Med Oradea - Anatomy II - Digestive System - Esophagus

The tracheal part doesn't exist, but there is a cervical part, which is 5-6cm long.

Lumbar part is made up (there is an abdominal part)

Again, the esophagus curves to the left, so it doesn't interact with the right bronchus. It isn't that wide!

The esophagus actually just has 3 coats- muscular, submucous, and mucous

The azygos vein is behind.

Actually the esophago-cardio-gastric artery comes from the left gastric artery. Think about how far to the left the esophagus is in relationship to the stomach.

Since these questions basically concern what is in front/behind of the cervical esophagus:

In front: Trachea, thyroidean artery and vein, left recurrent laryngean nerve, and left lobe of thyroid
Behind: cervical column and the prevertebral muscles & fascia

Just remember the esophagus is pretty far posterior! If you get confused, think about the aortic arch- the esophagus has to go all the way to the stomach, so if it were in front of the trachea it would pass in front of the lungs and contact the arch, which you know doesn't happen.

The cervical esophagus is actually inclined a little to the left. Lymph goes to the cervical nodes

The abdominal esophagus is limited by the diaphragm and cardia of the stomach. It joins the stomach pretty far to the left - so the lesser curvature mainly follows on the right.

The lower limit of the thoracic esophagus is the diaphragm. This is easy to remember in relationship to the vagus nerves - remember the left vagus becomes the anterior vagal trunk, and the right vagus the posterior vagal trunk - these pass through the diaphragm at the esophageal hiatus.

As for option D, it's correct, except the esophagus curves to the left - so it wouldn't narrow at the right bronchus (but it does narrow at the left one)

There's no such thing as a thoracic splanchnic artery. Option A is correct - actually esophageal arteries are branches of: thoracic aorta, inferior thyroid, and left gastric, but it's nevertheless true.

Option B is a little tricky- the ascending aorta is actually in front of the trachea (and in front of the esophagus). But the arch is slightly lateral, or rather antero-lateral. The descending aorta is lateral to the thoracic esophagus.

Option D is definitely true - the left recurrent laryngeal branches downward from the left vagus, passes over the root of the left subclavian artery and then loops around and behind the aortic arch as it passes upwards again (recurrent). Don't forget this relationship!

D is just totally wrong. Option C is wrong too because the azygos vein drains the upper part. The hepatic portal vein drains the lower part, as described.

Don't forget about option A - thyroidean arteries give off esophageal branches, and the left phrenic gives off a branch that supplies a small portion of the esophagus at the esophageal hiatus of the diaphragm.

The thoracic splanchnic nerves supply the celiac ganglion, the source of sympathetic innervation to the esophagus. Remember that the thoracic splanchic nerves are unusual because they are sympathetics but do not synapse in the paravertebral ganglia. In the case of esophageal innervation, they synapse in the celiac ganglion. The vagus contributes fibers to this ganglion but doesn't synapse in it - it synapses in the walls of the esophagus.

Also remember that the thoracic splanchnics (being sympathetics) come from the sympathetic trunk