Diaphragm

   

Origins

(A ) Three distinct origins – lumbar, costal and sternal

 

Lumbar Attachments Coastal Attachments Sternal Attachments Central Attachment
  • Bodies of L1-L3 : Crura
  • Median arcuate ligament opposite the discs T12 & L1 infront of aorta.

  •  Medial and lateral arcuate  ligaments:  Fascial thickenings over the upper parts of the psoas major and quadratus lamborum respectively.
  • Lower six costal cartilages, interdigitating with transversuss abdominis.
  • Back of the xiphoid process.
  • Lower surface of the fibrous pericardium.
 

 
Orifices related to the diaphragm

 
 
Hiatus
Vertebral Level
Contents

Aortic hiatus (1) 		T12.

(+) Aorta
(+) Thoracic duct
(+) Azygous vein
(+) Two intercostal lymph trunks.

Oesophageal hiatus (2)


T10
(+) Esophagus
(+) Anterior and posterior vagal trunks
(+) Esophageal branches of the left gastric  ,,,,,vessels.
Foramen for the inferior vena cava (3)

T8
(+) Inferior vena cava
(+) Branches of the right phrenic nerve
(+) Few lymphatics from the liver to the ,,,,,mediastinal nodes.
 

 
Posterior abdominal wall and diaphragm