文档介绍：贲门失弛缓症ACHALASIA
Anatomy- esophagus
- Muscular tube - Conduit from the pharynx to the stomach
- Length is defined anatomically, from cricoid cartilage to the gastric orifice
- Distance from the incisor 40-45 cm (actual length: M 22-28cm F 2cm shorter)
- Passes behind aortic arch and left main bronchus.
- Enters abdomen through esophageal hiatus → 2-4 cm below the diaphragm
Course of the esophagus
- Neck and upper esophagus:
left of midline
- Mid-esophagus: right of
midline
- Lower esophagus: left of
midline
Three area of normal
constrictions:
- Cricopharangeal
- Behind the aortic arch
- LES (thickening of the
Circular muscles ~ 4cm)
- Fixed in position at two places:
. Upper: firmly attached to the cricoid cartilage
. Lower: Phreno-esophageal ligament to the esophagus which
provides an air- tight seal between the thoracic and abdominal cavity.
(lack of fixation throughout its length allows both transverse and longitudinal mobility)
Vascular supply
ARTERIAL SUPPLY
Upper → superior and inferior thyroid
artery
Middle → Bronchial arteries and
esophageal branches directly from aorta
Lower → L inferior phrenic and gastric
VENOUS SUPPLY
Upper → esophageal venous plexus
to azygos vein
Lower → esophageal branches of
the coronary vein, a tributary of the
portal vein
Structure
- Consists of 3 layers: muscularis externa,
submucosa, mucosa
Achalasia-historical note