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Anatomy · Thorax: foramen of Morgagni
Sample itemA 55-year-old obese woman has a smooth opacity in the right cardiophrenic angle on a chest film. CT shows omental fat herniating into the chest through a defect just behind the sternum. Through which diaphragmatic gap has it passed?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Sternocostal triangle
The sternocostal triangle (foramen of Morgagni) lies between the sternal and costal origins of the diaphragm, where the superior epigastric vessels pass. Hernias here are anterior, retrosternal and usually right-sided because the pericardium and heart protect the left. The lumbocostal gap lies posteriorly.
Option by option
A. Sternocostal triangle (correct)
Correct. It is the anterior retrosternal gap between the sternal and costal slips of the diaphragm.
B. Oesophageal hiatus
This hiatus transmits the oesophagus and vagal trunks and causes sliding or rolling hiatus hernias.
C. Caval opening
The caval opening at T8 transmits the inferior vena cava and right phrenic branches, and is not a hernia site.
D. Lumbocostal triangle
This posterolateral gap is the site of the congenital posterior hernia, not a retrosternal one.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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