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Esophagus physiology

The main physiological function of the esophagus is to carry food from the mouth to the stomach. This becomes possible due to the implementation of successively arising reflexes. Various departments of the nervous system participate in the complex reflex activity of the digestive tract: the cerebral cortex, the medulla oblongata, where according to K.M. Bykov is the center of swallowing, the nuclei of the vagus nerves, the spinal cord, the paravertebral nodes of the sympathetic nervous system, the intramural plexuses of the esophagus, cardia and stomach (Saks F.F. et al., 1987).

In the swallowing act, three phases are distinguished: oral, pharyngeal and esophageal. Swallowing solid and liquid food has known differences, which is of interest in the clinic of foreign bodies of the esophagus. In the first, oral, swallowing phase, the solid food mass is crushed and wetted with saliva. Through teeth, the primary control of the food lump is carried out. A bone or some other solid body that enters the mouth is detected and removed from the mouth. The crushed food in the oral cavity is subjected to further control due to the tongue pressing the food lump to the hard palate, the mucous membrane of which is innervated by the sensitive branches of the trigeminal nerve. The oral phase is an arbitrary act. Depending on the nature of the food, it can be fast or slow. Semi-liquid and especially liquid food advances quickly and the oral phase can be minimized and, therefore, control over the content of inclusions (bones, etc.) that are dangerous for the digestive tract can be significantly reduced. That is why, foreign bodies of the esophagus are most often found when taking liquid food (first course).

As soon as the food lump passes the anterior palatine arches, the second phase begins - the pharyngeal, which is an involuntary act and is carried out without the participation of volitional control over the progress of the food lump. The pharyngeal phase proceeds very quickly - less than 1 s. In the implementation of the second phase of swallowing, many muscles are involved, a certain and coordinated order of reduction of which ensures the closure of the communication of the oropharynx with the nasal cavity, mouth and larynx. At the same time, the entrance to the esophagus opens and a short stop in breathing occurs. Even small functional or morphological changes in any of the links of the neuromuscular apparatus of the esophagus, reflex pathways, or centers of its primary regulation, can cause various motor disorders (dysphagia, dyskinesia).

Numerous electromyographic and X-ray kinematographic research methods have made it possible to study this complex reflex act in detail. It is important to note the almost synchronous movements of the tongue and larynx that occur during the pharyngeal phase of swallowing. At the same time, the tongue moves back and the larynx up and forward. These two movements directed towards each other ensure that the entrance to the larynx is closed by the root of the tongue and epiglottis, even in the absence of the latter.

X-ray cinematic studies have confirmed the presence of advancement of muscle protrusion in the form of a roller that occurs in a limited area of ​​the posterior wall of the upper pharynx at the level of the hard palate.
In the scientific literature, it is known as the Passavant roller and is part of the superior pharyngeal constrictor. Together with the muscles of the soft palate, the mentioned muscle protrusion provides isolation of the oral part of the pharynx from the nasopharynx. The second phase of swallowing ends with the delivery of the food lump from the pharynx to the esophagus.

The third phase of swallowing, the esophagus, begins with the passage of the food lump through the upper narrowing of the esophagus, which according to G. Desouches (1974) does not exceed 0.15 s. The movement of the food lump along the esophagus is accompanied by active motility. In this regard, the act of swallowing can be performed in any position of the body. Peristaltic contraction has the character of a wave that occurs in its upper part and propagates in the direction of the stomach. Distinguish between primary and secondary peristaltic waves. The primary peristaltic wave of the esophagus occurs reflexively in response to swallowing or when the cranial end of the esophagus contracts. According to published data, the primary peristaltic wave, depending on the nature and volume of the food lump, spreads through the esophagus in 2-12 seconds. A secondary peristaltic wave occurs in the esophagus in response to local irritation of the mucous membrane of the esophagus and is not directly related to the act of swallowing. Secondary peristaltic wave is an involuntary contraction of the smooth muscles of the esophagus, which usually begins at the level of the aortic narrowing of the esophagus and extends to its lower end. It is believed that it cleanses the esophagus from food debris by pushing them into the stomach.

