{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Board Pearls","title":"Chapter 2, Ep 1 of 4: Manometry Principles","html":"","width":"100%","height":180,"duration":346,"description":"Manometry from first principles: every swallow the esophagus has two jobs, the sphincter must open and the body must squeeze in a top-to-bottom wave, and every number the test reports measures one of those two jobs. This episode teaches the order you read them in, sphincter first then body, because that sequence decides which half of the differential you are even in. Master the three numbers here and every motility diagnosis in the chapter becomes a specific pairing of two answers.\n \nTopics covered\n\nThe two jobs of every swallow: sphincter opening and the peristaltic wave\nWhy you read the sphincter before the body, always\nThe manometry catheter and the standard ten supine, five upright protocol\nIRP: how completely the sphincter relaxes, not resting tone\nDCI bands: failed, weak, normal, and hypercontractile swallows\nDistal latency and premature contraction as the signature of spasm\nFragmentation and ineffective motility\nThe recurring trap: same body tracing, two opposite diseases\n \n \nKey decisions\n\nA high IRP means the sphincter failed to open: think achalasia or outflow obstruction; a normal IRP moves the problem into the body of the esophagus\nNormal IRP is under fifteen supine and under twelve upright, so a study that skips the upright swallows cannot finish the job\nA totally silent body with normal IRP is absent contractility, but the same silent body with high IRP is achalasia: the sphincter you already checked is the only thing that separates them\nDCI under 100 is a failed swallow, 100 to 450 weak, 450 to 8000 normal, over 8000 hypercontractile\nDistal latency under four and a half seconds means the contraction fired too early, and that premature squeeze is spasm on the tracing\nFragmented contractions plus many weak or failed swallows is how you land on ineffective motility\n \n \nThis is an AI-generated podcast, and some pronunciations may be imperfect. Thank you for your understanding, and we hope you enjoyed this content.\n \n \nStudy the full chapter on Board...","thumbnail_url":"https://img.transistorcdn.com/-FuAdDBcPDLhEoUmroZKtOBRvuBn_FHPpYlh41hOnU4/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9iNzlh/ZTU4Y2MzNWExMjQ5/MjA5OWMwMmI3ZTk5/NGFiZS5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}