scholarly journals Acquired Diaphragmatic Eventration in a Dog

2018 ◽  
Vol 47 ◽  
Author(s):  
Bruna Marquardt Lucio ◽  
Rafael Almeida Fighera ◽  
Saulo Tadeu Lemos Pinto Filho ◽  
Mariana Martins Flores
Keyword(s):  
Diaphragmatic Hernia ◽  
Phrenic Nerve ◽  
Polypropylene Mesh ◽  
Muscle Fibers ◽  
Exercise Intolerance ◽  
Diaphragm Muscle ◽  
Thoracic Cavity ◽  
Diaphragmatic Eventration ◽  
Diaphragmatic Muscle ◽  
Normal Diaphragm

Background: Diaphragmatic eventration is characterized by weakness of the diaphragmatic muscle, which leads to cranial dislocation of the affected diaphragm and, ultimately, in dyspnea. This condition is rare in humans and even rarer in animals, and may be congenital or acquired. The acquired form is less commom and may be induced by trauma or inflammation and neoplastic invasion of the phrenic nerve. Here, we report a case of acquired diaphragmatic eventration in a dog, with the aim of increasing the knowledge of this condition in animals and helping others to recognize and treat future cases.Case: A 12-year-old male dachshund presented with severe dyspnea, exercise intolerance and episodes of coughing. Based on a physical examination and imaging, the main suspicion was a diaphragmatic hernia, and surgery was performed. When the surgeon entered the thoracic cavity, an extremely thin - yet, intact - right hemidiaphragm was observed. The left side of the diaphragm was normal. A polypropylene mesh was sutured to the affected diaphragm in an attempt to strengthen the hemidiaphragmatic muscles and prevent further insinuations of viscera into the thoracic cavity. The dog developed bronchopneumonia, postoperatively, and was hospitalized and treated with antibiotics, analgesics and support medication. However, the dog died five days after surgery. A postmortem examination revealed that the right side of the diaphragm was markedly thin and flaccid. Diaphragm samples were collected for histopathological examination. For comparison, a sample of normal diaphragm was collected from a same age, matched dachshund that died due to an unrelated condition. This tissue was called “diaphragm control”, and it was collected in order to compare the histologic features of a normal diaphragm muscle with the affected one. Histopathology revealed a marked reduction of muscle fibers. In the affected sample, replacement of these fibers by fibrous connective tissue and a marked infiltration of fat were seen among the remaining muscle fibers.  Multifocal areas of necrosis were also observed affecting some muscles fibers. Microscopic comparisons of both diaphragm samples (affected vs. control) revealed a drastic difference in the amount of muscle fibers and fat, corroborating the intense diaphragmatic atrophy observed in the diaphragm from the affected dog. Based on clinical presentation, the gross lesions observed during surgery and later during the post mortem examination, and histopathological findings, a definitive diagnosis of acquired diaphragmatic eventration was established.Discussion: Diaphragmatic eventration is rarely reported in small animal clinics and thus may be confused with other conditions. It must be mainly differentiated from diaphragmatic hernia and should be considered as a differential diagnosis when an animal, regardless of age, presents with dyspnea, apathy and coughing episodes.  On suspecting diaphragmatic eventration, surgical intervention should be carried out as soon as possible. The recommended treatment is plication of the affected hemidiaphragm. However, in the present case, a polypropylene mesh was sutured to the affected area to support the atrophic muscles. It is thought that, trauma injured the dog’s phrenic nerve, affecting right hemidiaphragmatic innervation, and generating progressive atrophy of diaphragmatic muscle fibers. Subsequently, the dog developed diaphragmatic eventration due to diaphragmatic fragility. Diaphragmatic eventration is a very rare disorder in small animals and can be difficult to diagnose based solely on physical and radiographic examinations.

scholarly journals Eventratio diaphragmatica

1973 ◽  
Vol 13 (1) ◽  
pp. 35
Author(s):  
Subagjo Martodipuro ◽  
Nurjono Sunarjo ◽  
Pitono Suparto ◽  
L. Partana
Keyword(s):  
Surgical Procedures ◽  
Diaphragmatic Hernia ◽  
Phrenic Nerve ◽  
Pleural Cavity ◽  
Thoracic Cavity ◽  
Birth Injury ◽  
Diaphragmatic Eventration

