Anatomy Trachea Esophagus And Thoracic Duct Question And Answers

Trachea Esophagus And Thoracic Duct Question And Answers

Question 1. Describe the features and relations of the esophagus.
Answer:

Esophagus Anatomy

Esophagus Structure

• Esophagus is a long muscular tube
• Esophagus Length: 25 cm
• Esophagus Width: 2 cm
• Esophagus Function: Transport of food from pharynx to the stomach
• Parts of esophagus.

Esophagus Gross Features

• Esophagus Extent: Pharynx to cardiac orifie of stomach
• Esophagus Lumen:
  • It is flattened anteroposteriorly
  • Normally it is in a collapsed state but dilates during the passage of food

Esophagus Course

Esophagus Anatomy

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Esophagus  Curvatures: Esophagus during its course shows few curves

• Two anteroposterior curvatures
• Two side-to-side curvatures.

Esophagus Anatomy

Esophagus Constrictions There are four sites of constrictions present in the esophagus

1. First constriction: It is at a distance of 15 cm, at the pharyngoesophageal junction
2. Second constriction: It is at a distance of 22.5 cm at the place where it is crossed by arch of aorta
3. Third constriction: It is at a distance of 27.5 cm, at a place where it is crossed by left principal bronchus
4. Fourth constriction: It is at a distance of 40 cm, at a place where it pierces the diaphragm.

Esophagus Applied Anatomy: Constrictions of esophagus act as potential sites at which the swallowed foreign bodies can get stuck.

Esophagus Relations:

1. Esophagus Relations Cervical part

• Anteriorly
  • Trachea
  • Recurrent laryngeal nerve
• Posteriorly
  • Prevertebral fascia
  • Vertebral column
• Laterally
  • Common carotid artery
  • Lateral lobe of thyroid
• Left side
  • Thoracic duct

Esophagus Anatomy

2. Esophagus Relations Thoracic Part

• Anteriorly
  • Trachea
  • Arch of aorta
  • Right principal bronchus
  • Fibrous pericardium
  • Oblique sinus
  • Diaphragm
• Posteriorly
  • Vertebral column
  • Right posterior intercostal arteries
  • Thoracic duct
  • Azygos and hemiazygos veins
  • Descending thoracic aorta
• Right
  • Pleura
  • Right lung
  • Right vagus
  • Azygos
• Left
  • Arch of aorta
  • Left subclavian artery
  • Thoracic duct
  • Pleura
  • Left lung

3. Esophagus Relations Abdominal Part

• Anteriorly
  • Posterior surface of left lobe of liver
  • Left gastric nerve
• Posteriorly
  • Left crus of diaphragm
  • Right gastric nerve

Esophagus Anatomy

Question 2. Write a note on blood supply, lymphatic drainage, and nerve supply of the esophagus.
Answer:

Esophagus Arterial Supply

• Cervical part: Inferior thyroid arteries
• Thoracic part: Descending thoracic aorta and bronchial arteries
• Abdominal part: Left gastric artery and left phrenic artery

Esophagus Venous Drainage

• Cervical part: Inferior thyroid
• Thoracic part: Azygos and hemiazygos veins
• Abdominal part: Hemiazygos and left gastric vein

Esophagus Lymphatic Drainage

• Cervical part: Deep cervical lymph nodes
• Thoracic part: Posterior mediastinal nodes
• Abdominal part: Left gastric nodes

Esophagus Anatomy

Esophagus Nerve Supply

• Sympathetic supply:
  • These nerves reach it through splanchnic branches of the sympathetic trunk.
• Esophagus Parasympathetic supply:
  • Upper half of esophagus: Recurrent laryngeal nerve
  • Lower half of esophagus: Esophageal plexus

Question 3. Write a brief on the development of the esophagus.
Answer:

• Developed from posteriormost part of the foregut
• It is short in the beginning but it lengthens quickly due to descend of heart and lungs
• Musculature is derived from the splanchnic mesenchyme surrounding the foregut.

Question 4. Write a note on the thoracic duct.
Answer:

Esophagus Disease

Thoracic Duct Features

• Largest lymph vessel in the body
• It is 40–45 cm long
• Extent: From the upper part of abdomen to the lower part of neck.

Thoracic Duct Gross Features

It has a characteristic beaded appearance due to the presence of numerous valves.

Thoracic Duct Course

Mnemonic: Thoracic duct: Relation to azygos vein and esophagus.

‘The duck between two geese’: Thoracic duct (duck) is between two geese, azygos and esophagus

Esophagus Disease

Question 5. Write a note on the trachea.
Answer:

Trachea Definition

Trachea Structure

• Wide tube
• Lying more or less in the midline, in the lower part of neck
• Length: 10–15 cm
• External diameter:
  • Males – 2 cm
  • Females – 1.5 cm
• Internal diameter – 12 mm
• Upper end of the trachea is the continuation of larynx
• The laryngotracheal junction lies at the level of 6th cervical vertebrae
• Trachea enters the thorax through superior thoracic inlet and occupies the superior mediastinum
• Lower end of trachea end by bifurcating into right and left principal bronchi
• Level of bifurcation corresponds to lower border of T4 vertebrae or lower border of manubrium sterni.

Trachea Relations:

1. Trachea Relations Anteriorly

• Manubrium sterni
• Sternothyroid muscle
• Left brachiocephalic veins
• Arch of aorta
• Brachiocephalic trunk

2. Trachea Relations Posteriorly

• Esophagus
• T1–T4 vertebrae

3. Trachea Relations Right side

• Right lung
• Right vagus
• Azygos vein

4. Trachea Relations Left side

• Arch of aorta
• Left subclavian artery
• Left common carotid artery
• Left recurrent laryngeal nerve

1. Arterial supply: Inferior thyroid arteries
2. Venous drainage: Left brachiocephalic vein
3. Lymphatic drainage: Pretracheal and paratracheal nodes

Trachea Nerve supply:

• Sympathetic supply: From middle cervical ganglion
• Parasympathetic supply: From vagus and recurrent laryngeal nerves.

Trachea Definition

Trachea Esophagus And Thoracic Duct Multiple Choice Questions And Answers

Question 1. Trachea bifurcates at the level of:

1. Lower border of T4 vertebrae
2. Lower border of T5 vertebrae
3. Upper border of T3 vertebrae
4. Upper border of T4 vertebrae

Answer: 1. Lower border of T4 vertebrae

Question 2. One should watch for _____________ while passing a Ryle’s tube for gastric analysis:

1. Structures anterior to the esophagus
2. Constrictions of the esophagus
3. Pericardium
4. Trachea
5. None of the above

Answer: 2. Constrictions of the esophagus

Question 3. Length of esophagus in an adult is:

1. 15 cm
2. 20 cm
3. 25 cm
4. 30 cm

Answer: 3. 25 cm

Trachea Definition

Question 4. What is true of the anatomy of the trachea?

1. Starts at the level of C4
2. Drains to axillary lymph nodes
3. Is supplied by the glossopharyngeal nerve
4. Is marked at its lower end by the sternal angle

Answer: 4. Is marked at its lower end by the sternal angle

Question 5. The esophagus is narrowest at:

1. Level of cricopharyngeus
2. C6
3. At cardiac orifice
4. C4

Answer: 1. Level of cricopharyngeus