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THORACIC CAVITY

THORACIC CAVITY. RESPIRATORY DIAPHRAGM. Diaphragm. A diaphragm is a muscular sheet with an inferior and a superior fascia: Superior fascia = parietal thoracic fascia. Inferior fascia = transversalis fascia. Separates thorax and abdomen. In moderate expiration:

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THORACIC CAVITY

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  1. THORACIC CAVITY RESPIRATORY DIAPHRAGM

  2. Diaphragm • A diaphragm is a muscular sheet with an inferior and a superior fascia: Superior fascia = parietal thoracic fascia. Inferior fascia = transversalis fascia. • Separates thorax and abdomen. • In moderate expiration: Reaches level of 5th rib on right side and 5th IC space on left.

  3. Diaphragm Origins • Sternal part: Xiphoid process. • Costal part: Lower 6 ribs and cartilages. • Lumbar part: Lumbar vertebrae and crura: Right: L1-L3 Left: L1-L2

  4. Central Tendon • “Y-shaped” • Attaches to lumbar vertebrae via crura. • Pierced by three openings (described later).

  5. Central Tendon • Three parts to central tendon: Right: Largest part. Middle: Left: Smallest part. • Fig. 2.71

  6. Crura • Muscular pillars • Originate from lumbar vertebrae: Right from L3. Left from L2. Right swings left and forms a weak sphincter around the esophagus.

  7. Arcuate Ligaments • Median: Around aortic opening. Bridges proximal ends of crura. • Medial: From deep fascia of psoas major muscle. From transverse process to body of L1. • Lateral: From deep fascia of quadratus lumborum muscle. From transverse process of L1 to rib 12.

  8. Diaphragm Openings • Caval opening: Level T8 Inferior vena cava; right phrenic nerve • Esophageal opening: Level T10 Esophagus; vagus nerves • Aortic opening: Level T12 Aorta; thoracic duct; azygos vein

  9. Diaphragm Innervation • Phrenic Nerve • C3-5

  10. Diaphragm Arterial Supply • Superior aspect: Pericardiacophrenic artery from IT. Musculophrenic artery from IT. Superior phrenic artery from aorta. • Inferior aspect: Inferior phrenic artery from aorta.

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