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The diaphragm is formed from a number of composite parts in the embryo. The most important is the septum transversum. Understanding the history of the formation of the diaphragm explains why the heart, lungs, liver, gut tube, neck and fascia all resonate strongly with the diaphragm. Clinical points that arise from the embryology are summarised at the end.

The septum transversum is a thick mass of cranial mesenchyme that gives rise to parts of the thoracic diaphragm and the anterior mesentery of the foregut in the adult. After its descent, discussed below, the septum transversum merges with mesoderm surrounding the oesophagus, the growing pleura and peritoneum (‘pleuroperitoneal folds’) and the growing muscles of the abdominal wall.

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