Esophagus
•Presents with ? corresponding to the curvature's vertebral column. Why? Bc it is the most ? structure and lies on ? column •Is most contracted at its ?, & at the pt where it passes through the ?
flexures post vertebral beginning diaphragm
Esophageal hiatus Diaphragm functions as a physiological inferior esophageal sphincter aka ? -?/? -Immediately ? to this esophagogastric junction (located just above Z line) *? culprit* •? a muscle like the cervical sphincter •This is a ? sphincter
(LES) contracts and relaxes superior NOT physiological GERD
Barium swallow Coats inside of esophagus If filling defect is present, it is indicative of some pathology However we know that there are 3 natural constrictions of the esophagus that can be visualized: Note: phrenic ampulla -> dilation of the ? at the point of contact with ?
1. Cervical constriction @ pharyngoesophageal junction 2. Thoracic (broncho-aortic) constriction: where it is first crossed by the arch of aorta 3. Diaphragmatic constriction: At the esoph hiatus of the diaphragm esophagus diaphragm
Esophagogastric junction Lies to the L of the T11 vertebra on the horizontal plane that passes through the tip of the xiphoid process ?-line: a jagged line where the mucosa abruptly changes from esophageal -> gastric mucosa. Esophageal mucosa - ? tolerate acidic conditions Gastric mucosa - ? tolerate acidic conditions (? present here) Transition: of these 2 mucosa = ? junction
Z-line cannot can, HCl Esophagogastric
Esophageal hiatus Opening in the ? through which -> ? and the ? nerve pass
diaphragm esophagus vagus
Abdominal Esophagus •Lies in the ? groove on the posterior surface of the ? lobe of the ? •It is somewhat conical with its base applied to the upper orifice of the ? and is known as the antrum ?
esophageal left, liver stomach cardiacum
Esophagus •Extends from ? to the ? •Pharynx will terminate at ? and continue as -> esophagus •At C6, ? cartilage is present •Esophagus begins at the lower border of the ? cartilage •Descends ? to the vertebral column
pharynx stomach C6 cricoid cricoid anterior
•Travels through the ? and ? mediastina •Passes through the ? •Enters the abdomen -> opposite ?
superior and posterior diaphragm T11
Exam question! ? nerves (branches of ? nerve) -ascend between esophagus and the trachea to its L side is the thoracic duct -travel in the ? groove (2 of these on either side, between the trachea and the esophagus) Why is this important to know? •If you have a tumor of the esophagus, it can push on the ? nerves -> Can lead to loss/damage to ?
recurrent laryngeal nerves of the vagus tracheoesophageal recurrent laryngeal speech
GERD is a result of: Inappropriate ? of lower esophageal sphincter Inappropriate relaxation of LES causes ?
relaxation acid reflux
Thoracic esophagus Situated in the ? mediastinum between the ? and ? column -> a little to the ? of the median line. •It then: Passes ? and to the ? of the aortic arch Descends in the ? mediastinum, along the ? side of the descending aorta
superior trachea and the vertebral column L behind, R posterior R
Cervical esophogus •Relationships : In front ? Behind ? column Sides common ? artery parts of the ? gland
trachea vertebral carotid thyroid
Esophageal constrictions 1. Cervical constriction ? • @ pharyngoesophageal junction -> Caused by the cricopharyngeus muscle 2. Thoracic (broncho-aortic) constriction: where it is first crossed by the ? (seen in an AP view) 3. Then where it is crossed by the ? (seen in lateral views) 4. Diaphragmatic constriction: At the ? of the diaphragm
upper esophageal sphincter arch of the aorta L main bronchus esophageal hiatus
PS innervation- ? nerves L vagus ? R vagus ? Sympathetic innervation -> sympathetic ? -> Thus ANS of esophagus via esophageal nerve ? -containing both ?/? nerve fibers
vagus ant post chain plexus (BOTH symp and parasym)
Thoracic esophagus Relationships: •In front T A A R p a L b P D •Behind V C L C muscles (muscles associated with the vertebral column) R aortic ? arteries Thoracic duct ? veins •Below: Near the diaphragm, upon the front of the aorta
• trachea, aortic arch, right pulmonary artery, the left bronchus, the pericardium, and the diaphragm. vertebral column, the Longus colli muscles (muscles associated with the vertebral column), the right aortic intercostal arteries, the thoracic
