PAW: Diaphragm Flashcards
Enumerate types of origins of Diaphragm
- Sternal origin
- Costal origin
- Vertebral origin
Explain why diaphragm right copula is higher than left copula
Due to underlying large right lobe of Liver
Describe sternal origin of Diaphragm
at back of Xiphoid process by 2 fleshy slips
Describe costal origin of Diaphragm
at Lower 6 costal cartilages, interdigitating with origin of transversus abdominus
Describe Vertebral Origin of Diaphragm
by 2 crura & 5 Arcuate ligaments
* Right Crus (largest of the 2): attached to bodies of upper 3 lumbar vertebra, it extends upwards to surround eosophagus, thus forming physiological sphincter around Cardiac end of stomach
* Left Crus: attached to upper 2 lumbar vertebrae
* Median Arcuate ligament: extending between both crura & arches over Aorta
* 2 medial Arcute ligaments: extends from on of the crus to tip of transverse process of 1st lumbar vertebrae, and arches over psoas Major
* 2 Lateral Arcute ligaments: extends from TP of 1st LV to Last rib 7 Arches over Quadratus Lumborum
Defects found in origins of Diaphragm are filled with
Loose areolar CT
Enumerate defects found in origins of Diaphragm
- Foramen of Morgagni
- Foramen of Bockdalek (Vertebrocostal triangle)
foramen of Morgagni is located between____, it transmittes ____Vessels, it is site of ____Hernia
- Costal & sternal origins
- Superior epigastric vessels
- Anterior (parasternal) diaphragmatic hernia
foramen of Bockdalek is located between____, it’s site of contact between ____, it is site of ____Hernia, it is ____remnant in fetus
- Costal & Vertebral origins
- Costodiaphragmatic recess of Pleura & Posterior surface of kindey ( with loose areolar CT between them)
- Posterior Diaphragmatic hernia
- Pleuroperitoneal remnant
Describe Insertion of Diaphragm
- No bony insetion
- A central tendon which is a strong Semilunar Aponeurosis
- formed of 1 median folia & 2 lateral Folia (trifolate)
Superior surface of Medina folia (median Lobe) of Central tendon of diaphragm is related to
Pericardium & heart
Describe Nerve supply of Diaphragm
- Motor: Phrenic Nerve
- Sensory: Lower 6 thoracic spinal Nerves (peripheral), Phrenic Nerve (Central)
Action of Diaphragm
- Main muscle for respiration
- Increases Intraabdominal pressure for:
1. Coughing
2. Defecation
3. micturation
4. parturation (labour)
Superior relations of Diaphragm
- Right Copula: to right pleura & lung
- Left Copula: to left pleura & Lung
- Central Part: Heart & pericardium
Inferior Relations of Diaphragm
Right Side:
* Right Kidney
* Liver right Lobe
* Right Suprarenal Gland
Left side:
* Left kidney
* Liver left lobe
* Left suprarenal Gland
* (fundus of )Stomach
* Spleen