Notes in Chapter_29:_Esophagus

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Published	07/07/2024	The innermost layer of the esophagus is the {{c2::mucosa}} ({{c1::squamous}} epithelium)
Published	07/07/2024	The middle layer of the esophagus is the {{c1::submucosa}}
Published	07/07/2024	The outermost layer of the esophagus is the {{c1::muscularis propria}}
Published	07/07/2024	Does the esophagus have serosa?{{c1::No}}
Published	07/07/2024	Only the {{c1::upper 1/3rd}} of the esophagus is {{c2::striated}} muscle
Published	07/07/2024	The {{c2::thoracic}} esophagus gets its blood supply from the {{c1::vessels from the aorta}}
Published	07/07/2024	The {{c2::cervical}} esophagus gets its blood supply from the {{c1::inferior thyroid artery}}
Published	07/07/2024	The {{c2::abdominal}} esophagus gets its blood supply from the {{c1::left gastric artery}} and {{c3::inferior phrenic artery}}
Published	07/07/2024	The esophagus is drained by the {{c2::hemi-azygous}} and {{c1::ayzgous}} veins
Published	07/07/2024	The upper {{c1::2}}/3rd of the esophagus lymphatics drain cephalad
Published	07/07/2024	The {{c1::right}} vagus nerve of the esophagus travels to the {{c2::posterior}} portion of the stomach
Published	07/07/2024	The celiac plexus stems from the {{c1::right}} vagus nerve(right or left)
Published	07/07/2024	The {{c2::right}} vagus nerve gives rise to the criminal nerve of {{c1::Grassi}}
Published	07/07/2024	Failure to divide the criminal nerve of Grassi can cause persistently {{c1::high acid levels}} after vagotomy
Published	07/07/2024	The {{c1::left}} vagus nerve of the esophagus travels to the {{c2::anterior}} portion of the stomach
Published	07/07/2024	The liver and biliary tree receive parasympathetic innervation ultimately from the {{c1::left}} vagus nerve(right or left)
Published	07/07/2024	The thoracic duct crosses {{c2::pos}}terior to the esophagus from right to left at vertebrae level T{{c1::5}} then drains in to the left subclavian ve…
Published	07/07/2024	The upper esophageal sphincter is {{c1::15}} cm from the incisors
Published	07/07/2024	The upper esophageal sphincter is formed by the {{c2::cricopharyngeus}} muscle, which is innervated by the {{c1::recurrent laryngeal}} nerve
Published	07/07/2024	The normal upper esophageal sphincter pressure at rest is {{c1::60}} mmHg
Published	07/07/2024	The normal upper esophageal sphincter pressure with food bolus is {{c1::15}} mmHg
Published	07/07/2024	The most common site of esophageal perforation is at the level of the {{c1::cricopharyngeus muscle}}
Published	07/07/2024	Failure of the cricopharyngeus muscle to relax can result in {{c1::aspiration}}
Published	07/07/2024	The {{c1::upper}} esophageal sphincter is responsible for keeping air out of the esophagus
Published	07/07/2024	The lower esophageal sphincter is {{c1::40}} cm from the incisors
Published	07/07/2024	Is the lower esophageal sphincter visible via EGD?{{c1::No}}
Published	07/07/2024	The normal lower esophageal sphincter pressure at rest is {{c1::15}} mmHg
Published	07/07/2024	The normal lower esophageal sphincter pressure with food bolus is {{c1::0}} mmHg
Published	07/07/2024	The 3 anatomic areas of esophageal narrowing:1) {{c2::Cricopharyngeus muscle}}2) Compression by {{c3::left mainstem bronchus}} and {{c3::aortic arch}}…
Published	07/07/2024	Food bolus and swallow initiation in the esophagus causes {{c1::primary}} peristalsis
Published	07/07/2024	Incomplete emptying and esophageal distention in the esophagus causes {{c1::secondary}} peristalsis
Published	07/07/2024	Non-propagating and non-peristalsing waves in the esophagus is {{c1::tertiary}} peristalsis
Published	07/07/2024	The surgical approach for the cervical esophagus is from the {{c1::left}} side
Published	07/07/2024	The surgical approach for the upper 2/3rd thoracic esophagus is from the {{c1::right}} side
Published	07/07/2024	The surgical approach for the lower 1/3rd thoracic esophagus is from the {{c1::left}} side
Published	07/07/2024	Free card{{c1:::)}}Thought this info was interesting but didn't see the need to make cards over it. The only thing I thought about was maybe worth kno…