A diaphragmatic eventration is a displacement of abdominal structures into the thoracic cavity, due to weakness and balooning of the diaphragm (Nelson, 1969). In several aspects it has similarities with a diaphragmatic hernia, i.e. the space occupying effects to the lungs, and the sequences of it. An eventration can be divided in 2 groups, the congenital eventration, where the diaphragm is devoid of mucles and only a membrane is separating the abdominal from the pleural cavity; and the acquired one where the phrenic nerve is damaged, usually due to birth injury; but it can also be caused by any other trauma (Bernado et aI., 1961; Bisono et aI., 1970) such as surgical procedures at the time of thoracotomy, the so called iatrogenic  eventration (Jewett et aI., 1964).

scholarly journals Effect of nitrofen in the final stages of development of the diaphragm muscle in rats

2013 ◽  
Vol 28 (suppl 1) ◽  
pp. 13-18 ◽  
Author(s):  
Frances Lilian Lanhellas Gonçalves ◽  
Fábio Santana de Oliveira ◽  
Augusto Frederico Schmidt ◽  
Luís Antônio Violin Dias Pereira ◽  
Rodrigo Melo Gallindo ◽  
...  
Keyword(s):  
Body Weight ◽  
Congenital Diaphragmatic Hernia ◽  
Olive Oil ◽  
Diaphragmatic Hernia ◽  
Muscle Fibers ◽  
Diaphragm Muscle ◽  
External Control ◽  
Stages Of Development ◽  
Pregnant Rats ◽  
Histological Staining

PURPOSE: To evaluate the expression of myosin in muscle fibers of the diaphragm in experimental congenital diaphragmatic hernia (CDH). METHODS: Fetuses of pregnant rats were divided into four groups: External Control (EC), composed of non-manipulated rats; Nitrofen, composed of pregnant rats that received 100 mg of nitrofen (2,4-dichloro-4'nitrodiphenyl ether) diluted in olive oil on gestational day (GD) 9.5, whose fetuses developed CDH (N+) or not (N-), and Olive Oil Placebo (OO), composed of pregnant rats that received the oil on the same GD. The fetuses were collected on GD 18.5, 19.5, 20.5 and 21.5 (term = 22 days). We obtained body weight (BW) and photographed the diaphragm area (DA), hernia area (HA) and subsequent calculated the HA/DA ratio in N+ group. Samples of Diaphragm muscle were processed for histological staining with H/E and immunohistochemistry (IHQ) for myosin.} RESULTS: The fetuses of N- and N+ groups had decreased BW and DA compared to EC and OO groups (p <0.001). HA was decreased on GD 18.5 compared to 21.5 (p <0.001) and the HA/DA ratio showed no difference. IHQ showed decreased expression of myosin in nitrofen groups. CONCLUSION: CDH induced by nitrofen model contributes to the understanding of muscularization in the formation of the diaphragm where the myosin expression is decreased.

Effects of transverse fiber stiffness and central tendon on displacement and shape of a simple diaphragm model

1997 ◽  
Vol 82 (5) ◽  
pp. 1626-1636 ◽  
Author(s):  
Aladin M. Boriek ◽  
Joseph R. Rodarte
Keyword(s):  
Orthotropic Material ◽  
Shape Change ◽  
Muscle Fibers ◽  
Muscle Length ◽  
Diaphragm Muscle ◽  
Direction Transverse ◽  
Diaphragmatic Muscle ◽  
Transverse Fiber ◽  
Wide Range ◽  
Length Changes

