Gastrointestinal Anatomy
A thorough understanding of the gastrointestinal tract anatomy forms the basis of communicating with care providers, comprehending patterns of spread, and designing radiotherapy plans. This chapter details the gross anatomy, vasculature, and lymphatic dra
- PDF / 1,155,451 Bytes
- 12 Pages / 504.567 x 720 pts Page_size
- 100 Downloads / 232 Views
Gastrointestinal Anatomy Stuti Ahlawat, Rekha Baby, and Salma K. Jabbour
2.1
Esophagus
2.1.2 Physiologic Points of Constriction/Narrowing [2]
2.1.1 Gross Anatomy • Figures 2.1 and 2.2 • Fibromuscular tube that allows passage of food from the pharynx to the stomach • About 25 cm long and has a star-shaped lumen with a 2–3 cm diameter • Begins at the lower border of the C6 [1] • Cranially enters the thorax at about T1 and occupies the posterior mediastinum [2] • Caudally enters the abdomen through esophageal hiatus in the diaphragm through the right crus at about T10 [2] • Has a slight deviation from right to left with three curves: one on the sagittal and two on the frontal plane [1] • Divided into cervical, thoracic, diaphragmatic, and abdominal [3] • No serosal covering [4] • Esophageal wall consists of four layers: mucosa, submucosa, muscularis propria, and adventitia [4]
S. Ahlawat • R. Baby • S.K. Jabbour (*) Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA e-mail: [email protected]
• At the origin of the esophagus at the cricopharyngeus muscle (upper esophageal sphincter) • By the aortic arch, left anterolateral esophageal surface • By the left main bronchus • By the diaphragm at the esophageal hiatus
1
IVa VIII
4 3
VII
2
Fig. 2.1 1 heart, 2 aorta, 3 esophagus, 4 inferior vena cava
© Springer International Publishing AG 2017 T. Hong, P. Das (eds.), Radiation Therapy for Gastrointestinal Cancers, DOI 10.1007/978-3-319-43115-4_2
11
S. Ahlawat et al.
12
2.1.5 Thoracic Portion [1] III
IVa II VIII
I
2
3
5
1 VII
4
Fig. 2.2 1 aorta, 2 GE junction, 3 stomach, 4 spleen, 5 descending colon
2.1.3 Esophageal Portions [3] • Cervical esophagus starts at about 16 cm from the incisors • Upper thoracic esophagus begins around 20–21 cm from the incisors • Mid-thoracic esophagus begins at around 24 cm from the incisors, at the level of the carina • Lower thoracic esophagus begins around 32 cm from the incisors with the lower esophageal sphincter starting at 37–39 cm from the incisors
2.1.4 Cervical Portion [1] • About 4–5 cm long, begins at the lower border of the C6 and extends to the upper border of T2 • Anteriorly, connected to the trachea by soft connective tissues and tracheoesophageal muscular tissues • Posteriorly, connected to the deep cervical fascia and spinal column through the retroesophageal space • Laterally, connected to the right and left common carotid arteries and recurrent laryngeal nerve on the right
• About 16 cm long, extends from T2 to the diaphragm and is located in the posterior mediastinum • Upper thoracic esophagus, above the level of the mainstem bronchi –– Anteriorly connected to the trachea and attached to the initial part of the left main bronchus by the bronchoesophageal muscle –– Connected posteriorly to the vertebral column, up to T4 –– Laterally on right side, attached to mediastinal pleura forming the azygoesophageal recess. On the left side, c
Data Loading...
