Applied Anatomy and Physiology of the Esophagus

Blood Supply of the Esophagus

The esophagus receives its blood supply from multiple arterial sources, ensuring robust perfusion along its length.

• Cervical esophagus: Supplied by branches of the inferior thyroid artery.
• Thoracic esophagus: Receives blood from the esophageal branches of the thoracic aorta.
• Abdominal esophagus: Perfused by branches from the left gastric artery and the inferior phrenic artery.

Venous Drainage

Venous return follows a segmented pattern similar to arterial supply:

• Cervical region: Drains into the inferior thyroid vein.
• Thoracic region: Drains via the azygos and hemiazygos systems.
• Abdominal region: Drains into the portal vein, contributing to the esophageal varices seen in portal hypertension.

Innervation of the Esophagus

The esophagus receives autonomic innervation from both sympathetic and parasympathetic sources.

• Sympathetic innervation: Arises from the thoracic sympathetic chain and provides vasomotor control.
• Parasympathetic innervation: Mediated via the vagus nerve, facilitating peristalsis.

Clinical Significance

Understanding esophageal blood supply and innervation is crucial in surgical procedures like esophagectomy and conditions such as GERD and esophageal motility disorders.