{"id":1616,"date":"2020-08-14T11:27:47","date_gmt":"2020-08-14T11:27:47","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/"},"modified":"2021-01-22T16:45:34","modified_gmt":"2021-01-22T15:45:34","slug":"diaphragm","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/","title":{"rendered":"Diaphragm"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><div class=\"intro\">The diaphragm is a double-domed musculotendinous partition dividing the body cavity to the abdominal and thoracic cavities and serves as the chief respiratory muscle.<\/div><\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<figure class=\"wp-block-image\" id=\"attachment_17037\"><a href=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/diaphragm.png\" target=\"_blank\" title=\"Diaphragm\"><img decoding=\"async\" src=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/diaphragm-600x439.png\" alt=\"\" class=\"wp-image-17037\"\/><\/a><figcaption><strong>Diaphragm<\/strong>&nbsp;(Credit: OpenStax,&nbsp;<a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Location<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">The diaphragm reaches the 5th rib on the right side and 5th IC space on the left.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Divisions<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">The diaphragm consists of 3 parts:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>Sternal part<\/li><li>Costal part<\/li><li>Lumbar part<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">These three parts converge as a trifoliate (\u201cthree-leaves shaped\u201d) at the central tendon, which is fixed to the pericardium.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Lumbar part<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<ul class=\"wp-block-list\"><li>Arises from&nbsp;<strong>medial<\/strong>&nbsp;and&nbsp;<strong>lateral lumbocostal arches<\/strong>&nbsp;(also known as the&nbsp;<strong>arcuate ligaments<\/strong>)<ul><li>The arches attach to the fascia of the<strong>&nbsp;psoas major<\/strong>&nbsp;and&nbsp;<strong>quadratos lumbarum<\/strong>&nbsp;respectively (medial arch \u2014 psoas major, lateral arch \u2014 quadratos lumarum)<\/li><\/ul><\/li><li>Additionally, there are two muscular slips which attach to the vertebral bodies: the&nbsp;<strong>right<\/strong>&nbsp;and&nbsp;<strong>left crura<\/strong><ul><li>They attach to the 3 superior and 2 superior lumbar vertebrae, respectively) with a&nbsp;<strong>median arcuate ligament<\/strong>&nbsp;in between<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Costal part<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">Arises from the inferior six costal cartilages.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Sternal part<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">Arises from the posterior sternum and xiphoid process, via phrenicosternal ligaments.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Openings<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Caval hiatus<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<p class=\"wp-block-paragraph\">Formed at the right to the central tendon, at T8-T9. Inferior vena cava passes through it, along with the phrenic nerves.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_8\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Esophageal hiatus<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_8\">\n\n\n<p class=\"wp-block-paragraph\">Formed by the right crus, located at T10.<br>The esophagus passes through it, along with the vagal trunks and esophageal branches of the left gastric vein.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">As it passes through the right crus, the esophagus is being covered by a connective tissue sheath which blends with the fascia of the diaphragm \u2014 the&nbsp;<strong>phrenoesophageal ligament<\/strong>, with the&nbsp;<strong>subhiatal fat ring<\/strong>&nbsp;embedded within it.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/10\/Phrenoesophageal_ligament.jpg\" target=\"_blank\" title=\"Diaphragm\"><img decoding=\"async\" src=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/10\/Phrenoesophageal_ligament.jpg\" alt=\"\" class=\"wp-image-7209\"\/><\/a><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Phrenoesophageal ligament<\/strong>&nbsp;\u2014&nbsp;Copyright \u00a9 2008 Elsevier Inc. \u2014&nbsp;<a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA 4.0<\/a><\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_9\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Aortic hiatus<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_9\">\n\n\n<p class=\"wp-block-paragraph\">Formed by both crura. Located at T12. Descending aorta passes through it, along with the azygos system and thoracic duct.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_10\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Small openings<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_10\">\n\n\n<p class=\"wp-block-paragraph\">The sternocostal opening passing the inferior epigastric vessels, and small openings for the splanchnic sympathetic nerves.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_11\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Neurovasculature<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_11\">\n\n\n<p class=\"wp-block-paragraph\">The diaphragm is divided into the superior and inferior diaphragm; the neurovasculature depends on the surface.<\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table class=\"pure-table\"><tbody><tr><td><strong>Blood supply<\/strong><\/td><td>Superior diaphragm: The phrenic branch of the internal thoracic artery via&nbsp;pericardiophrenic&nbsp;and&nbsp;musculophrenic arteries, and phrenic branches of the aorta<br>Inferior diaphragm: The&nbsp;inferior phrenic artery&nbsp;from the abdominal aorta<\/td><\/tr><tr><td><strong>Venous drainage<\/strong><\/td><td>The brachiocephalic veins<br>Azygos-hemiazygos veins<br>Inferior phrenic veins<strong>&nbsp;<\/strong>(right side \u2014 directly into the IVC, left side \u2014 to the left suprarenal vein, and then the left renal vein)<\/td><\/tr><tr><td><strong>Innervation<\/strong><\/td><td>Phrenic nerve (C3,&nbsp;C4, C5)<\/td><\/tr><tr><td><strong>Lymphatic drainage<\/strong><\/td><td>The superior and inferior diaphragmatic surfaces communicate with each other via anterior and posterior diaphragmatic lymph nodes.<br>Superior diaphragm: Drains to the parasternal, posterior mediastinal, and phrenic lymph nodes.