Anatomy

Esophagus

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Esophagus, Gullet

  • See Also
  1. Swallowing
  2. Esophagitis
  3. Esophageal Dysphagia
  4. Esophageal Achalasia
  5. Esophageal Dysmotility
  6. Esophageal Foreign Body
  7. Esophageal Varices
  8. Esophageal Stricture
  9. Gastroesophageal Reflux
  • Images
  1. lungChestGrayBB1032.gif Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
  • Anatomy
  1. Esophagus is divided into three regions
    1. Cervical Esophagus
    2. Thoracic Esophagus
    3. Abdominal Esophaus
  2. Esophagus wall has three layers
    1. Mucosa (inner most layer)
    2. Submucosa
    3. Muscle
      1. Striated Muscle in the upper third of Esophagus
      2. Striated and Smooth Muscle in the middle third of Esophagus
      3. Smooth Muscle in the lower third of the Esophagus
  3. Innervation
    1. Sympathetic innervation (spinal nerves)
      1. Cervical Esophagus
    2. Parasympathetic innervation (Vagus Nerve)
      1. Thoracic and abdominal Esophagus
  4. Arterial Perfusion
    1. Inferior Thyroid artery supplies the upper Esophagus (proximal)
    2. Aorta supplies the middle Esophagus
    3. Left gastric artery supplies the lower third of the Esophagus
  • Pathophysiology
  1. Food Impaction Sites
    1. Cricopharyngeal Muscle at C6 Vertebrae (most common site in children age <4 years old)
    2. Aortic arch at T4 Vertebrae
    3. Diaphragmatic hiatus and Lower Esophageal Sphincter (LES) at T10-11 (most common site in adults)
  2. Diverticular Sites
    1. Upper Esophageal Sphincter
      1. Zenker Diverticulum
    2. Upper Esophagus below circular esophageal Muscle
      1. Laimer Diverticulum
    3. Lower Esophageal Sphincter
      1. Epiphrenic Diverticulum
  • References
  1. Hagen and Pickle (2023) Crit Dec Emerg Med 37(6): 24-9