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DIG: Biweekly 1 > Lopez: Esophagus > Flashcards

Lopez: Esophagus Flashcards

1
Q

layers of esophagus

A
  1. Mucosa
  2. submucosa
  3. muscularis propria
  4. adventitia or serosa
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2
Q

esophageal region locations

A

C6-T10

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3
Q

UES location

A

C6

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4
Q

LES location

A

T10

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5
Q

muscle lining top 1/3 of esophagus

A

striated m.

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6
Q

muscle lining middle 1/3 of esophagus

A

striated + SMC

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7
Q

muscle lining bottom 1/3 of esophagus

A

SMC

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8
Q

outer layer of esophagus name in thoracic cavity

A

adventitia

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9
Q

outer layer of esophagus name in abd cavity

A

serosa

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10
Q

squamocolumnar junction aka

A

Z line

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11
Q

3 layers of mucosa of esophagus

A
  1. epithelium
  2. lamina propria
  3. muscularis mucosae
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12
Q

esophageal mucosa consists of

A

stratified squamous epithelium

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13
Q

voluntary
CN V, VII, IX, X, XII

A

oral phase of swallowing

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14
Q

muscles of mastication innervated by what nerve

A

CN V (trigeminal)

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15
Q

involuntary
move bolus through
soft palate elevation
CN IX (sensory)
CN X (motor)

A

pharyngeal phase of swallowing

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16
Q

involuntary
peristalsis moves bolus
CN X and myenteric plexus

A

esophageal phase of swallowing

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17
Q

pressure increases or decreases down digestive tract during peristalsis

A

increases

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18
Q

beginning with dysphagia to solids followed by dysphagia to liquids

A

progressive dysphagia

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19
Q

backflow of gastric contents into the esophagus

A

GERD

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20
Q

pathophysiology of GERD

A

permanent relaxation of LES (reflux of contents into esophagus)

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21
Q

risk factors of this include:
smoking, caffeine, chocolate, alcohol, stress, obesity, pregnancy

A

GERD

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22
Q

pt presents with heartburn, cough, and hoarseness in the morning

A

GERD

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23
Q

gold standard to dx GERD

A

24-hour pH monitoring

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24
Q

GERD can lead to

A

reflux esophagitis

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25
Q
A

reflux esophagitis

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26
Q

intraepithelial eosinophils seen

A

reflux esophagitis

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27
Q

inflammation of the esophagus

A

Esophagitis

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28
Q
A

Esophageal candidiasis

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29
Q
A

Herpes esophagitis

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30
Q

ulcers w/ raised edge in distal esophagus
multinucleated cells
Cowdry A inclusions

