Esophagus Flashcards
What is the muscle distribution in the esophagus?
1st third: striated muscle only.
2nd third: striated and smooth muscle.
Last third: smooth muscle only.
UES: prevents passage of excess air into stomach during breathing.
LES: prevents reflux of gastric contents.
What is dysphagia?
Difficulty swallowing.
What is odynophagia?
Pain on swallowing.
What are the two types of dysphagia?
Mechanical: difficulty greater with solids than liquids.
Neuromuscular: difficulty with both.
What are causes of mechanical dysphagia?
Foreign body.
Inflammation (e.g. infectious esophagitis, caustic exposure).
Strictures (e.g. inflammatory, post-irradiation).
Neoplasms.
Extrinsic compression (e.g. aortic aneurysm, retropharyngeal abscess, thyromegaly).
What are causes of neuromuscular dysphagia?
Tongue paralysis.
Lesions to CN IX, X.
Disorders of NMJ (e.g. myasthenia gravis).
Primary muscle disorders (e.g. polymyositis, dermatomyositis).
Disorder of esophageal smooth muscle (e.g. scleroderma, achalasia, diffuse esophageal spasm).
What is an esophagomyotomy?
1) Esophagus exposed via transthoracic, transabdominal, thorascopic, laparoscopic technique.
2) Tunica muscularis is incised distally to the LES.
3) Complete division of LES necessitates Nissen 360 or partial fundoplication (anti-reflux procedure).
What is endoscopic dilatation?
1) Insert balloon or progressively larger-sized dilators.
2) Tear esophageal smooth muscle, decreasing competency of LES.
What is endoscopic sclerotherapy?
Injection of a bleeding vessel with a sclerosing agent via a catheter passed through an endoscope.
What is endoscopic band ligation?
A small elastic band is placed around a bleeding varix, resulting in hemostasis.
What is a Sengstaken-Blakemore tube?
A balloon tamponade used to treat ruptured esophageal varices.
What is TIPS?
TIPS = transjugular intrahepatic portocaval shunt.
Where are the anatomic narrowings of the esophagus?
Above UES.
Near aortic arch.
Above LES.
