Esophagus Path I Flashcards Preview

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Flashcards in Esophagus Path I Deck (48):
1

VACTERL association

vertebral anomalies
anal atresia
cardiac defects
TEF/esophageal atresia
renal and radial abnormalities
limb defects

non random birth defects - cause of association unknown

2

salivation, choking, vomiting, cyanosis with feeding

TEF - tracheoesophageal fistula

3

polyhydramnios in utero

esophageal atresia

4

most common congenital esophagus defect

blinding ending superior esophagus

fistula of trachea to lower esophagus

5

most common intestinal atresia

imperforate anus

6

pyloric stenosis

projectile vomiting 2 to 8 weeks of age

males

hypertrophied smooth m spasm on emptying of stomach

7

hypokalemic hypochloremic metabolic alkalosis

with pyloric stenosis - loss of gastric acid

also secondary hyperaldosteronism with hypovolemia

8

nipple sign

seen with pyloric stenosis

9

tx of pyloric stenosis

cut smooth m. to correct stenosis

10

double bubble

duodenal atresia

and annular pancreas

11

duodenal atresia

trisomy 21

majority below ampulla of vater

double bubble

12

low lesion imperforate anus

colon close to skin

common in females

anal stenosis or rectum ends in blind pouch

13

high lesion imperforate anus

colon higher up in pelvis
-fistula to bladder, urethra, vagina

look for other congenital defects

like VACTERL association

14

anoplasty

tx of imperforate anus
-making a new butthole

15

persitant cloaca

rectum, vagina, urinary tract joined in single tract/channel

16

diaphragmatic hernia

incomplete formation of diaphragm
-with pulmonary hypoplasia

17

bochdalek hernia

postero-lateral hernia
-more common
-majority on left side

18

morgagni hernia

anterior defect of hernia
-adjacent to xiphoid of sternum

19

diaphragm eventration

abnormal displacement of diaphragm

-results in pulmonary hypoplasia and HTN

20

omphalocele

outpouching of peritoneum at the umbilicus
-covered by amnion

21

gastroschisis

abdominal contents protrude
-no cover by amnion

majority to right of umbilicus

tx- stuff into opening - use gelly band

22

maternal serum alpha-fetoprotein

screening for gastroschisis - second trimester of pregnancy

23

ectopic tissue rest

congenital anomaly
-presence of gastric or pancreatic tissue

can lead to inflammation, bleeding, scarring, and obstruction

inlet patch** - upper 1/3 esophagus

24

inlet patch

island of pink mucosa surrounded by normal white squamous esophagus epithelium

-islant of heterotopic gastric** mucosa - below UES

with ectopic tissue rest

often asymptomatic

rarely - acid - ulceration and dysphagia

also adenocarcinoma risk

often colonized by h pylori

25

meckel diverticulum

most common malformation of small bowel
-failure of involution of vitelline duct

antimesenteric - with own blood supply

true diverticulum - all 3 layers of cells

may harbor ectopic tissue - gastric/pancreatic

26

rules of 2s

with meckel diverticulum

within 2 feet of ileocecal valve
2 inch length
2 ectopic tissue types
2 years most common age
2:1 male female ration

27

meckel clinical

often asymptomatic - silent

symptoms - before age 2 - painless rectal bleeding
-volvulus, intussesception, obstruction

may appear as appendicitis**

28

present like appendicitis

meckel diverticulum

29

technetium 99m scan

diagnosis of meckels

detects gastric mcosa presence

noninvasive and highly specific/sensitive in kids

not as good in adults

30

meckels diverticulum path

proximal vitelline duct failus to regress and involute

-has own blood supply

31

hirschsprung disease

megacolon
-lack meissner and auerbach plexuses and ganglion cells

rectum always affected**

receptor kinase susceptibility genes

32

hirschsprung path

normal migration of neural crest cells from cecum to rectum during embryogenesis fails

bowel constricts - proximal distension with feces

NO ganglion cells present

33

no passing of stool in newborn

hirschsprung

green or brown vomit, explosive stools after finger in rectum - abdominal swelling - gas and blood diarrhea

34

finger in rectum - poo explosion!

hirschsprung

35

diagnosis of hirschsprung

suction biopsy

lack of ganglion cells

gold standard

36

tx hirschsprung

resect part of colon

37

LES

physiologic construct
-prevents reflux and regurg of gastric contents

38

glandular mucosa

1 cell thick

39

squamous mucosa

numerous cells thick

40

odynophagia

pain associated with swallowing

41

pyrosis

heartburn

42

dysphagia

difficulty of discomfort swallowing

43

oropharyngeal dysphagia

difficulty transfer** food to esophagus or initiation of swallowing

44

esophageal dysphagia

difficulty transport** down esophagus

nutcracker

45

nutcracker esophagus

disorder of movement of esophagus

60-70yo

often chest pain - intermittent

46

dx of nutcracker

esophageal manometry - motility study

47

motility disorders

chest pain or dysphagia

48

steakhouse syndrome

sudden obstruction of esophagus - require urgent treatment