<br>Inferior diaphragm: Drains to right (caval) and left (aortic) lumbar lymph nodes<\/td><\/tr><\/tbody><\/table><figcaption><strong>Table 1. Neurovasculature of the diaphragm<\/strong><\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_12\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Innervation<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_12\">\n\n\n<p class=\"wp-block-paragraph\">The large, central part of the diaphragm is innervated by the phrenic nerves (C3-C5, mainly C4), while the peripheral parts are by the thoracoabdominal nerves. Each phrenic nerve innervates its own side of the diaphragm \u2014 therefore, even in case of damage to one of the nerves, the diaphragm will still contract, but in the unaffected side only.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pain in the central part is not well localized and radiates to the shoulder dermatome (due to the same roots \u2014 C3-C5).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Remember \u2014 C3,4,5 keeps the diaphragm alive!<\/em><\/p>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Location<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Divisions<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Lumbar part<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Costal part<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Sternal part<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Openings<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Caval hiatus<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Esophageal hiatus<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Aortic hiatus<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Small openings<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Neurovasculature<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Innervation<\/h4><\/div>","protected":false},"excerpt":{"rendered":"<p>Location The diaphragm reaches the 5th rib on the right side and 5th IC space on the left. Divisions The diaphragm consists of 3 parts: Sternal part Costal part Lumbar part These three parts converge as a trifoliate (\u201cthree-leaves shaped\u201d) at the central tendon, which is fixed to the pericardium. Lumbar part Arises from&nbsp;medial&nbsp;and&nbsp;lateral lumbocostal [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1615,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1616","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Diaphragm &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/musculoskeletal-system\\\/diaphragm\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/musculoskeletal-system\\\/diaphragm\\\/\",\"name\":\"Diaphragm &#8211; Meddists\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/musculoskeletal-system\\\/diaphragm\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/musculoskeletal-system\\\/diaphragm\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/meddists.com\\\/wp-content\\\/uploads\\\/2018\\\/08\\\/diaphragm-600x439.png\",\"datePublished\":\"2020-08-14T11:27:47+00:00\",\"dateModified\":\"2021-01-22T15:45:34+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/musculoskeletal-system\\\/diaphragm\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/musculoskeletal-system\\\/diaphragm\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/musculoskeletal-system\\\/diaphragm\\\/#primaryimage\",\"url\":\"https:\\\/\\\/meddists.com\\\/wp-content\\\/uploads\\\/2018\\\/08\\\/diaphragm-600x439.png\",\"contentUrl\":\"https:\\\/\\\/meddists.com\\\/wp-content\\\/uploads\\\/2018\\\/08\\\/diaphragm-600x439.png\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/musculoskeletal-system\\\/diaphragm\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\\\/\\\/meddists.com\\\/learn\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Pre-clinical\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Anatomy\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Abdomen and pelvis\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Musculoskeletal system\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/musculoskeletal-system\\\/\"},{\"@type\":\"ListItem\",\"position\":6,\"name\":\"Diaphragm\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/#website\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/\",\"name\":\"Meddists\",\"description\":\"Let&#039;s Get Studying\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/meddists.com\\\/learn\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Diaphragm &#8211; Meddists","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/","twitter_misc":{"Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/","url":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/","name":"Diaphragm &#8211; Meddists","isPartOf":{"@id":"https:\/\/meddists.com\/learn\/#website"},"primaryImageOfPage":{"@id":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/#primaryimage"},"image":{"@id":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/#primaryimage"},"thumbnailUrl":"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/diaphragm-600x439.png","datePublished":"2020-08-14T11:27:47+00:00","dateModified":"2021-01-22T15:45:34+00:00","breadcrumb":{"@id":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/#primaryimage","url":"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/diaphragm-600x439.png","contentUrl":"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/diaphragm-600x439.png"},{"@type":"BreadcrumbList","@id":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/diaphragm\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/meddists.com\/learn\/"},{"@type":"ListItem","position":2,"name":"Pre-clinical","item":"https:\/\/meddists.com\/learn\/pre-clinical\/"},{"@type":"ListItem","position":3,"name":"Anatomy","item":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/"},{"@type":"ListItem","position":4,"name":"Abdomen and pelvis","item":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/"},{"@type":"ListItem","position":5,"name":"Musculoskeletal system","item":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/musculoskeletal-system\/"},{"@type":"ListItem","position":6,"name":"Diaphragm"}]},{"@type":"WebSite","@id":"https:\/\/meddists.com\/learn\/#website","url":"https:\/\/meddists.com\/learn\/","name":"Meddists","description":"Let&#039;s Get Studying","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/meddists.com\/learn\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/1616","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/comments?post=1616"}],"version-history":[{"count":5,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/1616\/revisions"}],"predecessor-version":[{"id":4013,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/1616\/revisions\/4013"}],"up":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/1615"}],"wp:attachment":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/media?parent=1616"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}