Outer longitudinal layer of smooth m. contracts before the inner circular layer that can cause periodic short-lived esophageal obstruction
diffuse esophageal spasm
motor disorder of the esophagus (uncoordinated contraction) that causes diverticulae (small mucosal outpouchings) to form
palpable mass located above the upper esophageal sphincter, may cause regurgitation due to accumulation of food
esophageal stenosis is caused by thickening of the ___ or atrophy of the ___
fibrous thickening of the SUBMUCOSA,
atrophy of the MUSCULARIS PROPRIA
achalasia degenerative changes
neural innervation either w/in vagus n. itself or the dorsal motor nucleus
linear and longitudinal tears near gastroesophageal junction associated with vomiting due to alcohol intox
what will you see in CBC with infectious esophagitis?
neutrophil infiltrates in the lamina propria and necrosis of overlying mucosa
impedes passage of luminal contents causing ulceration, superficial necrosis , granulation tissue with fibrosis
pathogenic infectious esophagitis***
pseudomembranes*** composed of densely matted fungal hypahe and inflammatory cells covering the esophageal mucosa
shallow ulceration with nuclear and cytoplasmic inclusions within capillary endothelium and stromal cells
___ glands in the proximal and distal esophagus secrete ___ and bicarbonate
submucosal glands secrete mucin and bicarbonate
conditions that decrease LES tone or increase abdominal pressure (8)
alcohol and tobacco use, CNS depressants, obesity, pregnancy, hiatal hernia*, delayed gastric emptying or increased gastric vol
Endoscopy findings in GERD
hyperemia, eosinophils* (and neutrophils) in significant disease,basal zone hyperplasia
food impaction, dysphagia, feeding intolerance, abundance of eosinophils, do not respond to therapy with proton pump inhibitor, absence of reflux
intestinal metaplasia: esophageal squamous mucosa --> nonciliated columnar w/goblet
common in patients with portal hypertension due to?
cirrhosis associated with alcoholic liver disease
possible factors that lead to rupture?
erosion of mucosa, increased tension of dilated veins, increased vascular hydrostatic pressure due to vomiting
Adenocarcinoma is secondary to?
Barret esophagus (dysplasia of lower 1/3rd of esophagus) causing proliferation of glands
Squamous cell carcinoma of esophagus affects adults over age ___ and more common in which gender and ethnicity in America?
45, males, african americans
risk factors for Squamous cell carcinoma
alcohol and tobacco, achalasia (food is stuck and rots causing irritation), consumption of very hot beverages, esophageal webs, injury
early lesions of Squamous cell carcinoma appear as?
small, gray-white, plaque-like thickening that may cause luminal narrowing
Traction diverticulum occurs due to___, and is located _____
1) mediastinal or pulmonary tuberculosis
2) near the midpoint of the esophagus
epiphrenic diverticulum occurs due to ____, and is located____
1) dysfunction of LES
2) immediately above LES