Читать книгу The Esophagus - Группа авторов - Страница 143

The diaphragm, commonly the right crus, surrounds the LES at approximately the mid‐level of the sphincter [287]. The crura arise from a lumbar vertebra and encircle the distal esophagus in a scissor‐like fashion to form a 2 cm long hiatal canal (Figure 5.14). The diaphragm receives its motor innervation from second‐order neurons in the phrenic motor nucleus of the spinal cord [288]. However, afferent signaling from both the crural diaphragm and the phrenoesophageal ligament passes via the vagus nerve to the SPG and, through efferent vagal pathways from the DMNV, takes part in inhibition of both the LES and crural diaphragm [289, 290]. This inhibition is present with swallow‐induced relaxation and with spontaneous transient LES relaxations (TLESR).