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OESOPHAGUS

The document describes the anatomy and features of the oesophagus. It is divided into thoracic and abdominal parts. The thoracic part is about 25 cm long and passes through the thorax before piercing the diaphragm. The abdominal part is only 1.25 cm long and continues into the stomach. The oesophagus has muscular walls and four areas of constriction where it passes structures like the aortic arch. It receives blood supply from various arteries and drains into veins like the azygos vein. The oesophagus has clinical importance such as in portal hypertension which can cause esophageal varices.

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Ishant Singh
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46 views2 pages

OESOPHAGUS

The document describes the anatomy and features of the oesophagus. It is divided into thoracic and abdominal parts. The thoracic part is about 25 cm long and passes through the thorax before piercing the diaphragm. The abdominal part is only 1.25 cm long and continues into the stomach. The oesophagus has muscular walls and four areas of constriction where it passes structures like the aortic arch. It receives blood supply from various arteries and drains into veins like the azygos vein. The oesophagus has clinical importance such as in portal hypertension which can cause esophageal varices.

Uploaded by

Ishant Singh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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OESOPHAGUS

Anatomically oesophagus is studied in two parts:


1. Thoracic part
2. Abdominal part
THORACIC OESPHAGUS
 Oesophagus is narrow muscular tube forming the food passage between the pharynx and stomach.
 Begins in the neck from lower part of cricoid cartilage and ands by joining stomach at T11 vertebrae.
 It is about 25 cm long.
 Flattened anterio-posteriorly and lumen is kept collapsed which dilates only during food passage.
 It pierces the diaphragm at T10 thoracic vertebrae.

ABDOMINAL OESOPHAGUS

 Abdominal part of oesophagus is only about 1.25 cm long.


 Enters the abdomen slightly left to the medial plane and continues with cardia end of stomach.
 The oesophagus runs d own ward s and to the le ft in front of the left crus of the diaphragm and of the inferior
surface of the left lobe of the liver, and ends by opening into the cardiac end of the stomach a t the level of
vertebra T11, about 2.5 cm to the l eft of the median p lane. Its right border is continuous with the lesser
curvature of the stomach, but the left border is separated from the fundus of the stomach by the cardiac notch.
Peritoneum covers the oesophagus only anteriorly and on the left side.

CURVATURES
Generally, oesophagus id vertical but it shows side to side curvatures both towards left:
 One at the root of neck
 Near the lower end.
It also has anterio-posterior curvatures corresponding to cervico-thoracic spinal curvatures.

CONSTRICTIONS (4) – oesophagus shows four constrictions where it is


1. Crossed by cricopharyngeal muscle, 15 cm from incisors
2. Crossed by aortic arch, 22.5 cm from incisors.
3. Crossed by left bronchus, 27.5 cm from incisors.
4. Pierces diaphragm 37.5 cm from incisors.
*Distance from incisors is important in passing instruments like endoscope etc.

RELATIONS OF THORACIC PART OF OESOPHAGUS


ANTERIORLY POSTERIORLY TO THE RIGHT TO THE LEFT
 Trachea Vertebral column  Right lung and SUPERIOR MEDIASTINUM
 Right pulmonary artery Right posterior intercostal pleura  Aortic arch
 Left bronchus arteries  Azygous vein  Left subclavian artery
 Pericardium with left Thoracic duct  Right vagus  Thoracic duct
atrium Azygous vein  Left lung and pleura
 Diaphragm Thoracic aorta  Left recurrent laryngeal
Right pleural recess nerve
Diaphragm POSTERIOR MEDIASTINUM
 Descending thoracic
aorta
 Left lung and
mediastinal pleura

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OESOPHAGUS
ARTERIAL SUPPLY
1. Cervical part including the segment upto arch of aorta is supplied by- Inferior thyroid arteries.
2. Thoracic part- Oesophageal branch of aorta.
3. Abdominal part- Oesophageal branch of left gastric artery.

VENOUS DRAINAGE
1. Upper part- brachiocephalic veins
2. Middle part- azygous vein
3. Lower part- left gastric vein and vena azygos via hemiazygos vein.
Lower part of oesophagus is siter of portosystemic anastomoses.

NERVE SUPPLY
1. Parasympathetic nerves- upper half of oesophagus by recurrent laryngeal nerves and lower half by two vagi.
These nerves are sensory motor and secretomotor to oesophagus.
2. Sympathetic nerves- for upper half fibres comes from middle cervical ganglion and run with inferior thyroid
arteries. For the lower half fibres come directly from upper four thoracic ganglion to form oesophageal plexus.
Sympathetic nerves are vasomotor.

HISTOLOGY
Mucous membrane: longitudinal folds when empty. Stratified squamous non keratinised epithelium for protection.
Submucosa: contains oesophageal glands (mucus secreting with round or oval acini)
Muscularis externa: striated in upper 1/3rd mixed in middle and smooth in lower 1/3rd or the oesophagus.
Adventitia: outermost layer of loose connective tissue with capillaries and nerves.

CLINICAL ANATOMY
 In portal hypertension, communications between portal and systemic veins of lower part dilate known as
oesophageal varices, rupture of these varices can cause serious haematemesis or vomiting of blood.
 Normal indentations of oesophagus should be kept in mind before oesophagoscopy.
 Achalasia cardia: neuromuscular incoordination characterised by incapability of oesophagus to dilate.
 Trachea-oesophageal fistula: improper separation of trachea and oesophagus during development
 Dysphagia: difficulty in swallowing due to compression of oesophagus in mediastinal syndrome.

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