Richard
Belli, D.C.
Respiration, Chronic Rib Fixations and Zinc
We have all seen patients that have been
treated by other practitioners for mid and upper back pain that is temporarily
relieved by manipulation, then comes back after a day or two. Chronic rib
fixations are often the result of dysfunction of the respiratory centers in the
brain stem. Additionally, zinc is vitally important for normal function of the
brain stem respiratory centers. Zinc deficiencies are common because of high
carbohydrate and fast food consumption. This, in combination with a zinc
depleted food supply, is a sure recipe for deficiency and respiratory
dysfunction. As a matter of fact, for every molecule of insulin produced, the
pancreas needs four molecules of zinc.
Respiration
is a complex physiological process that is primarily driven by the stimulation
of a chemosensitive area in the ventral aspect of the medulla by hydrogen ions
(H+). As a matter of fact it is thought that H+ may be the only direct stimulus
to the chemosensitive area. The chemosensitive area projects to the dorsal
respiratory group in the medulla, stimulating respiration. The dorsal
respiratory group also receives afferent input from the nucleus solitarius
which receives projections from cranial nerves IX and X. These afferents come
from stretch receptors in the lungs, carotid bodies and the aortic arch. There
is also mechanoreceptor input form the intercostal muscles and the costosternal
and costovertebral joints. All of these inputs are necessary for normal
respiration.
The blood
brain barrier and the blood cerebrospinal barrier are pretty much impermeable
to H+, consequently the H+ needed to stimulate respiration is derived from a
source within the interstitial fluid of the medulla and CSF. Even though carbon
dioxide does not have a strong direct effect on respiration it has a very
powerful indirect effect. The blood brain barrier and blood CSF barrier is
completely permeable to carbon dioxide. Therefore respiration is directly
regulated by blood carbon dioxide levels. As blood carbon dioxide increased, so
does the carbon dioxide levels of the interstitial fluid of the medulla and the
cerebrospinal fluid.
Carbon
dioxide in the cerebrospinal fluid and the interstitial fluid of the medulla react
with water to form carbonic acid, the carbonic acid dissociates into H+ and
bicarbonate ions. This reaction provides the H+ necessary to stimulate the
chemosensitive center, which stimulates the inspiratory area. The chemical
reaction between carbon dioxide and water depends on carbonic anhydrase as a
catalyst. Carbonic anhydrase is a zinc dependent enzyme. That makes the
necessity of zinc for respiration obvious.
The
chemosensitive and respiratory centers are bilateral. If one side dysfunctions
more than the other, there will be incoordination of the respiratory mechanism
and consequent dyskinetic muscles and fixations. The fixations should be
treated with coupled reduction and fast‑stretch modalities and the
patient should be tested for zinc deficiency.