Neurovisceral Manipulation of the thorax and the abdomen with Olivier Bazin DO

Classically the visceral manipulations target their attachment systems, ligaments, omentum, fascia … JP Barral and A Croibier to be more complete have added vascular manipulations.

We know that manipulations in general have an effect on mechanoreceptors; without thenervous system, no central response can be obtained. We have studied the visceral system to develop precise manipulations on certain key points of the nerve centers of the organs. These manipulations allow a precise and complete actionon the sympathetic and parasympathetic systems.

For example, most of the right part of the colon is innervated by a cranial nerve, the vagus nerve, while the left part receives its innervation of the sacral parasympathetic system. It is this kind of precision that allows the osteopath’s hand to be effective.

By linking peripheral nerve manipulations with cranial nerve manipulations, this course will show you how to use the nervous system to act on the visceral sphere and achieve a lasting regulatory action on it. Thus, thanks to a good knowledge of the visceral nervous system, it is possible to improve our results for the benefit of patients.

We will see the thorax, the abdomen and the pelvis: we will discuss in particular the manipulative approach of the different branches of the spinal nerves:

• The intercostal nerves that are particularly interesting to manipulate because of their connection to the Autonomic Nervous System, and the viscera underlying their path. We will see that these nerves can either guide you to the diagnosis of visceral fixation, or allow you to remove dysfunctions that direct manipulation of the organ could not fix.

• The posterior branches that give branches to the intervertebral and costo-vertebral joints (joint capsule, ligament and intervertebral muscle). You will be surprised at how knowing how to act on neural ramus can facilitate the structural manipulation of the spine.

• The intercostobrachial nerves, closely connected with the brachial plexus and the pleural region.

• The cluneal nerves, because of their deep distribution for the urogenital sphere. We will see how to manipulate other nerves involved in the regulation of the visceral nervous system: the vagus nerves, the phrenic nerves, the sympathetic trunk and the sacral parasympathetic system.

We will also be interested in the skin, both in order to perfect our osteopathic diagnosis, and to use it reflexively on the viscera that are connected.

I.Course description

Treatment of the visceral dysfunctions by:

• Reflex Action: by manipulation of the neural system connected with the internal organs

– The emergence of the cutaneous branches of the sensory nerves of the organ (vagus, phrenics, splanchnics…)

– The intercostal nerves:  Responsible for the sensivity of the wall

• Connected with the sympathetic trunk

– The dermatome of the organ: reflex zones of Jarricot (diagnosis)

• Mechanical local action: role of re-information of the mechanical receptors (stopping for the nociceptive reflexogenic bows) to obtain a central answer: brain + cerebellum.

II.Course progression

On each chapter we will have a brief anatomical presentation of the structure considered and then a practical approach:

A.Manipulation of the spinal nerve and its different branches

a)Manipulation of the intercostal nerves

b)Manipulation of the intercostobrachial nerves

c)Manipulation of the dorsal ramus and the sinu-vertebral nerve

d)Manipulation of the long thoracic nerve

B.Manipulation of the cluneal nerves

C.Manipulation of the sympathetic system

D.Manipulation of parasympathetic system (vagus nerves + coccygeal plexus)

E.Manipulation of the phrenic nerves

III.General principles of neuro-visceral manipulations

A.Diagnosis

B.Treatment

IV.Integration of the course for a specific approach for each organ

A.Diagnosis

B.Treatment