How do esophageal varices form? - ANS In the lower part of the esophagus there is a combination of
portal and systemic drainage --> if have obstruction here then portal HTN increases blood supply to
this area and leads to esophageal varices that bleed like crazy
Explain the anatomy of the esophagus - ANS There are upper, middle and lower pharyngeal
sphincters --> as one contracts, the other relaxes (peristalsis)
Esophagus is 25 cm
- Cervical portion
- Upper thoracic
- Mid thoracic
- Distal esophagus
,What muscle relaxes as the lower pharyngeal sphincter pushes the bolus of food through? - ANS
Cricopharyngeal muscle
What is important about the distal esophagus? - ANS This is close to the gastroesophageal junction
which is where there is the transition from squamous epithelium to columnar epithelium
Which layer of muscle does the esophagus not have that the stomach does have? - ANS No oblique
muscle (stomach does more churning, whereas esophagus is a peristaltic organ)
What is Killian's triangle? - ANS This is an area of weak muscular coverage in the esophagus
Can get false diverticulum (Zenker's) -- herniation of mucosa d/t increased intraluminal pressure
What is manometry used for? - ANS Diagnostic test for esophageal motility disorders
Shows progressive peristaltic function of the esophagus and barium going through
What are the different diagnostic methods for esophageal disorders? - ANS Endoscopy -- best and
mc
CT
Manometry
24 hr pH monitoring
Endoscopic ultrasound
Barium swallow/esophagram
What are the functional disorders of the esophagus? - ANS Disordered Motility
,Achalasia
GERD/Barrett's
What is diffuse esophageal spasm commonly confused with? - ANS MI
What are the symptoms of diffuse esophageal spasm? - ANS Crushing chest pain
Dysphagia
What is seen on esophagogram of diffuse esophageal spasm? - ANS Corkscrew esophagogram
What medication relieves diffuse esophageal spasm? - ANS Nitroglycerin
What type of medication is used 1st line to treat diffuse esophageal spasm? - ANS Calcium Channel
Blockers
What surgical procedure may be performed for the treatment of diffuse esophageal spasm? - ANS
Myotomy -- disrupts the continuity of esophagus to relax the muscle
Used if medication fails
What is Achalasia? - ANS Achalasia is a disorder that makes it difficult for food and liquid to pass into
the stomach (LES fails to relax)
Neuromuscular discord problem!
What is the typical presentation of Achalasia? - ANS Middle aged adults
What is the rarity of Achalasia? - ANS Rare (1:100,000)
What are some possible etiologies of Achalasia? - ANS Unknown etiology (idiopathic, auto immune,
infectious - viral, parasitic)
What are the diagnostic methods for Achalasia? - ANS Barium swallow
EGD
Manometry
What is a characteristic finding in achalasia on barium swallow? - ANS Bird beak appearance of lower
esophagus --> dilated megaesophagus that narrows to bird beak
What are the treatment options for Achalasia? - ANS Endoscopic:
- Balloon dilatation (easiest, doesn't last long term so end up w/ repeat dilations)
- Botox injection (doesn't last forever, repeat injection leads to adhesions and makes more difficult
to perform myotomy if needed)
- POEM (newer procedure)
Surgical:
- Heller myotomy (definitive, best and longest acting treatment)
What is GERD? - ANS A condition where stomach contents leak into the esophagus, causing irration
What are the sxs of GERD? - ANS Regurgitation
Heartburn
Chest pain
Asthma
Laryngitis
Cough
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lectjoseph. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.99. You're not tied to anything after your purchase.