Published	07/07/2024	Trouble transferring food from the mouth to the esophagus is known as a(n) {{c1::pharyngoesophageal}} disorder
Published	07/07/2024	Pharyngoesophageal disorders are most commonly caused by {{c1::neuromuscular}} disease
Published	07/07/2024	Pharyngoesophageal disorders cause dysphagia that is worse with {{c1::liquids}}(liquids or solids)
Published	07/07/2024	Plummer-Vinson syndrome is treated with {{c1::dilation}}, iron supplements, and cancer screening
Published	07/07/2024	A Zenker's diverticulum is a false diverticulum that occurs in Killian's triangle between the pharyngeal constrictors and the {{c1::cricopharynge…
Published	07/07/2024	The surgical treatment for Zenker's diverticulum is a myotomy of the {{c1::cricopharyngeus}} muscle
Published	07/07/2024	A traction diverticulum is a {{c1::true}} diverticulum(true or false)
Published	07/07/2024	An esophageal diverticulum located just above the diaphragm is known as a(n) {{c1::epiphrenic}} diverticulum and is associated with esophageal mo…
Published	07/07/2024	The initial surgical treatment for achalasia is {{c1::balloon dilatation}}
Published	07/07/2024	Medical treatment for achalasia includes {{c2::nitrates}} and {{c1::calcium channel blockers}}
Published	07/07/2024	The treatment for refractory achalasia is {{c1::Heller}} myotomy
Published	07/07/2024	Medical treatment for diffuse esophageal spasm includes calcium channel blockers or {{c1::trazodone}}
Published	07/07/2024	Surgical treatment for diffuse esophageal spasm is {{c1::Heller myotomy}}
Published	07/07/2024	A disorder in which swallowing contractions are too strong is known as {{c1::nutcracker}} esophagus
Published	07/07/2024	Nutcracker esophagus is characterized by high-amplitude peristaltic contractions greater than {{c1::180}} mmHg
Published	07/07/2024	Treatment of nutcracker esophagus is identical to that of {{c1::diffuse esophageal spasm}}
Published	07/07/2024	The most commonly involved organ in scleroderma is the {{c1::esophagus}}
Published	07/07/2024	The medical treatment for scleroderma esophagus is PPI and {{c1::metoclopramide}}
Published	07/07/2024	Concerning symptoms in GERD are {{c1::dysphagia}}, bloating, and epigastric pain
Published	07/07/2024	A {{c2::Nissen}} fundoplication involves a {{c1::full 360}} degree wrap
Published	07/07/2024	A {{c2::Toupet}} fundoplication is a {{c1::partial 270}} degree wrap
Published	07/07/2024	A {{c2::Dor}} fundoplication is a {{c1::partial 180}} degree wrap
Published	07/07/2024	The phrenoesophageal ligament is an extension of the {{c1::transversalis fascia}}
Published	07/07/2024	Dysphagia following Nissen fundoplication is usually caused by a wrap that is too tight; treat initially with {{c1::conservative measures}}
Published	07/07/2024	Dilation for dysphagia following a Nissen fundoplication can be performed after {{c1::1 week::timeframe}}
Published	07/07/2024	A procedure that can be performed when the esophagus is too short to form a Nissen is a(n) {{c1::Collis gastroplasty}}
Published	07/07/2024	A hiatal hernia involving superior displacement of the GE junction is type {{c1::1}}
Published	07/07/2024	A hiatal hernia with a normal GE junction but a paraesophageal hernia alongside the esophagus is type {{c1::2}}
Published	07/07/2024	A hiatal hernia involving superior displacement of the GE junction AND a paraesophageal component is type {{c1::3}}
Published	07/07/2024	A hiatal hernia that includes the entire stomach plus another organ is type {{c1::4}}
Published	07/07/2024	Repair of paraesophageal hernias (types 2-4) usually involves a Nissen for GERD symptoms and to help anchor the {{c1::stomach}}
Published	07/07/2024	Should mesh be used in the repair of paraesophageal hernias?{{c1::No}}
Published	07/07/2024	Most patients with Schatzki's ring have concomitant {{c1::hiatal hernia}}
Published	07/07/2024	Treatment for Schatzki's ring includes PPI and {{c1::dilatation}}
Published	07/07/2024	A stricture found in the lower esophagus at the squamocolumnar junction is known as {{c1::Schatzki's ring}}
Published	07/07/2024	The only type of Barrett's esophagus that predisposes to esophageal cancer is {{c1::intestinal}} type columnar metaplasia
