Ch 56: Esophagus

Question 1

The esophagus is a thin-walled, hollow tube approximately _cm in length

Answer 1

The esophagus is a thin-walled, hollow tube approximately 25 cm in length

Question 2

It is
lined with _____ extending from the
cricopharyngeus muscle at the level of the cricoid cartilage superiorly to the
gastroesophageal junction inferiorly.

Answer 2

It is
lined with stratified keratinized squamous epithelium, extending from the
cricopharyngeus muscle at the level of the cricoid cartilage superiorly to the
gastroesophageal junction inferiorly.

Question 3

The ____ refers to the
endoscopically visible junction of the squamous and glandular epithelium.

Answer 3

The Z line refers to the
endoscopically visible junction of the squamous and glandular epithelium.

Question 4

The
esophageal wall is composed of three layers: __

Answer 4

The
esophageal wall is composed of three layers: the mucosa, submucosa, and
muscularis propria

Question 5

The mucosal layer contains the ____

Answer 5

The mucosal layer contains the epithelium,
lamina propria, and muscularis mucosae.

Question 6

The mucosa may be divided into distinct layers, including M1
(epithelium), M2 (lamina propria), and M3 (muscularis mucosae). Similarly, the
submucosal layer may be divided into inner (SM1), middle (SM2), and outer
(SM3) layers. The muscularis propria consists of a ___inner layer and
–____ outer layer. The adventitia (periesophageal connective tissue) lies
directly on the muscularis propria.1 No serosa is present, facilitating
extraesophageal spread of disease.

Answer 6

The mucosa may be divided into distinct layers, including M1
(epithelium), M2 (lamina propria), and M3 (muscularis mucosae). Similarly, the
submucosal layer may be divided into inner (SM1), middle (SM2), and outer
(SM3) layers. The muscularis propria consists of a circular inner layer and
longitudinal outer layer. The adventitia (periesophageal connective tissue) lies
directly on the muscularis propria.1 No serosa is present, facilitating
extraesophageal spread of disease.

Question 7

The cervical esophagus
lies within the neck and begins at the cricopharyngeus muscle (approximately
the __ level or ___ cm from the incisors) and extends to the thoracic inlet (at
approximately the __ level or at ___ cm from the incisors [the level of the
suprasternal notch]). T

Answer 7

The cervical esophagus
lies within the neck and begins at the cricopharyngeus muscle (approximately
the C7 level or 15 cm from the incisors) and extends to the thoracic inlet (at
approximately the T3 level or at ~20 cm from the incisors [the level of the
suprasternal notch]). T

Question 8

The thoracic esophagus extends from approximately the
level of T3 (beginning at about __ cm) to T10 or T11.The upper thoracic
esophagus is bordered superiorly by the thoracic inlet and inferiorly by the lower
border of the azygos vein, extending from approximately ____

Answer 8

The thoracic esophagus extends from approximately the
level of T3 (beginning at about 20 cm) to T10 or T11.1,2 The upper thoracic
esophagus is bordered superiorly by the thoracic inlet and inferiorly by the lower
border of the azygos vein, extending from approximately 20 to 25 cm

Question 9

The middle thoracic esophagus extends from the lower
border of the azygos vein to the inferior pulmonary veins, extending from
approximately ___ cm

Answer 9

The middle thoracic esophagus extends from the lower
border of the azygos vein to the inferior pulmonary veins, extending from
approximately 25 to 30 cm

Question 10

The lower thoracic esophagus extends from the
inferior pulmonary veins and to the stomach and is inclusive of the
gastroesophageal junction, typically extending from approximately ___ cm.

Answer 10

The lower thoracic esophagus extends from the
inferior pulmonary veins and to the stomach and is inclusive of the
gastroesophageal junction, typically extending from approximately 30 to 40 cm.

Question 11

Useful
landmarks in reference to endoscopy include the carina (__ cm from the
incisors) and gastroesophageal junction (___ cm from the incisors).

Answer 11

Useful
landmarks in reference to endoscopy include the carina (∼25 cm from the
incisors) and gastroesophageal junction (∼40 cm from the incisors).

Question 12

Siewert et al characterized cancer involving the gastroesophageal junction
according to the location of the tumor. If the tumor center is located
from ____above the gastroesophageal junction (Z line), the tumor
is classified as a type I adenocarcinoma of the distal esophagus. If the tumor
center is located _____ caudad to the gastroesophageal junction, it is classified as type II. If the tumor center is located ___ below the
gastroesophageal junction, the tumor is classified as type III.

Answer 12

Siewert et al.3,4 characterized cancer involving the gastroesophageal junction
according to the location of the tumor (Fig. 56.3). If the tumor center is located
from >1 cm up to 5 cm above the gastroesophageal junction (Z line), the tumor
is classified as a type I adenocarcinoma of the distal esophagus. If the tumor
center is located within 1 cm cephalad to 2 cm caudad to the gastroesophageal
junction, it is classified as type II. If the tumor center is located >2 cm below the
gastroesophageal junction, the tumor is classified as type III.

Question 13

Normal extrinsic impressions on the esophagus are
made by the _______

Answer 13

Normal extrinsic impressions on the esophagus are
made by the aortic arch, the left mainstem bronchus, and the
left atrium