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33 Cards in this Set
- Front
- Back
Z line
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demarcates nml squamocolumnar jxn
is a radio-opaque line separating esoph mucosa from gastric folds |
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nml impressions on esophagus
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aortic arch, LMSB, L atrium, have indentation on anterior esoph
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what can cause a gently sloping indentation on posterior esophagus (pseudomass appearance)
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a prominent azygoesoph recess
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what can cause an impression on anterior esoph in elderly
posteriorly |
LA'/LV enlargement
ectatic, desc aorta |
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describe pathway of uphill varices
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portal htn --> blood flow to coronary vein --> esoph/paraesoph folds that anast with azygous and hemiazygous system
azygous vein anastamoses with SVC to bypass portal system |
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ddx for esoph varices
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varicoid CA
lymphoma |
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B ring
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a nml mucosal rign at the GEJ
diameter should be >20mm (if <13, then schiaski's ring) |
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markers of GEJ on flx
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Z line
B rin g |
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A ring
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above B ring
broad smooth area that can change diameter during exam (transient finding) |
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which vascular anomaly leads to an anterior indentation on the esophagus
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pulmonary sling (only anomaly to have anterior indentation on esoph)
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what is a pulmonary sling
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when the LPA arises from the RPA
LPA passes between trachea and esoph, causing severe tracheal narrowing |
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what does R arch with aberrant L subclavian do to esophagram
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causes a posterior impression on eseoph (and trachea)
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what does a dbl aortic arch do to esoph
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compresses upper esoph b/l on frontal view
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findings of inflammatory esophagogastric polyp
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smooth, ovoid club shaped lesions on a thickened mucosal fold at GEJ
will see add'l findigns of reflux esoph |
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"stepladder" appearance of esophagus
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scarring from reflux esophagitis --> fixed transverse folds
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how to differentiate stepladder appearance of esoph from feline esoph
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stepladder appearance is wider than feline
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ddx smooth mid-esoph stricture
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radiation
castic ingestion barrett's |
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pathophys of glycogenic acanthosis
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accumulation of glycogen within squamous epithelial cells of esophageal epithelium
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appearance of glycogenic acanthosis
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white mucosal plaques in mid-distal esoph
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ddx gylocgenic acanthosis
how to differentiate |
reflux esoph
candida glycogenic acanthosis will have no clinical sx (incidental finding) |
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most common submucosal mass in esophagus
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leiomyoma
|
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ddx submucosal esophageal mass
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fibrom a
NF lipoma hemangioma |
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what is pulm artery sling assoc with
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tracheobronchiomalacia and/or stenosis in up to 50%
|
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what abn cause posterior impression on esoph
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doubl arch (sx)
2 arch + aberr l subclavian + L ductus (sx) L arch + aberr right subclavian (asx) |
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which vasc abn --> anterior impression on esoph
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pulm sling
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what are pseudosacculations and when are they seen when present in small bowel
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outpouchings in small bowel, seen along the antimesenteric side of small bowel.
assoc w scleroderma |
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where does small bowel dilatation occur in scleroderma vs celiac sprue
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scleroderma - duodenum proximal to its passage between the aorta and SMA
sprue - mid to distal jejunum |
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appearance esophagus in scleroderma
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hypomotility of the lower two-thirds (the smooth muscle component)
patulous GEJ mild to moderate dilatation of the esohpagus w reflux early, then strictures form |
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early appearance of small bowel in scleroderma
ddx? |
mild dilatation or may be nml
ddx: scleroderma, SBO, sprue |
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what are the 2 types of gastric volvulus
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organoaxial
mesenteroaxial |
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appearance of organoaxial gastric volvulus
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stomach rotates around long axis. antrum is superior to the proximal stomach
GEJ and the pylorus are at the same level and point downwards |
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appearance of meseteroaxial gastric volvulus
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GEJ below diaphragm.
The distal stomach is cephalad, and a beak can be seen at nml gej |
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rule of 2's for meckels diverticulum
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2% of the population
sx before the age of two, within 2 ft of the ileocecal valve length of 2 inches. |