Osteopathic Anatomy: Heart Fulcrum and Lesions

General Fulcrum of the Body

• The AP fulcrum is located in front of T4, where the ascending and descending lines of gravity intersect.
• The heart is situated at this fulcrum, and it's essential to liberate the surrounding areas, including ribs, sternum, and this point.

Lesions Affecting the Heart

• The most common lesions affecting the heart are found in Th.1-Th.4 and upper 4 ribs, specifically the 2nd and 3rd segments.
• Compromise of nervous integrity can lead to disturbances in function and eventually organic involvement.
• Spinal pathology can cause changes on a reflex basis, disrupting the integrative action of the local nervous mechanism.

Cervical Spine and Heart Function

• The upper 3 cervicals (C1, C2, C3) can disturb the heart's functioning if there is a disturbance of fibers from C2 that pass into the vagus nerve.
• The vagus nerve affects the rate, strength, and conductivity of the heart.
• Gentle structural adjustments are necessary to avoid irritating the sympathetic system.

Specific Centers and Their Effects

• The first rib is related to heart failure.
• 1st, 2nd, 3rd, 4th, 5th dorsal vertebrae are related to heart function.
• 2nd to 4th dorsal vertebrae are related to the valves of the heart.
• 3rd and 4th cervical vertebrae are related to the rhythm of the heart.
• The superior cervical ganglion is a sympathetic center.
• The upper four or five dorsal (thoracic) nerves, especially the 2nd and 3rd, are accelerator centers.
• The medulla is related to general circulatory function.

General Vasomotion Centers

• The superior cervical ganglion is related to general superficial capillary circulation.
• The 2nd dorsal and 5th lumbar are related to general vasomotion.

Heart in Relationship to Different Parts of the Body

• The thoracic cage, including the sternum, ribs, thoracic vertebrae, and clavicles, is related to the heart.
• Intrathoracic pressure is maintained by the negative pressure of the abdominal organs.
• The heart, pericardium, and lungs participate in regulating intrathoracic pressure.
• Intraabdominal pressure, affected by the liver and small intestine, influences intrathoracic pressure.

Cardiac Rhythm

• Chaotic or irregular beats are seen in states of depression or anger, with irregular or chaotic variations in cardiac rhythm.
• Coherent beats are seen in states of wellbeing, compassion, or gratitude, with regular and coherent variability in cardiac rhythm.
• The variability of cardiac rhythm is strongest at birth and decreases with age, with a loss of 3% per year due to inadequate parasympathetic training.