Boriek, Aladin M., and Joseph R. Rodarte. Effects of transverse fiber stiffness and central tendon on displacement and shape of a simple diaphragm model. J. Appl. Physiol. 82(5): 1626–1636, 1997.—Our previous experimental results (A. M. Boriek, S. Lui, and J. R. Rodarte. J. Appl. Physiol. 75: 527–533, 1993 and A. M. Boriek, T. A. Wilson, and J. R. Rodarte. J. Appl. Physiol. 76: 223–229, 1994) showed that 1) costal diaphragm shape is similar at functional residual capacity and end inspiration regardless of whether the diaphragm muscle shortens actively (increased tension) or passively (decreased tension); 2) diaphragmatic muscle length changes minimally in the direction transverse to the muscle fibers, suggesting the diaphragm may be inextensible in that direction; and 3) the central tendon is not stretched by physiological stresses. A two-dimensional orthotropic material has two different stiffnesses in orthogonal directions. In the plane tangent to the muscle surface, these directions are along the fibers and transverse to the fibers. We wondered whether orthotropic material properties in the muscular region of the diaphragm and inextensibility of the central tendon might contribute to the constancy of diaphragm shape. Therefore, in the present study, we examined the effects of stiffness transverse to muscle fibers and inextensibility of the central tendon on diaphragmatic displacement and shape. Finite element hemispherical models of the diaphragm were developed by using pressurized isotropic and orthotropic membranes with a wide range of stiffness ratios. We also tested heterogeneous models, in which the muscle sheet was an orthotropic material, having transverse fiber stiffness greater than that along the fibers, with the central tendon being an inextensible isotropic cap. These models revealed that increased transverse stiffness limits the shape change of the diaphragm. Furthermore, an inextensible cap simulating the central tendon dramatically limits the change in shape as well as the membrane displacement in response to pressure. These findings provide a plausible mechanism by which the diaphragm maintains similar shapes despite different physiological loads. This study suggests that changes of diaphragm shape are restricted because the central tendon is essentially inextensible and stiffness in the direction transverse to the muscle fibers is greater than stiffness along the fibers.

scholarly journals Is phrenic nerve conduction affected in patients with difficult-to-treat asthma?

2018 ◽  
Vol 76 (3) ◽  
pp. 177-182 ◽  
Author(s):  
Analúcia Abreu Maranhão ◽  
Marcia Maria Jardim Rodrigues ◽  
Sonia Regina da Silva Carvalho ◽  
Marcelo Ribeiro Caetano ◽  
Inaê Mattoso Compagnoni ◽  
...  
Keyword(s):  
Action Potential ◽  
Phrenic Nerve ◽  
Diaphragm Muscle ◽  
Motor Action ◽  
X Ray ◽  
Asthmatic Patients ◽  
Compound Motor Action Potential ◽  
Chest X Ray ◽  
Potential Area ◽  
Normal Diaphragm

ABSTRACT Objective The aim of this study was to obtain data on phrenic neuroconduction and electromyography of the diaphragm muscle in difficult-to-treat asthmatic patients and compare the results to those obtained in controls. Methods The study consisted of 20 difficult-to-treat asthmatic patients compared with 27 controls. Spirometry, maximal inspiratory and expiratory pressure, chest X-ray, phrenic neuroconduction and diaphragm electromyography data were obtained. Results The phrenic compound motor action potential area was reduced, compared with controls, and all the patients had normal diaphragm electromyography. Conclusion It is possible that a reduced phrenic compound motor action potential area, without electromyography abnormalities, could be related to diaphragm muscle fiber abnormalities due to overload activity.

scholarly journals Ultrasound diagnosis of reticular diaphragmatic hernia in bovines

2021 ◽  
Vol 41 ◽  
Author(s):  
Tatiane V. Silva ◽  
Jobson Filipe P. Cajueiro ◽  
Nivan A.A. Silva ◽  
Maria Isabel de Souza ◽  
Nivaldo A. Costa ◽  
...  
Keyword(s):  
Diaphragmatic Hernia ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Abdominal Distension ◽  
Ultrasound Diagnosis ◽  
Thoracic Cavity ◽  
Lung Sounds ◽  
Laboratory Examination ◽  
Diaphragmatic Muscle ◽  
Bovine Species

ABSTRACT: A reticular diaphragmatic hernia is a congenital or acquired alteration resulting from protrusion of the reticulum into the thoracic cavity. In ruminants, lesions to the diaphragmatic muscle, due to penetration of sharp metallic objects, is the most common cause of this disease. Therefore, given the low number of reports on this disease in the bovine species, the current study aims to describe the clinical, laboratory, and anatomopathological findings, with special emphasis on the ultrasound diagnosis of five cattle with reticular diaphragmatic hernia. The laboratory data were analyzed using mean and standard deviation, and clinical, ultrasound, and pathological findings were evaluated using descriptive statistics. Clinically the animals exhibited varying degrees of dehydration, abdominal distension, tympany, and alterations in ruminal motility, in addition to cardiorespiratory alterations such as murmur, dyspnea, and muffling of lung sounds. The laboratory examination showed neutrophilic leukocytosis and hyperfibrinogenemia. The ultrasonographic images demonstrated reticulum inside the thoracic cavity adjacent to the lung and heart, although no reticular motility was observed. The pathological lesions confirmed the findings of the ultrasound exams. Thus, the current study demonstrated that ultrasonography was efficient in diagnosing reticular diaphragmatic hernia in the bovine species.

