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Anatomy of The Trachea

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Anatomy of The TracheaThe trachea is a cylindrical tube that projects

onto the spine from C6 to the level of T5. As it passes downwards, it follows the curvature of the spine, and courses slightly backward. Near the tracheal bifurcation, it deviates slightly to the right. length: 10-12 cm ； 16-20 cartilage ringCervical trachea ： Cricoid cartilage - suprasternal fossa ， 7-8cartilage ringsThoracic trachea: suprasternal fossa - tracheal Long ridge， 9-12cartilage ringsTracheobronchial tree

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Cricoid

Cricoid Cartilage

Cricothyroid membrane

Thyroid glandThyroid

cartilage

Cricoid cartilage

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气管支气管气管 1. Tracheal lung ridge2. Tracheal branches of

a tree

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Tracheobronchial anatomy

Bronchial 1. Principal bronchus(left and

right) 2. lobar bronchi. （ L2 、 R3）

3. segmental bronchi →

4. Bronchiole 5. Terminal bronchiole 6. Respiratory bronchiole

7. Alveolar

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• When a patient aspirates (breathes in a strange object, mostly food) in which lung do you think the object will normally be found and why?

• Right lung

• Steeper bronchus

Gray, Anatomy of the Human Body (1918)

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physiological function

• 1. respiratory regulation passage to inhale Ｏ 2 and to excludeＣＯ 2 ， smooth muscle contraction,to stretch, to regulate respiration. to change the

resistance and pressure. • 2.clean function mucus cilia • 3.immune function IgAd ， IgG 、 IgM 、 IgE。

• 4.defensive cough reflex vagal afferent nerve ending The Trachea & Bronchi sensitive to mechanical irritationThe Trachea & Bronchi sensitive to mechanical irritation Receptor of inferior lobar bronchi sensitive to chemical irritation

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Esophageal Anatomy

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Esophageal Anatomy

• Esophageal Anatomy• • Fibromuscular tube

about 25cm long: C6–T10• • Esophageal plexus

(vagus + sympathetics)• • Vagal trunks (anterior &

posterior)• • Esophageal hiatus in

diaphragm• • Right crus of diaphragm

forms a sphincter-like sling

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Esophageal Anatomy

• • Superiorly: level of cricoid cartilage, juncture with pharynx

• • Middle: crossed by aorta and left main bronchus

• • Inferiorly: diaphragmatic sphincter

• 4 physiological stenosis

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食管的应用解剖食管的四个狭窄：①第一狭窄：即入口处，由环咽肌收缩所致，距上切牙约 16cm，是食管最狭窄之处。此段后壁咽下缩肌与环咽肌连接处有肌肉薄弱区，易在食管镜检查时造成穿孔。②第二狭窄：由主动脉弓压迫食管左侧而成，位第一狭窄下方 7cm（距上切牙 23cm）处。在管腔内可见主动脉产生的搏动。

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食管的应用解剖③第三狭窄：为左主支气管压迫前壁而成，位第二狭窄下方 4cm（距上切牙 27cm）处。时常把第二、三狭窄合称为第二狭窄。④第四狭窄：为食管通过膈肌裂孔而成，距上切牙约 40cm。

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Esophageal Anatomy

• • Inner circular & outer longitudinal muscle coats

• • All the muscle fibers are actually helical: outer loose helix, inner tight helix

• • Not all smooth muscle• • Inferior third smooth• • Superior third skeletal• • Middle third mixed

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Esophageal Anatomy

• Mucosa• • stratified

squamous, usually non-keratinizing

• • muscularis mucosae prominent

• Submucosa: mucous glands

• Muscularis externa• Adventitia• • loose conn. tissue• •no serosa

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Esophageal Anatomy

• Esophageal• Veins• • Esophageal vv.

drain into SVC via inferior thyroid vein

• Esophageal vv. drain into azygous

• • Esophageal vv. drain into portal v.

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