Thoracic Diaphragm And Respiratory Movement Flashcards
The diaphragm is a thin muscular and tendinous septum that separates —- and ——cavities.
The diaphragm is a thin muscular and tendinous septum that separates thorax and abdominal cavities.
The diaphragm is the most important muscle of —-
The diaphragm is the most important muscle of respiration.
It is —— shaped and consists of a —— muscular part, which arises from the margins of the —— opening, and a centrally placed ——.
It is dome shaped and consists of a peripheral muscular part, which arises from the margins of the thoracic opening, and a centrally placed tendon.
Origin of the diaphragm
✔A —— part— arising from the posterior surface of the xiphoid process
✔A ——part— arising from the deep surfaces of the lower six ribs and their costal cartilages & forms the
right and left domes
✔A ——/—— part— arising from upper three lumbar vertebrae; forms the right & left crura and the arcuate ligaments
Origin of the diaphragm
✔A sternal part— arising from the posterior surface of the xiphoid process
✔A costal part— arising from the deep surfaces of the lower six ribs and their costal cartilages & forms the
right and left domes
✔A vertebral/lumbar part— arising from upper
three lumbar vertebrae; forms the right & left crura and the arcuate ligaments
Insertion of the Diaphragm
The diaphragm is inserted into a ——
The superior surface of the tendon is partially fused with the inferior surface of the ———.
Some of the muscle fibers of the right crus pass up to the left and surround the ——orifice in a slinglike loop.
These fibers appear to act as a —— and possibly assist in the prevention of regurgitation of the stomach contents into the thoracic part of the esophagus.
Insertion of the Diaphragm
The diaphragm is inserted into a central tendon.
The superior surface of the tendon is partially fused with the inferior surface of the fibrous pericardium.
Some of the muscle fibers of the right crus pass up to the left and surround the esophageal orifice in a slinglike loop.
These fibers appear to act as a sphincter and possibly assist in the prevention of regurgitation of the stomach contents into the thoracic part of the esophagus.
Crura & Arcuate Ligaments
The right crus arises from the sides of the bodies of the L —to—& IV discs; the left crus arises from the sides of the bodies of the L — to — & IV disc.
Lateral to the crura the diaphragm arises from the —— & —— arcuate ligament.
The medial arcuate ligament extends from the side of the body of the ——lumbar vertebra to the tip of the transverse process of the ——lumbar vertebra.
The lateral arcuate ligament extends from the tip of the transverse process of the —— lumbar vertebra to the lower border of the —rib.
The medial borders of the two crura are connected by a —— arcuate ligament which crosses over the anterior surface of the aorta
Crura & Arcuate Ligaments
The right crus arises from the sides of the bodies of the L 1-3 & IV discs; the left crus arises from the sides of the bodies of the L 1-2 & IV disc.
Lateral to the crura the diaphragm arises from the medial & lateral arcuate ligament.
The medial arcuate ligament extends from the side of the body of the second lumbar vertebra to the tip of the transverse process of the first lumbar vertebra.
The lateral arcuate ligament extends from the tip of the transverse process of the first lumbar vertebra to the lower border of the 12th rib.
The medial borders of the two crura are connected by a median arcuate ligament which crosses over the anterior surface of the aorta
Functions of the Diaphragm
Muscle of inspiration: On contraction the
diaphragm pulls its central tendon ——and increases the ———of the thorax. The diaphragm is the most important muscle used in ——.
Muscle of abdominal straining: The
contraction of the diaphragm assists the contraction of the muscles of the anterior abdominal wall in raising the ——— pressure for micturition, defecation, and parturition.
Weight lifting muscle: In a person taking a deep breath and
holding it (fixing the diaphragm), the diaphragm assists the muscles of the anterior abdominal wall in raising the intra-abdominal pressure. Before doing this make sure that a person have adequate sphincteric control of the bladder and anal canal under these circumstances.
Thoracoaabdominal pump: The descent of the diaphragm
decreases the ——— pressure & increases the ———pressure. This compresses the blood in the inferior vena cava and forces it upward into the right atrium of the heart. Within the abdominal lymph vessels is also compressed, and its passage upward within the thoracic duct is aided by the —— pressure. The presence of valves within the thoracic duct prevents backflow.
Functions of the Diaphragm
Muscle of inspiration: On contraction the
diaphragm pulls its central tendon down and increases the vertical diameter of the thorax. The diaphragm is the most important muscle used in inspiration.
Muscle of abdominal straining: The
contraction of the diaphragm assists the contraction of the muscles of the anterior abdominal wall in raising the intra-abdominal pressure for micturition, defecation, and parturition.
