Flashcards in EXAM #1: UPPER GI ANATOMY Deck (50)
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1
What are the four layers of the GI tube?
1) Mucosa
2) Submucosa
3) Muscularis externa/ propria
4) Serosa
2
What are the four layers of the mucosa?
- Epithelium is in contact with chyme
- Basal lamina
- Lamina propria
- Muscularis mucosae
3
What are the two layers of the muscularis externa/ propria?
- Inner circular
- Outer longitudinal
4
Where in the mucosa are lymphatics, nerves, blood vessels, and glands located?
Lamina propria
5
In what two segments of the GI tube are glands in the submucosa?
Esophagus
Duodenum
6
What are the two plexus of the GI tube?
- Submucosal--inner
- Myenteric--outer
7
What is the eponym for the Submucosal plexus?
Meissner's plexus
8
What is the eponym for the Myenteric plexus?
Auerbach's plexus
9
What is the function of the submucosal plexus?
Ion and fluid movement
10
What is the function of Meissner's plexus?
Motility
11
What is the normal type of epithelium in the esophagus? Stomach? Describe their appearance.
Esophagus= Nonkeratinized stratified squamous epithelium (pale)
Stomach= Non-ciliated simple columnar epithelium with goblet cells(red/ tongue-like)
12
What is the name of the transition between the epithelium of the esophagus and stomach?
Z-line
13
What is Barrett's esophagus?
Metaplasia in the distal esophagus with simple columnar epithelium with goblet cells in response to GERD
14
How is Barret's Esophagus diagnosed?
ALCAIN BLUE staining
- Goblet cells in esophagus will produce mucous
- alcain blue stains mucous
15
What cancer are patients with Barett's Esophagus at risk for?
Adenocarcinoma
16
What third of the esophagus is most likely to harbor an adenocarcinoma?
Distal 1/3
17
What third of the esophagus is most likely to harbor a squamous cell carcinoma (SCC)?
Middle 1/3
18
What patient populations are at risk for stratified squamous cell carcinoma?
Males
African Americans
Smokers
Drinkers
19
What type of esophageal cancer is most likely to cause hoarseness? Why?
SCC
*****Middle 1/3 of the esophagus is in close proximity to the recurrent laryngeal nerve of the vagus (innervates the larynx) ******
20
Generally, how is SCC staged?
The deeper the penetration of the esophageal walls, the higher the stage
****Stage 4 has completely penetrated****
21
What histologic characteristic of the esophagus lends it to metastasis?
Lack of a serosa to contain the cancer
22
What are the four anatomic esophageal constrictions?
1) Upper Esophageal Sphincter
2) Aortic arch crosses the esophagus
3) Left Bronchus
4) Esophageal hiatus
23
How do the clinical constrictions of the esophagus differ from the anatomic?
Only 3x
--> Aortic arch and left bonchus are combined
24
What vertebral level is the esophageal hiatus located at?
T10
25
What is the clinical consideration that you need to keep in mind about the constrictions of the esophagus?
Be weary of constrictions on endoscopy i.e. don't force and penetrate the wall of the esophagus
26
What is pill esophagitis?
Difficulty swallowing pills in the elderly leading to inflammation of the esophagus
27
Where is there an anatomic weakness in the esophagus prone to developing a diverticula?
Inferior border of the pharynx, specifically between the oblique thyropharyngeus and cricopharyngeus
28
What is the eponym for the triangle between the thyropharyngeus and cricopharyngeus?
Killian's Triangle
29
What is the eponym for the diverticula that develops at Killian's Triangle?
Zenker's Diverticulum
30
