The human diaphragm is the most important respiratory muscle. It is absolutely unique in its structure.
The human diaphragm is made in the form of a flat membrane stretched horizontally inside the body. It is the border between the abdominal and chest cavity. The diaphragm includes muscle and tendon parts, the right and left dome. In addition, there are openings for the esophagus and aorta.
The diaphragm structure contains a large number of muscle fibers. They begin with the chest walls and converge, connecting the tendons in the center. According to the fiber attachment sites, the diaphragm is divided into the costal, sternal and lumbar parts.
With contraction and relaxation, the respiratory membrane adjusts the volume of the chest cavity. The diaphragm of a person also contributes to the flow of venous blood to the heart by increasing the suction pressure with the expansion of the chest cavity. In addition, the respiratory membrane is involved in maintaining normal constant pressure in the abdominal region and stable anatomical interaction of organs.
With traumatic or inflammatory damage to the phrenic nerves, acquired diaphragm relaxation occurs. It is manifested by a one-sided persistent high standing of a thinned, but not losing, membrane, provided it is attached to a normal site. Relaxation can be congenital.
There are also full and partial relaxation of the membrane. With complete relaxation, the entire dome relaxes, and with partial relaxation only a part rises.
There are cases of special surgical damage to the phrenic nerves. This may be due to the formed “free” pleural cavity, for example, when the lung is removed. Damage to the phrenic nerve leads to a relaxation of the membrane, it rises, thereby reducing the "empty" pleural cavity.
Complete or partial relaxation of the diaphragm may be accompanied by an upset digestion, breathing, or heart rhythm disturbance . Accurate diagnosis of the disorder is established during the X-ray examination.
During relaxation, the human diaphragm has a regular, continuous, arched contour. All organs of the abdominal cavity are located under the membrane, there are no retraction on the walls of the intestine and stomach. During relaxation, the x-ray picture is characterized by constancy.
Complete or limited relaxation of the membrane occurs predominantly on the right side. This may be due to the presence of weak muscle bundles extending from this side of the posterior surface of the sternum. The relaxation of the right dome of the diaphragm is accompanied by its arched protrusion towards the lung and deformation of the liver. In this case, the liver repeats the relaxation area, wedging into it. This circumstance is often the cause of diagnostic errors, since the relaxation area is mistaken for liver echinococcosis, although, according to some experts, the latter can cause diaphragm relaxation.
In many cases, such right-sided relaxation occurs without symptoms. However, sometimes it is accompanied by various disorders (chest and heart pain, cough or dyspeptic symptoms (indigestion)).
As a treatment, surgery is prescribed. One of the options for the operation is to create a diaphragm duplicate by means of thoracoscopic plasty using allografts. This technique allows for intervention at the initial stages of the development of the disorder. At the same time, the risk of injuries during surgery is significantly reduced.