Chapter 3 - Thorax & Ribcage Flashcards
Describe the Rule of 3’s
T1-T3 SPs located at level of TPs
T4-T6 SPs are located 1/2 segment below TPs
T7-T9 SPs are located 1 segment below TPs
T10 same as T7-T9
T11 same as T4-T6
T12 same as T1-T3
Spine of scapula is at
T3
Inferior angle of scapular is at
T7
Sternal notch is at
T2
Sternal angle is at
2nd rib & T4
Nipple is at
T4 dermatome
Umbilicus is at
T10 dermatome
Main motion of the Thoracic spine is
Rotation (Upper - R, Lower - F/E)
Motion of the Thoracic spine is limited by
the ribcage
Primary muscles of respiration
diaphragm & intercostals
diaphragm attachments
typhoid process, ribs 6-12, bodies & IV discs of L1-L3
diaphragm innervations
Phrenic C3-C5
diaphragm action
contracts for inspiration, causes venous & lymph return to thorax
Intercostal action
elevate ribs in inspiration, prevent retractions in inspiration
Secondary muscles of respiration
scalenes, pec minor, serratus anterior & posterior, quadratus lumborum, lats
Atypical ribs
1, 2, 11, 12, (some consider 10)
Typical ribs have
tubercle (TP articulation), head (vertebra articulation above & corresponding), neck, angle, shaft
True Ribs
1-7 - attach directly to sternum
False ribs
8-12 - do not attach directly to sternum
Floating ribs
11 & 12 - no anterior attachment
Which ribs primarily have pump-handle motion?
1-5
Which ribs primarily have bucket-handle motion?
6-10
Which ribs primarily have caliper motion?
11-12
Inhalation dysfunction
moves cephalad in inhalation, but not caudal in exhalation (held up)
Pump-handle ribs - inhalation dysfunction
anterior narrowing of ICS above dysfunctional rib, superior edge of posterior rib angle is prominent
Pump-handle ribs - inhalation dysfunction - TTC location
Costochondral & chondrosternal junctions & posterior rib angles
Bucket-handle ribs - inhalation dysfunction
lateral narrowing of ICS above dysfunctional rib, lower rib edge is prominent
Bucket-handle ribs - inhalation dysfunction - TTC location
IC mm at mid-axillary line & posterior rib angles
Exhalation dysfunction
moves caudad in exhalation, but not cephalad in inhalation (held down)
In a group inhalation dysfunction, the key rib is
the lowest rib
In a group exhalation dysfunction, the key rib is
the uppermost rib
OMT targets which rib
KEY rib
