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Patho: Exam 3 > Disorders of the Esophagus & Stomach (Adults Pt 1) > Flashcards

Disorders of the Esophagus & Stomach (Adults Pt 1) Flashcards

1
Q

Esophagus

A

No digestion or absorption occurs in the esophagus

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2
Q

What does the esophagus do?

A

Simple muscular tube that transports food from the pharynx to the stomach by coordinated muscle contraction.

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3
Q

What could wrong with the esophagus?

A

Obstruction, dysfunction (of the muscle or the nerves that innervate them, outpouchings (diverticula) that prevent the food from going where it’s supposed to go, GERD (prevents stomach contents from re-entering the esophagus)

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4
Q

Obstruction in the Esophagus can occur from what?

A

Inside: foreign object, tumor, “wings/webs” such as scar tissue
Outside: lung cancer, enlarged lymph nodes

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5
Q

Dysphagia can be caused by a _______ or ______ obstruction of the esophagus.

A

Mechanical; functional

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6
Q

Functional Obstruction is

A

An impairment of esophageal motility.

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7
Q

Upper esophageal obstruction discomfort occurring ____ seconds after swallowing, and lower esophageal ____ after swallowing.

A

Upper: 2-4 sec
Lower: 10-15 sec

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8
Q

Any muscle could fail in the esophagus one or two ways:

A

fail to contract (PSNS: Fight or flight) and or fail to relax (SNS: rest and digest)

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9
Q

If the PSNS is compromised, then the esophagus has ______ peristalsis and is unable to relax

A

Decreased

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10
Q

if the esophagus fails to contract esophageal ______ could occur in the ______ & other connective tissues such as _______.

A

Dilates; scleroderma; Chagas’ disease

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11
Q

If the esophagus fails to relax _____ could occur diffused throughout the entire esophagus. It can present as ______ ______ that mimics angina.

A

SPASMS; chest pain

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12
Q

Achalasia is a form of _____ ______ caused by the loss of esophageal innervation or relaxation of the lower esophageal sphincter.

A

Functional dysphagia

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13
Q

Achalasia Pathophysiology

A

“Failure to relax”, destroys PSNS neurons and remains constricted.

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14
Q

Late phase of Achalasia is a condition where food gets stuck and causes esophageal _____, proximal to that occlusion. Can’t relax!

A

Dilation

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15
Q

Bird Beak on Barium Swallow is known as?

A

Food travels down the esophagus and gets stuck before the stomach causing esophageal dilation proximal to the unrelaxed location.

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16
Q

Pulsion Diverticula

A

Outpouching of the esophagus causes esophageal diverticula

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17
Q

Esophageal diverticula can be

A

Congenital

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18
Q

Zenkers diverticulum outpouching causes what?

A

Outpouching of the lumen causes food and drink to get stuck down there before being digested.

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19
Q

IF regular food appears digested, it cant be a result of Zenkers diverticulum . T or F

A

True

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20
Q

What is the most common esophageal disorder?

A

GERD

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21
Q

What is the pathophysiology behind GERD?

A

chyme regurgitation from the stomach into the esophagus, causing esophagitis causing from repeated exposed to acids and enzymes (pepsin) in the regurgitated gastric contents.

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22
Q

Define Hiatal Hernia

A

Protrusion of the upper part of the stomach through the hiatus (esophageal opening in the diaphragm) at the gastroesophageal junction.

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23
Q

Clinical Manifestations of GERD

A

Heartburn from acid regurgitation, chronic cough, laryngitis, asthma attacks, sinusitis, and upper abdominal pain with one hour of eating

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24
Q

Define Esophagitis

A

Inflammation fo the esophagus

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25
Q

Esophagitis can be caused by:

A

Meds, chemotherapy, radiation, chronic disease, infection (candida, herpes, mycobacterium)

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26
Q

Clinical Manifestations of Hiatal Hernia

A

Asymptomatic, heartburn, regurgitation, dysphagia, & epigastric pain

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27
Q

Hiatal Hernia

A

Protrusion (herniation) of the upper part of the stomach through the diaphragm & into the thorax.

28
Q

3 types of hiatal hernia

A

Sliding, paraesophageal, mixed

29
Q

Type 1 Hiatal Hernia: _____

A

SLIDING: Most common; Proximal stomach portion moves moves into the thoracic cavity through an opening in the diaphragm for the esophagus & vagus nerves

30
Q

Type 2 Hiatal hernia: ________ aka “rolling”

A

Paraesophageal hernia: Herniation of the greater curvature of the stomach is through a secondary opening in the diaphragm

31
Q

Type 3 Hiatal Hernia: ______

A

Mixed; Type I & II

32
Q

Esophageal Cancer Pathophysiology

A

Facilitated by chronic inflammation & dysplasia caused by gastroesophageal reflux (Barrett’s esophagus) & long term exposure to irritants (alcohol and tobacco)

33
Q

What are the two types of esophageal cancer?

