Trachealis Muscle, Posterior View

Description

Viewed from a posterior perspective, the trachea is opened across its membranous wall to expose the trachealis muscle spanning the gap between the free ends of the C shaped tracheal cartilages. Smooth muscle fibers run predominantly transverse, forming the posterior boundary of the tracheal lumen as they bridge right and left cartilage ends. Superiorly this field approaches the cricoid cartilage and inferiorly continues toward the carina, with the esophageal surface lying immediately posterior to the trachealis along the shared tracheoesophageal plane. Reisseisen muscle is shown in its classic location. Posterior tracheal anatomy matters when you need to understand why the airway is not a rigid tube, the trachealis can contract to narrow the lumen during coughing and increase expiratory flow, and it also relaxes to accommodate an esophageal bolus passing behind it. Small details here carry real consequences: an endotracheal tube cuff that sits too high or is overinflated can drive focal pressure into the membranous wall, predisposing to posterior tracheal mucosal injury and, in severe cases, tracheoesophageal fistula. Surgeons also use the membranous wall as a landmark during tracheal resection and anastomosis, where suture handling differs from the cartilaginous rings. Use this artwork in airway modules for gross anatomy and respiratory physiology, in anesthesia teaching on cuff positioning and tracheal wall vulnerability, or in ENT and thoracic surgery publications illustrating posterior tracheal landmarks for tracheostomy and tracheal reconstruction planning. Anatomical accuracy verified by SciePro's Medical Advisory Board.