Page 147 - Color Atlas Of Pathophysiology (S Silbernagl Et Al, Thieme 2000)

A. Motility of Esophagus
Pharynx Swallowing
Upper
sphincter 40
Striated 1
muscles
0
Migration of the
Smooth 40
muscles Esophagus peristaltic wave
lumen
2 mmHg
Vagus n. Cholinergic 0
fibers
excite: Sphincter opening
shortening
Lower 40
NCNA fibers sphincter 3
inhibit: (after S. Cohen)
opening Stomach Esophagus I
0
Breathing
Neuronal control of sphincter 0 10 20 30 s
Plate 6.2
B. Pressure, Volume, and pH Clearance of Distal Esophagus
Acetylcholine, α-adrenergic
agonists, hormones, VIP, β-adrenergic agonists,
protein-rich food, histamine, Thoracic hormones, dopamine, NO,
high intra-abdominal esophagus PGI 2 , PGE 2 , chocolate,
pressure, PGF 2α , etc. acid gastric juice,
fat, smoking, etc.
Increased pressure in Diaphragm
esophageal sphincter Decreased pressure in
esophageal sphincter
Inhibits reflux
Promotes reflux

15 1 Abdominal
Bolus volume (mL) 10 5 Volume clearance with lower Swallowing 4
esophagus
sphincter

esophagus
8 0 pH 7 4 pH in distal
pH pH clearance 2
4 0
0
120 Esophageal pressure 3 Transient Pressure in 5
sphincter
lower sphincter
80
mmHg mmHg opening
0 40 in stomach
Acid Swallowing 0
bolus 137
1 min (after Helm et al.) 1 min (after Kahrilas and Gupta)
Silbernagl/Lang, Color Atlas of Pathophysiology © 2000 Thieme
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