[...]... sphincter 15 mm Hg 0 0 2 4 6 Time (s) Figure 1. 6 Manometric properties of the primary peristaltic wave 10 8 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 11 THE ANATOMY AND PHYSIOLOGY OF THE OESOPHAGUS 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 30... Hospital University Hospitals Coventry and Warwickshire NHS Trust Coventry UK 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 911 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 1 The Anatomy and Physiology of the Oesophagus Peter J Lamb and S Michael... Embryology, 5th edition, Williams & Wilkins, Baltimore, 19 85.) 18 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 19 THE ANATOMY AND PHYSIOLOGY OF THE STOMACH 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 anteroposterior and leads to the formation of the... muscular tube protected at its ends by the upper and lower oesophageal 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 3 THE ANATOMY AND PHYSIOLOGY OF THE OESOPHAGUS 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 sphincters It commences as a continuation... considered carefully when the surgical approach to the 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 5 THE ANATOMY AND PHYSIOLOGY OF THE OESOPHAGUS 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 oesophagus is determined For optimum exposure the cervical... portion of the oesophagus lies in the slightly positive 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 9 THE ANATOMY AND PHYSIOLOGY OF THE OESOPHAGUS 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 (0 to +5 mmHg) environment of the abdominal cavity... gastro-oesophageal reflux disease and to the development of pharmacological and surgical options for their management 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 15 THE ANATOMY AND PHYSIOLOGY OF THE OESOPHAGUS 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 ... splenic hilum it gives off the short gastric 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 23 THE ANATOMY AND PHYSIOLOGY OF THE STOMACH 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 arteries supplying the gastric fornix, and the left gastroepiploic... 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 13 THE ANATOMY AND PHYSIOLOGY OF THE OESOPHAGUS 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 Physiology of the Antireflux Mechanism The Oesophagogastric Junction The reflux of small quantities of gastric fluid and air into the oesophagus particularly after meals is... functional high-pressure zone in the lower oesophagus, the presence of an anatomical sphincter has been disputed There is, however, an increase in the circular muscle layer at this level and ultrastructural 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 7 THE ANATOMY AND PHYSIOLOGY OF THE OESOPHAGUS 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 . America 28/383 0-5 43 210 Printed on acid-free paper SPIN 10 873594 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 iv 11 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 v Foreword Surgical. the upper and lower oesophageal 1 · UPPER GASTROINTESTINAL SURGERY 2 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 2 Laryngotracheal. ultrastructural 1 · UPPER GASTROINTESTINAL SURGERY 6 11 11 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 2 011 1 2 3 4 5 6 7 8 9 3 011 1 2 3 4 5 6 7 8 9 4 011 1 2 3 4 5 6 7 8 9 5 011 1 2 311 6 Myenteric plexus Circular