A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, œsophagus, nose and naso-pharynx / by Morell Mackenzie.

  • Mackenzie, Morell, 1837-1892.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, œsophagus, nose and naso-pharynx / by Morell Mackenzie. Source: Wellcome Collection.

    18/610 (page 6)
    The constituent bundles of the submucous, like those of the mucous coat, include a considerable number of elastic fibres, and form a stratum supporting the vessels and nerves. The muscular coat is composed of two layers of fibres, a circular or internal, and a longi- tudinal or external. The latter Ls the thicker, esi>ecia!ly at the com- mencement of the tube, but it dimini.shes in thickness as it descen<is. It consists of three division!?—an anterior ami two lateraL The former, which is by far the sti'ongest of the three, is attachol aljove to the ridge on the posterior siu’face of the cricoid cartilage by means of a triangular elastic ligament, while the lateral portions take origin fi-oni the elastic exiiansion of the palato-pharjnigei muscles. In its course downwards the longitudinal layer often derives a small mus- cular slip from the left bronchus—the broncho-cesophageus muscle, while similar additions to the circular layer are described as being occasionally obtained from the left lateral waU of the ijosterior medias- tinum. The muscular coat of the oesophagus consists, in its upper fourth, mainly of striated fibres ; in its second fourth, of aiwut equal ju'ojiortions of voluntary and involuntary muscle; while in the remainder of its com-se it is constituted almost entirely of unstriped fibres. The muscular coat is attached to the adjacent structures by a loose areolar investment, which contains a large proportion of elastic fibres. The oesophagus contains a considerable number of mucous glands of the acinous, racemose, and compound tubular varieties. These glands are lineol with cylindrical epithelium, and are for the most part imbeddeil in the submucous connective tissue. They are less abundant in the human gullet than in that of many of the lower animals, and occur in greater numbers at the lower than the uj>per part of the tube. The vascular supply of the oesojdiagus is derived mainly from the thoracic aorta, inferior thyroid artery, and coronary branch of the cceliac axis : the vessels have mostly a longitudinal direction, and anastomose freely trith one another. At the lower pai't of the (Bsoj)hagus, the veins communicate jiretty freely with the coronary veins of the stomach, and are thus brought into relation with the portal system. The lymphatics differ in their arrangement from those in other parts of the alimentary canal by forming only one layer, which is placed internal to the muscular coat. They communicate with neigh- bouring glands, and near the root of the lungs terminate in the thoracic duct after having anastomosetl with the pulmonary lym- phatics. The nerves are derived from the pnenmogastric, recurrent laiyngeal, and sympathetic, offshoots from which join each other in a com- plicated network (]ilexus guhe), which encircles the msophagus, l.yiug for tlie most part between the longitudinal and circular layers of its muscular coat. EXAMIXATIOX OF THE GOLLET. The gullet can be exaniined (hiring life by auscultation, by sounding, and by direct insjiection with the oesojdiago- s(!0]ie. Falpation also .should not be neglected, for although the oesojihagus itself cannot be felt, u.sefnl infomiation may