Diaphragm Anatomy

Diaphragm
Origin
Insertion
Nerve supply
Actions of the diaphragm

1. DIAPHRAGM MARYAM JAMILAH BINTI ABDUL HAMID 082013100002 IMS BANGALORE

2. LEARNING OUTCOME Student should be able to understand:- Origin Insertion Nerve supply Actions of the diaphragm

3. ANATOMY OF THE DIAPHRAGM

4. ORIGIN Grouped into 3 parts Sternal part Costal part Lumbar part Medial lumbocostal arch Lateral lumbocostal arch Right crus Left crus

5. Sternal part Arises by 2 fleshy slips from the back of the xiphoid process .

6. Costal part Arises from inner surfaces of the cartilages Adjacent parts of the lower 6 th ribs on each side Interdigitating with transversus abdominis

7. Lumbar part :- Medial lumbocostal arch Tendinous arch in fascia covering psoas major Medially, attach to the side of the body of vertebra L1. Laterally, attach to the front of transverse process of vertebra L1

8. b) Lateral lumbocostal arch Tendinous arch in fascia covering upper part of quadratus lumborum . Medially, attach to front of the transverse process of vertebra L1 Laterally, attach to lower border of 12 th rib

9. c) Right crus Arises from anterolateral surfaces of the bodies of the upper three lumbar vertebrae and the intervening intervertebral disc. d) Left crus Arises from the corresponding parts of the upper two lumbar vertebrae. Medial margin of two crura form tendinous arc across the front of the aorta; median arcuate ligament.

10. INSERTION Insert into central tendon of diaphragm Trilobar in shape ; three leaflets Middle leaflet: Triangular in shape with its apex directed towards xiphoid process Right and left leaflets Tongue shaped, curve laterally and backwards Left is narrower than right Central point: Four well-marked diagonal bands comes out from central point of decussation (intersections); located in front of esophagus opening.

11. NERVE SUPPLY Motor Phrenic nerves Sensory Phrenic nerves ; central part of diaphragm Lower six thoracic nerves ; peripheral part of the diaphragm

12. ACTIONS OF DIAPHRAGM Contraction of diaphragm Flatten the diaphragm Vertical diameter for thorax increase Happens in inspiration Quiet breathing: 1.5 cm Deep breathing: 6 to 10 cm Expulsive act: sneezing, coughing, laughing, crying, vomiting, defecation, parturition, micturation , deep inspiration (closure of glottis & powerful contraction of trunk muscle)

13. Relaxation of diaphragm Concave of the diaphragm Vertical diameter for thorax decrease Main factors affecting position of diaphragm Elastic recoil of lung tissue Lying down, abdominal viscera pushes diaphragm upward s Standing, muscle in abdominal wall contract

14. CLINICAL IMPORTANCE Lumbocostal triangle  or  Bochdalek's foramen Diaphragmatic hernia Diaphragmatic paralysis Congenital eventration of diaphragm Hiccup

15. CONCLUSION Why diaphragm is important to us? Main muscle in respiration (75% in normal inspiration); by contracting Separating thorax and abdomen

16. REFERENCES Chaurasia , B. (2013).  Human anatomy regional and applied dissection and clinical . (6 ed., Vol. 2, pp. 331-335). New Delhi, India: CBS Publishers & Distributors. digitallab3d. ( n.d .).  3d model of human diaphragm . Retrieved from http://www.exchange3d.com/3D-Model-of-Human-Diaphragm/prod_28281.html

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