Lower Thoracic Aperture

Vertebrae

Muscles

• Diaphragm muscles

• Abdominal muscles

• The last seven intercostal muscles

Segments

• T6-T9: major splanchnic nerve

• T9-T12: minor splanchnic nerve

• Pelvic splanchnic nerve

Some Osteopathic Considerations

• Significance of the diaphragm for thoracic respiration, circulation, organ function, and posture.

• Functional unity between diaphragm, quadratus lumborum, and iliopsoas.

• Sympathetic nerve supply of all abdominal organs.

• Connection to the CSC via the phrenic nerve, which arises from the segments C3, C4, and C5.

• The diaphragm plays a central role for pressure conditions in the abdomen and thorax and therefore for all body functions.

Example: An increase of abdominal pressure moves the diaphragm upward to keep the pressure gradient constant between the thoracic and abdominal cavities. This increases pressure in the thorax, which eventually stresses respiration and circulation. With greater physical exertion, the auxiliary musculature of respiration must be increasingly activated. Both facts, the changed pressure conditions as well as the strain on the auxiliary musculature of respiration, affect the posture of the spine. When the diaphragm functions at a high level for a long time, this changes not only the axes of movement in the organs, but also the orientation of the respiratory movements in the diaphragm. This in turn affects the entire mobilization of the organs that depends on respiration.

• The iliopsoas and quadratus lumborum are significant muscles for the posture of the pelvis and lumbar spinal column (LSC). Their nerve supply comes from the upper LSC.

• The TLJ is a key area for torsions of the spinal column.

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