Diaphragm Dr. Hassan Shaibah

Diaphragm Function: Primary muscle of respiration Increase vertical diameter of thoracic cavity Increases abdominal pressure )Urinations, defecations & Parturition “Childbirth”) Weight lifting Thoracoabdominal pump ( blood & lymph back to the heart)

2)central tendon part (support heart) Diaphragm features: has: 1)Muscular part 2)central tendon part (support heart)

thorax Diaphragm Separate abdomen

Level may vary according to: respiration Setting vs. standing distention of abdominal viscera)

J From side shape like inverted J

Dome shaped muscle

Right dome higher than left

1)Sternal part “post. Xiphiod process” Has 3 origin: 1)Sternal part “post. Xiphiod process” 2) Costal part lower 6 rips 3)Vertebral part 2 crura and ligaments

Insertion central tendon part

1 2 3 Left crus 1st 2 lumbar Right crus 1st 3 lumbar

Has 3 ligaments 1)Median arcuate ligament ( 2 curua connected) Cross over Aorta

1 2 2) Medial arcuate ligament L2 to TP of L1

1 2 3)Lateral arcuate ligament L1 to TP 12th rib

3 main Openings: Caval Esophageal Aortic

Location of the 3 main Openings I Ate (8) 10 Eggs At Midnight (12)

Structures passing through the openings Aortic T12 Aorta , thoracic duct & Azygos vein Sympathetic trucks pass posterior to Medial arcuate ligament Superior epigastric vessels between sternal and costal part

Caval opening IVC & branch from RT phrenic n

Esophageal opening Esophagus Vagus esophageal branch from left gastric vessels

Aortic opening Aorta thoracic duct Somtime Azygos vein

Nerve supply Motor phrenic nerve (C3-5) Sensory : 1)Central part by phrenic n. 2)Peripheral part lower 6 intercostal nerves