Swallowing liquid food has its differences from swallowing solid food. When swallowing fluid, the oral phase, during which the food lump is controlled by the teeth and the hard palate, is practically absent. When the liquid is swallowed quickly by successive sips, the esophagus does not make peristaltic movements, but becomes a simple mechanical tube through which the fluid passes, pumped by the pharyngeal muscles. Only at the end of swallowing, after the last swallow, does the esophagus contract.

Thus, when swallowing liquid food, the pharyngeal phase is involved mainly, which, as has been said, is a reflex phase that does not obey our will. Consequently, the control over the passage of swallowed liquid food is significantly reduced compared to solid food, which explains the more frequent cases of foreign bodies of the esophagus when taking liquid food.

The given physiological information is of great importance for understanding the clinic of foreign bodies of the esophagus.
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Esophagus physiology

  1. Clinical anatomy and physiology of the esophagus
    The esophagus (oesophagus) is a continuation of the pharynx from the level of the lower edge of the cricoid cartilage (CV]) and is a flattened anteroposterior muscle tube 24-25 cm long. The esophagus passes into the stomach at the Thxi level, which corresponds to the site of attachment of the VII costal cartilage to the sternum. The total distance from the front teeth (through the mouth, pharynx and esophagus) to the stomach
  2. Physiology of the esophagus, trachea and bronchus
    Physiology of the Esophagus, Trachea and
  4. Barrett's esophagus, adenocarcinoma of the esophagus
    There is no reliable data on the incidence of adenocarcinoma with Barrett's esophagus, but it is proved that the risk of the disease increases in this case by 20-40 times. Presumably, the mechanisms of carcinogenesis are similar to those in colon cancer - chronic damage to the epithelium and cell proliferation lead to genetic rearrangements and, ultimately, to the neoplastic process.
  5. Esophageal stricture
    - narrowing of the esophagus associated with congenital or acquired factors Classification of cicatricial narrowing of the esophagus (G. L. Ratner, VI Belokonev, 1982) By etiology: burns with acids, alkalis, other burns By the time of obstruction: early (3-4 weeks), late (later than 1 month) According to the mechanism of development and clinical manifestations: A. Functional obstruction of the esophagus 1.
  6. Esophageal diseases
    1. What symptom is most often observed in diseases of the esophagus? Regurgitation. 2. What is the difference between regurgitation and reflux? Regurgitation is the passive, retrograde movement of swallowed food to the upper sphincter of the esophagus; as a rule, food does not have time to get into the stomach. Most often, regurgitation occurs as a result of a violation of the motility of the esophagus, esophageal obstruction or asynchronous
  7. Esophagus DIVERTICULES
    - blindly ending process or protrusion of the organ. LINKER DIVERTICULES - localized along the back wall of the pharynx and esophagus. Classification of diverticulums of the esophagus, diverticulitis (according to Yusbasic, 1961) By localization: 1. Pharyngo-esophagic (Tsenker), 2. Bifurcation. 3. Epiphrenal. Largest diverticulum: Stage I - protrusion of the mucous membrane of the esophagus
    The esophagus (esophagus) is a cylindrical tube 25-30 cm long that connects the pharynx to the stomach. It begins at the level of the VI cervical vertebra, passes through the chest cavity, diaphragm and flows into the stomach to the left of the X-XI thoracic vertebra. There are three parts of the esophagus: cervical, thoracic and abdominal. The cervical part is located between the trachea and the spine at the level of the VI cervical and up to the II thoracic
  9. Foreign bodies of the esophagus
    The ingress of foreign bodies into the esophagus is random and the predisposing moments are considered in the description of the physiology of the esophagus. Foreign bodies linger in places of physiological constriction, most often (50 - 60%) - in the area of ​​cricopharyngeal constriction, which has powerful striated muscles. The second place in the frequency of fixation of foreign bodies is in the thoracic region -
