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Diaphragm Origin Insertion Nerve supply Actions of the diaphragm
Citation preview
DIAPHRAGM
MARYAM JAMILAH BINTI ABDUL HAMID082013100002IMS BANGALORE
LEARNING OUTCOME
Student should be able to
understand:-
Origin
Insertion
Nerve supply
Actions of the diaphragm
ANATOMY OF THE DIAPHRAGM
ORIGIN
Grouped into 3 parts Sternal part Costal part Lumbar part
Medial lumbocostal arch Lateral lumbocostal arch Right crus Left crus
Sternal part
Arises by 2 fleshy slips from the back
of the
xiphoid process.
Costal part
Arises from inner surfaces of the
cartilages
Adjacent parts of the lower 6th ribs
on each side
Interdigitating with transversus
abdominis
Lumbar part:-
a) 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
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 12th
rib
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.
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.
NERVE SUPPLY
Motor
Phrenic nerves
Sensory
Phrenic nerves; central part of diaphragm
Lower six thoracic nerves; peripheral part
of the diaphragm
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)
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 upwards
Standing, muscle in abdominal wall contract
CLINICAL IMPORTANCE
Lumbocostal triangle or Bochdalek's
foramen
Diaphragmatic hernia
Diaphragmatic paralysis
Congenital eventration of diaphragm
Hiccup
CONCLUSION
Why diaphragm is important to
us?
Main muscle in respiration
(75% in normal inspiration); by contracting
Separating thorax and abdomen
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
THANKYOU