The names given to the various lines of a tooth on a gear-wheel are as follows: In Figure 233, A is the face and B the flank of a tooth, while C is the point, and D the root of the tooth; E is the height or depth, and F the breadth. P P is the ... Read more of Drawing Gear Wheels at How to Draw.caInformational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Is Physical Culture Good For Girls?

A NUMBER of women were watching a game of basket-ball...

Fomentation

Some general remarks on this important treatment we give here....

Gastroscopy

The stomach of any individual having a normal esophagus and n...

Vitamin Program For The Sick

No matter which way you look at it or how well insured you ma...

Cayenne And Mustard

Mustard spread on a cold towel and applied to the spine or lum...

Catarrh Chronic

If in the head, first give face-bath, as in common colds, exc...

Chloroform Or Ether (inhaled)

Fresh air. Pull tongue forward, and begin artificial respirati...

Small Pox - Variola

This disease begins with pain in the head and back, chilly se...

Infants' Food

For infants who cannot be nursed at the breast, cows' milk in ...

Sore Nipples

This affection of nursing women frequently comes on before th...

Diet For A Long, Long Life

Some people not only want to be healthy, but they want to liv...

Flatulence

This is the accumulation of gases in the body, usually caused ...

Painful Urination Incontinence Of Urine

_Involuntary Urination._ Where the discharge of urine prod...

The Teeth The Ivory Keepers Of The Gate

Why the Teeth are Important. The teeth are a very important...

The Prognosis

under a well conducted course of hydriatic treatment is, in g...

Catarrh Acute

If in the head, treat as prescribed for common colds in the h...

Diagnosis

The swallowing function can be studied only with the fluoros...

Physical Care

REST, fresh air, exercise, and nourishment, enough of each in...

Children

WORK for the better progress of the human race is most effect...

Symptomatology And Diagnosis Of Foreign Bodies In The Air And Food Passages

Initial symptoms are choking, gagging, coughing, and wheezing...



Spasmodic Stenosis Of The Esophagus





Category: DISEASES OF THE ESOPHAGUS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

Etiology - The functional activity of the esophagus is dependent upon
reflex action. The food is propulsed in a peristaltic wave by the same
mechanism as, and through an innervation (Auerbach and Meissner
plexus) similar to that which controls intestinal movements. The vagus
also is directly concerned with the deglutitory act, for swallowing is
impossible if both vagi are cut. Anything which unduly disturbs this
reflex arc may serve as an exciting cause of spasmodic stenosis.
Bolting of food, superficial erosions, local esophageal disease, or a
small foreign body, may produce spasmodic stenosis. Spasm secondary to
disease of the stomach, liver, gall bladder, appendix, or other
abdominal organ is clinically well recognized. A perpetuating cause in
established cases is undoubtedly nerve cell habit, and in many cases
there is an underlying neurotic factor. Shock as an exciting cause has
been well exemplified by the number of cases of phrenospasm developing
in soldiers during the World War.

Cricopharyngeal spasmodic stenosis usually presents the subjective
symptom of difficulty in starting the bolus of food downward. Once
started, the food passes into the stomach unimpeded. Regurgitation, if
it occurs, is immediate. The condition consists in a tonic
contraction, ahead of the bolus, of the circular fibers of the
inferior constrictor known as the cricopharyngeus muscle, or in a
failure of this muscle to relax so as to allow the bolus to pass. In
either case the disorder may be secondary to an organic lesion. Local
malignant disease or foreign bodies may be the cause. Globus
hystericus, lump in the throat, and the sense of constriction and
choking during emotion are due to the same spasmodic condition.

Diagnosis - At esophagoscopy there will be found marked exaggeration
of the usual spasm which occurs at the cricopharyngeus during the
introduction of the tube. The lumen may assume various shapes, or be
so tightly closed that the folds form a mammilliform projection in the
center. If the spasm gradually yields, and a full-sized esophagoscope
passes without further resistance, it may be stated that the esophagus
is of normal calibre, and a diagnosis of spasmodic stenosis can be
made. Considerable experience is required to distinguish between
normal and pathologic spasm in an unanesthetized individual. To the
less experienced esophagoscopist, examination under ether anesthesia
is recommended. Deep anesthesia will relax the normal cricopharyngeal
reflex closure as well as any abnormal spasm, thus assisting in the
differentiation between an organic stricture and one of functional
character. Under deep general anesthesia, however, it is impossible to
differentiate between the normal reflex and a spasmodic condition,
since both are abolished. Many cases of intermittent esophageal
stenosis supposed to be spasmodic are due to organic narrowness of
lumen plus lodgement of food, obstructive in itself and in the
esophagitis resulting from its presence. The organic narrowing,
congenital or pathologic, is readily recognizable esophagoscopically.

Treatment.--The fundamental cause of the disturbance of the reflex
should be searched for, and treated according to its nature. Purely
functional cases are often cured by the passage of a large
esophagoscope. Recurrences may require similar treatment.





Next: Functional Hiatal Stenosis Hiatal Esophagismus Phrenospasm Diaphragmatic Pinchcock Stenosis

Previous: Diffuse Dilatation Of The Esophagus



Add to del.icio.us Add to Reddit Add to Digg Add to Del.icio.us Add to Google Add to Twitter Add to Stumble Upon
Add to Informational Site Network
Report
Privacy
SHAREADD TO EBOOK


Viewed 2361