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48 Cards in this Set
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- Back
- 3rd side (hint)
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Esophageal Atresia
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Incomplete development of the esophagus where a blind pouch of the proximal esophagus is formed.
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Esophageal Fistula
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An abnormal connection between the esophagus and the trachea.
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**Most common esophageal abnormality
**Congenital **80-90% of the time you will have a proximal esophageal atresia with a distal trachea-esophageal fistula |
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Esophageal Stenosis
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Narrowing or stricture of the esophagus
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**May be congenital of acquired
**Stricture may be a result of schleroderma or post-inflammatory scarring. |
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Esophageal Scleroderma
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Autoimmune disease in which the body's immune system mistakingly attacks it's own body causing inflammation and an overproduction of collagen. Excessive collagen causes the skin/organ to turn hard and stiff.
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Dysphagia
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Difficulty swallowing
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Esphageal Achalasia
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Failure of the esophageal sphincter to relax = Dysphagia
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The act of swallowing causes a wave of esophageal contraction called peristalsis. Peristalsis pushes food along the esophagus. Normally, peristalsis causes the esophageal sphincter to relax and allow food into the stomach. In achalasia, which means "failure to relax," the esophageal sphincter remains contracted. Normal peristalsis is interrupted and food cannot enter the stomach. Caused by the degeneration of the nerve cells that normally signal the esophageal sphincter to relax.
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Hiatal Hernia
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A portion of the proximal stomach slips through a weak or slightly enlarged esophageal hiatus. = Dysphagia
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Sliding
Rolling |
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Diaphragmatic Hernia
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A congenital abnormality where a significant portion of the diaphragm failed to develop allowing abdominal structures to herniate in the pleural cavities.
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Zenker's Diverticulum
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A false diverticulum that occurs in the esophagus due to a weakness in the longitudinal fibers.
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**Problems arise from trapping food which can cause inflammation and access growth with risk of perforation.
**Halotosis (Bad Breath) |
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Infectious Esophagitis
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Infections of the esophagus are often seen in patient that are immunocompromised (HIV, Chemo, Steroids)
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Most common types of esophageal infections are Herpes, Candida, CMV (Cytomegalovirus)
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Esophageal Rings or Webs
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Ring = Mucosa, Submucosa, and Muscle
Web = Mucosa and Submucosa |
Obstructs the flow/passage of material through the esophagus and can cause dysphagia.
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Laceration of the Esophagus
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Any laceration of the esophagus can cause pain and hemoptosis.
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Mallory-Weiss Syndrome
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A tear in the mucosa between the esophagus and the stomach caused by severe, coughing or vomiting. Frequently associated with alcoholism and eating disorders.
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Esophageal Adenocarcinoma
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Malignant tumor of esophageal glandular structure.
**Most common |
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Esophageal Squamous Cell Carcinoma
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Malignant tumor of the epithelial lining of the esophagus.
**Second most common |
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Esophageal Leiomyosarcoma
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Malignant tumor of the smooth muscle surrounding the esophagus.
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Esophageal Fibrosarcoma
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Malignant tumor of the connective tissue surrounding the esophagus.
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Gastro-Esophageal Reflux Disease (GERD)
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A defect in the lower esophageal sphincter that allows gastric juices to enter the lower esophagus.
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The lower pH and gastric material may cause damage to the squamous epithelium.
**Sometime associated with a hiatal hernia. **Can cause mild to severe esophagitis **Ulceration of the squamous mucosa with scar formation in deep ulcers. |
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Barretts Esophagus
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Metaplasia of the squamous epithelium to an intestinal type of gastric mucosal type within the esophagus.
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**Likely to turn into an adenocarcinoma!!
*Neoplastic transformation where the cells develop into an adenocarcinoma which may invade through the basement membrane and metastasize. |
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Displastic Barretts Esophagus
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Change of your esophageal cells to columnar type found in the stomach, but has not crossed the basement membrane yet.
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Cardia
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Part of the stomach that accepts the distal end of the esophagus.
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Contains mucous cells.
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Fundus
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The body of the stomach.
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Contains parietal cells that secretes hydrochloric acid & chief cells that produce pepsinogen.
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Pepsin
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Active form of pepsinogen (produced by parietal cells in the body of the stomach) that degrades food proteins into peptides to be absorbed by the intestinal lining.
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Antrum
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Area near the base of the stomach before the pylorus.
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Contains G-Cells that produce gastrin.
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Gastrin
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Peptide hormone released by G-Cells in the antrum of the stomach, duodenum, and pancreas that stimulates the secretion of HCl by parietal cells.
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Pyloric Stenosis
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Narrowing of the pylorus/sphincter of the stomach. May be congenital of acquired.
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Gastric Dilation
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Severe dilation of the stomach.
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**One cause would be beer bing drinking in which the stomach can possibly rupture.
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Acute Gastritis
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Inflammation of the stomach secondary to an acute event that causes reversible damage to the gastric mucosa.
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*Results in erosion of the gastric mucosa.
*Inflammation is limited to the mucosa. Designations 1. Acute Gastritis 2. Acute Hemorrhagic Gastritis 3. Acute Erosive Gastritis **Petechial hemorrhages may form which may develop into ulcers. |
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Causes of Acute Gastritis
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- Aspirin OD
- Alcohol - Infections - Sepsis - Shock - Smoking - Food Poisoning - Severe Stress - Radiation Damage - Chemo Drugs - Physical Trauma - Ischemia |
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Symptoms of Acute Gastritis
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- None
- Vague Abdominal Discomfort - Nausea and Vomiting - Melena - Massive hematemesis |
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Chronic Gastritis
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Chronic inflammation of the stomach that is usually a sign of an underlying disease.
