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17 Cards in this Set
- Front
- Back
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dysphagia |
sensation of food being hindered in passage from mouth to stomach
oropharyngeal; stoke, enlarged thyroid, skeletal muscle disorder, decreased saliva
esophageal; obstruction, motility disorder (both solids and liquids) |
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3 zones of esophagus |
upper esophageal sphincter body lower esophageal sphincter
between swallows tone in UES and LES protect against reflux |
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Achalasia |
failure of complete LES relaxation with swallows, hypertensive LES
aperistalsis of smooth muscle of esophagous = none, zilch, zero peristaltic propagations |
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Type 1 achlasia |
high res vs regular, high res has more sensors so better pictures and straight line measure the contractions all the way down
in normal we expect a smooth change in pressure
no change in the pressure in the LES,
ALL have aperistalsis and no LES opening |
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achalasia clinical symptoms |
dysphagis for solids in all and liquids in 2.3 chest pain weight loss regurg increased risk for squamous cell carcinoma |
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Achalasia in X-Ray |
movement image
dilated esophagus
bird beack distal esophagus due to hypertensive poorly relaxing LES
chest x ray of gastric bubble |
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Endoscopy of LES |
dilated esophagous with poor motility, retention of food
puckered closed LES
esophagitis due to retained food, candida
can pass a scope thru |
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achalasia LES |
can't do much with the aperistalsis, but can relax he muscles
esophagomyotomy
pneumatic dilatation
botulinum toxin into LES, interfers with aceytlcholine release
drugs to relace smooth muscle, nitrates, cqclium channel blockers |
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Pseudoachalasia |
usually caused by cancer, does not present with other symptoms or causes of normal achalasia
need to always check to make sure its not a tumor |
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Scleroderma |
hypotensive LES
atrophy of the muscle and replacement with fibrous tissue
neural dysfunction may proceed muscle disease
manometry; esophageal body dysfunction, weak LES
clinical featuresl esophagitis from reflux, dysphagia due to dysmotility |
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difuse esophageal spasm |
simultaneous contractions some nl peristlasis
spontaneous repetitive contractioncs |
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nutcracker eso |
high amplitude conractions |
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GERD |
any sympotmatic condition or histopatholigic alteration resulting from GER |
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Factors that maintain the GE junction |
intrinsic LES pressure
extrinsic pressure via diaphragm
intraabdominal location of LES (hiatal hernia)
phrenoesophagela ligament
acute angle of his |
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pathogenesis of GERD |
transient LES relaxation
hypotensive LES, LES affect by hormones, drugs, and food, progesteron decreases LES, LES decerased by beta blockers
LES decreased by fat chocolate alcohol peppermint
only a small numer |
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Consequences of GERD |
heartburn, without endoscopic esophagitis
esophagitis
dysphagia, peptic stricture and a schatzkis ring about a hiatal hernia, peristaltic dysfunction and mucosal inflammation
barretts |
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Impedance |
correlated to the number of ions and if the bolus is present |
