Intramuscular distribution of the phrenic nerve in human diaphragm as shown by Sihler staining

• Published in: Muscle & nerve Vol. 45; no. 4; pp. 522 - 526
• Main Authors: AN, Xiaochun, Yue, Bin, Lee, Je-Hun, Lee, Mi-Sun, Lin, Chenghe, Han, Seung-Ho
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.04.2012; Wiley
• Subjects: Aged; Biological and medical sciences; Cadaver; Coloring Agents; diaphragm; Diaphragm - innervation; Diseases of striated muscles. Neuromuscular diseases; Esophagus - anatomy & histology; Esophagus - innervation; Female; human; Humans; intramuscular distribution; Male; Medical sciences; Middle Aged; Muscle, Skeletal - innervation; Nerve Net - anatomy & histology; Neurology; phrenic nerve; Phrenic Nerve - physiology; Sihler staining; Staining and Labeling; Human; Sihler staining; Diaphragm; Phrenic nerve; intramuscular distribution; Innervation
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.22141

Introduction: Intramuscular innervation of the human diaphragm has not been well described. The goal of this study was to elucidate the detailed intramuscular distribution of the phrenic nerve in the human diaphragm. Methods: Fifteen human diaphragms were visualized using modified Sihler staining, and the detailed intramuscular phrenic nerve distribution was photographed and recorded. Results: Three types of primary phrenic nerve branches were noted. Each type of primary branch innervated a confined muscular subvolume of the diaphragm, and the intramuscular branches in each subvolume anastomosed largely with one another and formed a characteristic “net” of nerve branches. A few small nerve filaments were seen entering the peripheral diaphragm. The directions and locations of nerve branches innervating the hiatal diaphragm were not symmetrical between sides. Conclusion: These findings may offer useful information for anatomists, physiologists, and clinicians. Muscle Nerve, 2012