!Diaphragm and Respiratory Muscles
!!Anatomy
The diaphragm is the foremost ((Respiratory - System Overview|respiratory)) muscle, and it __separates the thorax from the abdomen__. It consists of ((Musculoskeletal - Skeletal Muscles|striated muscle)) tissue that has both voluntary as autonomous innervation, and of the central aponeurosis. It's upper side is covered by the ((Respiratory - Visceral Fascia - Pleura|pleura)) and the lower side by the ((Digestive - Visceral Fascia - Peritoneum|peritoneum)). Because of the __vacuum__ in the pleural cavity, the diaphragm is dome-shaped.

{img fileId="221" thumb="box"}

In inhale the diaphragm contracts, in exhale it relaxes and is drawn to the thorax where it __compresses the lung space__. In the contrary sense, the accessory respiratory ((Musculoskeletal - Skeletal Muscles|muscles)) of rib cage and abdomen expand or compress the breathing space in the thorax: The __inspiratory muscles__ lift the ribs and pull them apart, while the __expiratory muscles__ depress and pull them together.

{img fileId="222" thumb="box"} graphic: [https://cnx.org/contents/FPtK1zmh@8.25:fEI3C8Ot@10/Preface]

In the respiratory movement the diaphragm also massages the intestines. Together with the abdominal muscles, it also helps with __pressing__ in defecation and in childbirth.

When we __laugh__, the diaphragm carries out fast and rhythmic contractions. A hiccup is spasms of the diaphragm. 

{img fileId="47" thumb="y" rel="box[g]"}graphic: wikipedia

!!Brain
{img fileId="202" thumb="box"}

!!!Relay
__Cerebral Medulla__ (-/+) by myocardium relays
{img fileId="175" thumb="box"}

__Brain Stem/Pons__ (+/-) for autonomous innervation of the diaphragm
{img fileId="190" thumb="box"}

__Cerebral Cortex__/Phrenic Nerve (-/+) parietal region for motoric and sensory innervation
{img fileId="104" thumb="box"}

!!Mind
!!!Theme:
Self-devaluation regarding breathing. Diaphragm also overload, overwhelm like chamber myocardium.

!!!Emotions and Thoughts:
__Shock__
*This knocked the wind out of me. 
*This is a standstill. 
*I don´t dare to breathe. 
*I can´t breathe!

!!!META-Meaning:
My breath is flowing smoothly and faithfully.

!!Organ
!!!Stress Phase Symptoms:
The diaphragm is __seldom affected by unfunctionality__, because it has a double system of innervation with contrary stress reaction (the brain stem relay for automatic breathing causes increased stimulation in stress phase while the cortex relay causes decreased stimulation). __Hyperinspiration__ is a common reaction in general fright and shock situations. However, there is the possibility of diaphragm __paresis or paralysis__ with __apnea__ under certain circumstances, including stroke.

!!!Regeneration Phase Symptoms:
First muscle ache, then gradual return to normality. Accessory muscles get stronger and bigger after completed regeneration. 

!!!Healing Peak:
Spasms (diaphragm: hiccup) during healing peak.The diaphragm has been observed to react simultaneously with the ((Circulatory - Myocardium - Ventricles|myocardium)) during it´s healing peak, the myocardial infarction, leading to __apnoe__.

!!!Biological Meaning:
The biological meaning of the doubled-up system lies in it´s flexibility and support of the most vital life function, the breathing.

!!Social
!!!Examples:
*A woman who survived a car accident, reacts since then with hyperinspiration and fright whenever she hears a crash.
*A boy develops diaphragmatic weakness with shallow breathing after having seen his sister beaten and not being able to help her.

!!Additional Information
!!!Differential Diagnosis:
__((Respiratory - Bronchial Mucosa and Muscle|Bronchial muscle))__ (Midbrain, Sympathetic, +/-) stress phase (competition, social fear): hyperventilation, depression; regeneration phase:coughing; asthma in constellation.

__((Respiratory - Bronchial Mucosa and Muscle|Bronchial)) or ((Respiratory - Larynx - Muscle|Laryngeal)) Asthma__ (CC -/+, constellation) Stress (social fear): aggravated in- or exhale, spasms. Both relays together effect in healing peak or by trigger signal the asthma attack.

__((Respiratory - Visceral Fascia - Pleura|Pleura))__(Cerebellum, +/-) Regeneration phase after attack to the lungs: Dyspnoe, pleural effusion

__Intercostal ((Musculoskeletal - Skeletal Muscles|Muscles))__ (Cerebral Medulla, -/+ and Cerebral Cortex, -/+ for innervation)  functional loss/paralysis in stress phase (performance self-devaluation).    


