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.

Learn about the general fulcrum of the body known as the heart, its location in front of T4, and common osteopathic lesions affecting it. Explore how compromising nervous integrity can impact function. This quiz is based on the teachings of Velda Lulic DO and McConnell.