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Esofag Flashcards

(35 cards)

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1
Q

Lungime esofag

A

25 cm

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2
Q

Structuri in stransa vecinatate cu esofagul

A
  1. Trahee
  2. AS
  3. Aorta desc toracica
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3
Q

Zone de ingustare esofagiana

A
  1. Proximal - m cricofaringian
  2. Mijl - arcul aortic
  3. Distal - diafragm
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4
Q

Esofagul cervical - a, v, l, n

A
  1. A. tiroidiana inf
  2. V. tiroidiana inf
  3. Ggl jugulari (cervicali profunzi)
  4. Nv laringieni recurenti + lant sy cervical
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5
Q

Esofagul toracic - a, v, l, n

A
  1. A. bronsice + esofagiene (aorta)
  2. V. azygos + hemiazygos
  3. Ggl paratraheali, hilari pulm (med post)
  4. Vag, lantul sy toracic
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6
Q

Esofagul distal - a, v, l, n

A
  1. A. gastrica stg
  2. V. gastrica stg + coronariana gastrica
  3. Ggl celiaci, gastrici stg, parahiatali
  4. Vag + lant sy toracic
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7
Q

Zonele esofagului la EUS

A
  1. Mucoasa superf
  2. Mucoasa profunda
  3. Submucoasa
  4. Musculara proprie
  5. Adventice
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8
Q

Localizari carcinoame esofag

A

CSC - 1/3 prox, 1/3 medie, rar distal

AC - distal

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9
Q

Adenocarcinomul este asociat cu

A

BRGE

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10
Q

Primul test folosit pt evaluarea disfagiei

A

Tranzit baritat

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11
Q

Imagistica in cancerul esofagian

A

EUS - T, N

CT + PET - M

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12
Q

Cancerul esofagian metastazeaza cel mai frecv in

A

Ficat

Plamani

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13
Q

Substitute folosite pt reconstructie

A

Stomac
Colon stg
Jejun

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14
Q

Avantaje si dezavantaje ale folosirii stomacului ca grefon

A

Avantaje: - Vascularizatie bogata
- Mobilizare chir facila
- Necesar redus de anastomoze
Dezav: - Risc de ischemie fornix
- Reflux

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15
Q

Artere si nerv sectionat in folosirea stomacului ca grefon

A

A. gastrica stg + gastrice scurte

Nv vag

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16
Q

Avantaje si dezav a;e folosirii colonului ca grefon

Study These Flashcards
A

Av: - Lungime mare
- Anatomie favorabila, dim similare esofagului
- Ascensiune facila la niv cervical
Dezav: - + 2 anastomoze
- experiente tehnice
- colonoscopie preop + angio

17
Q

Principalul avantaj al abordului transhiatal

Study These Flashcards
A

Evitarea toracotomiei

18
Q

Cel mai comun abord chir in efectuarea unei toracotomii

19
Q

Tehnica McKeon. Cand, cum

Study These Flashcards
A
  • Tumori esofag proximal / mediotoracic

- Triplu abord: toracotomie dr, abd, cervical

20
Q

Abordul transhiatal este ideal pt tumori situate in …

Study These Flashcards
A

Esofagul distal

21
Q

Terapia neoadjuvanta in cancerul esofagian

Study These Flashcards
A

5 FU + Cisplatin

Iradiere ext 45 Gy 6-7 sapt

22
Q

Metode paliative

Study These Flashcards
A
  1. Dilatatia endoscopica
  2. Stenturi esofagiene
  3. Terapie laser / fotodinamica
  4. Radio-chimio
23
Q

Simptome initiale in lezarea esof cervical

Study These Flashcards
A
  1. Odinofagie

2. Durere la flexie

24
Q

Tratament in lez esof cervical

Study These Flashcards
A
  • Atb iv
  • Debridare
  • Drenaj
25
Sd Boerhaave
Ruptura esof distal spontana dupa eructatii si varsaturi violente
26
HH de alunecare: - Cea mai comuna - Asociata BRGE - Jonct gastro-esof in torace
!!!
27
Gold std in dg HH
Tranzit baritat sup cu subst de contrast
28
Etapele operatorii in HH
1. Reducere sac de hernie 2. Mobilizare esof toracic -> 2-3 cm intraabd 3. Inchidere defect diafragm fara tensiune 4. Fundoplicatura
29
Simptomatologia princ in achalazie
Disfagie progresiva la solide apoi lichide
30
Semnul clasic la tranzitul baritat in achalazie
Cioc de pasare
31
Trat med + chir in achalazie
Med: - nitriti po/sl, Ca blocante Chir: - Dilatare cu balon (nechir) - Miotomie - Heller transtoracic/transabd - Laparoscopic - POEM
32
Tulburari majore si minore ale persitaltismului esof
1. MEI (asimpt) 2. Spasm esofagian distal 3. Jackhammer = esofag hipercontractil (ambele cu distagie si dureri toracice)
33
Care sunt diverticulii de pulsiune
Zenker (cervical) | Epifrenic (distal)
34
Tumori benigne si localizare
1. Leiomiom - cel mai frecv - str muscular 2. Chist - adventice 3. T cu cel granulare + polip fibrovasc - mucoasa / submucoasa
35
Gradele in ingestia subst caustice si descrierea lor
I - hiperemie, eroziuni superf II - ulceratii superf, benzi albe III - ulceratii prof

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