Esophagus

• General
  • Extends from the pharynx to the stomach
  • 25 cm long and .5 cm in diameter
  • It is the narrowest part of the GI tract, other than appendix
  • Sites of narrowing
    • Origin
    • Aortic arch
    • Left main bronchus
    • Diaphragm
• Course
  • It begins in the neck at the lower border of the cricoid cartilage, opposite the sixth cervical vertebra, descends in front of the vertebral column, through the superior and posterior mediastinum, passes through the diaphragm, and entering the abdomen, ends at the cardiac orifice of the stomach, opposite the eleventh thoracic vertebra
  • The general direction of the esophagus is vertical, but it presents two slight curves in its course
  • Just before it perforates diaphragm it presents a distinct dilatation
  • We need to consider its relationship to structures at different levels
    • Neck
    • Mediastinum
    • Abdomen
• On Left anterior oblique view of the Barium swallow, following impressions are seen on the esophagus:
  • Aortic arch
  • Left main bronchus
  • Left atrium
• Relations
  • The cervical portion
    • Anterior
      • Trachea
      • Thyroid gland
    • Posterior
      • Vertebral column
      • Longus coli muscles
    • Either side
      • Common carotid artery
      • Thyroid gland
  • The thoracic portion  Superior Mediastinum    Superior Mediastinum  At Carina   At Heart   Distal
    • Anterior
      • Trachea
      • Left main stem bronchus
      • Pericardium
      • behind and to the right of aortic arch
    • Posterior
      • Vertebral column
      • Hemiazygous vein
      • right aortic intercostal arteries
      • aorta near diaphragm
    • Right
      • right pleura
      • azygous vein
    • Left
      • aortic arch
      • left subclavian artery
      • left pleura
      • descending aorta
  • Abdominal portion
    • Lies in the esophageal grove on the posterior surface of the left lobe of the liver
    • It measures about 1.25 cm in length
    • It is somewhat conical with its base applied to the upper orifice of the stomach, and is known as the antrum cardacum

Applied anatomy

Why do you have to know the sites of narrowing in Esophagus?

Which pleural space will be infected in Esophageal tear?

Which cardiac chamber when enlarged can  indent and displace Esophagus?

How do you recognize dilatation of esophagus in chest x-ray?