By Harvey J. Dworken
ISBN-10: 0409950211
ISBN-13: 9780409950212
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Example text
T h i s w a v e of p e r i s t a l s i s a p p e a r s to b e of multiple origins. Initially, distention of the e s o p h a g u s p r o d u c e s a b r i e f c o n t r a c t i o n of the c i r c u l a r m u s c l e , w h i c h d o e s n o t a p p e a r to b e d e p e n d e n t o n i n t r i n s i c i n n e r v a t i o n . F o l l o w i n g t h i s c o m e s a s u s t a i n e d c o n t r a c t i o n of t h e l o n g i t u d i n a l c o a t , c o n s e q u e n t t o m y e n t e r i c n e r v e s t i m u l a t i o n .
CHAPTER 3 The Esophagus T h e s q u a m o u s epithelium of the e s o p h a g u s differs strikingly from the c o l u m n a r e p i t h e l i u m of the r e m a i n d e r of the a l i m e n t a r y c a n a l . T h e r e a r e also far fewer mucosal glands in the esophagus than in the stomach and intestine. Its n o r m a l function is to t r a n s m i t s w a l l o w e d m a t e r i a l from the p h a r y n x to the s t o m a c h , w h i l e preventing g a s t r i c contents from regurgitating into the e s o p h a g u s and, w i t h a s s o c i a t e d structures, preventing s w a l l o w e d m a t e r i a l from e n t e r i n g the r e s p i r a t o r y t r e e .
4. D i s o r d e r s i n w h i c h t h e l u m e n o f t h e e s o p h a g u s is c o m p r o m i s e d b y a n i n t r i n s i c o r e x t r i n s i c l e s i o n . T h i s c a t e g o r y i n c l u d e s s u c h int r i n s i c l e s i o n s a s c a n c e r , s t r i c t u r e s or i n f l a m m a t i o n o f t h e e s o p h agus, and extrinsic lesions, such as bronchogenic carcinoma, m e d i a s t i n a l t u m o r s , o r a n e u r y s m s of t h e a o r t a . T h e d e g r e e of d y s p h a g i a v a r i e s d i r e c t l y w i t h t h e a m o u n t o f o b s t r u c t i o n a n d is u s u a l l y w o r s e f o r s o l i d f o o d s t h a n it i s for l i q u i d s .
Gastroenterology. Pathophysiology and Clinical Applications by Harvey J. Dworken
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