Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ INTRODUCTION ++ Test Taking Tips Some of the more common scenarios on the esophagus involve perforations—both iatrogenic and from cancer. Err on the side of being conservative, with wide drainage, surgical diversion, and antibiotics being the cornerstone. Only consider a repair in low-risk situations such as early diagnosis of an iatrogenic perforation. Benign esophageal disease is also frequently tested. The most common scenarios will involve chronic reflux and how to manage iatrogenic perforations. Many different modalities aid in the diagnosis of esophageal pathology. Know the indications for each test and the results associated with each disease process. +++ ANATOMY +++ Name the layers of the esophagus: ++ Mucosa and muscularis propria (the esophagus has no serosa) ++ FIGURE 18-1 Arterial blood supply of the esophagus. (Reproduced with permission from Shields TW. General Thoracic Surgery, 3rd ed. Philadelphia, PA: Lea & Febiger; 1989.) Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ What is the arterial blood supply to the cervical esophagus? ++ Inferior thyroid arteries (branch of thyrocervical trunk on the left and subclavian artery on the right) +++ What is the arterial supply to the thoracic esophagus? ++ Direct blood supply from 4 to 6 esophageal arteries off of the aorta; esophageal branches off of right (R) and left (L) bronchial arteries; supplemented by descending branches off the inferior thyroid arteries, intercostal arteries, and ascending branches of the paired inferior phrenic arteries +++ What is the arterial blood supply to the abdominal esophagus? ++ Left gastric artery and the paired inferior phrenic arteries +++ Describe the venous drainage for the cervical esophagus: ++ The submucosal venous plexus drains into the inferior thyroid veins (tributaries of L subclavian vein and R brachiocephalic vein) +++ Describe the venous drainage for the thoracic esophagus: ++ The submucosal venous plexus of the thoracic esophagus joins with the more superficial esophageal venous plexus and the venae comitantes that surround the esophagus at this level. This plexus then drains into the azygos veins on the right and the hemiazygos veins on the left. ++ FIGURE 18-2 Venous drainage of the esophagus. (Reproduced with permission from Shields TW. General Thoracic Surgery, 3rd ed. Philadelphia, PA: Lea & Febiger; 1989.) Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ Describe the venous drainage of the abdominal esophagus: ++ Drains into both the systemic and portal venous systems through the L and R phrenic veins and the L gastric (coronary) vein and short gastric veins +++ In what direction is the lymphatic flow in the upper two-thirds of the esophagus? ++ Cephalad +++ In what direction is the ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.