Dooley Noted: 1/23/2016
In Immaculate Dissection I: Core Concepts today, we discussed the three natural anatomic hiatuses of the thoracic diaphragm.
These holes pass through the thoracic diaphragm to allow for passage of structures to and from the thorax and the abdomen.
The three major hiatuses include holes for the inferior vena cava, aorta, and esophagus.
These particular hiatuses are located at particular vertebral levels, which made present with mobility lock-ups.
The following mnemonic can help you remember the hiatal levels:
“I ate (8) ten eggs at 12.”
I ate (8) = inferior vena cava at T8
Ten Eggs = Esophagus at T10
At 12 = Aorta at T12
Because the diaphragm can tighten around these structures, impediments in the flow through said tissues may be altered.
Diaphragmatic pressure at the inferior vena cava can result in cold feet and lower limbs that lack circulation.
Diaphragmatic pressure at the aorta can increase the visibility of the aortic pulse and contribute to aortic hyperextension.
Diaphragmatic pressure at the esophagus an result in acid reflux, GERD and indigestion.
Plus, the corresponding vertebral levels may experience pain or mobility problems due to viscerosomatic reflexive referral pain.
The diaphragm and its ability to contract (on inhalation) and eccentrically load (on exhalation) must be assessed in thoracic spine hypomobilities at the above listed hiatuses.
Consider the role of breathing and the effects on circulation and digestion.
As always, it’s your call.
– Dr. Kathy Dooley