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Thoracic diaphragm

life science Maturity 9-11 Next article →

The thoracic diaphragm is a vital sheet of internal skeletal muscle found in humans and other mammals. It sits at the base of the thoracic cavity, which is the chest area containing the heart and lungs. This muscle acts as a physical divider, separating the thoracic cavity from the abdominal cavity below. Because breathing is a constant necessity, the diaphragm is the most important muscle for respiration. It requires a massive amount of oxygen to function continuously. To support this, it contains more mitochondria and capillaries than any other skeletal muscle in the body.

3D Medical Animation Diaphragm Structure
3D Medical Animation Diaphragm Structure

The diaphragm operates through a specific mechanical process to move air. During inhalation, the muscle contracts and moves in an inferior, or downward, direction. This contraction increases the volume of the thoracic cavity. As the space inside the chest grows, it creates negative pressure, which acts like a vacuum. This low pressure pulls air into the lungs to fill the void. During exhalation, the diaphragm relaxes and moves in a superior, or upward, direction. The lungs then push air out through a process called elastic recoil.

Structurally, the diaphragm is an upward-curved, C-shaped dome of muscle and fibrous tissue. The muscle fibers originate from the circumference of the inferior thoracic aperture. These fibers radiate outward and converge at a central tendon, which forms the crest of the dome. The diaphragm is composed of two distinct functional regions. The costal diaphragm serves as the primary driver for the work of breathing. The crural diaphragm acts as an anchor, attaching the muscle to the lower ribs and the lumbar vertebrae.

Diaphragm def 1707
Diaphragm def 1707

The anatomy of the diaphragm includes several complex parts and ligaments. The vertebral part arises from the crura and arcuate ligaments. The right crus arises from the L1 to L3 vertebral bodies and their intervertebral discs. The left crus is smaller and arises from the L1 and L2 vertebral bodies. There are three specific arcuate ligaments: the medial, lateral, and median. The medial arcuate ligament arises from the fascia of the L2 vertebrae. The lateral arcuate ligament arises from the L1 transverse process and attaches to the 12th rib. The median arcuate ligament is formed by the fibrous parts of the right and left crura.

Gray577
Gray577

Because several major structures must travel between the chest and the abdomen, the diaphragm contains several openings. At the T8 vertebral level, the caval opening allows the inferior vena cava to pass through. This opening is located at the junction of the right and middle leaflets of the central tendon. At the T10 level, the esophageal hiatus allows the esophagus to pass through. This opening is located slightly left of the central tendon and is surrounded by the right crus. Finally, at the T12 level, the aortic hiatus allows the aorta, the thoracic duct, and the azygos vein to pass. The aorta actually passes behind the diaphragm between the left and right crus rather than piercing it.

1113 The Diaphragm
1113 The Diaphragm

The diaphragm is controlled by the phrenic nerve, which is formed from the cervical nerves C3, C4, and C5. This nerve supply is unique because of how the diaphragm develops during embryogenesis. In the third week after fertilization, the septum transversum forms the primitive central tendon in the cervical region. As the embryo grows, the septum transversum moves to the ventral thoracic region. The phrenic nerve must follow this descending muscle, resulting in its long, circuitous route from the neck to the chest. While the phrenic nerve handles the central portion, the intercostal and subcostal nerves provide sensory input for the peripheral parts.

Diaphragm Arthur Keith 1
Diaphragm Arthur Keith 1

Beyond breathing, the diaphragm performs several other essential functions. By increasing intra-abdominal pressure, it helps the body expel vomit, feces, and urine. It also assists during the process of childbirth. Additionally, it helps prevent acid reflux by exerting pressure on the esophagus as it passes through the esophageal hiatus. However, diaphragm dysfunction can lead to serious medical complications. Problems such as respiratory failure or difficulties with mechanical ventilation are often linked to diaphragm issues. In some diseases, such as sepsis or COVID-19, a reduction in diaphragm thickness can serve as a prognostic marker for a patient's condition.

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🖼️ Images & Media (7)
File:3D Medical Animation Diaphragm Structure.jpg
3D Medical Animation Diaphragm Structure.jpg
File:Diaphragm def 1707.png
Diaphragm def 1707.png
File:1113 The Diaphragm.jpg
1113 The Diaphragm.jpg
File:Gray577.png
Gray577.png
Real-time MRI - Thorax.ogv
File:Chest labeled.png
Chest labeled.png
File:Diaphragm Arthur Keith 1.jpg
Diaphragm Arthur Keith 1.jpg
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