An overview of phrenic nerve and diaphragm muscle development in the perinatal rat

1999 ◽  
Vol 86 (3) ◽  
pp. 779-786 ◽  
Author(s):  
John J. Greer ◽  
Douglas W. Allan ◽  
Miguel Martin-Caraballo ◽  
Robert P. Lemke
Keyword(s):  
Phrenic Nerve ◽  
Muscle Development ◽  
Developmental Stages ◽  
The Body ◽  
Limb Bud ◽  
Diaphragm Muscle ◽  
Membrane Properties ◽  
Formation Continue ◽  
Diaphragmatic Muscle ◽  
Firing Properties

In this overview, we outline what is known regarding the key developmental stages of phrenic nerve and diaphragm formation in perinatal rats. These developmental events include the following. Cervical axons emerge from the spinal cord during embryonic (E) day 11. At ∼E12.5, phrenic and brachial axons from the cervical segments merge at the brachial plexi. Subsequently, the two populations diverge as phrenic axons continue to grow ventrally toward the diaphragmatic primordium and brachial axons turn laterally to grow into the limb bud. A few pioneer axons extend ahead of the majority of the phrenic axonal population and migrate along a well-defined track toward the primordial diaphragm, which they reach by E13.5. The primordial diaphragmatic muscle arises from the pleuroperitoneal fold, a triangular protrusion of the body wall composed of the fusion of the primordial pleuroperitoneal and pleuropericardial tissues. The phrenic nerve initiates branching within the diaphragm at ∼E14, when myoblasts in the region of contact with the phrenic nerve begin to fuse and form distinct primary myotubes. As the nerve migrates through the various sectors of the diaphragm, myoblasts along the nerve’s path begin to fuse and form additional myotubes. The phrenic nerve intramuscular branching and concomitant diaphragmatic myotube formation continue to progress up until E17, at which time the mature pattern of innervation and muscle architecture are approximated. E17 is also the time of the commencement of inspiratory drive transmission to phrenic motoneurons (PMNs) and the arrival of phrenic afferents to the motoneuron pool. During the period spanning from E17 to birth (gestation period of ∼21 days), there is dramatic change in PMN morphology as the dendritic branching is rearranged into the rostrocaudal bundling characteristic of mature PMNs. This period is also a time of significant changes in PMN passive membrane properties, action-potential characteristics, and firing properties.

Respiratory Activity of the Rat Posterior Cricoarytenoid Muscle

1997 ◽  
Vol 106 (11) ◽  
pp. 897-901 ◽  
Author(s):  
Robert G. Berkowitz ◽  
John Chalmers ◽  
Qi-Jian Sun ◽  
Paul M. Pilowsky
Keyword(s):  
Phrenic Nerve ◽  
Muscle Activity ◽  
Electrophysiological Study ◽  
Emg Activity ◽  
Diaphragmatic Muscle ◽  
Posterior Cricoarytenoid Muscle ◽  
Inspiratory Activity ◽  
Intramuscular Nerve ◽  
Posterior Cricoarytenoid ◽  
Nerve Discharge

