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*OSII > 3. DSA- Ribs > Flashcards

3. DSA- Ribs Flashcards

1
Q

The _______ of a typical rib articulates with its own vertebra at the ________ costal facet, and articulates with the vertebra above at the ______ costal facet

A

Head; superior; inferior

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2
Q

______ = area of the rib between the head and the tubercle

A

Neck

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3
Q

______ = area of the rib that articulates with the transverse process of the corresponding vertebra

A

Tubercle

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4
Q

_____ = abrupt change in rib curvature

A

Angle

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5
Q

2 joints associated with anterior rib cage

A

Costochondral joint

Sternocostal joint

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6
Q

Which ribs only articulate with their own vertebrae, and NOT the one above?

A

1
10
11
12

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7
Q

Which ribs do NOT have tubercles, and therefore do not articulate with transverse processes?

A

11

12

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8
Q

Which ribs are considered atypical?

A

1
2
11
12

[sometimes 10]

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9
Q

Which ribs are considered typical?

A

3-9 [sometimes 10]

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10
Q

True ribs 1-7 have cartilage attachments to _______

False ribs 8-10 have cartilage attachments to the costal cartilage of the rib _______

A

Sternum

Above

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11
Q

T/F: floating ribs 11 and 12 have no anterior attachment

A

True

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12
Q

The sternal angle of the sternum is associated with which rib’s costal cartilage?

A

2

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13
Q

Which of the following is not associated with the ribs in some way?

A. Scalenes
B. Pectoralis minor m.
C. Serratus anterior m.
D. Latissimus dorsi m.
E. Quadratus lumborum m.
F. All of the above are associated with the ribs
A

F. All of the above are associated with the ribs

Scalenes elevate 1st and 2nd rib
Pec minor originates on ribs 3,4,5
Serratus anterior inserts on ribs 2-8
Part of Lat dorsi originates on lower 4 ribs
Quadratus lumborum inserts on 12th rib, fixes it during inhalation

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14
Q

Which muscles associated with the ribs are involved in respiration?

A

External intercostals
Internal intercostals
Innermost intercostals
Diaphragm

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15
Q

Action of external intercostals

A

Elevate ribs during forced inspiration

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16
Q

Action of internal intercostals

A

Depression of ribs

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17
Q

Action of innermost intercostals

A

Depression of ribs

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18
Q

Action of diaphragm

A

Descends during inspiration

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19
Q

Differentiate the actions of the 3 scalene muscles

A

Anterior scalene and middle scalene elevate 1st rib

Posterior scalene elevates 2nd rib

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20
Q

How much of the rib cage circumference is covered by the following:

External intercostal mm.

Internal intercostal mm.

Innermost intercostal mm.

A

External = starts from spine around to costal cartilage

Internal = starts from rib angle to sternum

Innermost = starts from rib angle to costal cartilage

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21
Q

Which of the following is most superior in the costal groove on the inferior side of each rib (between the internal intercostal m. and the innermost intercostal m.)?

A. Intercostal nerve
B. Intercostal vein
C. Intercostal artery
D. Phrenic nerve

A

B. Intercostal vein

[VAN from superior to inferior]

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22
Q

Respiratory motion known as “bucket handle”

A

Moves superiorly and laterally

Increases transverse diameter

Ribs 1-2, 8-10

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23
Q

Respiratory motion known as “pump handle”

A

Moves superiorly and anteriorly

Increase A/P diameter

Ribs 3-7

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24
Q

Respiratory motion of ribs 11 and 12 is ______ and _______ with inhalation

A

Downward; posterior

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25
Q

Respiratory motion of ribs 11 and 12 is _____ and _____ with exhalation

A

Upward and superior

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26
Q

When T5 is rotated left, aka torsonal movement, what motions occur with the associated rib?

A

Left 6th rib: posterior aspect turns externally; anterior extremity more flat with its inferior border sharp

Right 6th rib: posterior aspect rib turns internally; anterior extremity having its superior margin accentuated

[caused by articulation at the inferior costal facet

27
Q

What is considered non-physiologic movement of the ribs?

A

Due to trauma or repetitive microtrauma; ribs become subluxed anteriorly or posteriorly

28
Q

What are the 2 general types of rib SD?

A

Respiratory SD: where rib is unable to move in its normal physiologic motion (inhalation vs. exhalation dysfunction)

Structural SD: can be torsional where rotation becomes fixed, or non-physiologic where the SD always exists (subluxation)

29
Q

If ribs 1,2, and 8-10 have bucket handle motion, and ribs 3-7 have pump handle motion, what type of motion occurs at ribs 11-12?

A

Caliper

30
Q

______ dysfunction = rib being held in a position of inhalation such that motion toward inhalation is more free and motion toward exhalation is restricted

A

Inhalation

[the opposite is true of exhalation dysfunction]

31
Q

What is the “key rib”?

A

The rib that maintains a group of ribs in dysfunctional motion = this is the rib you treat FIRST!

32
Q

If a group of ribs is found to have an inhalation SD, which one is your key rib aka the one you treat first?

A

The bottom of the dysfunctional group

[mnemonic BITE = Bottom Inspired, Top Expired]

33
Q

Causes of rib dysfunction

A

Thoracic scoliosis or kyphosis

Asymmetries such as pectus excavatum or carinatum

Osteoporosis or osteoarthritis

COPD (increased AP diameter)

Abnormal tension in musculature

Trauma to rib cage

Lifestyle and affective states

34
Q

An elevated rib would indicate what type of SD?

