Recommended
More Related Content
What's hot
What's hot (20)
Similar to Diaphragm and Adrenal Glands: Structure, Function and Clinical Significance
Similar to Diaphragm and Adrenal Glands: Structure, Function and Clinical Significance (20)
More from anatomysrs
More from anatomysrs (20)
Recently uploaded
Recently uploaded (20)
Diaphragm and Adrenal Glands: Structure, Function and Clinical Significance
- 2. Diaphragm • Separates • Thoracic & abdominal cavity • Principle muscle of respiration • Peripheral muscular part • Central fibrous part • Central tendon Diaphragm Thorax Abdomen
- 3. Muscles forming posterior abdominal wall • Psoas major • Quadratus lumborum • Iliacus
- 4. Psoas major • Occupies in 3 regions • Abdomen, false pelvis & upper thigh • Origin • T12 lower border to L5 (upper border) • Discs above 5 lumbar vertebrae • Adjoining parts of vertebral bodies • 4 fibrous arches across the sides of upper 4 lumbar vertebrae • Insertion • Lesser trochanter • As Iliopsoas tendon
- 5. Psoas fascia • Covers psoas muscle • Attachments • Superiorly • Thickened and forms medial arcuate ligament (body of L1 to tip of L1 transverse process) • Laterally • Fused with anterior layer of thoracolumbar fascia • Medially • Bodies of lumbar vertebrae & inter vertebral discs • Inferiorly • Fused with fascia covering iliacus • Forms a sheath around muscle – psoas sheath
- 6. • Lateral muscle of posterior abdominal wall • Origin • Iliolumbar ligament • Adjacent part of iliac crest • Insertion • Medial part of inferior border of 12th Rib • Anterior surface of transverse process • Of Upper four lumbar vertebrae Quadratus Lumborum
- 7. Thoracolumbar fascia • Extends • From back of sacrum to neck • Binds erector spinae to vertebral column • and encloses the quadratus lumborum • Very strong in lumbar region • Laterally it gives origin to • Internal oblique & transversus abdominis muscles • Lumbar part medially splits into three layers
- 8. Attachment of anterior layer • Above • Medially • Transverse process of first lumbar vertebra • Laterally • 12th rib • This forms a thin tendinous arch • Lateral arcuate ligament
- 9. Parts of muscles of diaphragm • Takes origin from surrounding skeleton • Sternum • Anteriorly • Lumbar vertebrae • Posteriorly • Ribs & costal cartilages • On sides
- 10. Sternal part • Arises by 2 fleshy slips • From back of xiphoid process
- 11. Space of Larry • Gap between • Muscular slips from • Xiphoid process & 7th costal cartilage • Structure passing • Superior epigastric vessels
- 12. Costal part • Adjacent parts of • Lower 6th ribs on each Side and • Inner surfaces of the cartilages
- 13. Vertebral part • Arises by • 2 crura • 5 arcuate ligament
- 14. Crura • Right & Left • Right crus • Arising from • Anterolateral part of Right side of bodies of of upper 3 lumbar vertebrae • & intervertebral discs between them • Left crus • Left side of anterior aspect of upper 2 lumbar vertebrae • & intervertebral discs between them 1 2 3 Right crus 1st 3 lumbar Left crus 1st 2 lumbar
- 15. Arcuate ligaments • Median • Between upper ends of two crura • Medial • Tendinous arch • From • The side of body of L1 vertebra • To • Front of transverse process of L1 vertebra
- 16. Median arcuate ligament • Arched fibrous band • Lies in front of aorta • Stretches between • Upper margins of • Medial and lateral crus Median arcuate ligament ( 2 curua connected) Cross over Aorta
- 17. Medial arcuate ligament • Thickened upper psoas fascia • Extends • Side of body of L2 vertebra • To • Tip of transverse process of L1 2 1 Medial arcuate ligament L2 to TP of L1
- 18. Lateral arcuate ligament • Thickened upper margin of fascia (anterior layer of Thoracolumbar fascia) • Covers Quadratus lumborum muscle • Extends • Tip of transverse process of L1 • To • Lower border of 12th rib 2 1 Lateral arcuate ligament L1 to TP 12th rib
- 19. Insertion • Central tendon • From circumferential origin • Muscle fibres converge • Features of central tendon • Trifoliate in shape • An anterior • Two tongue shaped posterior • Fused with fibrous pericardium Nearer to sternum than vertebral column central tendon
- 20. Shape of Diaphragm • Curves up into right & left domes or cupolae • Right dome • Reaches upto upper border of 5th rib • Left dome • Reaches upto lower border of 5th rib • Central tendon • Lies at level of xiphisternal joint
- 21. Surfaces • Superior • Relations • Rt. & Lt. Pleura & fibrous pericardium • Inferior • Lined by peritoneum • Rt. Side • Liver, kidney, suprarenal gland • Lt. side • Liver, fundus, spleen, kidney, suprarenal gland
- 22. Openings in diaphragm • Major openings • Minor openings
