diaphragm
TRANSCRIPT
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By-
Dr. Praveen Kumar Banjare
Final yr PG (MD Anatomy)
Pt.JNM Medical College Raipur(C.G.)
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Contents1. Introduction
2. Origin
3. Insertion
4. Nerve supply
5. Bloodsupply
6. Actions
7. Positions of Diaphragm
8. Relations of Diaphragm
9. Openings of Diaphragm 10. Development of Diaphragm
11. Applied
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Introduction
•Greek, from dia 'through, apart' + phragma 'a fence'.
•Fibro-muscular sheet
•Separates the thoracic cavity from the abdominal cavity
• Performs an important function in respiration.
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Origin
3 parts:-
1. Sternal
2. Costal
3. lumbar
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Insertion
Central tendon of diaphragm
Central tendon :
trilobar in shape
3 leaflets (middle, right & left)
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Direction of muscle fibres
Upwards & inwards
Right and left dome
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Nerve Supply
Motor – Phrenic nerve(C3,4,5)
Sensory –1.central part- phrenic nerve
2.peripheral part- lower six thoracic nerve
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Blood Supply
1. Musculophrenic artery
2. Superior phrenic arteries
3. Lower 5 intercostal arteries + subcostal artey
4. Inferior phrenic artery
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Actions
1. Principal muscle of Inspiration.
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2. Helps in expulsive acts-
sneezing, coughing, laughing, crying, vomiting
micturition, defaecation or parturation.
3. May have sphincteric action on the lower oesophagus.
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Position of Diaphragm
3 Factors :-
1.The elastic recoil of Lung
2.The pressure exerted by abdominal viscera
3.The muscles of abdominal wall
Highest- in supine position
Lowest- in sitting
Intermediate- in standing
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Relations
Superiorly-pleuraepericardium
Inferiorly -peritoneumliverfundus of stomachspleenkidneyssuprarenal
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Openings
Caval opening
Oesophageal opening
Aortic opening
Major openings
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Minor openings
2 aperture in right crus
3 lesser aperture in left crus
under the medial lumbocostal arches
under the lateral lumbocostal arches
foramina of Morgagni
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Development
The Diaphragm 'develops from the following sources.
1. Septum transversum
2. Pleuroperitoneal membranes
3. Lateral thoracic wall
4. Dorsal mesentery of oesophagus
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Applied Anatomy
1. Hiccough- a)peripheral
b)central
2. Shoulder tip pain
3. Unilateral paralysis of Diaphragm
4. Eventration
5. Diaphragmatic hernia – a) Congenital
b) Acquired
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Congenital Hernia
a) Morgagni hernia or Retrosternal herniab) Bochdalek hernia or Posterolateralc) Central hernia
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e) Congenital hiatal hernia
d) Posterior hernia
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Bochdalek hernia
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Acquired Hernia
a) Traumatic hernia
b) Acquired hiatal hernia
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