Motility Flashcards
pressure in the esophagus is (higher/lower) than in the stomach
lower
lack of peristalsis in the esophageal body and no relaxation of LES
achalasia
only known etiology of achalasia
chagas dz
inflammatory infiltrate in myenteric plexus leads to?
ganglionic drop-out
achalasia presentation
dysphagia with solids and liquids, chest pain, heartburn, reflux?
complications of achalasia
malnutrition, pulmonary aspiration, SSC
barium swallow shows a “bird beak” – dx?
achalasia
name 3 tx for achalasia
botox injection every 6 months (prevents muscle contraction by blocking ACh release), balloon dilation of LES, esophageal myotomy
repetitive, simultaneous, abnormally long contractions of esophagus in response to swallowing
esophageal spasm
presentation of esophageal spasm
chest pain, dysphagia
“corkscrew esophagus” on imaging: dx?
esophageal spasm
tx for esophageal spasm
similar to angina – SM antagonists (ca channel blockers, nitrates), can do myotomy but NOT standard
weakened peristalsis often associated with reflux dz
peristaltic dysfunction or ineffective esophageal motility
autoimmune disorder causing diffuse fibrosis, inflammation, vasculopathy, affects skin and organs
scleroderma
calcinosis and Raynaud’s can be sx of?
scleroderma
complications of scleroderma
renal crisis, pulmonary HTN, interstitial lung dz
in the GI tract, scleroderma results in replacement of _____ with collagen, leading to?
muscle; myopathy
esophageal sx of scleroderma
reflux, dysphagia (decreased LES pressure and peristalsis)
gastric sx of scleroderma
stasis leads to N/V
small bowel sx of scleroderma
impaired motility leads to bloating, nausea, and often bacterial overgrowth (malabsorption, steatorrhea)
colonic sx of scleroderma
constipation
vomiting is a coordinated event mediated by the ____ and triggered by?
CNS; toxins/noxious stimuli
ddx for acute N/V
infection, toxin, obstruction, trauma, pregnancy
ddx for chronic N/V
motility disorder, medications, endocrine, obstruction, brain-stem lesion
most common cause of gastroparesis
diabetes
sx of gastroparesis
N/V, bloating, epigastric pain, weight loss
physical findings of gastroparesis
hypovolemia, succussion splash
dx of gastroparesis
endoscopy to r/o obstruction, gatric emptying study
intrinsic causes of bowel obstruction
neoplasm, ulcer, stenosis, foreign body
extrinsic causes of bowel obstruction
adhesions, pancreatitis, neoplasms, endometriosis, fibroid, etc.
what does H-I-V stand for?
hernias, intususception, volvulus
dx of obstruction is through?
encoscopy, imaging (can tell location based on what is dilated on xray)
for intussusception in adults, it is important to?
identify the lead point, rule out malignancies
