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SURGERY > Esophagus > Flashcards

Esophagus Flashcards

1
Q

Esophagus starts at the level of __ and ends at __

A

Cricoid catilage (c6)
Cardia of stomach (T11)

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2
Q

Layer that is absent in the esophagus is

A

Serosa

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3
Q

Blood supply of the cervical region of esophagus is

A

Inferior thyroid artery

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4
Q

What is the blood supply of the thoracic region of the esophagus

A

Bronchial arteries

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5
Q

Blood supply of the abdominal region of esophagus

A

Ascending branch of the left gastric artery
Inferior phrenic artery

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6
Q

This is the gold standard for the diagnosis of GERD

A

24 hour ambulatory pH monitoring

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7
Q

Most consistent characteristic of a mechanical defective LES

A

Intraabdominal sphincter length of <1cm

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8
Q

Hallmark of intestinal metaplasia

A

(+) intestinal goblet cells

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9
Q

Gold standard treatment for GERD

A

Proton Pump Inhibitor

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10
Q

Most common antireflux procedure that involves 360 deg fundoplication around the lower esophagus for a distance of 4-5cm, without division of the short gastric vessel

A

Nissen fundoplication

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11
Q

270 deg fundoplication around the distal 4cm of esophagus

A

Toupet fundoplication

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12
Q

180 deg anterior fundoplication of the distal esophagus

A

Dor fundoplication

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13
Q

This procedure uses stapler to divide the cardia and upper stomach which results to gastric tube continuous with the esophagus thereby extending length of esophagus by several centimeters

A

Collis gastroplasty

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14
Q

A 240-270 deg fundoplication is done thru thoracic approach

A

Belsey mark IV

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15
Q

Arcuate ligament repair plus gastropexy to diaphragm

A

Hill Posterior Gastropexy

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16
Q

Deterioration of the phrenopharyngeal membrane

A

Diaphragmatic hernia

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17
Q

Signs and symptoms of sliding hernia

A

GERD (heart burn, regurgitation)

18
Q

Common symptoms of paraesophageal hernia

A

Dysphagia
Postprandial fullness
Massive bleeding
Gastric volvolus
Infarction

19
Q

Borchardt triad

A

Chest pain
Retching with inability to vomit
Inability to pass a nasogastric tube

20
Q

This is indicative of incarcerated intra thoracic stomach

A

Borchardt triad

21
Q

Findings of the upper GI barium swallow in hiatal hernia

A

Outpouching of barium at the lower end of esophagus
Wide hiatus
Free reflux of barium

22
Q

Most common esophageal diverticula that results from high pressure from the hypopharynx

A

Zenker diverticulum or pahryngoesophageal diverticulum

23
Q

This is the area of potential weakness situated behind the esophagus at the level of cricopharyngeus muscle

A

Killian triangle

24
Q

Symptoms of zenker diverticulum

A

Dysphagia
Regurgitation of undigested food
Halitosis
Choking
Aspiration

25
Q

Tx of zenker diverticulum of less than or equal 2cm

A

Pharyngotomy

26
Q

Tx for zenker diverticulum that is more than 2cm

A

Diverticulectomy or diverticulopexy

27
Q

It is a primary motility disorder characterized by loss of peristaltic waveform in the esophageal body and failure of the LES to relax

A

Achalasia

28
Q

Triad of achalasia

A

Hypertensive LES
Aperistalsis of the esophagus
Failure of the LES to relax

29
Q

Gold standard for dx of Achalasia

A

Manometry

30
Q

Sign of Achalasia in esophagram

A

(+) Bird’s beak

31
Q

Most effective non surgical management for achalasia

A

Pneumatic dilatation

32
Q

Medications that can be given for Achalasia

A

CCB, Nitrate or Botilinum toxin

33
Q

Most common primary esophageal motility disorder

A

Nutcracker esophagus

34
Q

Necrosis caused by alkali

A

Liquefactive necrosis

35
Q

Acids cause this necrosis

A

Coagulation necrosis

36
Q

Most common type of esophageal carcinoma

A

Squamous cell carcinoma

37
Q

Squamous cell carcinoma of the esophagus is most commonly seen at what site?

A

Middle 3rd of the thoracic esophagus

38
Q

Most common site of adenocarcinom of esophagius

A

Distal esophagus

39
Q

Premalignnt lesion of adenocarcinoma

A

Barret’s esophagus

40
Q

Triad of plummer vinson syndrome

A

Iron deficiency anemia
Dysphagia
Esophageal web

SURGERY (6 decks)

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