Diaphragm

Question 1

The origin of the diaphragm lies?

Answer 1

Two flashy slips from the back of the xiphoid process

Inner surface of lower 6 ribs and costal cartilage

Right and left side of the vertebra:
Middle acruate ligament
Crux
Lateral arcuate ligament

Question 2

The the right crux arises from?

Answer 2

L1-L3

Question 3

The right crux gives rise to which attachment?

Answer 3

Suspensory ligament or ligament of treitz

Question 4

The left crux arises from?

Answer 4

L1-L2

Question 5

The left crux gives attachment to the?

Answer 5

Gastro phrenico ligament

Question 6

The gastrophrenic ligament role is?

Answer 6

It helps anchor the stomach in place, especially the fundus.

Question 7

What are the subdiaphragmatic organs?

Answer 7

Right and left kidney and Supra renal gland
Fundus of the stomach
Spleen
Lobe of the liver

Question 8

The major openings through the diaphragm is?

Answer 8

Esophageal opening
Vena cava opening
Aortic opening

Question 8

The minor openings are

Answer 8

Foramen of morgagni- (Superior epigastric artery and lymph vessels)
Right crux
left crux
Foramen of Morgani
Medial arcuate ligament
Lateral arcuate ligament

Question 9

What are the symptoms of bochdakeks hernia?

Answer 9

Cyanosis
Difficulty breathing
Increased heart rate
One side of the chest becomes larger

Adults on auscultation bowel sounds in chest area

Question 10

The lateral arcuate ligament serves as an attachment point for what nerves or vessels

Answer 10

Subcostal nerves and vessels

Question 11

The right crux also gives rise to which nerve?

Answer 11

Lesser and greater splanchnic nerve

Question 12

The septum transversal gives rise to what part of the diaphragm

Answer 12

Anterio median aspect including the central tendon, esophageal opening, vena caval opening

Question 13

The posterior part (between the esophageal and aortic opening) develops from?

Answer 13

Dorsal mesentery of the esophagus

Question 14

Phrenic nerve of the diaphragm role is to?

Answer 14

It’s the sole motor supply to the diaphragm (left and right halves).
Without it, the diaphragm can’t contract → no proper breathing.

Question 15

The phrenic nerve that supplies the diaphragm is?

Answer 15

C3-C5

Question 16

The right crux is supplied by?

Answer 16

Both phrenic nerves

Question 17

The left crux I supplied by which phrenic nerve

Answer 17

Only the left

Question 18

What often cause diaphragmatic paralysis!

Answer 18

Phrenic nerve injury (e.g. during neck surgery or trauma) can cause diaphragmatic paralysis on that side.

Referred pain: irritation of the diaphragm (e.g. from liver, gallbladder, or spleen) can cause shoulder pain — because C3–C5 dermatomes supply the shoulder area.

Question 19

The sympathetic coelic plexus role is to?

Answer 19

Maintain tone of the diaphragm by lessen g fatigue, this is called the orbeli phenomenon

Question 20

The sympathetic system supports the diaphragm in what ways or way?

Answer 20

Increasing blood flow
Maintaining muscle tone
Reducing fatigue

Question 21

What arteries supply the diaphragm

Answer 21

Musculophrenic and pericardiophrenic arteries

Lower 5-6 intercostal arteries

Inferior phrenic artery

Superior phrenic artery

Question 22

What artery beaches from the 1st branch of the abdominal artery?

Answer 22

Inferior phrenic artery

Question 23

The last branch of the descending thoracic aorta is?

Answer 23

Superior phrenic artery

Question 24

The internal thoracic arteries give rise to!

Answer 24

Musculophrenic and pericadiophrenic arteries

Question 25

During contraction of the diaphragm what happens to the structure passing through the major opening?

Answer 25

Venacaval dilates Esophageal arteries constrict Aortic opening- no change

Question 26

Foramen of Morgagni forms due to?

Answer 26

The sternal slips of the diaphragm fails to arise forming the gap

Question 27

Which dormant of the diaphragm is often the cause of hernia?

Answer 27

Foramen of morgagni

Question 28

The most common organ that may herniate into the foramen of morgagni is?

Answer 28

Colon and omentum

Question 29

If the hernia caused by morgagni foramen is left untreated it can develop into?

Answer 29

Necrotizing enterocolitis and sepsis

Question 30

The hernia is often repaired through?

Answer 30

Laparotomy, thoracotomy and laparoscopy

Question 31

When the diaphragm fails to develop with the lateral arcuate ligament this causes?

Answer 31

Bochdaleks triangle/hernia Often seen on the left side

Question 32

In the case of bochdaleks triangle what often cause the the thorax to herniate?

Answer 32

Positive intra abdominal pressure

Question 33

A bochdaleks hernia appears on X-ray as?

Answer 33

Cyst like structures in the hemithorax As the mediastinum shifted to the right

Question 34

A hiatal hernia is often cause by?

Answer 34

Dialated esophageal opening

Question 35

What are the types of hiatal hernia?

Answer 35

Sliding and rolling type

Question 36

When the gastro esophageal junction goes into the thorax via the esophageal opening is what type of hiatal hernia?

Answer 36

Sliding type

Question 37

Describe the sliding type of hernia?

Answer 37

The gastroesophageal junction projects into the thorax

Question 38

Describe the rolling type of hernia?

Answer 38

The fundus of the stomach projects into the thorax

Question 39

During rolling type of hiatal hernia the patient often complains of?

Answer 39

Nausea, abdominal pain, dysphasia

Question 40

What is the sniff test?

Answer 40

This is the fluroscopic sniff used to evaluate the muscles that control breathing

Question 41

What condition can damage the nervous system and impair the function of the phrenic nerve?

Answer 41

Amyotrophic lateral sclerosis, multiple sclerosis, guillain barre syndrome

Question 42

Agenesis of the diaphragm is?

Answer 42

a congenital diaphragmatic developmental anomaly where all or part of diaphragm fails to form

Question 43

Symptoms of agenesis of diaphragm is?

Answer 43

Increased heart rate, chest pain, difficulty breathing, hiccups Can cause collapsed lung as well as herniation of abdominal contents into the chest

Question 44

The aorta pierces the diaphragm at?

Answer 44

Level T12

Question 45

What is a complication of agenesis of diaphragm?

Answer 45

Cardiopulmonary failure within hours of birth

Question 46

Overstretching is the cervical nerves during birth can cause

Answer 46

Paralysis of diaphragm