Esophagus and Stomach Flashcards
portal hypertension
an abnormally increased blood pressure in the portal venous system - blood can’t pass through liver, so flow reverses in esophageal tributary
esophageal varices
marked enlargement of the esophageal tributaries due to portal hypertension - commonly develop in w/ alcoholic cirrhosis
alcoholic cirrhosis
fibrous scarring of the liver
pyrosis
heartburn - most common type of esophageal discomfort or substernal pain, usually due to regurgitation or hiatal hernia
GERD/gastroesophageal reflux disorder
regurgitation of small amounts of food or gastric fluid into the lower esophagus
where is pyrosis commonly perceived?
chest sensation rather than the abdominal region
pancreatitis
inflammation of the pancreas
what can pancreatitis cause the stomach to adhere to?
part of the posterior wall of the omental bursa that covers the pancreas
hiatal hernia
protrusion of part of the stomach into the mediastinum through the esophageal hiatus of the diaphragm
who experiences hiatal hernias most commonly?
middle age people
two types of hiatal hernia?
para-esophageal and sliding
para-esophageal hiatal hernia
cardia remains in normal position; pouch of peritoneum, often w/ part of fundus, extend through the esophageal hiatus anterior to the esophagus
sliding hiatal hernia
cardia of esophagus and parts of fundus slide superiorly through the esophageal hiatus into the thorax, especially when lying down or bending over
pylorospasm
failure of the smooth muscle fibers encircling pyloric canal to relax normally - food doesn’t pass easily from stomach into duodenum, usually resulting in discomfort and vomiting (infants)
congenital hypertrophic pyloric stenosis
hypertrophy of smooth muscle in the pylorus - may cause the stomach to become secondarily dilated
gastroscope
used to inspect the mucosa of an air-inflated stomach, enabling physicians to observe gastric lesions and take biopsies
total gastrectomy
removal of the entire stomach - uncommon
partial gastrectomy
removal of part of the stomach - may be done to remove carcinoma
which lymph nodes are often taken out with partial gastrectomy?
pyloric lymph nodes and right gastro-omental lymph nodes (also celiac nodes if cancer advanced)
gastric ulcers
open lesions of the mucosa of the stomach
peptic ulcers
lesions of the mucosa of the pyloric canal or duodenum
what causes most ulcers?
Helicobacter pylori bacteria
vagotomy
surgical section of the vagus nerves - performed in people w/ chronic or recurring ulcers to reduce production of acid
antrectomy
resection of an ulcerated area or resection of the pyloric antrum
truncal vagotomy
surgical section of the vagal trunks - rarely done b/c innervation of the abdominal structures also sacrificed
selective gastric vagotomy
stomach denervated but the vagal branches of the pylorus, liver, biliary duct, intestines, and celiac plexus are preserved
selective proximal vagotomy
attempts to denervate even more specifically the area in which the parietal cells are located
posterior gastric ulcer
ulcer that may erode through the stomach wall into the pancreas, resulting in referred pain to the back
erosion of the splenic artery
severe hemorrhage into the peritoneal cavity - caused by posterior gastric ulcer that erodes through stomach wall into pancreas
pain
unpleasant sensation associated with actual or potential tissue damage and mediated by specific nerve fibers to the brain, where its conscious appreciation may be modified
organic pain
arises from an organ - varies from dull to severe, but poorly localized - radiates to dermatome level
