• thin fibro muscular partition between abdomen … lectures/anatomy/thorax...attachment origin :...
TRANSCRIPT
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DIAPHRAGM• Thin fibro muscular partition between abdomen and
thorax• Important muscle of respiration
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• Extent Normal Breathing Full Expiration
Right At level of 4th Ribnipple
Left One rib lower 5th rib
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FEATURES• Has fibrous central tendon• Depressed in centre• Raised on right and left side as domes or
cupola
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ATTACHMENTOrigin : • Sternal part – Inner surface
of xiphoid• Costal part – Lower 6 costal
cartilages• Vertebral – By
crura -right -left
Arcuate ligame- Medial- Lateral- Median
Insertion:• Central Tendon
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OPENINGS IN DIAPHRAGM•Venacaval – 8th thoracic vertebra
– inf venacava ,
-right phrenic nerve
•Oesophageal – 10th thoracic vertebra
– oesophagus, -right & left vagal trunks,
-oesophageal branches of lt gastric vs
-lymphatics
•Aortic (Aortic hiatus) – 12th thoracic vertebra
–abdominal aorta, -thoracic duct, -azygos vein
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OTHER OPENINGSSuperior epigastric vessels – sternal and costal originSubcostal nerve & vessel – posterior to lateral arcuate ligSympathetic trunk - posterior to medial arcuate lig Splanchnic nerves - pierce cruraLeft phrenic n - pierce left dome
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RELATIONSSUPERIOR• Lung & pleura on dome• Pericardium on central tendonINFERIOR-lined by peritonium• Right – right lobe of liver,
right kidney,right suprarenal
• Left- fundus of stomach,spleenleft kidney,left suprarenal
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Nerve supply
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Blood supply
• Pericardiophrenic• Musculophrenic• Inf phrenic
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ACTION• Increases vertical diameter of thoracic cavity
FUNCTIONS• Muscle of inspiration• Muscle of abdominal straining• Thoracoabdominal pump – forcing blood from
IVC to rt. Atrium• Weight- lifting muscle
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CLINICAL APPLICATIONS
1. Diaphragmatic hernias
• aquired
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• Congenital • Due to defect in development• Bochdalek’s hernia – lumbocostal gap• Reterosternal hernia-through foamen of Morgagni
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2. Paralysis of diaphragm3. Hiccups
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MECHANISM OF RESPIRATION
Increase in• vertical diameter by diaphragmatic contraction• Anteroposterior diameter by pump handle movement of sternum • Transverse diameter by bucket handle movements of lower ribs