A

Adenocarcinoma & squamous cell carcinoma

34
Q

Clinical manifestations for esophageal cancer

A

Back pain, chest pain, dysphagia, resp symptoms, trachea compressed

35
Q

Esophageal varices

A

Dilation of esophageal veins, usually caused by liver disease/portal hypertension.

36
Q

Pathophysiology of Esophageal Varices

A
  1. Lower esophagus is drained into the superficial veins lining the esophageal mucosa
  2. Esophageal mucosa drains into the LEFT gastric vein, then drains into the portal vein
  3. Gradient greater than 10, builds collateral circulation in the lower esophagus, abdominal wall, stomach, and rectum.
  4. blood vessels become distended, becoming more thin walled and appear as varicosities.
37
Q

Pyloric obstruction is the

A

Narrowing or blockage of the pylorus which is the opening btw the stomach and the duodenum

38
Q

What can lead to Pyloric obstruction?

A

Congenital, inflammation and scarring secondary to a gastric ulcer, or tumor growth.

39
Q

Intestinal obstruction prevents the normal movement of _______ thorough the intestinal tract.

A

Chyme; usually mechanical (torsion, herniation, or tumor is usually the cause.

40
Q

Paralytic Ileus causes

A

Functional obstruction

41
Q

What are the most severe consequences of intestinal obstruction:

A

Fluid/electrolyte loss, HYPOvolemia, shock, intestinal necrosis, and perforation of the intestinal wall.

42
Q

Most common stomach disorder?

A

Peptic ulcers

43
Q

What is a peptic ulcer?

A

Circumscribed area of mucosal inflammation and ulceration caused by excessive secretion of gastric acid, disruption of protective mucosal barrier, or BOTH!

44
Q

Name the 3 type of peptic ulcers?

A

Lower esophagus, stomach, or duodenal ulcers

45
Q

Clinical manifestations of peptic ulcers

A

Pain begins 30 mins to 2 hours after eating when the stomach is empty

46
Q

Gastric/peptic ulcers are frequently caused by

A

H.pylori

47
Q

Is gastritis an acute or or chronic inflammation of the gastric mucosa?

A

It is both!

48
Q

What is the PRIMARY defect in gastric ulcer development?

A

Increased mucosal permeability to hydrogen ions

49
Q

Gastric ulcer manifestation

A

Pain occurs immediately after eating; chronic; anorexia, vomiting, weight loss

50
Q

Zollinger - Ellison Syndrome

A

Pancreatic tumor called a gastrinoma secretes gastrn / chronic secretion of gastric acid

51
Q

Define “Stress related mucosal” disease

A

It’s a peptic ulcer related to a severe illness, multisystem organ failure or major trauma

52
Q

________ ulcers most common peptic ulcers; associated w/ increased numbers of parietal cells, elevated gastrin levels, and rapid gastric emptying.

A

Duodenal

53
Q

Gastric ulcers develop near _____ cells.

A

Parietal

54
Q

Ischemic Ulcer

A

Develops within hours of an event

55
Q

Curling ulcer

A

Develops after a brain injury

56
Q

Curling ulcer

A

Develops after a burn injury

57
Q

Cushing ulcer

A

Develops as a result of head trauma or brain surgery from hypersecretion of hydrochloric acid from the vagal nuclei

58
Q

_____ is an inflammatory disorder of the gastric mucosa (acute or chronic)

A

Gastrities

59
Q

______ gastrities is an acute injury to protective ______ barrier.

A

Acute; Mucosal

60
Q

_____ gastrities is chronic inflammation, mucosal atropy & epithelial metaplasia that progresses over the years.

A

Chronic

61
Q

This disorder is also defined as type A or type B

A

Chronic gastrities

62
Q

Type A, is most rare severe form of chronic _____ gastritis. Associated with ________ to parietal cells & intrinsic factor, resulting in atrophy & pernicious anemia.

A

FUNDAL; autoantibodies

63
Q

Type B, is a chronic _____ gastritis ______ more common associated with H.Pylori, NSAIDs, alcohol, and tobacco.

A

ANTRAL; nonimmune

64
Q

Alkaline Reflux Gastritis

A

Stomach inflammation caused by reflux of bile & alkaline pancreatic secretions.

65
Q

Pyloric (gastric outlet) obstruction

A

Blocking or narrowing of the opening btw the stomach and duodenum

66
Q

Gastroparesis also called

A

“delayed gastric emptying” is a medical disorder consisting of
WEAK muscular contractions (peristalsis) of the stomach, resulting in food & liquid remaining in stomach for a PROLONGED period of time.

67
Q

Gastric Cancer

A

More common in Asia decent (from lifestyle, smoking, alcohol)

Patho: Exam 3 (7 decks)

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