The Œsophagus

The œsophagus is short and nearly straight. It has (according to Rubeli) a potential caliber of nearly 3 inches (ca. 7 cm.) at either end, and about 1⁷⁄₁₀ inches (ca. 4.2 cm.) in its middle part. The muscular coat, except near the cardia, is striated. There are mucous glands in the submucosa to about the middle of the tube.

THE STOMACH

The stomach is large and pyriform. Its average capacity is about 1½ to 2 gallons (ca. 5.7 to 8 liters). When full it extends backward to the last left intercostal space laterally and the umbilicus ventrally. The left portion is large and rounded, while the right portion (Pars pylorica) is small, and bends sharply upward to join the small intestine. The parietal surface is related to the liver, gall-bladder, and diaphragm. The visceral surface is related to the intestine, the mesentery, and the pancreas. The great curvature is related to the diaphragm, spleen, and abdominal floor. The pyloric end lies on the right lateral lobe of the liver. The left extremity presents a flattened conical blind pouch, the diverticulum ventriculi, the apex of which projects backward. The œsophagus joins the stomach very obliquely, almost in the median plane, and about three or four inches (ca. 8 to 10 cm.) below the twelfth thoracic vertebra. The cardiac opening is slit-like and is bounded above and to the left by a fold which contains a thickening of the internal oblique layer of the muscular coat. The opening into the diverticulum is situated above and a little to the left of the cardia; it is transversely oval, and is bounded (except externally) by a thick fold which contains spirally arranged muscular fibers. The mucous membrane may be divided into four regions. Over a quadrilateral area around the cardia (about one inch on the right and two or three inches on the left side of the orifice) it is œsophageal in character, and presents a number of folds. A sharp line of demarcation separates this from the rest of the mucous membrane, which is soft and glandular. The second or cardiac gland region is pale gray in color and thin (ca. 0.5 to 1 mm.); it extends about to the middle of the stomach. The third or fundus gland region is readily distinguished by its thickness (ca. 3 mm.) and its brownish-red mottled appearance. The fourth or pyloric region is pale, thinner than the preceding, and presents a number of irregular folds. At the pylorus there is a remarkable ridge which projects from the wall of the lesser curvature and diminishes considerably the size of the orifice. It is about an inch and a half (ca. 3 to 4 cm.) long and nearly half an inch (ca. 1 cm.) high. Sometimes it is grooved; in other cases it has the form of a rounded eminence attached by a pedicle to the wall. Fibers from the circular muscular coat extend into it.