Semmelweis University Faculty of Medicine 1st year 2nd semester Department of Anatomy Histology and Embryology Katalin Kocsis 2018030910 Diaphragm thoracic ID: 920836
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Slide1
Structure and development of the diaphragm
Semmelweis University,
Faculty
of
Medicine
1st
year
2nd
semester
Department
of
Anatomy
,
Histology
and
Embryology
Katalin Kocsis
2018.03.09-10.
Slide2Diaphragm (thoracic
)
diaphrassein
=
separate
(
Greek
)
Slide3Slide4Slide5Diaphragm
4-5 mm
thick
striated
muscle
sheet
Separates
thoracic
cavity
from
abdominal
cavity
Most
important
respiratory
muscle
Role
in
abdominal
pressure
Important
structures
pierceing
it
:
Esophagus
Aorta
Inferior
vena
cava
Nerves
Lymph
vessel
Slide65th
rib
upper
edge
5th
intercostal
space
Centrum tendineum
Abdominal
cavity
(Abdomen)
Thoracic cavity (Thorax)
Muscular-tendineous
separating
sheet
between
thoracic
and
abdominal
cavities
Slide7Parts
of
diaphragm
Tendinuous
part: centrum
tendineum
Muscular
part:
sternal
part (
xyphoid proc.)costal part (lower 6 ribs)lumbal partmedial crus(intermediate crus)laterale crus
Slide8Lumbal
part
Medial
crus
:
Right
:
L1-L(3)4 body
Left:
L1-L(2)3 body (median arcuate lig.)Aortic hiatus (L1)Esophageal hiatus (Th11)(Intermediate crus: L2 body)Lateral crus:Medial arcuate lig. - L2 body- L2 Costal proc.
(M. psoas major)Lateral arcuate lig. - L2 Costal proc. - 12th rib (M. quadratus lumborum)
Slide9Lumbal part
Medial crus
Lateral crus
Lateral
and
medial
arcuate
ligaments
Median
arcuate
ligament
Slide10Diaphragm
superior
view
centrum tendineum
inf
.
vena
cava
esophagus
aorta thoracica
costal
part
pericardium
stomach
liver
abdominal
muscles
Slide11centrum tendineum
lumbal
part
sternal
part
costal
part
inf
.
vena
cava
esophagus
aortic
hiatus
esophageal
hiatus
vertebral
column
m. psoas major
m. psoas minor
m. quadratus lumborum
Diaphragm
inferior
view
Slide12Diaphragm
inferior
view
Slide13Openings
Hiatus
of
inferior
vena
cava
Esophageal
hiatus
Aortic
hiatus
Sternocostal
triangle
Lumbocostal triangle
Slide14Structures passing
through
internal
thoracic
a. (
superior
epigastric
a.
)sternocostal triangleinferior vena cava (right phrenic n., pericardiacophrenic a.)inf. v. cava hiatusesophagus
n. vagus(left gastric a. (v.), esoph. branches)esophageal hiatus aortathoracicus ductaortic hiatus v. azygos , v. hemiazygosgreater
splanchnic n.medial crus truncus sympathicuslesser splanchnic n.mediale crus - laterale crus
Slide15internal
thoracic
a., v.
superior
epigastric
a., v.
Sternocostal
triangle
(
Larrey
,
Morgagni
foramen
)Structures passing through
Slide16Structures passing through
Slide1717
Sternum
manubrium
Sternum
body
xyphoid
process
heart
Thoracic
aorta
Abdominal
aorta
Aortic
arch
Structures
passing
through
Slide18Structures passing through
Slide19esophagus
left vagus n.
right vagus nerve
inf. vena cava
Esophageal
hiatus
Aortic
hiatus
Thoracic duct
Cysterna chyli
Descending aorta
Structures
passing
through
Slide20Between medial and lateral crus:
sympathetic trunk and lesser splanchnic nerve
Between
the
fibers
of
medial
crus
:
greater splanchnic nerve and azygos/hemiazygos vein (ascending lumbar veins)
sympathetic
trunk
hemiazygos v.
azygos v.
greater splanchnic n.
Structures
passing
through
Slide21Blood supply, innervation
pericardiacophrenic
a.
musculophrenic
a.
sup
.
phrenic
a.
inf
. phrenic a.
interna thoracica a. (subclavian a.)
thoracic
aorta
abdominal
aorta
Motor innervation: phrenic n. (C3-4-5)
(Cervical pl.)Sensory innervation:phrenic n.: centrum tendineum(diaphragmatica pleura, parietal peritoneum)intercostal nerves (7-12):muscular part
Blood
supply
Slide22Slide23http://
www.flspinalcord.us
/
innervation-of-diaphragm
/innervation-of-diaphragm-studydroid-flashcards-on-the-web-and-in-your-hand/
Slide24Blood supply
From internal thoracic artery:
-pericardicophrenic artery
-musculophrenic artery
From descending aorta:
-superior phrenic artery
-inferior phrenic artery
Slide25pleura
serous
pericardium
peritoneum
fibrous pericardium
diaphragm
Serous
membranes
on
the
diaphragm
Slide26Slide27Normal inspiration
Paralysis of right phrenic nerve
Paralysis of the phrenic nerve – paradox movement of diaphragm
Slide28Slide29Development
of
diaphragm
Slide30Slide31Development
of
diaphragm
develops
from
4
parts
:
Septum
transversum (C3-C5 cervical somites)2. Dorsalis mesentery of esophagus3. Pleuroperitoneal membrane
4. Lateral body wall
Septum
transversum
Szív
Szív
Máj
Slide325th
week
4th
week
Development
of
diaphragm
Slide33Development
of
diaphragm
Slide34Development
of
diaphragm
Slide35Development
of
diaphragm
Slide36D
iaphragmatic
hernia
Slide37congenital
(
CDH
)
aquired
(
hiatushernia
)
D
iaphragmatic
hernia
Slide38References