Esophagus Flashcards
The esophagus is a muscular tube extending from the _____ to the stomach through the mediastinum. It is usually _____ and not visible on survey radiographs.
pharynx — collapsed
The esophagus is located _____ to the trachea in the cervical region, ____ and ____ to the trachea at the throacic inlet, ____ to the trachea in the thoracic cavity, and continues slightly ____ of midline and _____ of the aorta to the diaphram.
dorsal—-left and ventral—-dorsal — left—-right
The esophagus passes through the ___ ____ of the diaphram to the cardia of the stomach, where it terminates at the ___________ junction. The crainal and caudal aspects are fixed in position, but the middle is quite movable and ______. Two sphincters are present, which are_____ ______ and the caudal _____.
left crus (the aorta passes through the right crus)—-gastroesphageal —distensible—–cranial cricopharyngeal and esophageal.
A slight redundancy is present caudal to the thoracic inlet (exaggerated in brachycephalic breeds), called a __________.
pseudodiverticulum
The caudal esophagus is often visible as a faint, horizontal soft tissue opacity between the ____ and the ___ ____ ____ (commonly seen on the left lateral rad). The esophageal wall is thinnest in the ____ region.
aorta and the caudal vena cava—–thoracic
In dogs, the full length of the esophagus is composed of _____ muscle.
striated
In cats, the proximal portion of the esophagus is striated muscle, but the distal third consists of ______ muscle. In this area, the mucosa forms a series of transverse or oblique lines on a positive contrast study commonly called a “______ _____”
smooth–herringbone pattern
Tracheobronchial LN are located between the ______ and the tracheal _____.
esophagus–bifurcation
Esophageal diverticula is a ___ that extends outward from the esophagus. It may be congenital or acquired. (Uncommon in dogs and cats). Congenital diverticli result from a _______ _____ and weakness of the esophageal wall. Aquired diverticuli are caused by increased ________ _______ or an external adhesion. The esophagal lumen is usually normal size but deviates ______ and _____.
sac—developmental thinning—intraluminal pressure—ventrally and laterally
Congenital diverticuli most often occur in the cranial esphagus, usually near the _____ ____ where they must be differentiated from _____-_____. Lateral radiographs made with the neck extended and then with the neck flexed aid in differentiation: ____-_____ will diminish during extension of the neck.
thoracic inlet— pseudo-diverticuli–pseudo-diverticuli
______ diverticuli are common in the distal esophagus and ______ diverticuli may develop anywhere and often have thickened walls
Pulsion —-traction
Esophageal inflammation (esophagitis) may be localized or generalized. It can be caused from swallowing a ____ FO or from ______ _____ or reflux. Severe chronic inflammation may lead to _____ and _____ of the mucosa. Chronic esophagitis can result in _____, _____, and partial or complete obstruction.
caustic—gastroesophageal regurgitation–errosion and inflammation–scarring, strictures
Contrast radiographs (barium esophagram) of esophagitis may show a thickened _____, mucosal margins are _____. Mucosal ulcerations may appear as barium-filled focal ___-_____ along mucosal boarders. Superficial ulcers may not be detected on rads (best seen on endoscopy). Adherence of barium to esophageal mucosa suggests ____ or _____.
wall—irregular— out-pouchings—errosion or ulceraton
Esophageal FO are usually bones, or objecs with _____ or ______ edges. The perforation of the esophagus results in ______. Esophageal stricture, diverticulum, or fistula is a potential compliction, especially in _______ cases.
irregular or sharp—mediastinitis—–neglected
Clinical signs of esophageal FO include:
regurgitiation, anorexia, dysphagia and ptylalism.
Common sites where most foreign objects lodge are:
Cranial cervical region, thoracic inlet, heart base, and immediately cranial to the diapharam. Metal and mineral opacity objects usually are readily identifed. ST opacity objects may mimic a cervical or mediastinal mass. Small objects must be outlined by gas or contrast medium to be visible.
Iodineated contrast media may be perferred if esophageal _____ is suspected. Barium in mediastinum can cause a severe _______ reaction. However, iodinated agents provide poor _______ detail and are rapidly _____, which may compromise dx.
rupture—-granulomatous—-mucosal —diluted
Complete or severe esophageal obstruction will result in dialation _____ to the lesion. Incomplete obstructions present with a ____ ____ at the site of the FO. Esophagrams may document a ____ or a _____ (esophagobronchial, esophago-tracheal.
proximal—filling defect—leak or fistula
DDF for esophageal FO:
Espohageal mass (tumor, abscess, granuloma)
Hiatal hernia
Normal swallowing (transient conditon)
Position abnormalities of the esophagus:
- Mediastinal shift (pneumothorax, atelectasis0
- hernia (diaphragmatic, hiatal)
- djacent mass
- Conditions that mimic esophageal displacement (rotation positioning- mediastinum follows sterunm)
Esophageal neoplasias are uncommon in the dog and cat. Granulomas from _____ ____ can transform into fibrosarcoma or osteosarcoma. Clinical signs of neoplasia include progressive _____, dysphagia, weight loss and anorexia. Dx is made with ____ AND ____.
Spirocerca lupi—regurgitation—-endoscopy and biopsy
Gastroesophageal intussusception are invagination of the _____ into the esophagus. It usually results in seophageal obstruction and an _______ situation. (GSD is overrepresented)
Stomach- (may or may not be accompanied by other abdominal organs (duodenum, spleen, pancreas, omentum)
Emergency
Most often in young dogs (<1yr), males more common than females
Clinical signs of gastroesophageal intussusception include:
persistent regurgitation which may progress to hypovolemic shock and death
Endoscopy can make or confirm the dx and aid in ruling out other esophageal masses such as FO, tumor, abscess or ganuloma
Gastroesophageal intussusceptions may be ______ and difficult to see on radiographs. You may see a well-defined, homogeneouus or heterogenous soft tissue mass in the _____ mediastinum. The esophagus is _____ crainal to the lesion. The ____ ____ may not be visible or in a abnormal shape. Rugal folds may be visible in intussusecption portion if ____ ____ gas is present. Spleen may not be ______.
transient—caudal—-dialated (usually with gas)–gastric fundus—-sufficient luminal–identified
