| Esophageal hiatus | |
|---|---|
 The diaphragm. Under surface. (Esophageal hiatus labeled at center right.) | |
| Details | |
| Identifiers | |
| Latin | hiatus oesophageus |
| TA98 | A04.4.02.011 |
| TA2 | 2344 |
| FMA | 58289 |
| Anatomical terminology | |
In human anatomy, the esophageal hiatus is an opening in the diaphragm through which the esophagus and the vagus nerve pass.
The esophageal hiatus is an oval opening [1] in (sources differ) the right crus of the diaphragm [1] /left crus of the diaphragm, with fibres of the right crus looping around the hiatus to form a sling (upon inspiration, this sling would constrict the esophagus, forming a functional (not anatomical) sphincter that prevents gastric contents from refluxing up the esophagus when intra-abdominal pressure rises during inspiration[ citation needed ]). [2] Fibers of the right crus decussate inferior to the hiatus. [1]
The esophageal hiatus gives passage to the oesophagus as well as the anterior and the posterior vagal trunk, esophageal branches of the left gastric artery and vein, and some lymphatic vessels. [1] [2] The transversalis fascia lining the inferior surface of the diaphragm extends superiorly through the hiatus to blend with the endothoracic fascia and attach to the oesophagus 2-3 cm superior to the phrenoesophageal ligament. [2]
The esophageal hiatus is located at level of the tenth thoracic vertebra (T10), 2.5 cm to the left of the midline, [2] and (sources differ) posterior to the 7th left costal cartilage [2] /at the level of the 8th or 9th intercostal spaces. [3] It is placed superior, anterior, and slightly left of the aortic hiatus.[ citation needed ]
Hiatal hernia occurs when part of the stomach passes through the esophageal hiatus. [4] [5]
The esophagus or oesophagus, colloquially known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the stomach. The esophagus is a fibromuscular tube, about 25 cm (10 in) long in adults, that travels behind the trachea and heart, passes through the diaphragm, and empties into the uppermost region of the stomach. During swallowing, the epiglottis tilts backwards to prevent food from going down the larynx and lungs. The word oesophagus is from Ancient Greek οἰσοφάγος (oisophágos), from οἴσω (oísō), future form of φέρω + ἔφαγον.
A hiatal hernia or hiatus hernia is a type of hernia in which abdominal organs slip through the diaphragm into the middle compartment of the chest. This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn. Other symptoms may include trouble swallowing and chest pains. Complications may include iron deficiency anemia, volvulus, or bowel obstruction.
In human anatomy, the subclavian arteries are paired major arteries of the upper thorax, below the clavicle. They receive blood from the aortic arch. The left subclavian artery supplies blood to the left arm and the right subclavian artery supplies blood to the right arm, with some branches supplying the head and thorax. On the left side of the body, the subclavian comes directly off the aortic arch, while on the right side it arises from the relatively short brachiocephalic artery when it bifurcates into the subclavian and the right common carotid artery.
In human anatomy, the thoracic duct is the larger of the two lymph ducts of the lymphatic system. The thoracic duct usually begins from the upper aspect of the cisterna chyli, passing out of the abdomen through the aortic hiatus into first the posterior mediastinum and then the superior mediastinum, extending as high up as the root of the neck before descending to drain into the systemic (blood) circulation at the venous angle.
The thoracic diaphragm, or simply the diaphragm, is a sheet of internal skeletal muscle in humans and other mammals that extends across the bottom of the thoracic cavity. The diaphragm is the most important muscle of respiration, and separates the thoracic cavity, containing the heart and lungs, from the abdominal cavity: as the diaphragm contracts, the volume of the thoracic cavity increases, creating a negative pressure there, which draws air into the lungs. Its high oxygen consumption is noted by the many mitochondria and capillaries present; more than in any other skeletal muscle.
The omohyoid muscle is a muscle in the neck. It is one of the infrahyoid muscles. It consists of two bellies separated by an intermediate tendon. Its inferior belly is attached to the scapula; its superior belly is attached to the hyoid bone. Its intermediate tendon is anchored to the clavicle and first rib by a fascial sling. The omohyoid is innervated by the ansa cervicalis of the cervical plexus. It acts to depress the hyoid bone.
In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta.
The mediastinum is the central compartment of the thoracic cavity. Surrounded by loose connective tissue, it is an undelineated region that contains a group of structures within the thorax, namely the heart and its vessels, the esophagus, the trachea, the phrenic and cardiac nerves, the thoracic duct, the thymus and the lymph nodes of the central chest.
The celiacartery, also known as the celiac trunk or truncus coeliacus, is the first major branch of the abdominal aorta. It is about 1.25 cm in length. Branching from the aorta at thoracic vertebra 12 (T12) in humans, it is one of three anterior/ midline branches of the abdominal aorta.
In human anatomy, the inferior epigastric artery is an artery that arises from the external iliac artery. It is accompanied by the inferior epigastric vein; inferiorly, these two inferior epigastric vessels together travel within the lateral umbilical fold The inferior epigastric artery then traverses the arcuate line of rectus sheath to enter the rectus sheath, then anastomoses with the superior epigastric artery within the rectus sheath.
The hemiazygos vein is a vein running superiorly in the lower thoracic region, just to the left side of the vertebral column.
The inferior phrenic artery is a bilaterally paired artery of the abdominal cavity which represents the main source of arterial supply to the diaphragm. Each artery usually arises either from the coeliac trunk or the abdominal aorta, however, their origin is highly variable and the different sites of origin are different for the left artery and right artery. The superior suprarenal artery is a branch of the inferior phrenic artery.
The central tendon of the diaphragm is a thin but strong aponeurosis situated slightly anterior to the vault formed by the muscle, resulting in longer posterior muscle fibers.
The aortic hiatus is a midline opening in the posterior part of the diaphragm giving passage to the descending aorta as well as the thoracic duct, and variably the azygos and hemiazygos veins. It is the lowest and most posterior of the large apertures.
The phrenoesophageal ligament is the ligament by which the esophagus is attached to the diaphragm. It is an extension of the inferior diaphragmatic fascia and is divided into an upper and lower limb which attach to the superior and inferior surfaces of the diaphragm respectively at the esophageal hiatus. The upper limb attaches the esophagus to the superior surface of the diaphragm and the lower limb attaches the cardia region of the stomach to the inferior surface of the diaphragm at the cardiac notch of stomach. The ligament allows independent movement of the diaphragm and esophagus during respiration and swallowing.
The esophageal plexus is formed by nerve fibers from two sources, branches of the vagus nerve, and visceral branches of the sympathetic trunk. The esophageal plexus and the cardiac plexus contain the same types of fibers and are both considered thoracic autonomic plexus.
The anterior vagal trunk is one of the two divisions into which the vagus nerve splits as it passes through the esophageal hiatus to enter the abdominal cavity. The anterior and posterior vagal trunks represent the inferior continuation of the esophageal nervous plexus inferior to the diaphragm. The majority of nerve fibres in the anterior vagal trunk are derived from the left vagus nerve.
The posterior vagal trunk is one of the two divisions into which the vagus nerve splits as it passes through the esophageal hiatus to enter the abdominal cavity. The anterior and posterior vagal trunks together represent the inferior continuation of the esophageal nervous plexus inferior to the diaphragm.
The following outline is provided as an overview of and topical guide to human anatomy:
