Diaphragm

Question 1

What is the innervation of the diaphragm?

Answer 1

Phrenic nerve (C3, C4, C5).

Question 2

Where is the insertion of the diaphragm?

Answer 2

Central tendon.

Question 3

What are the origins of the diaphragm?

Answer 3

Costal part:
- Lower margin of costal arch (inner surface ribs 7-12).

Lumbar part:
- Medial: L1-L3 vertebral bodies and intervertebral discs (2nd and 3rd), anterior longitudinal ligament.
- Lateral: arcuate ligaments (median, medial and lateral).

Sternal part:
- Posterior surface of xiphoid process.

Question 4

Describe the length-tension relationship of the diaphragm.

Answer 4

• In some respiratory conditions (e.g. COPD), the diaphragm is flattened because the lungs are hyperinflated.
• This affects the length/tension relationship so the diaphragm cannot work as effectively.

Question 5

What positioning can positively impact length-tension relationship of the diaphragm & why?

Answer 5

Forward-lean sitting
- to dome the diaphragm