ENT

ANATOMY and PHYSIOLOGY OF AERODIGESTIVE

TRACT
Dra. Clydine G. Barrientos
090409
Anatomy
Mucosally lines neuromuscular tube
Begins lower neck
Traverse mediatinum
Ends stomach
20-25cm long
Segments
Upper 3rd 10% esophageal cancer
Mid 4rd 40
Lower 50
Regions: cervical
4-5cm long
Lower end of pharynx
o CV6
o Below cricoid cartilage
Thoracic inlet
o Suprasternal notch
o Shifts to left
Thoracic
Upper
o Thoracic inlet to level of tracheal
bifurcation
o TV 4

Opposite the sterna angle

Pushed to midline by aorta

Mid
Lower
Abdominal T11
3 Physiologic Sphincters
UES
o Cricopharyngeus ONLY TRUE
sphincter
LES
GE junction
*for foreign body ingestion
Zenkers diverticulum outpouching
TRACHEA
TV5
1st tracheal ring broader
Respiratory ep[ithelium warms and moistens
the air
Cartilaginous layer
CN10 parasympathetic
Sympathetic trunk

BRONCHI
Common in left- children

ANATOMY and PHYSIOLOGY OF AERODIGESTIVE TRACT

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Common in right adult

Right below and in front
Left above and in front

Physiology
Pharyngeal stage - Most critical stage
8-20secs peristalsis
90% during expiration - swallow
-

Zline jxn bet str sq and columnar epith

Control peristalsis Auerbachs plexus
External muscular coat ICOL, striated, mixed,
smooth
o Impt in carcinomas
Sensory input regulation and regulate secretion
Submucosa dense collagenous CT, Meissners
plexus (moves the bolus down), regulates
secretions
17 degrees to midline
Inc in smooth muscles (reduction in diameter)
Pharyngeal space most critical stage
Fine muscular control of tongue most
important action of the tongue
Prolong cricopharyngeal opening and oral
transit time
o Elderly