4- Ribs II

Question 1

What 4 things that must be mentioned every time you name a rib dysfunction?

Answer 1

• side of dysfunction
• # of the rib
• where the rib lives (prefers to be)
• Predominant type of dysfunction that you are ASSESSING

Question 2

Rib somatic dysfunction characteristics

Answer 2

• pain in one cycle of breathing, not the other cycle
• palpation = tender
• usually pain along the entire rib

Question 3

Every time I inhale, my 6th rib hurts, but when I exhale it feels good. What type of somatic dysfunction is it?

Answer 3

exhalation somatic dysfunction

Question 4

A 45 yo male comes in complaining of pain along the costosternal and costotransverse areas that is sharp and pinpoint. What type of somatic dysfunction is this?

Answer 4

pump handle rib dysfunction

Question 5

A 45 yo male comes in complaining of pain mostly along the mid-axillary line that is aching and regional. What type of somatic dysfunction is this?

Answer 5

bucket handle rib dysfunction

Question 6

If a patient comes in to your clinic complaining of rib pain, and you determine that it is likely a pump handle rib dysfunction with a T5 NRLSR, what do you treat first?

Answer 6

The thoracic dysfunction - T5 NRLSR

Question 7

A 54 yo female patient comes complaining of pain in the ribs. You notice upon examination that she has with tenderness, puffiness, stringy tissue texture changes along the sternum with no edema. What is the disease? How do you treat?

Answer 7

Costochondritis

• treat all somatic dysfunctions and give NSAIDS

Question 8

A 54 yo female patient comes complaining of pain in the ribs. You notice upon examination that she has pain with tenderness, puffiness, stringy tissue texture changes along the sternum with low levels of edema. What is the disease? How do you treat?

Answer 8

Tietze’s syndrome

• treat all somatic dysfunctions and give NSAIDS

Question 9

The thoracic inlet area is covered by the cervico-thoracic diaphragm called what?

Answer 9

Sibson’s fascia

Question 10

Why does the 1st rib, manubrium and T1 act as a unit?

Answer 10

They are all part of a synchondrosis joint

Question 11

If there is an inhalation pump handle somatic dysfunction, where is the rib narrowing and widening?

Answer 11

Rib narrowing = above

Rib widening = below

Question 12

What is the most prominent part of the front rib in an inhalation pump handle somatic dysfunction?

Answer 12

Front prominence = inferior part of the rib

Question 13

Ribs 11 and 12 are primarily of what motion?

Answer 13

caliper motion (like tongs)

Question 14

When assessing a patient on their stomach and feeling their 11th and 12 ribs, how are the ribs supposed to move normally on inhalation?

Answer 14

posterior and inferior

Question 15

When assessing a patient on their stomach and feeling their 11th and 12 ribs, how are the ribs supposed to move normally on exhalation?

Answer 15

anterior and superior

Question 16

When you have a group of ribs in inhalation somatic dysfunction, which rib do you treat?

Answer 16

The most inferior rib

Inhalation = Inferior (both start with “i”)

Question 17

When you have a group of ribs in exhalation somatic dysfunction, which rib do you treat?

Answer 17

The highest (most superior) rib.

Question 18

If a 40 yo patient with an exhalation somatic dysfunction from ribs 1-2, what muscle do you use to help treat the dysfunction?

Answer 18

anterior and middle scalenes = rib 1 (most superior rib)

Question 19

If a 40 yo patient with an exhalation somatic dysfunction from ribs 2-10, what muscle do you use to help treat the dysfunction?

Answer 19

posterior scalene = rib 2 (most superior rib)

Question 20

If a 40 yo patient with an exhalation somatic dysfunction from ribs 5-10, what muscle do you use to help treat the dysfunction?

Answer 20

pectoralis minor = ribs 3-5 (most superior rib)

Question 21

If a 35 yo patient with an exhalation somatic dysfunction from ribs 10-12, what muscle do you use to help treat the dysfunction?

Answer 21

serratus anterior = ribs 6-10 (most superior rib)

Question 22

If a 35 yo patient with an exhalation somatic dysfunction from ribs 11, what muscle do you use to help treat the dysfunction?

Answer 22

Latissimus Dorsi/Quadratus lumborum = Ribs 11-12 (most superior rib)

Question 23

You are in the jungle performing a search and rescue mission when a deadly alien warrior confronts you. Do you….
A. Treat his inhaled first rib
B. Explain to him the difference between bucket and pump handle rib dysfunctions.
C. GET TO DA CHOPPA. DO IT NOW! BLAGHGHGH

Answer 23

C. DA CHOPPA