A

Inhalation dysfunction

35
Q

Treatment for inhalation dysfunction at any rib 1-10

A

Depress key rib with exhalation

36
Q

Treatment for inhalation dysfunction at ribs 11-12

A

Quadratus lumborum m.

37
Q

Treatment for exhalation dysfunction at rib 1

A

Ant/med scalene m.

38
Q

Treatment for exhalation dysfunction at rib 2

A

Posterior scalene m.

39
Q

Treatment for exhalation dysfunction at rib 3-5

A

Pectoralis minor m.

40
Q

Treatment for exhalation dysfunction at ribs 6-8

A

Serratus anterior m.

41
Q

Treatment for exhalation dysfunction at rib 9-10

A

Latissimus dorsi m.

42
Q

Treatment for exhalation dysfunction at ribs 11-12

A

Quadratus lumborum m.

43
Q

What are the 5 rib motions?

A
  1. bucket handle
  2. pump handle
  3. caliper
  4. torsional
  5. non-physiologic
44
Q

Describe the movement of the bucket handle motion. Which ribs move?

A
  • superiolateral movement = ↑ transverse diameter

- ribs 1-2, 8-10

45
Q

Describe the movement of the pump handle motion. Which ribs move?

A
  • Superoanterior movement = ↑ AP diameter

- Ribs: 3-7

46
Q

Describe the movement of the caliper/pincer motion. Which ribs move?

A
  • downward and posterior w/ inhalation
  • up and superior w/ exhalation
  • ribs 11 and 12
47
Q

Subluxation

A

incomplete/partial dislocation of joint or organ

48
Q

Describe torsional movement: how are both the same/opposite side of the ribs changed?

A

Thoracic vertebra is rotated either side, say to the right

Same side/”right”:

  • Posterior rib on inferior segment turns externally
  • anterior rib on inferior segment: more flat w/ its inferior sharp border

Opposite side/”left”:

  • Posterior rib on inferior segment turns internal
  • anterior rib on inferior segment: superior margin accentuated
49
Q

Describe non-physiologic movement of the rib:

  • cause?
  • rib dysfunction and effect
  • rib state?
A
  • due to trauma/repetitive movement
  • ribs subluxed (misaligned/partially dislocated) anteriorly or posteriorly -> create abnormal/hypernormal ribs that are carried either more anterior/posterior along axis b/t costovertebral or costotransverse articulations
  • 1+ ribs lose usual plasticity and become restricted
50
Q

What causes torsional rib movement?

A

rotation of thoracic spine

51
Q

2 types of respiratory rib dysfunctions

A

inhalation and exhalation restriction

52
Q

5 types of structural rib dysfunction

A
  1. Anterior and posterior subluxation
  2. Superior subluxation of the first rib
  3. Anteroposterior compression
  4. Lateral compression
  5. Torsion
53
Q

What types of rib movement can cause respiratory somatic dysfunction? Why?

A

Rib can’t move in normal physiologic motion

  1. bucket handle (rib 1,2,8-10)
  2. pump handle (rib 3-7)
  3. Caliper (rib 11-12)
54
Q

What types of rib movement can cause structural somatic dysfunction? Why?

A
  1. torsional- rotation of thoracic spine, rotation becomes fixed
  2. non-physiologic: anterior/posterior subluxation
55
Q

Describe an inhalation SD

A

Rib being held in a position of inhalation such that motion toward inhalation is more free and motion toward exhalation is restricted.

56
Q

Describe an exhalation SD

A

Rib being held in a position of exhalation such that motion toward exhalationis more freeand motion toward inhalation is restricted.

57
Q

What is the key rib in a SD?

A
  • Key rib –rib that maintains a group of ribs in dysfunctional motion
  • Treat this rib FIRST
58
Q

What is the key rib in an inhalation SD?

A

Bottom of the group

59
Q

What is the key rib in an exhalation SD?

A

Top Expired

Exhalation Dysfunction = Top of the group

60
Q

other names for inhalation SD

A
  • Inhaled
  • Inspired
  • Moves inhaled
  • Symmetrical in inhalation
  • Doesn’t move in exhalation
  • Elevated rib
  • Restricted in exhalation/Exhalation restriction
61
Q

other names for exhalation SD

A
  • Exhaled
  • Expired
  • Moves exhaled
  • Symmetrical in exhalation
  • Doesn’t move in inhalation
  • Depressed rib
  • Restricted in inhalation
  • Inhalation restriction
62
Q

What is the general tx for each rib (or rib group) w/ an inhalation SD (exhalation restriction)?

A
  • Ribs 1-10: Depress key rib with exhalation

* Ribs 11-12 –Quadratus lumborum

63
Q

What is the general tx for each rib (or rib group) w/ an exhalation SD (exhalation restriction)?

A
  • Rib 1 –Ant/Med Scalene
  • Rib 2 –Post Scalene
  • Ribs 3-5 –Pectoralis minor
  • Ribs 6-8 –Serratus anterior
  • Ribs 9-10 –Latissimus dorsi
  • Ribs 11-12 –Quadratus lumborum
64
Q

What happens to rib location w/ osteoporosis?

A

ribs become anteriorly depressed

*OSII (39 decks)

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