DSA 2: Ribs

Question 1

What does the head of the rib articulate with?

Answer 1

• Inferior costal facet of the vertebra above
• Superior costal facet of its own vertebra

(Only ribs 2-9)

Question 2

What does the tubercle of the rib articulate with?

Answer 2

The transverse process of the corresponding vertebra

(Only ribs 1-10)

Question 3

Which ribs only articulate with their own vertebra and not the one above?

Answer 3

Ribs 1, 10, 11, 12

Question 4

Which ribs do not have tubercles and cannot articulate with transverse processes of the corresponding vertebrae?

Answer 4

Ribs 11, 12

Question 5

Which ribs are atypical?

Answer 5

Ribs 1, 2, (maybe 10), 11, and 12

Question 6

Which ribs are typical?

Answer 6

Ribs 3-9

Sometimes 10

Question 7

Which ribs are true ribs?

Why are they called true ribs?

Answer 7

Ribs 1-7

Cartilage attaches to sternum

Question 8

Which ribs are false ribs?

Why are they called false ribs?

Answer 8

Ribs 8-12

Cartilage attaches to the costal cartilage of the rib above

Question 9

What are the floating ribs?

Answer 9

Ribs 11-12

No anterior attachment

Question 10

What muscles insert onto the first rib and are responsible for elevating it?

Answer 10

Anterior Scalene

Middle Scalene

Question 11

What muscle inserts onto the second rib and elevates it?

Answer 11

Posterior scalene

Question 12

What muscle are found on rib 3-5?

Answer 12

Pectoralis Minor Muscle

• Origin: Anterior superior surface of ribs 305
• Insertion: Medial pectoral nerve

Question 13

What is the action of the pectoralis minor muscle?

Answer 13

Stabilizes the scapula, drawing it inferiorly and anteriorly

Question 14

What muscles correspond with ribs 6-8?

Answer 14

Serratuos Anterior

• Origin: Anterior surface of the medial border of scapula
• Insertion: superior lateral surface of ribs 2-8

Question 15

What is the action of the serratus anterior muscle?

Answer 15

Protracts the scapula

Question 16

What muscles correspond to ribs 9-10?

Answer 16

Latissimus Dorsi Muscle

• Origin: Spinous processes of T7-S3 and lower 4 ribs
• Insertion: intertubercular/bicipital groove of the humerus

Question 17

What is the action of the Latissmus Dorsi Muscle?

Answer 17

Extends, adducts, medially rotates the humerus

Question 18

What muscles correspond to ribs 11-12?

Answer 18

Quadratus Lumborum

• Origin: Iliac crest and iliolumbar ligament
• Insertion: inferior aspect of rib 12, TPs of L1-4

Question 19

What is the action of the Quadratus Lumborum Muscle?

Answer 19

Fixes the 12th rib in inhalation

Extends and laterally flexes the vertebral column

Question 20

What does the external intercostal muscles do?

Answer 20

Forced and quiet inhalation by elevating ribs

Question 21

What is the action of internal and innermost intercostal muscles?

Answer 21

Fored exhalation via depression of ribs

Question 22

What is the role of the diaphragm?

Answer 22

Descends during inspiration

Question 23

Where are the intercostal vessels found and how are they oriented?

Answer 23

Located between internal and innermost intercostal muscles on inferior side of the rib

• Vein: most superior
• Artery: middle
• Nerve: inferior

Question 24

Which ribs have bucket handle motion?

Describe the motion.

Answer 24

• Ribs 1-2, 8-10
• Moves superiorly and laterally, increasing transverse diamater on AP axis.

Question 25

What are the 5 motions of the ribs?

Answer 25

* Bucket Handle * Pump Handle * Caliper * Torsional * Non-physiologic

Question 26

Which ribs have pump handle motion? Describe the motion.

Answer 26

* Ribs 3-7 * Moves superiorly and anteriorly, increasing AP diameter on transverse axis

Question 27

What motion is performed by Ribs 11-12 during respiration? Describe the motion.

Answer 27

Caliper * Inhalation: down and posterior * Exhalation: up and anterior

Question 28

What occurs during torsional movement of the ribs?

Answer 28

Respiration is restricted on the side the vertebra is rotated towards because ribs have been flattened

Question 29

What causes non-physiologic motion of the ribs?

Answer 29

* Trauma/repetitive microtrauma * Rib becomes subluxed anterior/posterior or laterally compressed

Question 30

What is subluxation?

Answer 30

Incomplete or partial dislocation of joint or organ

Question 31

What are the respiratory motions that can cause rib somatic dysfunction?

Answer 31

* Bucket handle * Pump handle * Caliper

Question 32

What are the structural motions that can cause rib somatic dysfunction?

Answer 32

* Torsional * Non-physiologic

Question 33

Describe inahlation somatic dysfunction.

Answer 33

Ribs are a in a position where motion toward **inhalation is more free** and motion toward exhalation is restricted.

Question 34

Describe exahlation somatic dysfunction.

Answer 34

Ribs are a in a position where motion toward **exhalation is more free** and motion toward inhalation is restricted.

Question 35

When treating a grouped inhalation somatic dysfunction, which rib is the key rib for treatment?

Answer 35

Bottom rib

Question 36

When treating a grouped exhalation somatic dysfunction, which rib is the key rib for treatment?

Answer 36

TOp rib

Question 37

What are some typical causes of rib dysfunction?

Answer 37

* Thoracic scoliosis/kyphosis * Rib cage asymmetry (pectus excavatum/carinatum) * Osteoporosis/osteoarthritis * Increased chest wall diameter associated with illness such as COPD * Abnormal tension in cervical, rotator cuff, or shoulder girdle musculature * Lifestyle (slumping and depression)