Updated: 3/6/2020

Diaphragm Embryology

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Overview
  • Diaphragm
    • derived from 4 different sites
      • septum transversum (located between primitive heart and liver) → central tendon
      • pleuroperitoneal folds
      • body wall→ peripheral parts of diaphragm
      • dorsal mesentery of esophagus → crura
    • diaphragm descends during development and becomes innervated on week 4 of development by the phrenic nerve C 3, 4, 5
Herniations
  • Congenital diaphragmatic hernia 
    • failure of the pleuroperitoneal membrane to develop  
    • abdominal contents herniate into the pleural cavity
      • contents can compress lungs buds preventing proper development causing pulmonary hypoplasia
    • commonly presents on left posterolateral side
    • Symptoms in newborn
      • flat abdomen
      • dyspnea
      • bowel sounds in chest area
      • cyanosis
  • Esophageal hiatal hernia 
    • stomach herniates through esophageal hiatus
    • due to the elevated level, esophagogastric sphincter does not work properly
      • "acid reflux" in adults
      • infants typically vomit when laid down after feeding

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