CHAPTER 25: Esophagus

Learning Objectives: At the end of this chapter, the student will be able to:

I. Review the anatomy and physiology of the Esophagus

a. Anatomy
i. Functional anatomy
ii. Blood supply, Innervation & Lymphatic drainage
b. Physiology
i. Swallowing mechanism
ii. Physiologic reflux

II. Determine the tests to assess esophageal function and differentiate their indications and advantages
a. Tests for structural abnormalities
i. Endoscopy
ii. Radiology
b. Tests for functional abnormalities
i. Esophageal Motility Studies
ii. High Resolution Manometry
iii. Esophageal Impedance
iv. Esophageal Transit Scintigraphy
v. Video-Cineradiology
c. Tests for exposure to gastric juice
i. 24h ambulatory pH monitoring
d. Tests for duodenogastric function
i. Gastric emptying studies
ii. Gastric acid analysis

III. Identify the incidence, etiology, pathogenesis, manifestations, diagnosis and treatment of several
esophageal diseases
a. GERD
b. Diaphragmatic hernia
c. Schatzki’s rings
d. Scleroderma
e. Esosinophilic esophagitis
f. Motility disorders
i. Zenker’s diverticula
ii. Achalasia
iii. Diffuse and segmenta esophageal spasm
iv. Nutcracker esophagus
v. Hypertensive LES
g. Esophageal diverticula
h. Esophageal perforation
i. Mallory-Weiss Syndrome
j. Caustic injury
k. Esophageal fistulas
l. Esophageal cancer

IV. Identify surgical procedures commonly used in the treatment of esophageal disease
a. Antireflux surgery
b. Long esophageal myotmy
c. POEM
d. Heller’s myotomy
e. Partial Esophagectomy
f. Total Esophageal resection and reconstruction
 TABLE OF SPECIFICATION
Topic/
Course
Title: 25 – Esophagus and Diaphragmatic Hernia
No. of
Hours
Taught: 6
Type of
Exam: Long Exam #1, 1st Bimonthly Exam
Faculty-In -
Charge:  Dr Dy

LEVELS / SKILLS
Remembering Understanding Thinking
(Analysis/ TOT
(Comprehension
(Knowledge) Synthesis/ AL
/ Application)
SUBTOPIC Evaluation)
S Item Item Item
No. No. No.
Placem Placem Placem No.
of of of
% ent or % ent or % ent or of %
Ite Ite Ite
Questio Questio Questio Items
ms ms ms
n No. n No. n No.
Anatomy
Physiology
Tests
Diseases
Surgical
procedures
TOTAL