Weight lifting muscle: In a person taking a deep breath and
holding it (fixing the diaphragm), the diaphragm assists the muscles of the anterior abdominal wall in raising the intra-abdominal pressure. Before doing this make sure that a person have adequate sphincteric control of the bladder and anal canal under these circumstances.
Thoracoaabdominal pump: The descent of the diaphragm
decreases the intrathoracic pressure & increases the intra-abdominal pressure. This compresses the blood in the inferior vena cava and forces it upward into the right atrium of the heart. Within the abdominal lymph vessels is also compressed, and its passage upward within the thoracic duct is aided by the negative intrathoracic pressure. The presence of valves within the thoracic duct prevents backflow.
3 main opeinings
The caval opening:lies at the level of
the T— vertebra in the ——. Consists:————.
The esophageal opening: lies at the
level of the T—vertebra in a sling of muscle fibers derived from the —-crus at the —- of median plane. Consists:———-.
The aortic opening: lies anterior to
the body of the T— vertebra between
the crura. Consists: ——-
3 main opeinings
The caval opening lies at the level of
the T 8 vertebra in the central tendon.
Inferior vena cava & branches of the right phrenic nerve.
The esophageal opening lies at the
level of the T 10 vertebra in a sling of muscle fibers derived from the right crus at the left of median plane.
Esophagus, the right and left vagus nerves, the esophageal branches of the left gastric vessels, & the lymph vessels.
The aortic opening lies anterior to
the body of the T 12 vertebra between
the crura.
Aorta, thoracic duct, & azygos vein.
Nerve Supply of the Diaphragm
Motor nerve supply: ———
Sensory nerve supply:
The parietal pleura and peritoneum covering the central surfaces of the diaphragm are from the ——nerve and the periphery of the diaphragm is from the ——— nerves.
Nerve Supply of the Diaphragm
Motor nerve supply:
The right and left phrenic nerves (C3, 4, 5)
Sensory nerve supply:
The parietal pleura and peritoneum covering the central surfaces of the diaphragm are from the phrenic nerve and the periphery of the diaphragm is from the lower six intercostal nerves.
Hiccup
Hiccup is the ———of the diaphragm accompanied by the approximation of the —— and closure of the —— of the larynx. It is a common condition in normal individuals and occurs after eating or drinking as a result of gastric irritation of the ——nerve endings. It may, however, be a symptom of disease such as ——, ——, ——, or ——
Hiccup
Hiccup is the involuntary spasmodic contraction of the diaphragm accompanied by the approximation of the vocal folds and closure of the glottis of the larynx. It is a common condition in normal individuals and occurs after eating or drinking as a result of gastric irritation of the vagus nerve endings. It may, however, be a symptom of disease such as pleurisy, peritonitis, pericarditis, or uremia.
Paralysis of the Diaphragm
A single dome of the diaphragm may be paralyzed by crushing or sectioning of the ——nerve in the neck.
Occasionally, the contribution from the fifth cervical spinal nerve joins the phrenic nerve late as a branch from the nerve to the subclavius muscle. This is known as the —— phrenic nerve. To obtain complete paralysis under these circumstances, the nerve to the subclavius muscle must also be sectioned.
Paralysis of the Diaphragm
A single dome of the diaphragm may be paralyzed by crushing or sectioning of the phrenic nerve in the neck.
Occasionally, the contribution from the fifth cervical spinal nerve joins the phrenic nerve late as a branch from the nerve to the subclavius muscle. This is known as the accessory phrenic nerve. To obtain complete paralysis under these circumstances, the nerve to the subclavius muscle must also be sectioned.
Penetrating Injuries of the Diaphragm
Any penetrating wound to the chest below the level of the nipples should be suspected of causing damage to the diaphragm until proved otherwise. The arching domes of the diaphragm can reach the level of the —— rib (the right dome can reach a higher level).
Penetrating Injuries of the Diaphragm
Any penetrating wound to the chest below the level of the nipples should be suspected of causing damage to the diaphragm until proved otherwise. The arching domes of the diaphragm can reach the level of the fifth rib (the right dome can reach a higher level).
Respiratory consisted of 2 phases:
Inspiration
Expiration
The respiratory rate varies between—- and —- per minute in normal resting patients and is —— in children and —— in the elderly
16 to 20
Faster
Slower
Quiet Inspiration
In quiet inspiration the three diameters of the thoracic cavity will be increased:
• The —— diameter.
• The —— diameter
• The ——diameter
Quiet Inspiration
In quiet inspiration the three diameters of the thoracic cavity will be increased:
• The vertical diameter.
• The anteraposterior diameter
• The transverse diameter