- 23. Location of the 3 main Openings I Ate (8) 10 Eggs At Midnight (12)
- 24. Venacaval opening • Lies 2.5 cm right of median plane at T8 vertebral level • Located at meeting point of • Right and median leaflets of central tendon • Quadrilateral in shape • Structures passing • IVC • Rt. Phrenic nerve Contraction of diaphragm enlarges caval opening to enhance / dilate venous return
- 25. Esophageal opening • Situated in muscular part of diaphragm • Lies at T10 • About 1.25 cm left of median plane • Formed by • Splitting of right crus • Oval / elliptical in shape • Structures passing • Oesophagus • Anterior & posterior vagal nerves (gastric nerves) • Oesophageal branch of left gastric artery (vein accomapanies) • Lymph vessels Contraction has sphincteric effect on oesophageal opening
- 26. Aortic opening • Osseo-aponeurotic • Lies behind diaphragm at T12 level • Round in shape • Boundaries • Posterior - T12 • Anterior – media arcuate lig. • Sides – Rt. & Lt. crura of diaphragm • Structures passing • Aorta (Thoracic aorta continue as abdominal aorta) • Thoracic duct • Azygos (when begins as lumbar azygos vein)
- 27. Minor openings • Musculophrenic artery • Between 7th & 8th ribs • Lower 5 intercostal nerves and vessels • Between adjacent costal slips (7th to 11th) • Subcostal nerves & vessels • Deep to lateral arcuate ligament • Sympathetic chain • Deep to medial arcuate ligament • Greter, lesser and least splanchnic • Piercing crus
- 28. Nerve supply Motor Phrenic nerve (C3-5) Sensory Central part By phrenic n. Peripheral part Lower 6 intercostal nerves Referred Pain to the Shoulder
- 29. • Superior phrenic • Throcic aorta • Pericardiophrenic • Internal thoracic • Musculo phrenic • Internal thoracic • Superior epigastric • Internal thoracic • Inferior phrenic • Abdominal aorta • Lower five intercostal • Throcic aorta • Subcostal
- 30. Venous drainage • Superior surface into • Internal thoracic veins • By pericardiophrenic & musculophrenic veins • Azygos system of veins • By superior phrenic vein • Inferior surface into • Inferior vena cava • By right inferior phrenic vein • By left inferior phrenic vein
- 31. Development • Septum transversum - central tendon • Pleuriperitoneal membrane – at sides • Dorsal mesentery – dorsally • Body wall - peripherally
- 32. Diaphragmatic Hernias • Retrosternal Hernia • Foramen of Morgagni or Space of Larry • Hernial sac lies between pericardium and right pleura
- 33. • Bochdalek's foramen • Space between the costal and lumbar parts of the diaphragm • Due to failure of closure of pleuroperitoneal canal • Paraoesophageal hernia • Right & anterior of oesophageal opening there is a defect in diaphragm • Anterior wall of stomach rolls upwards into thoracic cavity
- 34. Applied anatomy • Hiccup • involuntary spasmodic contraction of diaphragm • accompanied by approximation of vocal folds & closure of glottis of larynx • After eating or drinking • As a result of gastric irritation of vagus nerve endings • Other reasons may be • Pleurisy, peritonitis or pericarditis
- 35. Suprarenal glands / Adrenal • Yellowish retroperitoneal organs • Lie on the upper poles of kidneys • Surrounded by renal fascia • But are separated from the kidneys by the perirenal fat • Has an outer yellow cortex and an inner dark brown medulla
- 36. Right suprarenal gland • Is pyramid shaped • Lies on upper pole of right kidney • Has • Apex, base • 2 surfaces • Anterior and posterior surfaces • Borders • Lateral and medial border
- 37. Right suprarenal gland • Relations • Anterior • Inferior vena cava medially & Liver laterally • An ill defined vertical ridge is separating • Posterior • Diaphragm (right crus)
- 38. Left suprarenal gland • Is crescentic in shape • Extends along the medial border of left kidney • From upper pole to hilum
- 39. Left suprarenal gland • Relations • Anterior • Pancreas (lower part) lesser sac and stomach (upper part) • Ridge is horizontal • Posterior • Diaphragm • Hilum • In anterior surface • Near lower end • Structure • Left suprarenal vein
- 40. Adrenal gland - Blood supply • Arterial supply • 3 arteries • Superior suprarenal - Inferior phrenic artery • Middle suprarenal - Abdominal aorta • Inferior suprarenal - Renal artery
- 41. Adrenal gland - Blood supply • Drained by one vein • Right suprarenal vein drains into • Inferior vena cava • Left suprarenal vein drains into • Left renal vein
- 42. Adrenal gland - Structure • Outer cortex • Inner medulla • Completely enclosed by cortex
- 43. Development of Adrenal • 2 zones are there • Cortex • Medulla • Cortex • Mesoderm • Medulla • Neuroectoderm (Neuralcrest cells)