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Swallowology > Esophageal Disorders Lecture > Flashcards

Esophageal Disorders Lecture Flashcards

1
Q

What is Zenker’s diverticulum?

A

pouch in the upper esophagus

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2
Q

What happens to the food in Zenker’s diverticulum?

A

the food gets stuck; “pocketed”

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3
Q

How can you tell if the food is getting “pocketed” in the Zenker’s diverticulum?

A

there is a lot of residue that isn’t moving; seen in a swallow study

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4
Q

What does the severity and treatment of Zenker’s diverticulum depend on?

A

the size of the pouch

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5
Q

What can cause Zenker’s diverticulum?

A

GERD or reflux that weakens the area

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6
Q

Where does the Zenker’s diverticulum typically form?

A

cricopharyngeus

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7
Q

What is a cricopharyngeal bar?

A

cricopharyngeus muscle is thickening and slower to relax so there is an obstruction of the flow

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8
Q

What is the common complaint a patient with a cricopharyngeus bar?

A

thicker and stickier textures are harder; feeling of food stuck in the neck

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9
Q

In what MBS component can you diagnose a cricopharyngeus bar?

A

component 14: PES opening

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10
Q

What is a Schatzki ring?

A

a circular membrane of tissue in the lower esophagus that causes a narrowing of the esophagus

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11
Q

What are symptoms of Schatzki ring?

A

more difficulty with solid food; feeling like food is impacted; chest pain

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12
Q

How big does a Schatzki ring have to be to by symptomatic?

A

<13mm

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13
Q

How do you treat a Schatzki ring?

A

dilation, PPI

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14
Q

What are causes of a Schatzki ring?

A

hiatal hernia; chronic acid reflux; Barrett’s esophagus

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15
Q

What is a hiatal hernia?

A

the upper part of the stomach bulging through the diaphragm and into your chest

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16
Q

What happens in a hiatal hernia?

A

food and acid can back up in the esophagus and cause reflux and heartburn

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17
Q

What two disorders are usually comorbid?

A

hiatal hernia and Schatzki ring

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18
Q

How can you correct hiatal hernia?

A

if bad enough it can be corrected surgically; smaller ones can be corrected with diet changes to reduce reflux

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19
Q

What is Barrett’s esophagus?

A

flat pink liniing of the esophagus becomes damaged by acid reflux causing the lining to thicken and become red

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20
Q

Can you see Barrett’s esophagus on a fluoroscopy?

A

no

21
Q

Patients with Barrett’s esophagus are at risk for cancer. Why?

A

the irritation can cause pre-cancer to develop

22
Q

What is achalasia?

A

narrowing or incomplete relaxation of the lower esophageal section and prevents passage of swallowed material into the stomach

23
Q

What kind of regurgitation is common in achalasia?

A

late regurgitation of undigested food; emesis

24
Q

Why do patients with an achalasia vomit?

A

food couldn’t pass into the stomach

25
Q

What is GERD?

A

chronic acid reflux

26
Q

How does GERD result?

A

from abrupt periods of relaxation of the LES during non-swallow events

27
Q

T/F the LEW tone is usually normal in GERD

A

T

28
Q

Why do you use pH monitoring in GERD patients?

A

to determine presence of and severity of reflux (the acid)

29
Q

What does GERD stand for?

A

gastro-esophageal reflux disease

30
Q

What is NERD?

A

GERD that does not result in esophagitis

31
Q

T/F NERD doesn’t cause dysmotility and dysphagia symptoms

A

F

32
Q

What is laryngopharyngeal reflux?

A

when stomach contents reach the laryngeal level and irritate the vocal folds

33
Q

What does laryngopharyngeal reflux cause?

A

odynophagia, hoarseness, sore throat, globus sensation, and chronic throat clearing

34
Q

What do you look for on a FEES exam to diagnose laryngopharyngeal reflux?

A

mucosal abnormalities on pos pharyngeal wall, edema of arytenoid cartilages, generalized erythema in laryngeal aditus

35
Q

When do GERD patients experience the most symptoms?

A

when they are lying down

36
Q

When do patients with laryngopharyngeal reflux experience symptoms?

A

day and night

37
Q

What is esophageal stentosis?

A

narrowing of the lumen affecting ability of sold food to pass

38
Q

T/F Patients can be fairly accurate when pointing to where the esophageal stenosis is

A

F

39
Q

One third of patients with obstructing esophageal lesions think the problem is where?

A

the neck

40
Q

What is benign stricture?

A

related to esophagitis

41
Q

What can cause benign stricture?

A

pharmaceuticals (tetracycline, potassium, quinidine)

42
Q

What is malignant stricture?

A

stricture caused by squamous cell carcinoma; adenocarcinoma

43
Q

For whom is tracheoesophageal fistula common?

A

those who have had a laryngectomy; after radiation

44
Q

How can cardiac issues cause esophageal complaints?

A

compression of the esophagus due to aortic aneurysm, cardiomegaly (enlarged heart), congenital deformities, lung cancer

45
Q

T/F Esophageal diverticulum is rare

A

T

46
Q

What causes esophageal diverticulum?

A

pressure in the esophagus resulting in bulging at a point of weakness

47
Q

How can peristalsis issues affect the esophagus?

A

it can spasm

48
Q

What is nutcracker esophagus?

A

chest pain, mean pressure of 180 mm Hg with manometry

49
Q

What is eosinophilic esophagitis?

A

history of allergies, build up of esosinophils interfere with motility

Swallowology (15 decks)

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