Imtiaz Ahmad, Nabila Kaukab, Muhammad Ikram, Anwar Hussain.
Diaphragmatic Crural Splitting and Median Arch Formation Variations.
Annals Punjab Med Coll Jan ;6(1):1-4.

Objective: This study was designed to note down variations in the way of attachment of the crura of thoraco abdominal diaphragm and the way they form the median arch in view of their role as a barrier in gastro esophageal reflux and in designing esophageal hiatus. The Study Methodology:  It was carried out in the anatomy department of Punjab medical college Faisalabad during years from 2006 to 2010. A total number of 45 human cadavers were dissected for this study. The observed variations were recorded and analysed. Results and Conclusion:  The crura at their vertebral attachment seen divided into slips both on right and left sides in64.4% of the cases. In the remaining 35.6% of the cases they did not show this division on either side. Two slips were noted in 48.9% of cases on right side and in 60% of cases on the left side. The medial most slips of both sides joined each other to form median arch in 88.9 % of cases. In 22.2 % of cases the arch formed at level between 1st and 2nd lumbar vertebra. Identification of these anatomical variations would be helpful in understanding the bases and treatment of gastroesophageal reflux disease and hiatal hernia etc.

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