Esophagus and Stomach

Question 1

portal hypertension

Answer 1

an abnormally increased blood pressure in the portal venous system - blood can’t pass through liver, so flow reverses in esophageal tributary

Question 2

esophageal varices

Answer 2

marked enlargement of the esophageal tributaries due to portal hypertension - commonly develop in w/ alcoholic cirrhosis

Question 3

alcoholic cirrhosis

Answer 3

fibrous scarring of the liver

Question 4

pyrosis

Answer 4

heartburn - most common type of esophageal discomfort or substernal pain, usually due to regurgitation or hiatal hernia

Question 5

GERD/gastroesophageal reflux disorder

Answer 5

regurgitation of small amounts of food or gastric fluid into the lower esophagus

Question 6

where is pyrosis commonly perceived?

Answer 6

chest sensation rather than the abdominal region

Question 7

pancreatitis

Answer 7

inflammation of the pancreas

Question 8

what can pancreatitis cause the stomach to adhere to?

Answer 8

part of the posterior wall of the omental bursa that covers the pancreas

Question 9

hiatal hernia

Answer 9

protrusion of part of the stomach into the mediastinum through the esophageal hiatus of the diaphragm

Question 10

who experiences hiatal hernias most commonly?

Answer 10

middle age people

Question 11

two types of hiatal hernia?

Answer 11

para-esophageal and sliding

Question 12

para-esophageal hiatal hernia

Answer 12

cardia remains in normal position; pouch of peritoneum, often w/ part of fundus, extend through the esophageal hiatus anterior to the esophagus

Question 13

sliding hiatal hernia

Answer 13

cardia of esophagus and parts of fundus slide superiorly through the esophageal hiatus into the thorax, especially when lying down or bending over

Question 14

pylorospasm

Answer 14

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)

Question 15

congenital hypertrophic pyloric stenosis

Answer 15

hypertrophy of smooth muscle in the pylorus - may cause the stomach to become secondarily dilated

Question 16

gastroscope

Answer 16

used to inspect the mucosa of an air-inflated stomach, enabling physicians to observe gastric lesions and take biopsies

Question 17

total gastrectomy

Answer 17

removal of the entire stomach - uncommon

Question 18

partial gastrectomy

Answer 18

removal of part of the stomach - may be done to remove carcinoma

Question 19

which lymph nodes are often taken out with partial gastrectomy?

Answer 19

pyloric lymph nodes and right gastro-omental lymph nodes (also celiac nodes if cancer advanced)

Question 20

gastric ulcers

Answer 20

open lesions of the mucosa of the stomach

Question 21

peptic ulcers

Answer 21

lesions of the mucosa of the pyloric canal or duodenum

Question 22

what causes most ulcers?

Answer 22

Helicobacter pylori bacteria

Question 23

vagotomy

Answer 23

surgical section of the vagus nerves - performed in people w/ chronic or recurring ulcers to reduce production of acid

Question 24

antrectomy

Answer 24

resection of an ulcerated area or resection of the pyloric antrum

Question 25

truncal vagotomy

Answer 25

surgical section of the vagal trunks - rarely done b/c innervation of the abdominal structures also sacrificed

Question 26

selective gastric vagotomy

Answer 26

stomach denervated but the vagal branches of the pylorus, liver, biliary duct, intestines, and celiac plexus are preserved

Question 27

selective proximal vagotomy

Answer 27

attempts to denervate even more specifically the area in which the parietal cells are located

Question 28

posterior gastric ulcer

Answer 28

ulcer that may erode through the stomach wall into the pancreas, resulting in referred pain to the back

Question 29

erosion of the splenic artery

Answer 29

severe hemorrhage into the peritoneal cavity - caused by posterior gastric ulcer that erodes through stomach wall into pancreas

Question 30

pain

Answer 30

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

Question 31

organic pain

Answer 31

arises from an organ - varies from dull to severe, but poorly localized - radiates to dermatome level