle
47
pyogenic granuloma
lobular cap hemangioma w/ surface ulceration- inflam seconday
48
aphtous ulcer
idiopathic shalow painful
49
leukoplakia
clinical term: nonspecific squamous cell hyperplasia--precance
50
hairy leukoplakia
immunocomp pts- fluffy can scrape of | hyperkeratosis, acanthosis, balloon cells
51
erythroplakia
lower lip, buccal mucosa, soft palate | more likely to progess to oral cancer
52
SCC
95% oral cancer, ass w/ HPV
53
main site of salivary gland neoplasm
parotid gland
54
main site of salivary malignancy
sublingual
55
MC benign
pleomorphic adenoma
56
MC malignant
mucoepidermoid
57
2 components warthin's
epithelial- dense eosino | lymphoid component
58
mucoepidermoid
mucus secreting | squamous cells
59
squamous cells predom in
high grade
60
plummer vinson syndrome
``` web/stricture Fe def anemia glossitis cheilosis risk for carcinoma ```
61
main cause SCC
alcohol, smoking
62
main cause adenocarcinoma
GERD
63
barrrett's esoph- high grade dysplasia
intestnalized mucosa w/ villous arch | mucin depletion

GI (12 decks)

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