An anatomic and electrophysiological study of the rat posterior cricoarytenoid (PCA) muscle is described. The intramuscular nerve distribution of the PCA branch of the recurrent laryngeal nerve was demonstrated by a modified Sihler's stain. The nerve to the PCA was found to terminate in superior and inferior branches with a distribution that appeared to be confined to the PCA muscle. Electromyography (EMG) recordings of PCA muscle activity in anesthetized rats were obtained under stereotaxic control together with measurement of phrenic nerve discharge. A total of 151 recordings were made in 7 PCA muscles from 4 rats. Phasic inspiratory activity with a waveform similar to that of phrenic nerve discharge was found in 134 recordings, while a biphasic pattern with both inspiratory and post-inspiratory peaks was recorded from random sites within the PCA muscle on 17 occasions. The PCA EMG activity commenced 24.6 ± 2.2 milliseconds (p < .0001) before phrenic nerve discharge. The results are in accord with findings of earlier studies that show that PCA muscle activity commences prior to inspiratory airflow and diaphragmatic muscle activity. The data suggest that PCA and diaphragm motoneurons share common or similar medullary pre-motoneurons. The earlier onset of PCA muscle activity may indicate a role for medullary pre-inspiratory neurons in initiating PCA activity.

Differential actions of brevetoxin on phrenic nerve and diaphragm muscle in the rat

Toxicon ◽  
1993 ◽  
Vol 31 (4) ◽  
pp. 459-470 ◽  
Author(s):  
Sharad S. Deshpande ◽  
Michael Adler ◽  
Robert E. Sheridan
Keyword(s):  
Phrenic Nerve ◽  
Diaphragm Muscle

Diaphragmatic Hernia

1983 ◽  
Vol 4 (8) ◽  
pp. 244-266
Keyword(s):  
Intensive Care ◽  
Pulmonary Arterial Hypertension ◽  
Diaphragmatic Hernia ◽  
Neonatal Intensive Care ◽  
Pulmonary Hypoplasia ◽  
Thoracic Cavity ◽  
Hemodynamic Changes ◽  
Life Threatening ◽  
Pulmonary Arterial ◽  
Immediate Surgery

In spite of the availability of almost immediate surgery and neonatal intensive care, congenital diaphragmatic hernia is a life-threatening anomaly in the newborn. It is the result of early embryologic malformation or failure of fusion of the components of the diaphragm allowing for the displacement of the abdominal contents into the thoracic cavity. There is consequent compression of the lung which may result in pulmonary hypoplasia or compression of the cardiovascular structures resulting in deleterious hemodynamic changes. Hypoxia and acidosis result in the presentation of respiratory distress and cyanosis. This is frequently associated with pulmonary arterial hypertension with right to left shunting through fetal circuits.

scholarly journals Exercise-induced alterations and loss of sarcomeric M-line organization in the diaphragm muscle of obscurin knockout mice

2017 ◽  
Vol 312 (1) ◽  
pp. C16-C28 ◽  
Author(s):  
D. Randazzo ◽  
B. Blaauw ◽  
C. Paolini ◽  
E. Pierantozzi ◽  
S. Spinozzi ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Fibers ◽  
Detailed Examination ◽  
Diaphragm Muscle ◽  
Hindlimb Muscles ◽  
Skeletal Muscle Fibers ◽  
Exercise Induced ◽  
Old Mice ◽  
Ankyrin B ◽  
Deficient Mice

We recently reported that skeletal muscle fibers of obscurin knockout (KO) mice present altered distribution of ankyrin B (ankB), disorganization of the subsarcolemmal microtubules, and reduced localization of dystrophin at costameres. In addition, these mice have impaired running endurance and increased exercise-induced sarcolemmal damage compared with wild-type animals. Here, we report results from a combined approach of physiological, morphological, and structural studies in which we further characterize the skeletal muscles of obscurin KO mice. A detailed examination of exercise performance, using different running protocols, revealed that the reduced endurance of obscurin KO animals on the treadmill depends on exercise intensity and age. Indeed, a mild running protocol did not evidence significant differences between control and obscurin KO mice, whereas comparison of running abilities of 2-, 6-, and 11-mo-old mice exercised at exhaustion revealed a progressive age-dependent reduction of the exercise tolerance in KO mice. Histological analysis indicated that heavy exercise induced leukocyte infiltration, fibrotic connective tissue deposition, and hypercontractures in the diaphragm of KO mice. On the same line, electron microscopy revealed that, in the diaphragm of exercised obscurin KO mice, but not in the hindlimb muscles, both M-line and H-zone of sarcomeres appeared wavy and less defined. Altogether, these results suggest that obscurin is required for the maintenance of morphological and ultrastructural integrity of skeletal muscle fibers against damage induced by intense mechanical stress and point to the diaphragm as the skeletal muscle most severely affected in obscurin-deficient mice.

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