Clinical & Applied anatomy of trachea and Oesophagus

1. PRESENTED BY-
ASHISH KUMAR SHARMA
BPT 1ST YEAR
NOIDA INTERNATIONAL UNIVERSITY
CLINICAL & APPLIED
ANATOMY OF TRACHEA AND
OESOPHAGUS

2. TRACHEA
The trachea is a cartilaginous tubular
structure of the middle respiratory tract and is
more commonly known as the wind pipe. It
connects the inferior margin of larynx with the
lower respiratory tract or the lungs

3. Structure of trachea
• The Trachea is a hollow cylinder that
Extends approximately nine to fifteen
Centimeters from the sixth cervical
Vertebra where it continues from the
larynx to the point at which it bifurcates
into the two major bronchi at the level of
the fourth to the seventh thoracic
vertebrae. In ….diameter it spans
approximately 25 millimeters ….and only
widens at it lower margin where it divides.
Ventral view of
trachea

4. • It descends into the
thoracic cavity just
anterior to the
oesophagus and
bifurcates in the
superior
mediastinum with a
slight deviation to the
right, creating the
right and left
bronchus. Above this
however it should be
noted that the trachea
is a median
Lateral right view of trachea

5. • Anteriorly, the aortic
arch also descends
before turning to the
left side of the
trachea, just above
the left main
bronchus. Other
adjacent structures
include the
branchiocephalic
and left common
carotid arteries.
Ventral view of trachea

6. • It is comprised of approximately fifteen to
twenty Hyaline cartilages which are C-
shaped. These cartilages provide structural
rigidity to the trachea and its internal
longitudinal elastic fibers enable it to stretch
and shift inferiorly during inspiration. At the
tracheobronchial bifurcation, there is an
anatomical landmark known as the carina,
which is a superior pointing ridge on the inner
surface.

7. • The trachea is
supplied by the
inferior thyroid
arteries and
innervated by
both
sympathetic
and
parasympatheti
c fibers. Pain
sensation ia
governed by the
sensory fibers of
the vagus nerve
Inferior thyroid artery – Ventral view

8. BLOOD SUPPLY OF TRACHEA
• The upper two third is supplied by the
inferior thyroid arteries and the lower third is
supplied by the bronchial arteries.
LYMPH DRAINAGE OF TRACHEA
• The lymph drains into the pretracheal and
paratharacheal lymph nodes and the deep
cervical nodes.
NERVE SUPPLY OF TRACHEA
• The sensory nerve supply is from the vagi
and the recurrent laryngeal nerves.
• Sympathetic nerves supply the trachealis
muscle.

9. OESOPHAGUS
The oesophagus is a muscular tube that
connects the pharynx to the stomach, enabling
the passage of food and liquids. It is part of the
upper gastrointestinal tract and runs through the
middle of the chest cavity.

10. • The esophagus is about 8 inches long, and is
lined by moist pink tissue called mucosa. The
esophagus runs behind the windpipe
(trachea) and heart, and in front of the spine.
Just before entering the stomach, the
esophagus passes through the diaphragm.
• Its lengths correlates with individuals height
and it is usually longer in men than in women.

11. It may be divided into three parts
Cervical part –pharyngoesophageal junction to
suprasternal notch.
Thoracic part –suprasternal notch to diaphragmatic
haitus.
Abdominal part –diaphragmatic haitus to cardiac
orifice.

12. RELATION OF THE THORACIC PART
OF THE OESOPHAGUS
ANTERIORLY
1.Trachea
2.Right pulmonary artery
3.Left bronchus
4.Pericardium with left atrium
5.The diphragm
POSTERIORLY
1.Vertebral column
2.Right posterior intercostal artery
3.Thoracic duct
continued........

13. 4. Azygus vein with the terminal part of the
hemiazygos veins
5 Thoracic aorta
6. Right plural recess
7. Diaphragm
TO THE RIGHT
1. Right lung & the pleura
2. Azygos vein
3. The right vagus
TO THE LEFT
1. Aortic arch
2. Left subclavian artery
3. Thoracic duct
4. Left lung & pleura
5. Left recurrent lyrangeal nerve

14. MUSCLES OF THE ESOPHAGUS
• The upper esophageal sphincter (UES) is a
bundle of muscles at the top of the esophagus.
The muscles of the UES are under conscious
control, used when breathing, eating, belching,
and vomiting. They keep food and secretions
from going down the windpipe.
• The lower esophageal sphincter (LES) is a
bundle of muscles at the low end of the
esophagus, where it meets the stomach. When
the LES is closed, it prevents acid and stomach
contents from traveling backwards from the
stomach. The LES muscles are not under