L14 Esophageal Dysphagia Flashcards
In the esophagus, sympathetic innervation controls __________ and parasympathetic innervation controls ________-
peristaltic contractions
digestion
What are the 4 cardinal symptoms of pharyngeal dysphagia?
- problems initiating swallow
- postnasal regurgitation
- deglutitive cough
- repetitive swallows
What is a hiatal hernia?
when the LES is loose and part of the stomach goes up through it
Describe GER
- backflow of stomach contents into esophagus
- heartburn symptoms
- high incidence of esophagitis
- night supine reflux
- prolonged episodes
- greater incidence of obesity
- esophagus has natural protection against acid and pepsin
Describe laryngopharyngeal reflux LPR
- backflow of stomach contents into laryngopharynx
- don’t experience heartburn
- low incidence of esophagitis
- daytime upright reflux
- brief episodes
- BMI varies
- larynx is vulnerable to acid and pepsin
What is a Schatzki ring?
just above LES is an indentation in the esophagus - a mucosal shelf where food can stick
What is an A ring
a muscular ring in the esophagus
What is a a web?
a mucosal web higher up in the esophagus
What is a stricture?
progressive tightening of the esophagus where liquids can get through but not solids, may need to be dilated
If someone has esophageal problems that involve only solids, are progressive and rapid weight loss, what is the likely problem?
cancer
What is achalasia?
-absence of peristalsis and failure of the LES to open leads to a dilated esophagus with a ‘birds beak’ appearance at the bottom
Describe distal esophageal spasm
- high amplitude non-peristaltic contractions. Involve chest pain and dysphagia
- ‘corkscrew’ esophagus
Describe hypertensive persitalsis
AKA nutcracker esophagus
- high intensity peristaltic contractions > 180mmHg
- chest pain and dysphagia
T or F: imaging of the esophagus may be optionally included in a VFS study done by an SLP
True - but we aren’t qualified to interpret esophageal motility or anatomical findings, if these are suspected we must refer to physician for interpretation
If someone has difficulty swallowing and alump in their throat between meals it is likely _____
globus
If someone has difficulty swallowing and food sticks during meals in their sternum the problem is likely _________
esophageal
If someone has difficulty swallowing and food sticks during meals in their neck the problem is likely _________
pharyngeal or esophageal (referred)
If someone has difficulty swallowing and food sticks during meals in their neck and they have postnasal regurgitation and deglutitive cough, the problem is likely _________
pharyngeal
In esophageal dysphagia, if the problem involves solids only it is likely _________ if it involves solids and liquids its is likely ________
structural
dysmotility
If someone has esophageal dysphagia, affecting solids only and it is intermittent non progressive, what is it?
ring and/or web
If someone has esophageal dysphagia, affecting solids only and it is progressive, with reflux what is it?
stricture
If someone has esophageal dysphagia, affecting solids and liquids and it involves pain and a lot of regurgitation what is it?
achalasia
If someone has esophageal dysphagia, affecting solids and liquids and it involves a lot of pain and possibly regurgitation what is it?
spasm
