Surgery>>>>>The Esophagus and Diaphragmatic Hernia
Question 1#

Locations of anatomic narrowing of the esophagus seen on an esophagram include all of the following EXCEPT:

a. Lower esophageal sphincter
b. Crossing of the left mainstem bronchus and aortic arch
c. Thoracic outlet
d. Cricopharyngeal muscle

Correct Answer is C


Three normal areas of esophageal narrowing are evident on the barium esophagogram or during esophagoscopy. The uppermost narrowing is located at the entrance into the esophagus and is caused by the cricopharyngeal muscle. Its luminal diameter is 1.5 cm, and it is the narrowest point of the esophagus. The middle narrowing is due to an indentation of the anterior and left lateral esophageal wall caused by the crossing of the left main stem bronchus and aortic arch. The luminal diameter at this point is 1.6 cm. The lowermost narrowing is at the hiatus of the diaphragm and is caused by the gastroesophageal sphincter mechanism. The luminal diameter at this point varies somewhat, depending on the distention of the esophagus by the passage of food, but has been measured at 1.6 to 1.9 cm. These normal constrictions tend to hold up swallowed foreign objects, and the overlying mucosa is subject to injury by swallowed corrosive liquids because of their slow passage through these areas.