A muscular tube about 25 cm long that starts behind the cricoid cartilage at C6 and ends at the stomach
Oesophagus — the gullet.
Anatomy · Organs & viscera
Oesophagus
About 25 cm long
Neck, thorax and abdomen · gastrointestinal tract
The oesophagus is the muscular tube, about 25 cm long, that carries swallowed food from the pharynx to the stomach. It begins at the level of the sixth cervical vertebra behind the cricoid cartilage, runs down through the neck and the back of the chest behind the trachea and heart, and pierces the diaphragm at about T10 to join the stomach. It moves food by peristalsis, not by gravity alone.
How to spot them
- ▸A collapsed muscular tube lying in front of the vertebral column and behind the trachea and left atrium
- ▸Runs from the lower border of the cricoid cartilage (C6) to the stomach (about T11), passing through the diaphragm at T10
- ▸Three natural narrowings: at its start, where the aortic arch and left main bronchus cross it, and at the diaphragm
- ▸Wall changes from skeletal muscle at the top to smooth muscle at the bottom
What to know
Passes through the diaphragm at the level of T10, together with the two vagus trunks
The oesophageal hiatus of the diaphragm, transmitting the oesophagus.
Has three constrictions, the lowest at the diaphragm and the middle where the aortic arch and left main bronchus cross in front of it
The constrictions of the oesophagus, where swallowed foreign bodies lodge.
A tube whose upper third is skeletal muscle and whose lower third is smooth muscle, with no outer serous coat in the chest
Oesophagus — a mix of muscle types and only an adventitia in the thorax.
Lies behind the left atrium of the heart, so a barium swallow shows its indentation when that chamber enlarges
The oesophagus, the posterior relation of the left atrium.
A lining that changes from stratified squamous to columnar where it meets the stomach, and can turn to intestinal type after chronic reflux
Barrett's oesophagus — a change in the oesophageal lining.
Its lower end, where the portal and systemic veins meet, can develop bleeding varices in cirrhosis
Oesophageal varices, at the lower end of the oesophagus.
Key ideas
- Swallowing sets off a wave of peristalsis; the upper oesophageal sphincter relaxes at the top and the lower oesophageal sphincter relaxes at the bottom so the bolus can pass to the stomach.
- The lower oesophageal sphincter is a physiological sphincter, helped by the diaphragmatic crura and the angle at which the oesophagus joins the stomach.
Quick-fire facts
- •The oesophagus is about 25 cm (10 inches) long in adults, and about 40 cm from the incisor teeth to the stomach.
- •It starts at the lower border of the cricoid cartilage (C6), passes through the diaphragm at T10 and joins the stomach at T11.
- •The constrictions are about 15 cm (start), about 22 to 25 cm (aortic arch and left bronchus) and about 40 cm (diaphragm) from the incisors.
- •Its wall has an inner mucosa of stratified squamous epithelium, a submucosa, and a muscularis of inner circular and outer longitudinal layers.
- •The abdominal portion is only about 1 to 2 cm long and is covered by peritoneum.
- •In the neck it lies just to the left of the midline; in the chest it lies behind the left atrium and in front of the descending aorta.
- •Oesophageal varices are enlarged veins at its lower end where portal and systemic venous systems join, and can bleed heavily.
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