diaphragm Flashcards

1
Q

where does the diaphragm start its development

A

in the neck from the septum transversum

it picks up the phrenic nerve here

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2
Q

what is the nerve supply of the diaphragm

A

ventral rami C3-5

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3
Q

what are the embryological components of the diaphragm

A

pleuroperitoneal membranes, dorsal mesentery of the oesophagus, body wall ingrowth and the septum transversum

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4
Q

where do the muscle fibres of the diaphragm originate from

A

the xiphoid process

then costal margin, ribs 11 and 12 and then arcuate ligaments

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5
Q

where does the left crus arise from

A

L1 and 2

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6
Q

where is the median arcute ligament

A

midline between the two crura at T12

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7
Q

what does the right crus form

A

some fibres pass vertically and insert on the central tendon
some fibres cross over to the LHS to form a sling around the oesophagus

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8
Q

what passes through the diaphragm at T8

A

right phrenic nerve and IVC

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9
Q

what passes through at T10

A

oesophagus, ant and post vagal trunks and left gastric vein

left gastric artery

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10
Q

what passes through at T12

A

thoracic duct, azygous and hemiazygous

aorta

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11
Q

what passes through the crura

A

greater, lesser and least splanchnics

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12
Q

what passes behind the medial arcuate ligament

A

left and right sympathetic trunks

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13
Q

what forms the oesophageal hiatus

A

mainly the right crus but also the left

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14
Q

what are the symptoms of a rolling hernia

A

no heartburn due to no acid being secreted into the oesophagus and no reflux

dysphagia, early satiety or inability to hold solids

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15
Q

what are the symptoms of a sliding hernia

A

hearburn and dysphagia worse after eating or lying down

acid is secreted into the lower oesophagus

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16
Q

what type of hernia is found in newborns

A

diaphragmatic
usually affects the left side more
cyanosis and respiratory distress

17
Q

why might abdominal disease present as chest pain

A

phrenic nerve supplies the diaphragm and pericardium

blood and pus might collect in the subphrenic space and irritate the diaphragm