The Diaphragm

Dr. Hamd Syed,

Asst. Prof.
Anatomy Dept.
CIMS Multan
Learning Objectives

At the end of this session , students should

be able to

 Describe the location, origin, insertion,

innervation and blood supply of the
diaphragm
 Identify the openings in the diaphragm and
structures that pass through these openings
 Enumerate and explain the functions of the
diaphragm

 Correlate
the functional anatomy of the
diaphragm with congenital and acquired
hernias
What is the Diaphragm?

Dia=“ through”
Phragm=“fence”
 The curved musculofibrous sheet that
separates the thoracic from the abdominal
cavity.
 pierced by structures that pass between
these two regions of the body.
 primary muscle of respiration.
 dome shaped and consists of a peripheral
muscular part and central tendinous part.
Location

 The levels of the diaphragm vary with:-

1. The phase of respiration
2. The posture
3. The degree of distension of the abdominal
viscera
 Thedomes support the right and left lungs
whereas the central tendon supports the
heart
Origin of the diaphragm
 sternal part- arising from the posterior
surface of the xiphoid process.

 costal part arising from the deep

surfaces of the lower six ribs and their
costal cartilages & forms the right & left
domes.
 vertebral/lumbar part arising from the
lumbar vertebrae; forms the right & left
crura & the arcuate ligaments.

 Crura:The right crus is from the bodies of

first three lumbar vertebrae. The left crus,
from the bodies of first two lumbar
vertebrae.
 Arcuate ligaments:Lateral to the crura
on both sides.

 Medial arcuate ligament is thickened

upper margin of fascia that covers the
psoas muscle.
 Lateral arcuate ligament is thickened
upper margin of the fascia covering the
quadratus lumborum muscle.
Insertion of the Diaphragm

 The diaphragm is inserted into the

central tendon that is trifoliate (like three
leaves)

 On the superior side, the surface of

the tendon is partially fused with the
pericardium.
 Some of the muscle fibers of the right crus
pass up to the left and surround the
esophageal orifice in a sling-like loop.

 These fibers have a sphincteric action

Openings in the Diaphragm

Major Openings

From below upwards;

1. Aortic opening
2. Esophageal opening
3. Caval opening
Nerve Supply of Diaphragm

 Motor – phrenic nerve (C3,4,5)

 Sensory-
1. Central part – phrenic nerve
2. Peripheral part- lower six thoracic (intercostal)
nerves
Blood Supply of Diaphragm

 Right and left inferior phrenic arteries from

abdominal aorta
 Lower six intercostal arteries
Actions of Diaphragm

 Muscle of inspirationSlide 26
 Muscle of abdominal straining
 Weight-lifting muscle
 Thoracoabdominal pump
Diaphragmatic Hernias
 Reflective Exercise

“In a fixed mindset, students believe that their

basic abilities, their intelligence, their talents
are just fixed traits”