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ABDOMINO-THORACIC DIAPHRAGM

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ABDOMINO-THORACIC DIAPHRAGM

ABDOMINO-THORACIC DIAPHRAGM It dome shaped musculo aponeurotic partition intervenes between thorax and abdomen

Roof of abdomen

Thoracic surface is convex on rt and lt side and centrally depressed

Cupola OriginInsertionOpeningsAction Nerve supplyBlood supply Applied anatomy

Origin

Sternal

Costal

Vertebral

Sternal

By two fleshy slips from back of xiphoid process

Costal Inner surfaces of lower 6 ribs and their costal cartilages interdigitating with transverse abdominis

Vertebral Right crus & lt crus

Rt & lt medial arcuate lig

Rt & lt lateral arcuate lig

Right crus

Left crus

Rt and lt medial arcuate ligament

Rt and lt lateral arcuate lig

Insertion

Openings in the diaphragmMajor openings

Minor openings Major openings

Vena caval opening

Esophageal opening

Aortic opening Vena caval opening

Situation

Shape

Structures passing

Effect of contraction

Level-T8, quadrilateral in shape

Structures IVC

Rt phrenic nerve

Lymphatics of liver

Effect of contractionVena caval opening dilates when diaphragm contracts during inspiration

Esophageal opening Situation, Shape & formation

Vertebral level

Structures OesophagusAnterior & posterior vagal trunksEsophageal branches of lt gastric arteryEsophageal tributaries of lt gastric veins Lymphatics of liverPhrenoesophageal ligEffect of contraction

Aortic opening

Vertebral level

Shape and boundaries

Median arcuate ligstructuresAorta

Thoracic duct

Azygos vein

Minor openings Space of Larrey- triangular gap b/w sternal origin and 7th costal cartilage superior epigastirc Ab/w digitations of costal origin of diaphragm and transversus abdominis lower 5 intercostal vessels & nervesBehind the lateral arcuate lig subcostal vessels and nervesBehind medial arcuate lig sympathetic trunk

Space of Larrey

b/w digitation

Behind medial arcuate lig

Behind Lateral arcuate lig

Action On thoracic cavity

On abdominal cavity

On the openingsNerve supply Motor phrenic nerve (C3,4,5)Sensory central part by phrenic nerve and peripheral part by lower 6 intercostal nerves

Blood supply Superior phrenic Ainferior phrenic AMusculo phrenic Pericardio phrenic Lower 5 posterior intercostal a

Applied anatomy Foramen of Morgagni

Bochdaleks hernia when diaphragm fails to arise from lateral arcute lig

Hiatal hernia

Hiatus hernia


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