diaphragm Flashcards
where does the diaphragm start its development
in the neck from the septum transversum
it picks up the phrenic nerve here
what is the nerve supply of the diaphragm
ventral rami C3-5
what are the embryological components of the diaphragm
pleuroperitoneal membranes, dorsal mesentery of the oesophagus, body wall ingrowth and the septum transversum
where do the muscle fibres of the diaphragm originate from
the xiphoid process
then costal margin, ribs 11 and 12 and then arcuate ligaments
where does the left crus arise from
L1 and 2
where is the median arcute ligament
midline between the two crura at T12
what does the right crus form
some fibres pass vertically and insert on the central tendon
some fibres cross over to the LHS to form a sling around the oesophagus
what passes through the diaphragm at T8
right phrenic nerve and IVC
what passes through at T10
oesophagus, ant and post vagal trunks and left gastric vein
left gastric artery
what passes through at T12
thoracic duct, azygous and hemiazygous
aorta
what passes through the crura
greater, lesser and least splanchnics
what passes behind the medial arcuate ligament
left and right sympathetic trunks
what forms the oesophageal hiatus
mainly the right crus but also the left
what are the symptoms of a rolling hernia
no heartburn due to no acid being secreted into the oesophagus and no reflux
dysphagia, early satiety or inability to hold solids
what are the symptoms of a sliding hernia
hearburn and dysphagia worse after eating or lying down
acid is secreted into the lower oesophagus