A

Herpes esophagitis

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31
Q
A

Cytomegalovirus

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32
Q

“owl eyes” cowdry B cells
ulcers in upper esophagus

A

CMV

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33
Q

infectious esophagitis is mainly seen in what kind of patients

A

immunocompromised

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34
Q

young adults and children w/ dysphagia and atopic disease

A

Eosinophilic Esophagitis

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35
Q

endoscope dx

A

Eosinophilic Esophagitis

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36
Q
A

Eosinophilic Esophagitis

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37
Q

NSAIDs, tetracycline, doxycycline and iron supplements, and KCl can cause this

A

pill-esophagitis

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38
Q

damage to esophageal mucosa caused by radiation therapy

A

radiation esophagitis

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39
Q

injury to esophagus due to ingestion of caustic substances

A

caustic esophagitis

40
Q

chronic GERD can lead to this

A

Barrett’s esophagus

41
Q

metaplasia of esophageal squamous epithelium to intestinal type epithelium

A

Barrett’s esophagus

42
Q

pathophys of Barrett’s esophagus

A

squamous to columnar epithelium with GOBLET cells due to chronic GERD

43
Q
A

Barrett’s esophagus

44
Q
A

Barrett’s Esophagus

45
Q
A

stage 1 barrett’s esophagus

46
Q

loss of goblet cells

A

stage 4 barrett’s esophagus

47
Q

barrett’s esophagus can lead to dysplasia and eventually what

A

carcinoma

48
Q

malignancy from glandular cells

A

Adenocarcinoma

49
Q

barrett’s esophagus and chronic GERD can lead to this

A

Adenocarcinoma

50
Q

mutation of what can lead to adenocarcinoma

A

TP53 and SMAD4

51
Q

pt has hx of GERD

A

Adenocarcinoma

52
Q

glandular changes and cluster of glands and mitotic figures

A

Adenocarcinoma

53
Q

malignancy from squamous cells

A

SCC

54
Q

smoking and alcohol use high risk for

A

SCC

55
Q

NO metaplasia seen with this, malignancy from squamous cells

A

SCC

56
Q

how to dx adenocarcinoma or SCC

A

endoscope and biopsy

57
Q
A

SCC

58
Q

protrusion of stomach into chest cavity

A

Hiatal hernia

59
Q

Z line area is migrated up and herniated

A

hiatal hernia

60
Q

pt has heartburn and GERD and dx w/ barium swallow or chest xray or endoscope

A

hiatal hernia

61
Q
A

hiatal hernia

62
Q
A

Zenker Diverticulum

63
Q

outpouching of pharyngeal mucosa in PROXIMAL esophagus through defect in muscular wall at Killian’s triangle

A

Zenker diverticulum

64
Q

eccentric membranes of tissue in proximal esophagus

A

esophageal webs

65
Q

concentric diaphragm of tissue located in distal esophagus

A

esophageal rings

66
Q

triad: iron deficiency anemia + dysphagia + cervical esophageal web

A

Plummer-Vinson Syndrome

67
Q
A

Plummer-Vinson Syndrome

68
Q
A

Plummer-Vinson Syndrome

69
Q

esophageal defect in which a part of the esophagus does not develop; pathway from lungs to stomach

A

congential esophageal atresia w/ or w/out tracheoesophageal fistula

70
Q
A

top: esophageal atresia
bottom: atresia w/ tracheoesophageal fistula

71
Q

Motor disorder of the esophagus characterized by a triad of incomplete lower esophageal sphincter relaxation, increased lower esophageal sphincter tone, and aperistalsis of the esophagus

A

Achalasia

72
Q

hypomotility disorder

A

Achalasia

73
Q

food unable to progress further down digestive tract and proximal part will dilate

A

Achalasia

74
Q

barium swallow dx

A

Achalasia

75
Q

dysphagia, regurg, halitosis, weight loss

A

Achalasia

76
Q

bad breath

A

halitosis

77
Q

Uncoordinated, simultaneous contractions of the esophagus

A

diffuse esophageal spasm

78
Q

hypermotility disorder

A

diffuse esophageal spasm

79
Q

barium swallow dx

A

diffuse esophageal spasm

80
Q

pt has hx of GERD; experiencing dysphagia and has weight loss

A

Barrett’s esophagus to dysplasia to adenocarcinoma

81
Q

Mucosal tears at the gastroesophageal junction from severe vomiting

A

Mallory-Weiss Tear

82
Q

mucosal tears from severe rise in pressure in retching phase of emesis

A

Mallory-Weiss Tear

83
Q
A

Mallory-Weiss Tear

84
Q

pt has hematemesis, hx of forceful vomiting, severe epigastric pain

A

Mallory-Weiss Tear

85
Q

full-thickness tear of esophagus from forceful vomiting

A

Boerhaave syndrome

86
Q

vomiting blood from internal bleeding of upper digestive tract

A

hematemesis

87
Q

full thickness tear of distal esophagus w/ massive amounts of pain

A

Boerhaave syndrome

88
Q

consequences of this include mediastinitis (contents in esophagus into mediastinum)

A

Boerhaave syndrome

89
Q

Mackler Triad to dx Boerhaave syndrome

A

vomiting
severe retrosternal pain
subcutaneous emphysema

90
Q

barium swallow dx

A

Boerhaave syndrome

91
Q

subcutaneous emphysema
air in mediastinum

A

Boerhaave syndrome

92
Q

Dilated submucosal veins in the lower esophagus from portal hypertension

A

Esophageal varices

93
Q

cirrhosis to portal HTN to _____

A

esophageal varices

94
Q

hx of chronic liver dx (cirrhosis) high risk for

A

Esophageal varices

95
Q
A

Esophageal varice

96
Q

pt presents w/ severe chest pain and hematemesis; few hours ago had forceful vomiting with a tearing chest pain in his back (vomiting and severe retrosternal pain)

A

Boerhaave syndrome

DIG: Biweekly 1 (11 decks)

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