diafragmatische

Diaphragmatic (diafragmatische) describes anything relating to the diaphragm, a dome-shaped musculo-tendinous partition that separates the thoracic and abdominal cavities. The diaphragm consists of a central tendon and peripheral muscular parts attached to the lower ribs, sternum, and lumbar spine. Its main purpose is to facilitate breathing. When the diaphragm contracts, its fibers pull downward, expanding the thoracic cavity and reducing intrathoracic pressure, drawing air into the lungs. Relaxation allows passive exhalation.

Anatomy and innervation: The diaphragm is innervated by the phrenic nerves (C3–C5), with arterial supply from the phrenic and inferior phrenic arteries. The diaphragm has several openings for structures passing between the thorax and abdomen: the caval opening for the inferior vena cava, the esophageal hiatus for the esophagus, and the aortic hiatus for the aorta.

Clinical significance: Diaphragmatic conditions include hernias, where abdominal contents herniate through the diaphragm. The most common acquired form is hiatal hernia, while congenital Bochdalek and Morgagni hernias occur in infants. Diaphragmatic eventration and diaphragmatic paralysis due to phrenic nerve injury can impair ventilation. Diaphragmatic fatigue may contribute to respiratory distress in chronic lung disease.

Diagnosis and treatment: Imaging such as chest X-ray, ultrasound (often in infants), CT, or MRI is used to assess anatomy and motion; fluoroscopic sniff tests evaluate diaphragmatic movement. Management ranges from observation in mild cases to surgical repair of hernias or plication for paralysis or eventration; diaphragmatic pacing or ventilatory support may be used in selected cases.