1. H. Pylori = Most Common! 2. Autoimmune Gastritis |
Chronic Gastritis Catergories:
1. Superficial 2. Atrophic - Diminished rugi 3. Gastric Atrophy - Rugal folds are gone. **Atrophy associated with metaplasia, dysplasia, and atypia. |
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Zollinger-Ellison Syndrome
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A tumor of the duodenum or pancreas causes an excessive production of gastrin which in turn causes the stomach to produce an excess amount of HCl.
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**Associated with chronic gastritis and peptic ulcers in 95% of patients.
**Excessive gastrin will be found in the blood (hypergastrinemia) |
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Pernicious Anemia
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A decrease in RBC count when intestines can not properly absorb vitamin B12
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Intrinsic Factor produced by the stomach allows for absorption of vitamin B12. If the stomach cannot properly produce IF, then vitamin B12 will not be absorbed = decreased RBC production.
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Clinical Implications of Chronic Gastritis
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*Peptic Ulcer
* Zollinger-Ellison *Pernicious Anemia |
- Decrease parietal cells leading to decrease in IF = Pernicious Anemia
- Hypergastrinemia - Increased Peptic Ulcers - Increased Polyp Formation - Inc. Tendancy towards gastric carcinoma. |
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Helicobacter pyori
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Is a gram negative curvilinear rod shaped bacteria and affects the antrum and distal funds of the stomach and is the most common cause of chronic gastritis.
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**By age 50, over 50% of the population infected.
**Attaches to the superficial gastric epithelium and breaks down the mucous barrier and exposes underlying tissue to the acidic environment of the stomach. |
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H. Pylori Diagnostic Test
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1. Urease breath test
2. Serology testing for antibodies 3. Biopsy |
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H. Pylori Treatment
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1. Antimicrobials
2. Bismuth Compounds (Pepto-Bismol) |
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H.Pylori Signs & Symptoms
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1. Nausea, vomiting, abdominal discomfort
2. Hypochloridia (loss of parietal cells) 3. Gastrin levels usually normal |
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Auto-Immune Chronic Gastritis
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A diffuse gastritis involving the fundus and body of the stomach in which antibodies are produced against parietal cells and intrinsic factor leading to mucosal atrophy.
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*Decreased Acid Secretion
*Pernicious Anemia secondary to lack of IF from parietal *4% of cases progress to carcinoma *Associated with Hashimoto's Thyroiditis and Addisons Disease *Hypergastrinemia from G-Cell hyperplasia secondary to decrease in acid secretion |
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Addison's Disease
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Endocrine disorder in which the body's own immune system attacks the adrenal gland preventing adequate production of steroid hormones.
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Additional Causes of Chronic Gastritis
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1. Toxicity (Alcohol & Smoking)
2. Postsurgical with associated duodenal reflux 3. Mechanical, obstructive, or motor disorders 4. Radation/Chemotherapy |
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Chronic Peptic Ulcers (PUD)
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98-99% in the duodenum (4) : stomach (1)
Wearing down and possible tearing of the stomach wall due to a variety of factors. Has nice sharp, well-defined borders. - Excessive HCl - H. Pylori = Most Common |
Risk Factors
1. Environmental Factors: Cirrhosis, Aspirin, Cigarettes 2. Genetics 3. Blood type O has 30% greater chance. |
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Stromal Cell (Gist) Tumors
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Gastrointestinal Stromal Tumor (GIST) are tumors of the connective tissue of the stomach (sarcoma) unlike most stomach tumors with arise from epithelium.
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**Most common type of benign stomach cancer.
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Benign Stomach Tumors
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1. Leiomyomas
2. Schwannomas 3. Neurofibroma 4. Lipomas 5. Neurogenic Tumors 6. Hemangiopericytoma 7. Hemangioma |
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Stomach Polyps
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Growth of cells within the stomach
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**90% are hyperplastic meaning you have exaggerated growth secondary to mucosal regeneration (No genetic mutation)
**10% are neoplastic adenomatous polyps that are benign but have a 40-60% chance of progressing to malignancy. |
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Malignant Stomach Tumors
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1. Adenocarcinoma (90-95%)
2. Lymphoma (4%) 3. Carcinoid - Endocrine Cells within the Epithelium (3%) 4. Malignant Spindle Tumors (2%) *****90-95% of stomach cancers arise from the endothelium. |
**Five year survival rate = 10-15
**Incidence greater in Japan and Colombia and is the leading cause of death in countries where it's incidence is high. |
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Linitis Plastica
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A gastric adenocarcinoma arising from glandular epithelium. It quickly invades the stomach muscle wall that turns the muscle cells into leather-like scar tissue that connote swell or contract like it should.
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**Very fast growing and often spreads to other parts of the body.
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Stomach Cancer Risk Factors
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Environmental
- Ingestion of certain food or poor food prep. - Food contains carcinogens or stomach converts food to carcinogen - Salted Meats - Pickled Raw Vegetables - Salty Sauces |
Other
- High Gastric pH - Chronic Gastritis - Pernicious Anemia - Partial Gastrectomy (Risk inc. secondary to high pH **Risks decreased with eating leafy green vegetables. |
