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NURS 2514 > Week 5 - Esophageal Disorders > Flashcards

Week 5 - Esophageal Disorders Flashcards

1
Q

list 3 types of esophageal disorders

A
  • gastroesophageal reflux disease (GERD)
  • hiatal hernia
  • esophageal cancer
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2
Q

what is GERD

A
  • a condition where gastric contents move into the esophagus, creating the sensation of heartburn and/or esophagitis
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3
Q

what kind of cells line the esophagus? what does this allow?

A
  • stratified squamous

- protects against friction

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4
Q

what kind of epithelial cells line the stomach?

A
  • simple columnar epithelium
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5
Q

what is the lower esophageal sphincter

A
  • bundle of muscles at the lower end of the esophagus, where it meets the stomach
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6
Q

what is the function of the lower esophageal sphincter

A
  • opens to allow food & drink to pass into the stomach from the mouth
  • then closes to keep those contents inside the stomach for digestion
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7
Q

what happens if the LES is damaged

A
  • it becomes weak & relaxes = stomach acids & its contents flow back into the esophagus
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8
Q

what are the 2 parts of the lower external sphincter? what kind of muscle makes up each?

A
  • internal = smooth muscle

- external = skeletal muscle

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9
Q

what is important about the external & internal LES

A
  • must line up so they can work together and create enough pressure to close the esophagus
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10
Q

list 6 causes of GERD

A
  • weak or incompetent LES
  • hiatal hernia
  • decreased esophageal peristalsis
  • decreased saliva function
  • increased gastric acid production
  • delayed stomach emptying
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11
Q

what pressure should the LES normally exert? at what point does the pressure become not enough to keep it closed?

A
  • normal = 10-30

- <10 = too weak

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12
Q

how does decreased esophageal peristalsis cause GERD

A
  • it wont push stuff down
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13
Q

how does decreased saliva function cause GERD

A
  • get decreased flushing effect of the salivia = won’t push down what comes up
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14
Q

how does increased gastric acid production or delayed stomach emptying cause GERD

A

= overwhelms LES

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15
Q

what are the 2 categories of symptoms that occurs with GERD

A
  1. heartburn

2. respiratory symptoms

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16
Q

what is heart burn? where can it radiate to?

A
  • retrosternal or epigastric pain that can radiate to the throat, shoulder, or back
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17
Q

what is heartburn often confused w

A
  • angina
18
Q

what makes heartburn worse (3)

A
  • occurs 30-60 min after eating
  • worse w bending at the waist
  • recumbency
19
Q

why does recumbency and bending at the waist make heart burn worse?

A
  • no longer get the help of gravity to push the contents down
20
Q

what respiratory symptoms occur with heartburn (4)

A
  • aspiration of gastric contents =

- coughing, wheezing, and hoarseness

21
Q

what respiratory symptoms occur with heartburn (4)

A
  • aspiration of gastric contents =

- coughing, wheezing, and hoarseness

22
Q

list 4 chronic complications of GERD

A
  • esophageal stricture
  • barrett’s esophagus
  • hiatal hernia
  • hemorrhage and ulcerations
23
Q

what is esophageal stricture

A
  • narrowing of the esophagus
24
Q

what causes esophageal stricture

A
  • scar tissue formation
  • spasm
  • edema
25
Q

what does esophageal stricture lead to (4)

A
  • futher reflux (bc scar tissue prevents it from fully closing)
  • dysphagia (bc difficult to swallow)
  • obstruction
  • perforation
26
Q

what % of people w esophagitis develop stricture?

A

10

27
Q

what is barrett’s esophagus

A
  • replacement of esophageal stratified squamous epithelium with simple columnar epithelium so it resembles the stomach and intestine
28
Q

what causes barrett’s esophagus

A
  • the acid kills the stratified squamous epithelium
29
Q

what % of patients with Barrett’s develop esophageal cancer

A

10

30
Q

what is the hiatus

A
  • the opening of the diaphragm

- basically it is the hole that the esophagus passes thru

31
Q

what is the hiatus normally like? what is it like during a hiatal hernia

A
  • normally v tight, so that contents of the stomach cannot go up
  • during a hiatal hernia, the hiatus dilates
32
Q

what is a hiatal hernia

A
  • herniation of a portion of the stomach into the esophagus thru the hiatus (opening of the diaphragm)
33
Q

what does a hiatal hernia cause

A
  • GERD
34
Q

what are 2 types of hiatal hernias

A
  1. sliding

2. rolling

35
Q

what is the gastro-esophageal junction

A
  • point where the esophagus ends and the stomach begins
36
Q

what is a sliding hiatal hernia

A
  • where the gastro-esophageal junction slides above the hiatus of the diaphragm & part of the stomach slides into the hiatal opening
37
Q

what is a rolling hiatal hernia

A
  • the fundus (top) of the stomach rolls up thru the hiatus, but the gastro-esophageal junction remains in place
38
Q

describe the treatment for GERD (7)

A
  • avoid large meals
  • avoid foods that relax LES
  • sitting upright
  • drink fluids
  • antacids
  • inhibit gastric acid production
  • surgery
39
Q

list 4 foods that relax LES

A
  • alcohol
  • caffeine
  • nicotine
  • fat
40
Q

why is sitting upright a treatment for GERD

A
  • get help from gravity to push the stomach contents down
41
Q

why is drinking fluids a treatment for GERD

A
  • flushes the esophagus clean
42
Q

when might surgery be done for GERD (2)

A
  • if severe or unresponsive cases

NURS 2514 (75 decks)

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