Published	07/07/2024	Cancer risk with the intestinal type of Barrett's esophagus increases cancer risk to {{c1::50}} times that of the normal population
Published	07/07/2024	"Carcinoma in situ" for Barrett's esophagus is known as {{c1::high grade dysplasia (HGD)}}
Published	07/07/2024	High grade dysplasia (HGD) for Barrett's esophagus must be confirmed by {{c1::2}} pathologist(s)
Published	07/07/2024	The two main treatment options for confirmed high grade dysplasia (HGD) in Barrett's esophagus is {{c2::esophagectomy}} or {{c1::endoscopic surve…
Published	07/07/2024	Endoscopic surveillance for high grade dysplasia (HGD) in Barrett's esophagus occur's in {{c1::3}}-month intervals, 4 quadrant biopsies at {…
Published	07/07/2024	Treatment for uncomplicated Barrett's (non-HGD) is similar to the treatment for {{c1::GERD}}
Published	07/07/2024	Is the risk for cancer in Barrett's esophagus decreased with treatment (PPI/fundoplication)?{{c1::No}}
Published	07/07/2024	Esophageal tumors are most commonly {{c1::malignant}}(benign or malignant)
Published	07/07/2024	Hoarseness in esophageal cancer is concerning for {{c1::recurrent laryngeal nerve}} invasion
Published	07/07/2024	Horner's syndrome in esophageal cancer is concerning for {{c1::brachial plexus}} invasion
Published	07/07/2024	Invasion of esophageal cancer into another structure most likely means the cancer is {{c1::unresectable}}
Published	07/07/2024	The best test to determine resectability of esophageal cancer is {{c1::CT scan (of chest and abdomen)}}
Published	07/07/2024	{{c2::Adenocarcinoma}} of the esophagus usually metastasizes to the {{c1::liver}}
Published	07/07/2024	{{c2::Squamous cell carcinoma}} of the esophagus usually metastasizes to the {{c1::lungs}}
Published	07/07/2024	Nodal disease outside the area of resection (M1 disease) in esophageal cancer is a contraindication to {{c1::esophagectomy}}
Published	07/07/2024	Pre-op chemo-XRT is indicated for stage {{c3::T2}} or greater esophageal tumors and the drugs used are {{c2::cisplatin}} and {{c1::5-fluorouracil…
Published	07/07/2024	The margins necessary during esophagectomy are {{c1::6}}-{{c1::8}} cm
Published	07/07/2024	When the stomach is in the chest after esophagectomy, its primary blood supply is from the {{c1::right gastroepiploic}} artery
Published	07/07/2024	During a fundoplication, the {{c1::short gastric}} vessels must be ligated to free up the fundus for the wrap
Published	07/07/2024	An esophagectomy approach that involves abdominal and neck incisions is the {{c1::transhiatal approach}}
Published	07/07/2024	An esophagectomy approach that involves an abdominal incision and a right thoracotomy is the {{c1::Ivor Lewis approach}}
Published	07/07/2024	An esophagectomy approach that involves abdominal, thoracic, and cervical incisions is the {{c1::3-hole esophagectomy approach}}
Published	07/07/2024	All esophagectomies must have a {{c1::pyloromyotomy}} performed when the stomach is translocated to the chest
Published	07/07/2024	An option for esophagectomy that preserves gastric function is {{c1::colonic interposition}}
Published	07/07/2024	Contrast studies after esophagectomy are required on post op day {{c1::7}} to rule out leak
Published	07/07/2024	Postoperative strictures after esophagectomy can usually be managed with {{c1::dilation}}
Published	07/07/2024	A chylothorax is whitish/clear fluid that is high in {{c2::lymphocytes}} and {{c1::triglycerides}}
Published	07/07/2024	Medical therapy for a chylothorax includes NPO, TPN, and {{c1::short-chain fatty acids}}
Published	07/07/2024	A chylothorax that is refractory to medical treatment or has output > 2 L/day is treated with {{c1::thoracic duct ligation}}
Published	07/07/2024	Malignant fistulas in the esophagus are highly fatal due to {{c1::aspiration}}
Published	07/07/2024	The most common benign esophageal tumor is {{c2::leiomyoma}}, which is located in the {{c1::muscularis propria::esophageal wall layer}}
Published	07/07/2024	An esophageal leiomyoma is usually found in the {{c1::lower::upper or lower}} part of the esophagus
Published	07/07/2024	The biopsy of choice for esophageal leiomyoma is {{c1::no biopsy}}
Published	07/07/2024	Treatment for esophageal leiomyoma with excision is only necessary if > {{c1::5}} cm or symptomatic
