I'm still a little unclear on the actual question. Basically the output impedance is low because that's what amplifiers do...they "convert" a small signal into a larger one and I suppose the ratio of input to output impedance could be one measure of such.
By "physically small" I'm guessing you don't mean inches and microns, but "resistance" wise. If that's the case, all(?) opamps have an output stage made of a couple of relatively large transistors that can source a (relatively) large amount of current.
For instance look at the internal schematic for the 741 opamp on page 4 of this datasheet:
http://www.national.com/ds/LM/LM741.pdf
On the right side is the output pin connected to two transistors (Q14, Q20) through 25 ohm resistors. These transistors are "turned on" by the preceding circuitry and supply power to whatever is connected to the output...