angle of His.pptx

surgery

1. Angle of His Monday, January 23, 2023 1

2. Angle of His The  eponym  "angle of His" remembers Dr. Wilhem His Jr. (1864 -1934), a German physician and anatomist , who also described the atrioventricular bundle or " Bundle of His ", one of the components of the  conduction system of the heart. Monday, January 23, 2023 2

3. Nature and development The  angle of His , also known as the  esophagogastric angle , is the acute angle created between the cardia at the entrance to the stomach, and the esophagus. It helps to prevent acid reflux of stomach acid into the esophagus. It is commonly undeveloped in infants , making acid reflux more common. Monday, January 23, 2023 3

4. Anatomy The lower esophageal sphincter (LES) is a composite of different muscles spanning 2.4–4.5 cm in length That Allows coordinated passage of food into the stomach Venting of gas after meals Prevents reflux of contents back into the esophagus Monday, January 23, 2023 4

5. Structure It is created by the collar sling fibres and the circular muscles around this g astro e sophageal j unction. Monday, January 23, 2023 5

6. Monday, January 23, 2023 6

7. The diaphragm pinches the abdominal part of the esophagus as it enters the abdomen through the hiatus, acting as an extrinsic component to the lower esophageal sphincter Monday, January 23, 2023 7

8. Variation The angle of His is normally undeveloped in infants , with the esophagus making a vertical junction with the stomach. As a result, reflux of stomach contents is common. Monday, January 23, 2023 8

9. Function The angle of His forms an anatomical sphincter. This prevents the reflux of stomach acid, digestive enzymes, and duodenal bile from entering the esophagus.  This is important in preventing  gastroesophageal reflux disease and inflammation of the esophagus. Monday, January 23, 2023 9

10. Physiology When the fundus of the stomach gets expanded by air , because of the normal anatomy and relations of the esophageal hiatus, the esophagogastric junction structures are " pushed" from left to right , pushing close the gastroesophageal flap valve or "rosette". Monday, January 23, 2023 10

11. Diaphragmatic role The hiatus is formed by the right crus of the diaphragm, which forms a sling around the esophagus with the right and left pillars, so that the esophagus narrows when the diaphragm contracts.   The actual contribution the diaphragm provides in maintaining an adequate length of intra-abdominal esophagus is not clearly understood Monday, January 23, 2023 11