PRESENTED BY

QUALITY
 The oesophagus

At the end of this presentation learners should be able to:

• Describe the location of the oesophagus
• Describe the function of the oesophagus
• Outline the structure of the oesophagus
• Explain the mechanisms involved in swallowing
Cont….
The oesophagus is a tubular, elongated organ of the digestive system
that connects the pharynx to the stomach. It lies in the median plane in
the thorax in front of the vertebral column and behind the trachea and
the heart. It is continuous with the pharynx above, and just below the
diaphragm it joins the stomach.
CONT…….
• . It passes between muscle fibres of the diaphragm behind the central
tendon at the level of the 10th thoracic vertebra. The oesophagus also
passes through the diaphragm it curves upwards, before opening into
the stomach so that sharp angle is believed to be one of the factors
that prevents regurgitation (backflow) of the gastric contents into the
oesophagus.
Cont………
The upper and lower ends of the oesophagus are enclosed by
sphincters. The upper oesophageal sphincter prevents the passage of
air into the oesophagus during inspiration, and the aspiration of
oesophageal contents. The lower oesophageal (cardiac) sphincter
prevents the reflux of acid gastric contents into the oesophagus.
Cont…….
Function of the oesophagus
• Transport food and fluids from the oral cavity to the stomach. So as
the food and fluids passes through the oesophagus, muscles in the
oesophageal wall contract and relax in a wave like motion called
peristalsis.
Structure of the oesophagus
The oesophagus is composed of four layers of the alimentary tract
which are:
• Adventitia
• Muscle layer
• Submucosa
• Mucosa
Cont..
• Adventitia is outer most layer and consists of loose fibrous tissue and
in the abdomen the organs are covered by the serous membrane
called peritoneum
• muscle layer consists of two layers of smooth involuntary muscle. The
muscle fibres of the outer layer are arranged longitudinally, and those
of the inner layer are circular
• Submucosa consists of loose areolar connective tissue containing
collagen and some elastic fibres which binds the muscle layer to the
mucosa.
• Mucosa is the lining of the tract. Is most superficial layer and is made
from columnar epithelium and has three functions which are:
Protection, secretion and absorption.
Cont….
• Blood supply
Arterial supply
The thoracic region is supplied mainly by the paired oesophageal
arteries, branches from the thoracic aorta. The abdominal region is
supplied by branches from the inferior phrenic arteries and the left
gastric branch of the coeliac artery.
Cont….
Venous drainage
From the thoracic region venous drainage is into the azygos and the
hemiazygos veins. The abdominal part drains into the left gastric vein.
There is a venous plexus at the distal end that links the upward and
downward venous drainage.

NB: The azygos vein is a large vein in the chest that drains blood from
the thoracic wall and the right lung.
Hemiazygos vein is a small vein that drains blood away from the left
thoracic wall and the left lung and return it to the superior vena cava.
Cont….
Activities involved in swallowing
Swallowing(deglutition)
1. Oral stage: With the mouth closed, the voluntary muscles of the
tongue and cheeks push the bolus backwards into pharynx
2. Pharyngeal stage: The muscles of the pharynx are stimulated by the
reflex action initiated in the walls of the oropharynx and
coordinated by swallowing center in the medulla. Involuntary
contraction of these muscle propels the bolus down into the
oesophagus. All routes that the bolus can take are closed. The soft
palate rises up and closes off the nasopharynx: the tongue and the
pharyngeal folds block the way back into the mouth.
Cont………
The larynx is lifted up and forwards so that its opening is occluded by
the overhanging epiglottis, preventing entry into the airway(trachea).
3. Oesophageal stage
The presence of the bolus in the pharynx stimulates a wave of
peristalsis that propels the bolus through the oesophagus to the
stomach.
Peristaltic waves pass along the oesophagus only after swallowing
begins. The lower oesophageal sphincter guiding the entrance to the
stomach relaxes to allow the descending bolus to pass into the
stomach. Usually, constriction the lower oesophageal sphincter
prevents reflux of gastric acid into the oesophagus
Cont…
Factors preventing gastric reflux:
• The attachment of the stomach to the diagram by the peritoneum.
• The acute angle formed by the position of oesophagus as it enters
the fundus of the stomach; the acute cadio-oesophagus angle.
• Increased tone of the cardiac sphincter when intra-abdominal
pressure, and the pinching effect of the diaphragm muscle fibres.
STRUCTURE OF OESOPHAGUS