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