Podcast
Questions and Answers
At which vertebral level does the thoracic duct ascend and cross from the left to the right side?
At which vertebral level does the thoracic duct ascend and cross from the left to the right side?
Which structure is NOT anterior to the thoracic duct at the aortic opening?
Which structure is NOT anterior to the thoracic duct at the aortic opening?
What is the location of the thoracic duct in the superior mediastinum?
What is the location of the thoracic duct in the superior mediastinum?
What is the most common cause of chylothorax?
What is the most common cause of chylothorax?
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Which of the following is a tributary of the thoracic duct?
Which of the following is a tributary of the thoracic duct?
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What is the level at which the thoracic duct begins?
What is the level at which the thoracic duct begins?
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What is the termination point of the thoracic duct?
What is the termination point of the thoracic duct?
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Which of the following is a variation of the thoracic duct?
Which of the following is a variation of the thoracic duct?
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What is the location of the thoracic duct at the posterior mediastinum?
What is the location of the thoracic duct at the posterior mediastinum?
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What is the function of the thoracic duct?
What is the function of the thoracic duct?
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Study Notes
Oesophagus
- A muscular tube that lies in the posterior mediastinum, extending from the pharynx at the level of the cricoid cartilage and C6 vertebrae to the stomach
- Length: 25cm
- Runs downwards and pierces the diaphragm at the level of T10 to enter the stomach
- Has a cervical, thoracic, and abdominal part (1.25cm)
Relations of the Oesophagus
- Anteriorly: left lobe of liver, left vagus, trachea, right pulmonary artery, left bronchus, pericardium with left atrium
- Posteriorly: right crus of diaphragm, right vagus nerve, thoracic vertebrae, right posterior intercosal artery, thoracic duct, thoracic aorta
Blood Supply and Lymphatics of the Oesophagus
- Arterial Supply: cervical part - inferior thyroid artery, thoracic part - esophageal arteries from aorta, abdominal part - branches of left gastric artery
- Veins: left gastric veins to portal vein
- Lymphatics: left gastric nodes
- Nerve Supply: anterior and posterior gastric nerves (vagi), sympathetic nerve supply from branches of sympathetic trunk
Oesophageal Sphincters
- Upper and lower oesophageal sphincters
Constrictions of the Oesophagus
- Three normal constrictions: at the level of the cricoid cartilage, at the level where the arch of aorta and bronchi are in contact, and at the point of piercing the diaphragm
Applied Anatomy of the Oesophagus
- Achalasia cardia: a motility disorder of the oesophageal muscle due to nervous incoordination, causing dysphagia and chest pain after eating
- Oesophageal varices
- Gastrointestinal reflux disease
- Oesophageal cancer
Stomach Anatomy
- J-shaped, 1.5 liters at puberty and 2 liters in adults
- Four parts: cardia, fundus, body, and pylorus
- Relations: see diagrams
Blood Supply of the Stomach
- Arteries: left and right gastric arteries from coeliac trunk, left gastroepiploic artery from splenic artery, right gastroepiploic artery from gastroduodenal artery, and short gastric arteries to fundus from splenic and left gastroepiploic arteries
Lymphatic Drainage of the Stomach
- Left gastric nodes
Thoracic Duct
- Largest lymphatic vessel in the body, 45cm long
- Course: begins as a continuation of the upper end of the cisterna chyli at the lower border of T12, ascends through the posterior mediastinum, and ends by opening into the angle of junction between the left subclavian and left jugular veins
- Relations: at aortic opening - diaphragm, posteriorly - vertebral column, right Azygous vein, left aorta
- Tributaries: left and right intestinal lymph trunk, mediastinal lymph trunk, left jugular trunk, left subclavian
- Variant: may divide into two in its course
Applied Anatomy of the Thoracic Duct
- Chylothorax: leakage of lymph into the pleural cavity
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Description
Learn about the different parts of the gastrointestinal tract, including the esophagus, its extent, and its relations.
