esophagus ch 29.txt

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alshada
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3418
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esophagus ch 29.txt
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2010-01-14 06:37:06
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esophagus ABSITE
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ABSITE ch 29 esophagus
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  1. Type of epithelium covering the esophagus
    Squamous
  2. Blood supply of esophagus
    Vessels directly off the aorta
  3. Blood supply of the cervical esophagus
    Inferior thyroid artery
  4. Blood supply of the abdominal esophagus
    Left gastric and inferior phrenic arteries
  5. Muscle type in upper esophagus
    Striated
  6. Muscle type in lower esophagus
    Smooth
  7. Nerve that travels on the posterior stomach; becomes celiac plexus
    Right vagus
  8. Nerve that travels on the anterior stomach; goes to liver and biliary tree
    Left vagus nerve
  9. Position of thoracic duct
    Travels from right to left chest at upper 1/3 of mediastinum; inserts into left subclavian vein
  10. Location and muscle making up UES
    15 cm from incisors, cricopharyngeus muscle
  11. innervation of UES
    recurrent laryngeal
  12. normal UES pressure with food bolus
    12-14 mmHg
  13. normal UES pressure at rest
    50-70 mmHg
  14. most common site of esophageal perforation
    cricopharyngeus
  15. location of LES
    40cm from incisors
  16. anatomic areas of esophageal narrowing (3)
    cricopharyngeus, by left mainstem and aortic arch, diaphragm
  17. normal LES resting pressure
    10-20 mmHg
  18. side of approach to access the cervical esophagus
    left
  19. side of approach to access upper thoracic esophagus
    right
  20. side of approach to access lower thoracic esophagus
    left
  21. causes of hiccups (4)
    gastric distension, temperature changes, ETOH, tobacco
  22. causes of secondary esophageal dysfunction (4)
    systemic disease, GERD, scleroderma, polymyositis
  23. procedure of choice for heartburn
    endoscopy
  24. procedure of choice for dysphagia and odynophagia
    barium swallow
  25. swallowing disorders where liquids are worse than solids
    pharyngoesophageal disorders
  26. pathology caused by increased pressure during swallowing
    zenker�s diverticulum
  27. EGD in Zenker�s patient?
    Increased perforation risk
  28. Treatment of Zenkers
    Cricopharyngeal myotomy
  29. True diverticula in esophagus due to inflammation, granulomatous disease or tumor
    Traction diverticulum
  30. Diverticulum common in distal esophagus; associated with esophageal motility disorders
    Epiphrenic diverticulum
  31. Treatment of epiphrenic diverticulum
    Diverticulectomy, long esophageal myotomy on opposite side of esophagus
  32. Failure of peristalsis and lack of LES relaxation after food bolus
    Achalasia
  33. Workup of dysphagia
    EGD, barium swallow, manometry
  34. Medical treatment of achalasia (3)
    Calcium channel blockers, LES dilation, BoTox, nitrates
  35. Esophageal dysmotility characterized by frequent strong body contractions of inc amplitude and duration, with normal LES tone
    Diffuse esophageal spasm
  36. Treatment of diffuse esophageal spasm
    Calcium channel blocker, nitrates, antispasmodics
  37. Fibrous replacement of smooth muscle in esophagus
    Scleroderma
  38. Treatment of scleroderma
    Esophagectomy
  39. Surgical indications for GERD (4)
    Stricture, esophagitis, Barrett�s, cancer
  40. Fundoplication performed from chest
    Belsey
  41. 360 degree fundoplication used to treat GERD
    Nissen
  42. Surgical elongation of a brachyesophagus
    Collis gastroplasty
  43. Sliding hernia from dilation of hiatus
    Type I hiatal hernia
  44. Paraesophageal hernia with hole in diaphragm alongside the esophagus (nL GE junction)
    Type II hiatal hernia
  45. Dilation of hiatus + hole in diaphragm alongside
    Type III hiatal hernia
  46. Entire stomach in chest + other organs
    Type IV hiatal hernia
  47. Squamous to columnar metaplasia of esophagus
    Barretts
  48. Esophageal spread pattern
    Along submucosal lymphatic channels
  49. Symptoms indicating unresectability of esophageal ca (7)
    Hoarseness, horner�s syndrome, phrenic nerve involvement, pleural effusion, fistula, airway invasion, vertebral invasion
  50. Most common esophageal cancer
    Adenocarcinoma
  51. Common esophageal ca in lower esophagus
    Adenocarcinoma
  52. Common esophageal ca in upper esophagus
    Squamous cell carcinoma
  53. Primary blood supply to stomach after esophagectomy
    Right gastroepiploic artery
  54. Esophagectomy with neck and abdominal incision
    Transhiatal
  55. Esophagectomy with abdominal and right thoracotomy
    Ivor lewis
  56. Esophageal operation when preserved gastric function is desirable
    Colonic interposition
  57. Most common benign esophageal tumor
    Leiomyoma
  58. Biopsy leiomyoma?
    No, can form scar and make resection difficult
  59. 2nd most common benign tumor of esophagus
    esophageal polyp
  60. mode of injury after alkali ingestion
    liquifaction necrosis
  61. mode of injury after acid ingestion
    coagulation necrosis
  62. area of most perforations during EGD
    cricopharyngeus
  63. criteria for nonsurgical management of esophageal perforation (3)
    contained perforation, self-draining, no systemic effect
  64. forceful vomiting causing perforation of esophagus
    Boerhaave�s syndrome
  65. Mediastinal crunching on auscultation
    Hartmann�s sign
  66. Diagnosis method for boerhaave�s
    Gastrograffin swallow
  67. Surgical treatment of Boerhaave�s
    Left thoracotomy, longitudinal myotomy, primary repair

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