Lp 38 Flashcards
Another word for swallowing
Deglutition
Swallowing involves
-tongue
-soft palate
-pharynx
-esophagus
-several muscles
(Voluntary) bolus to back of mouth w/tongue
Buccaneers
(Involuntary) controlled by medulla & pons
-send motor impulses to CNS (mostly CN X)
Pharyngeal-esophageal
-muscular tube moves food from pharynx to stomach
-typical 4 layers
-posterior to trachea; intersects diaphragm at T11
-muscularis- contractions for peristalsis
-secretes mucus: protection & lubricates surface: ease movement of food
-sphincters at both ends: 1-way movement
Esophagus
Different disorders w/ltd. Range of sx’s
Esophageal lesions
? Require tax to prevent aspiration of food into lungs
Dysphagia & achalasia
-difficult/ painful swallowing
-caused by:
*changes in Fxn
*narrowing of esophagus, leads to scarring
*esophageal cancer
CNS lesions
-motor dysfunction
-1 symptom of achalasia
Dysphagia
-incomplete relaxation of LES in swallowing
-idiopathic: possible decreased innervation in esophageal myenteric plexus
-slow passage of food- stasis & inflammation
Achalasia
-most common reported sx
-burning sensation in eternal region often d/t GE reflux
-30-60 minutes after eating
-worse w/bending over or lying down
-antacids provide sx relief
-liquids dilute GI contents
Heartburn
-backward movement of stomach contents
-brining stomachs acidic contents to esophagus
-prompt medical attention
GE reflux
-inflammation of esophageal mucosa
-caused by irritation d/t:
*reflux
*ingested irritants
*vomiting
*achalasia
infection
-in Canada: 1 cause is GE reflux
Esophagitis
Outpouching of esophageal/ intestinal wall d/t weak muscularis
-requires surgical intervention
Diverticulum/ diverticula
-outpouchings retain food
Esophageal diverticulum
-protrusion of segment of stomach above diaphragm
-2 types: sliding (esophageal)- common & rolling (paraesophgeal) -10%
-cause: unclear
-requires surgical intervention
-sx’s: discomfort, pn, Dysphagia
-factors: short esophagus (ABN), repeated vomiting & GE reflux
Hiatal hernias
-esophagogastric jct is displaced upward
-protrusion is large & bell-shaped
-stomach slides up into thoracic cavity in supine & moves back down in upright
Sliding hernia
-defect of diapharagmatic- esophageal hiatus
-gastroesophageal jct remind in position
-stomachs fungus bulges through diaphragmatic opening & does not move back
-olds up along esophagus
-relatively small (3-6cm)
-not often assoc. w/reflex
-idiopathic
Rolling hernia
-protrusion of intestine into femoral canal (increase common in female)
-coughing, lifting, straining, accidents
Femoral hernia
Protrusion of part of peritoneum& momentum through abdominal wall behind external inguinal ring
Inguinal hernia
-malignant neoplasm
-uncommon (1-2%)
-male: female ratio= 3;1
-more common in men >50
-contributing factors:
*persistent achalasia
*food stasis in esophagus
*alcohol consumption
*cigarette smoking
Esophageal cancer
