The Esophagus

Clinical anatomy
The esophagus is a straight muscular tube (25 to 30cm long and 2cm in diameter
at its widest) that connects the pharynx to the stomach. (Rice University. 2017) It
begins between the C6 vertebra, posterior to the cricoid cartilage and finishes at
the level of the T6 vertebra. (Saladin. 2020) Its located posterior to the trachea and
remains collapsed when not engaged in swallowing. Entering the abdomen level,
the esophagus penetrates the diaphragm through an opening called esophageal
hiatus, and continues downward until meeting with the stomach. (Saladin. 2020)
This opening (into the stomach) is called cardiac orifice (due to its proximity with
the heart). This is where when swallowing, food briefly pauses before entering the
stomach due to a constriction called lower esophageal sphincter (LES), that
prevents the stomach contents from returning into the esophagus, thus protecting
its mucosa (heartburn). (Saladin. 2020)

The passage of food through the Esophagus

Swallowing or deglutition is a complex process, that involves over 22 muscles

in the mouth, pharynx and esophagus, all of which are coordinated by the
swallowing center (at the medulla oblongata). (Saladin. 2020) It’s through this
center that a coordinated communication occurs with the various muscles
enervated by the trigeminal, facial, glossopharyngeal and hypoglossal nerves
(cranial nerves V, VII, IX and XII). The process follows three phases: The oral or
buccal, pharyngeal and esophageal phases. (Saladin. 2020)
When swallowing, different pharyngeal muscles work together to prevent food or
drink from entering the glottis.
Food is therefore crushed and chewed into a bolus before being swallowed. When
ready to swallow, different muscles of the neck and pharynx elevate the larynx
which bends the epiglottis over the glottis letting the bolus slide across rather than
falling into the larynx. The pharyngeal constrictor muscles push the bolus towards
and into the esophagus which occurs with the glottis closed. (Shier et al. 2015) All
this process takes less than a second for the pharyngeal muscles to propel the
bolus into the esophagus. During such action, the respiratory centers are inhibited
and breathing stops. Each day we swallow approximately 2400 times. (Shier et al.
2015)

The esophageal phase

As soon as food enters the esophagus, the esophageal phase begins. Such phase
is characterized by deglutition and the initiation of peristalsis. As in previous
phases, complex neuromuscular actions occur and are controlled by the medulla.
(Rice University. 2017)
The upper esophageal sphincter (continuous with the inferior pharyngeal
constrictor) controls the movement of food from the pharynx into the esophagus. At
this point, rhythmic waves of peristalsis (2 waves may occur; primary and
secondary), beginning at the upper esophagus. The circular muscle layer contracts
pinching the pharyngeal wall to propel the bolus forward toward the stomach. At
the same time, the longitudinal muscle layer also contracts, shortening the area,
and pushes out its walls to receive the bolus.
As the bolus reaches the stomach, a distention of the esophagus begins a short
reflex relaxation of the lower esophageal sphincter to allow the bolus to enter the
stomach. The bolus enters the stomach at the lower esophageal sphincter
(contracting and relaxing), a muscle surrounded by the muscular diaphragm.
Relaxing lets the bolus into the stomach and contracting keeps the bolus inside the
stomach preventing the stomach acids from returning back into the esophagus.
The muscular diaphragm helps to seal and close the sphincter when no swallowing
occurs. (Rice University. 2017) When this sphincter doesn’t close completely, reflux
may occur, causing heartburn or gastroesophageal reflux disease (GERD). (Rice
University. 2017)

During the esophageal phase, esophageal glands secret mucus to lubricate the
esophagus and food, preventing dryness and friction. (Rice University. 2017)
References:
David Shier, Jackie Butler and Ricki Lewis. (2015). Hole’s essentials of human
anatomy & physiology. Twelfth edition. McGraw-Hill Education, New York, NY.
USA

Saladin. (2020). Anatomy & Physiology: The Unity of Form and Function, ninth
edition, Published by McGraw-Hill Education, 2 Penn Plaza, New York, NY 10121.
2020

Rice University. (2017). Anatomy and Physiology. Openstax. https://openstax.org.