Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
SB82 Esophagus
SB82 Esophagus - loosely taken from Fiser's ABSITE review
| Question | Answer |
|---|---|
| The source of major blood supply to the esophagus _____________ | Vessels off the aorta |
| The esophageal wall lacks this layer ___________ | Serosa |
| This artery supplies the cervical esophagus _____________ ____________ | Inferior thyroid |
| These two arteries supply the abdominal esophagus ______________ | Left gastric and inferior phrenic |
| This branch of the right vagus nerve can cause persistently high post-op acid levels if left undivided during a vagotomy ________________ | Criminal nerve of Grassi |
| Which portion of the vagus nerve travels on the anterior portion of the stomach (right / left)? _________ | Left |
| Where does the thoracic duct cross from left to right in the chest? | At the upper 1/3 of the mediastinum |
| What is the muscle delineating the upper esophageal sphincter? ____________ | Cricopharyngeus |
| What nerve innervated the UES? _______________ | Recurrent laryngeal nerve |
| What is the most common site of esophageal perforation? __________________ | Cricopharyngeus |
| What mediates the relaxation of the LES? ______________ | Inhibitory neurons |
| What side is the appropriate approach to the cervical esophagus? _________ | Left |
| Which portion of the esophagus should you approach from the right? _____________ | Upper 2/3 thoracic esophagus |
| What is the diagnostic procedure of choice for dysphagia or odynophagia? ______________ | Barium swallow |
| What esophageal disease is caused by iron deficiency? _________________ | Plummer-Vinson |
| False diverticula usually lie in this orientation _________ | Posterior |
| This type of false diverticulum is caused by increased pressure during swallowing _________ | Zenker’s |
| What is the treatment for Zenker’s diverticulum? ________________ | Cricopharyngeal myotomy with or without resection of diverticulum |
| What are the causes of traction diverticulum? _________________ | Inflammation, granulomatous disease, tumor |
| Where in the esophagus is a traction diverticulum usually found? ___________ | Mid-thoracic |
| What is a common cause of epiphrenic diverticulum? ________________ | Esophageal dysmotility disorders |
| What is the treatment of epiphrenic diverticulum? __________ | Diverticulectomy and long esophageal myotomy opposite |
| What are two medical treatments for achalasia? ___________ | Calcium channel blocker, nitrates |
| What infectious organism can cause symptoms similar to achalasia? ______________ | Trypanosoma cruzi |
| What differentiates diffuse esophageal spasm from achalasia? | DES has normal LES tone; in achalasia the tone is increased |
| For which esophageal dysmotility disorder is a Heller myotomy more effective? ___________ | Achalasia |
| In this disease, fibrous replacement of esophageal smooth muscle causes dysphagia and loss of LES tone __________________ | Scleroderma |
| What is the most common cause of dysphagia following a Nissen? ___________ | Wrap is too tight |
| The key maneuver in a Nissen is identification of the ________________ | Left crura |
| This operation involves stapling a portion of the stomach into a “new” esophagus when the esophagus is not long enough to pull into the abdomen ______________ | Collis gastroplasty |
| What is the initial medical therapy for GERD and for how long? ___________________ | Omeprazole for 12 weeks |
| This most common hiatal hernia is due to dilation of the hiatus ____________ | Type I (sliding) hernia |
| Type II hiatal hernias are in this location _________________ | Paraesophageal |
| What is the risk of leaving a Type II hiatal hernia unrepaired? ______________ | Incarceration |
| This condition is characterized by short episodes of dysphagia following rapid swallowing, and often has an associated sliding hernia ______________ | Schatzki’s ring |
| What is the treatment of Schatzki’s ring? ___________ | Dilation |
| Severe Barrett’s esophagus is an indication for what treatment? _____________ | Esophagectomy |
| Esophageal cancer spreads along this route _______________ | Submucosal lymphatic channels |
| If you are trying to determine whether or not an esophageal cancer is unresectable, what do you order? _______________ | Chest/abd CT |
| Where does an esophageal adenocarcinoma usually occur? ____________ | Lower 1/3 |
| Is esophageal cancer that has spread to the supraclavicular node resectable or unresectable? ______________ | Unresectable |
| What is the primary blood supply to the stomach after using it to replace the esophagus? _________________ | Right gastroepiploic |
| Chemotherapy for esophageal cancer includes these two medications ____________ and ___________________ | 5-FU and cisplatin |
| The most common benign tumor of the esophagus ____________ | Leiomyoma |
| The location within the esophageal wall of leiomyomas ____________ | Submucosa |
| Why do you refrain from biopsying leiomyomas? | Scar that forms may make resection difficult |
| Criteria for operating on esophageal leiomyomas | Size greater than 5 cm, or symptomatic |
| Treatment of leiomyomas | Thoracotomy and enucleation |
| Diagnostic test for leiomyoma ___________ | Esophagram, then endoscopy to rule out cancer |
| Most common location of esophageal polyps ________________ | Cervical esophagus |
| Caustic esophageal injury: What kind causes liquefaction? __________________ | Alkali |
| What type of caustic esophageal injury is more likely to cause cancer? _________ | Alkali |
| What part of the GI tract is most injured by acid ingestion? ______________ | Stomach |
| What is the treatment for tertiary esophageal caustic injury? _____________ | Esophagectomy |
| What modality do you use to follow caustic esophageal injuries? | Gastrografin followed by thin barium swallow on hospital day 2-3 |
| Criteria for non-surgical management of esophageal perforations | Contained perforation on contrast study, self-draining, no systemic effects |
| What are the potential treatments for non-contained esophageal perforations? | Primary repair with drains and intercostal muscle flap if <24 hours since injury; otherwise cervical esophagostomy, washout and chest tubes |
| What incision on the esophagus do you perform to assess the extent of esophageal injury? _________ | Longitudinal myotomy |
| What esophageal condition is caused by forceful vomiting, and characterized by severe chest pain, with eventual finding of perforation? _____________________ | Boerhaave’s syndrome |
| Where is the most common location of perforation in Boerhaave’s syndrome? _______________ | Left lateral wall of the esophagus at T8 level |
| Mediastinal crunching on auscultation of patient with Boerhaave’s syndrome also known as _________________ | Hartmann’s sign |
Created by:
StudyBug82
Popular Surgery sets