Diaphragm Origin Insertion Nerve supply Actions of the diaphragm

1. MARYAM JAMILAH BINTI ABDUL HAMID
082013100002
IMS BANGALORE

2. Student should be able to understand:-
 Origin
 Insertion
 Nerve supply
 Actions of the diaphragm

4. Grouped into 3 parts
 Sternal part
 Costal part
 Lumbar part
 Medial lumbocostal arch
 Lateral lumbocostal arch
 Right crus
 Left crus

5. Sternal part
Arises by 2 fleshy slips from the back of the
xiphoid process.

6. Costal part
 Arises from inner surfaces of the cartilages
 Adjacent parts of the lower 6th ribs on each
side
 Interdigitating with transversus abdominis

7. 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

8. 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

9. 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.

10.  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.

11. Motor
 Phrenic nerves
Sensory
 Phrenic nerves; central part of diaphragm
 Lower six thoracic nerves; peripheral part of the
diaphragm

12. 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)

13. 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

14.  Lumbocostal triangle or Bochdalek's foramen
 Diaphragmatic hernia
 Diaphragmatic paralysis
 Congenital eventration of diaphragm
 Hiccup

15. Why diaphragm is important to us?
 Main muscle in respiration
(75% in normal inspiration); by contracting
 Separating thorax and abdomen

16.  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

17. THANK
YOU