A 58-year-old male with a history of chronic obstructive pulmonary disease (COPD) presents with increased shortness of breath and a productive cough.
On osteopathic structural exam, you note boggy, edematous tissue texture changes and tenderness over the anterior chest at the 2nd intercostal spaces bilaterally, near the sternum.
These findings are most consistent with viscerosomatic reflexes related to which of the following?
