The clinical anatomy of the musculotendinous part of the diaphragm

Autor: Sameer Shah, Jessica D. Holland, Marios Loukas, Daryl Ramai, Maira du Plessis, R. Shane Tubbs
Rok vydání: 2015
Předmět:
Zdroj: Surgical and Radiologic Anatomy. 37:1013-1020
ISSN: 1279-8517
0930-1038
Popis: The thoracoabdominal diaphragm is a com- posite musculotendinous structure, separating the thoracic and abdominal cavities. Reemphasis of the already well- delineated variations of the muscular and tendinous por- tions, and blood and nerve supply of the diaphragm is becoming apparent. Scientific reports concerning recon- struction of the pericardium, activation of the muscle and the phrenic nerves by use of laparoscopically placed in- tramuscular electrodes, and repair of congenital and trau- matic hernias reemphasize the importance of the muscular to tendinous relationships. The objective of this study, therefore, was to measure the ratio of the surface area of the tendinous central region to the muscular region of the diaphragm and provide a clear description across various specimens. We classified diaphragmatic measurements from 104 adult human diaphragms into six classes (I-VI) based on the ratio of surface area between its tendinous and muscular components. The majority of specimens, 56.7 %, was attributed to class II and indicated a tendon-to-muscle ratio of between 10 and 15 %; however, a small number of specimens indicated a very large tendon area at the expense of muscle bulk. Future research should be geared toward assessing the relationship between surface area of the musculature and its motor points with focus on interven- tions for herniation repair and recovery. Our results have shown that surgical interventions should be tailored to the individual, as diaphragm size may not necessarily predict tendon-to-muscle ratio.
Databáze: OpenAIRE
Externí odkaz: