Diaphragm Overview: What Is The Diaphragm?

What Is The Diaphragm, Exactly?

The primary muscle that is used in respiration is the diaphragm. This dome-shaped muscle can be found just below the heart and lungs. It contracts continuously as you breathe in or out.

Anatomy & Function of The Diaphragm


The diaphragm, a thin skeletal muscular muscle located at the base or the chest, separates the abdomen and chest. When you breathe in, it contracts and then flattens. This creates a vacuum effect, which pulls air into your lungs. Inhaling, the diaphragm contracts and pushes air out of the lungs.

It has other functions, too. To help eliminate vomit, urine and feces from the body, the diaphragm raises abdominal pressure. It also puts pressure on the stomach to prevent acid reflux.

The movement is controlled by the phrenic nerve which runs from the neck to its diaphragm.

Three large openings are found in the diaphragm, which allow certain structures to pass between your chest and your abdomen.

These are the openings:

  • Esophageal opening: This is where the esophagus, vagus nerve and much of the digestive system pass.
  • Aortic open: The main blood vessel that transports blood from heart to body, the aorta passes through this opening. This opening also houses the thoracic drain, which is the main vessel of lymphatic system.
  • Caval opening: This is where the inferior Vena cava, which transports blood to your heart, passes.

Diaphragm Conditions

It can be affected by a variety of medical conditions:

Hiatal Hernia

A hiatal hernia occurs when the upper portion of the stomach protrudes through the esophageal aperture of the diaphragm. Although experts aren’t certain why this happens, they believe it could be caused by:

  • Age-related changes in diaphragm
  • Birth defects or injuries
  • Chronic pressure on the surrounding muscles due to straining, coughing, or lifting heavy objects can cause chronic pain.

These are more common among people over 50 and obese.

Small hiatal hernias rarely cause symptoms and don’t require treatment. A larger hiatal hernia can cause symptoms such as:

  • heartburn
  • acid reflux
  • Trouble swallowing
  • Sometimes, chest pain radiates to your back.

Sometimes, larger hiatal hernias require surgery. However, other cases can be managed with over-the counter anti-inflammatory medication. Acid production can be reduced and any damage to the stomach treated with proton pump inhibitors.

Diaphragmatic Hernia

An diaphragmatic hernia occurs when at least one of the abdominal organs bulges into your chest through an opening in your diaphragm. Sometimes it is present at birth. It’s known as a congenital dialygmatic hernia (CDH).

A diaphragmatic hernia can also be caused by injuries sustained in an accident or during surgery. It’s also known as an acquired diaphragmatic shenia (ADH).

The cause and severity of symptoms can affect how severe the hernia is. These symptoms may include:

  • Trouble breathing
  • Rapid breathing
  • Rapid heart rate
  • Blueish-colored skin
  • The chest makes bowel sounds

Both ADH and CDH need immediate surgery to remove abdominal organs from the chest cavity, and repair the diaphragm.

Cramps and Spasms

An spasm or diaphragmatic cramp can cause chest pain, shortness of breath, and can even be mistakenly thought to be a coronary. Some suffer from anxiety and sweating during diaphragm spasms. Some people describe feeling like they cannot take a full breathe during spasms.

The diaphragm does not rise after exhalation during a spasm. This causes the diaphragm and lungs to expand, which in turn causes them to tighten. The chest can feel cramped. Vigorous exercise can cause diaphragm spasms, which can often lead to what is called a side stitch.

Diaphragm spasms will usually disappear on their own in a matter of hours or days.

Diaphragmatic Flutter

Diaphragmatic Flutter is a rare condition. It’s often confused for spasm. A person might feel the fluttering in the abdomen wall as a pulse sensation.

It can also lead to:

  • Breathing difficulty
  • chest tightness
  • chest pain
  • Abdominal pain

Nerve Damage Due to Phrenic Symptoms

The phrenic nerve can be damaged by a variety of things, including

  • Traumatic injuries
  • Surgery
  • Cancer in the lungs and lymph nodes nearby
  • Conditions of the spinal cord
  • Autoimmune Disease
  • neuromuscular disorders such as Multiple Sclerosis
  • certain viral illnesses

Paralysis or dysfunction of the diaphragm can result from this damage. But phrenic nerve damage doesn’t always cause symptoms. Symptoms that may be present include:

  • Shortness of breath while lying down or exercising
  • Morning headaches
  • Trouble sleeping
  • chest pain


Diaphragm Conditions: Signs & symptoms

Diaphragm problems can mimic a heart attack. If you feel chest pain, pressure, or swelling, seek emergency medical attention.

A diaphragm condition can present with the following symptoms:

  • When lying down, difficulty breathing
  • Breathing difficulty
  • Chest, shoulder, back, and abdominal pain
  • Pain in the lower ribs
  • A fluttering, or pulsing sensation within the abdomen
  • Bluish-colored skin
  • Heartburn
  • Trouble swallowing
  • Regurgitation of food
  • upper abdominal pain after eating
  • hiccups
  • Side pain

Tips To Maintain A Healthy Diaphragm

Because of its vital role in breathing, the diaphragm ranks among the most important muscles of our body.

Protect your diaphragm by:

  • Limiting foods that cause acid reflux or heartburn
  • You can eat smaller portions at once
  • Stretching and warming up before you start your exercise
  • Be within your limitations

It can be strengthened by doing special exercises, just like any other muscle. Abdominal breathing is the best method to achieve this. This involves slowly inhaling through your nose and breathing deeply. As your belly expands, your lungs will fill with air. Diaphragmatic breathing is a way to strengthen your diaphragm and lower blood pressure.

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