Diaphragm Flashcards
What are the three openings of the diaphragm?
Caval opening, esophageal and aortic hiatus
What level is the caval opening and what passes through it?
T8
IVC and right phrenic nerve
What level is the esophageal hiatus and what passes through it?
T10
Esophagus and anterior/posterior vagal trunks
What level is the aortic hiatus and what passes through it?
T12
Aorta, thoracic duct, and sometimes the azygos and hemiazygos veins
Don’t necessarily go through the diaphragm just behind it
What are the three parts of the muscular diaphragm?
Sternal, costal and lumbar (crural) parts
What does the sternal part of the muscular diaphragm attach to?
Xiphoid (may or may not be present)
What does the costal part of the muscular diaphragm attach to?
Inferior 6 costal cartilages
What does the lumbar (crural) part of the muscular diaphragm attach to?
Lumbar vertebral bodies
Describe the right crus of the diaphragm
Larger and longer than left
L1-3/4 vertebral bodies
Some fibers run along left side of aortic hiatus
The left crus spans along which vertebral bodies?
L1-3
Which arteries are on the superior side of the diaphragm?
Musculophrenic and pericardiophrenic A
off internal thoracic A
What arteries are along the inferior side of the diaphragm?
Inferior phrenic A (off abdominal A) + intercostal branches for peripheral diaphragm
Describe a para-esophageal hiatal hernia
Pouch of peritoneum and fundus part of the stomach extends through the esophageal hiatus usually anterior to the esophagus
Gastric regurgitation usually doesnt occur as cardiac portion is normal
Describe a sliding hiatal hernia
Abdominal esophagus, cardiac and part of fundus portion of the stomach extend through esophageal hiatus
Regurgitation of stomach contents possible
Hiatal hernias are thought to be due to what?
Weakening of muscular diaphragm
