DIAPHRAGM

Dr Nto, Nto Johnson

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DIAPHRAGM

29/11/2023
 Introduction
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 The word diaphragm is derived from

the Greek word ‘diáphragma’, meaning
partition
 It is a double-doomed,
musculotendinous partition
 Separating the thoracic and abdominal
cavities
 It is the chief muscle of inspiration

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 DIAPHRAGM
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LOCATION
 It is located at the inferior-most aspect
of the ribcage
 Fills the inferior thoracic aperture.
 It acts as the floor of the thoracic
cavity and the roof of the abdominal
cavity.

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 DIAPHRAGM
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SURFACES
 Superior Surface – convex, faces the
thoracic cavity
 Inferior surface – Concave faces the
abdominal cavity
DOMES
 The diaphragm curves superiorly into
 Right dome
 Left dome
 The right dome is higher than the left
 During Expiration the right reaches the 5th rib 29/11/2023

and the left ascends to the 5th intercostal space

 DIAPHRAGM
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PARTS
 Central Aponeurotic Part – the pericardium
lies on it.
 Muscular Part – it pheripheral and its fibres
MUSCULAR
converge ORIGIN
on the central tendon
 Divided into three parts
 Sternal Part – two muscular slips attached to the
posterior aspect of xiphoid process
 Costal part – wide muscular slips attached to the
internal surfaces of 7-10coastal cartilages and
their adjoining ribs and 11-12 ribs
 Lumbar part – 1. Two aponeurotic arches, the
medial and lateral arcuate lgaments. 2. The
29/11/2023
lumbar part forms the right and left muscular crura
that ascends to the central tendon
 DIAPHRAGM
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THE CRURA OF THE
DIAPHRAGM
 A musculotendinous bundles that arise from
the anterior surfaces of the bodies of L1- 3, the
anterior longitudinal ligament and
intervertebral disc
 The right crus is larger and longer than the
left
 The right crus arise L1- 3 vertebrae
 The left crus arise L1- 2 vertebrae
 The median arcuate ligament unites the crura
as they arch to form the aortic aperture
 The oesophageal hiatus is a formation of the 29/11/2023

right crus
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 DIAPHRAGM
9 DIAPHRAGMATIC APERTURES
 Caval Opening – T8
 Inferior vena cava
 Terminal branches of right phrenic nerve
 Oesophageal Opening – T10
 Oesophagus
 Right and left vagus nerves
 Oesophageal branches of left gastric artery/vein
 Aortic Opening – T12
 Aorta
 Thoracic duct
 Azygous vein
 A tip for remembering the vertebral levels: vena cava has
eight letters (T8), oesophagus has ten letters (T10), and aortic 29/11/2023

hiatus has twelve letters (T12).

 DIAPHRAGM
10 NERVES
 Motor supply to the diaphragm is from
the right and left phrenic nerves (C3-5)
 Sensory innervation (pain and
propioception) to the diaphragm from
phrenic nerve, intercostal nerves (7-12
nerves) and subcostal nerves

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 DIAPHRAGM
11 BLOOD
SUPPLY
 The superior surface of the diaphragm is
supplied by branches of the internal
thoracic artery
 Pericardiophrenic artery
 Musculophrenic artery
 The inferior surface of the diaphragm is
supplied by the inferior phrenic arteries
 Venous drainage through accompaning
veins to these arteries
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 DIAPHRAGM
12 LYMPHATIC DRAINAGE
 The superior surface of the diaphragm is
drained by
 Anterior diphragmatic lymph nodes
 Posterior diphragmatic lymph nodes
 The inferior surface of the diaphragm is
drained by
 Anterior diphragmatic lymph nodes
 Phrenic lymph nodes
 Superior lumbar (caval/aortic) lymph 29/11/2023

nodes
 13 Action
 The diaphragm is primarily a muscle of
respiration
 During inspiration it contracts flattens
 Increasing the vertical diameter of the thoracic
cavity
 This produces lung expansion and air is drawn
in
 During expiration, the diaphragm passively
relaxes and returns to its original shape
 This reduces the volume of the thoracic cavity
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 Applied Anatomy
14 Diaphragmatic Paralysis
 Results from interruption in nerve
supply
 Injury to phrenic nerve, cervical
spinal cord or brain stem.
 Mechanical trauma - Ligation or damage
to nerve during surgery
 Compression due to tumour in the
thoracic cavity
 Myopathies –Myasthenia gravis
 Neuropathies – diabethic neuropathy 29/11/2023
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Thank you for your attention

29/11/2023