  10. Esophagus Features
    The esophagus in young children has a fusiform shape, it is narrow and short. In a newborn, its length is only 10 cm, in children in 1 year of life - 12 cm, in 10 years - 18 cm. Its width, respectively, is 7 years old - 8 mm, at 12 years old - 15 mm. There are no glands on the mucous membrane of the esophagus. It has thin walls, poor development of muscle and elastic tissues, and is well supplied with blood.
  11. Benign Tumors of the Esophagus
    Classification 1. Solitary myomyomas. - acquired neoplasia. 2. Nodose-multiple myomas. 3. Common leiomyomatosis 4. Polyps: adenomas, lipomas, etc. 5. Cysts. Diagnostic criteria Dysphagia, dyspepsia; pain along the esophagus. Examples of diagnosis: 1. Solitary myoma of the esophagus. 2. Knotty-multiple esophageal myomas. 3.
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    - A variety of esophagitis, often combined with cholelithiasis and gastroduodenal ulceration, accompanied by cardia insufficiency, due to the cup of the entire hernia of the esophageal opening of the diaphragm. Diagnostic criteria 1) Pain behind the sternum, worse after eating, when swallowing, in a prone position; 2) dysphagia; 3) heartburn, belching, regurgitation of gastric contents; 4) complications:
  13. Esophagus (problems)
    The esophagus is the part of the digestive tract between the larynx and the stomach. The esophagus passes through the neck, chest and diaphragm. The following diseases are characteristic of it; DIVERTICULITIS, HERNIA, OR CONGENITAL DEFECTS. Pain in the esophagus can be caused by a foreign object in it or the sensation that a foreign object is in it. Since the esophagus is the beginning of the digestive tract,
  14. Esophagus
    The normal esophagus is a hollow, well-stretched muscle tube extending from level VI of the cervical vertebra to level XI or XII of the thoracic vertebrae. These levels correspond to the transition of the pharynx to the esophagus and esophageal-gastric connection. In newborns, the esophagus has a length of 10-12 cm, and in adults - 23-25 ​​cm. There are three anatomical narrowing of the esophagus, which lasts for
  15. Clinical anatomy and topography of the esophagus
    The esophagus (oesophagus) is a continuation of the pharynx from the level of the lower edge of the cricoid cartilage (VI cervical vertebra). The esophagus passes into the stomach at the level of the 11th thoracic vertebra. The esophagus is a tube flattened in the anteroposterior direction 24-25 cm long. Three sections are distinguished in the esophagus: 1. Cervical. 2. Thoracic. 3. The abdominal. In the cervical and early thoracic
  16. Blockage of the esophagus
    Most often found in kittens, which during the game can swallow plastic or rubber toys or their pieces. In adult cats, blockage of the esophagus is extremely rare, usually due to excessively greedy eating of food. Symptoms: the first signs of an esophageal blockage are restless behavior, the cat twists its head, twitches, scratches its mouth, coughs, can be observed
  17. Esophageal atresia
    DEFINITION Atresia of the esophagus is a malformation in which the proximal and distal ends of the esophagus do not communicate with each other. CODE ICD-Q39.0 Atresia of the esophagus without fistula. Q39.1 Atresia of esophagus with tracheoesophageal fistula. Q39.2 Congenital tracheoesophageal fistula without atresia EPIDEMIOLOGY Among newborns with esophageal atresia, about 30% are premature. CLASSIFICATION Accepted
  18. Clinical anatomy of the esophagus
    The esophagus - one of the most important organs of the digestive system, is a natural continuation of the pharynx, connecting it to the stomach. It is a smooth, stretching fibro-muscular mucous tube, oblate in the anteroposterior direction. The esophagus begins behind the cricoid cartilage at its lower edge, which corresponds to level VI-VII of the cervical vertebrae and ends at the cardia
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