DR. HASSAN SHAIBAH

Diaphragm

Diaphragm Function:

Primary muscle of respiration

Increase vertical diameter of thoracic cavity

Increases abdominal pressure )Urinations, defecations & Parturition “Childbirth”)

Weight lifting

Thoracoabdominal pump ( blood & lymph back to the heart)

Diaphragm features:

has:

1)Muscular part

2)central tendon part

(support heart)

DiaphragmSeparate

thora

xabdom

en

Level may vary according to:

• respiration• Setting vs. standing• distention of abdominal

viscera)

JFrom side shape like inverted J

Dome shaped muscle

Right dome higher than left

1)Sternal part

“post. Xiphiod process”

2) Costal part lower 6 rips

3)Vertebral part2 crura and ligaments

Has 3 origin:

central tendon part

Insertion

Right crus1st 3 lumbar

1

2

3Left crus1st 2 lumbar

Has 3 ligaments

1)Median arcuate ligament ( 2 curua connected) Cross over Aorta

1

2

2) Medial arcuate ligament L2 to TP of L1

1

2

3)Lateral arcuate ligament L1 to TP 12th rib

3 main Openings:

Caval

Esophageal

Aortic

Location of the 3 main Openings

I Ate (8) 10 Eggs At Midnight (12)

Structures passing through the openings

Aortic T12 Aorta , thoracic duct & Azygos vein

Sympathetic trucks pass posterior to Medial arcuate ligament

Superior epigastric vessels between sternal and costal part

Caval opening

IVC & branch from RT phrenic n

Esophageal opening

• Esophagus

• Vagus• esophage

al branch from left gastric vessels

Aortic opening

• Aorta• thoracic

duct • Somtime

Azygos vein

Nerve supply

Motor phrenic nerve (C3-5)

Sensory :1)Central part by phrenic n.

2)Peripheral part lower 6 intercostal nerves