Published	07/07/2024	Esophageal polyps can present with dysphagia and {{c1::hematemesis}}
Published	07/07/2024	The 2nd most common benign esophageal tumor is {{c1::esophageal polyps}}
Published	07/07/2024	Esophageal polyps are usually located in the {{c1::upper}} esophagus(upper or lower)
Published	07/07/2024	3 things to be avoided in caustic esophageal injury1) {{c1::NG tube}}2) {{c2::Induced Vomiting}}3) {{c3::PO fluids}}
Published	07/07/2024	Are acid or alkali caustic esophageal injuries worse?{{c1::Alkali}}
Published	07/07/2024	{{c2::Alkali}} esophageal caustic ingestion causes {{c1::liquefaction}} necrosis
Published	07/07/2024	{{c2::Acid}} esophageal caustic ingestion causes {{c1::coagulation}} necrosis
Published	07/07/2024	CT chest and abdomen are used in caustic esophageal injury to assess for {{c1::perforation}}
Published	07/07/2024	The best test for assessment of injury in caustic esophageal injury is {{c1::endoscopy}}
Published	07/07/2024	Hyperemia seen after caustic esophageal injury is characteristic of a {{c1::primary}} burn
Published	07/07/2024	Ulcerations, exudates, and slouging seen after caustic esophageal injury are characteristic of a {{c1::secondary}} burn
Published	07/07/2024	Deep ulcers, charring, and lumen narrowing seen after caustic esophageal injury is characteristic of a {{c1::tertiary}} burn
Published	07/07/2024	Treatment for primary and secondary burns in caustic esophageal injury is {{c1::conservative}}
Published	07/07/2024	Treatment for tertiary burns in caustic esophageal injury is usually {{c1::esophagectomy}}
Published	07/07/2024	Caustic esophageal perforations are usually treated with {{c1::esophagectomy}}
Published	07/07/2024	The most common cause of esophageal perforation is {{c1::iatrogenic (EGD)}}
Published	07/07/2024	The best initial test for esophageal perforation is {{c1::chest X-ray}}
Published	07/07/2024	The best overall test for esophageal perforation is {{c1::gastrograffin swallow}}
Published	07/07/2024	Esophageal perforations can be treated conservatively when the perforation is {{c1::contained}}, {{c2::self-draining}}, and there are no {{c3::systemi…
Published	07/07/2024	Primary repair with drains can be used for esophageal perforations if the diagnosis is quick (<{{c2::24 hours::timeframe}}) and the area has {{c1::…
Published	07/07/2024	Primary repair cannot be performed for esophageal perforation if the diagnosis is late (>{{c2::48 hours::timeframe}}) or if the area has {{c1:…
Published	07/07/2024	Late diagnosis of a neck esophageal perforation is treated with {{c1::surgical drains}}
Published	07/07/2024	Late diagnosis of chest esophageal perforation is treated with either {{c2::resection}} or {{c1::exclusion and diversion}}
Published	07/07/2024	Late diagnosis of esophageal perforation will typically require {{c1::gastric}} replacement of the esophagus after the patient fully recovers
Published	07/07/2024	Perforation in Boerhaave's syndrome is most likely to occur in the {{c2::left::left or right}} {{c3::lateral::medial or lateral}} wall of the esophagu…
Published	07/07/2024	Mediastinal crunching noted during auscultation is known as {{c1::Hamman's}} sign
Published	07/07/2024	The highest mortality of all esophageal perforations is seen with {{c1::Boerhaave's syndrome}}
Published	07/07/2024	Prior to performing a fundoplication, there must be at least {{c1::3}} cm of esophagus length below the diaphragmatic hiatus
Published	07/07/2024	On EGD, the {{c1::piriform}} fossae roughly line up with the superior portion of the {{c2::thyroid cartilage::external land mark}}
Published	07/07/2024	The {{c1::piriform fossa::depression}} are {{c2::pos}}terior to the epiglottis
Published	07/07/2024	The {{c1::valleculae::depression}} are {{c2::ant}}erior to the epiglottis
Published	07/07/2024	The base of the vocal cords (aka {{c1::epiglotic tubercle}}) attaches {{c2::an}}teriorly
Published	07/07/2024	The {{c1::left}} vagus gives rise to pulmonary and esophageal plexus
Published	07/07/2024	The top two risk factors for {{c3::Zenker}} diverticulum include {{c2::age (>70)::#1}} and long-standing chronic {{c1::GERD}}
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