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14 Cards in this Set
- Front
- Back
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Trace the venous drainage from the esophagus.
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esophageal veins drain into the azygos and hemiazygos veins which ultimately drain into the superior vena cava.
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What innervates the esophagus?
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Branches of the anterior and posterior VAGUS nerve and the RLN form the esophageal plexus.
Vagus Nerve-- Relaxation of the lower esophageal sphincter |
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What are the names of the 2 esophageal sphincters?
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cricopharyngeal sphincter (upper)
(cardiac) sphincter (lower) |
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The function of the esophagus includes propulsion of nutrients and:
A. Production of digestive enzymes B. Secretion of mucus C. Absorption of nutrients D. All of the Above |
B; secretions of mucus
(The esophagus does not produce enzymes or absorb nutrients.) |
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The outer layer of the muscularis is covered by:
A. Serosa like the stomach and small intestine B. Adventitia that merges with surrounding connective tissue |
B. Adventitia that merges with surrounding connective tissue
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Venous drainage of the esophagus is via:
A. Inferior vena cava B. The Azygos system C. Thoracic duct D. Thyroid veins |
B. The Azygos system
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While performing transesophageal echocardiography on a patient, the posterior wall of the esophagus, immediately behind the left atrium, was punctured from within. The patient subsequently developed an infection in the space around the esophagus at this point, namely the:
A. Anterior mediastinum B. Middle mediastinum C. Posterior mediastinum D. Superior mediastinum |
C. The esophagus is in the posterior mediastinum, along with the descending aorta, thoracic duct, and azygos system.
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5. Since the puncture in the previous question was through the posterior wall of the esophagus, the doctors were also concerned about damage to the vessel just behind the esophagus and between the azygos vein and aorta, i.e., the:
A. Hemiazygos vein B. Left bronchial vein C. Left pulmonary vein D. Superior vena cava E. Thoracic duct |
E. The thoracic duct is found directly behind the esophagus in the posterior mediastinum, with the aorta to its left and the azygos vein to its right. This relationship between these three vessels is an important one to keep in mind! The other vessels do not share the same relationship with the azygos and aorta.
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What are gastro-esophageal varices
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Manifestations of porto-caval shunting....
In portal hypertension these collateral venous vessels develop an extreme dilation secondary to increased venous pressure in the portal circulation. |
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What is the most common location of gastro-esophageal varices and why?
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Because the distal 2-5 cm of the esophagus contains superficial veins without significant support from surrounding connective tissues, this is the most common site of venous dilatation
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What is the pathophsiologic mechanism for the development of gastro-esophageal varices?
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Portal hypertension (increased portal venous pressure)
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Methods of treating the portal hypertension
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1. variceal ligation,or banding,
2. sclerotherapy 3. intrahepatic portosystemic shunt (TIPS), 4. distal splenorenal shunt procedure 5. liver transplantation. |
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True or False? The majority of blood from the esophagus is drained away via the esophageal veins, which drain deoxygenated blood from the esophagus to the azygos vein which in turn, directly drains into the superior vena cava --causing esophageal varices when pressure is increased..
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False...superficial veins lining the esophagus interior, which drain into the coronary vein (left gastric vein) which in turn, drains directly into the portal vein. These superficial veins lining the esophagus interior (normally only approximately 1mm in diameter) become distended up to 1-2 cm in diameter in association with portal hypertension.
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What decreases Lower Esophageal Sphincter tone which can increase risk of aspiration?
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Cricoid pressure
inhaled agents opiods, Propofol, Tiopentathal, Anticholinergics Obesity, & pregnancy Hiatal hernia |
