DSA 2: Ribs Flashcards
What does the head of the rib articulate with?
The inferior costal facet of the vertebra above and the superior costal facet of its own vertebra
(Only ribs 2-9)
What does the tubercle of the rib articulate with?
The transverse process of the corresponding vertebra
(Only ribs 1-10)
Which ribs only articulate with their own vertebra and not the one above?
Ribs 1, 10, 11, 12
Which ribs do not have tubercles and cannot articulate with transverse processes of the corresponding vertebrae?
Ribs 11, 12
Which ribs are atypical?
Ribs 1, 2, (maybe 10), 11, and 12
Which ribs are typical?
Ribs 3-9
Which ribs are true ribs?
Ribs 1-7
Which ribs are false ribs?
Ribs 8-12
What are the floating ribs?
Ribs 11-12
What muscles insert onto the first rib and are responsible for elevating it?
Anterior Scalene
Middle Scalene
What muscle inserts onto the second rib and elevates it?
Posterior scalene
What is the action of the serratus anterior m.?
Protracts the scapula
What is the action of the Quadratus Lumborum M.?
Fixes the 12th rib in inhalation
Extends and laterally flexes the vertebral column
What is the origin and insertion of the thoracic diaphragm?
Xiphoid process, lower 6 ribs, L1-3 to the Central tendon of the diaphragm
Where are the intercostal vessels found and how are they oriented?
Located between internal and innermost intercostal ms. in VAN orientation (sup to inf)
Which ribs have bucket handle motion? How do they move?
Ribs 1-2, 8-10
Superiorly and laterally (increases horizontal/transverse diameter)
Which ribs have pump handle motion? How do they move?
Ribs 3-7
Superiorly and anteriorly (increases the A/P diameter)
What motion is performed by Ribs 11-12 during respiration?
Caliper
Inhalation - down and posterior
Exhalation - up and anterior
What are the 5 motions of the ribs?
Bucket Handle
Pump Handle
Caliper
Torsional
Non-physiologic
What occurs during torsional movement of the ribs?
Vertebrae of the rib turns towards one side, causing the anterior portion of that rib to move back and twist upwards (inferior border up) and the opposite rib to move front and twist downwards (superior border up). Side the rib cage rotates toward shrinks = less air in
Example: If T5 is rotated to the left, left R5 moves back and twists upward and right R5 moves front and twists downward
What causes non-physiologic motion of the ribs?
Trauma/repetitive microtrauma
Rib becomes subluxed anterior/posterior or laterally compressed
Describe an inhalation dysfunction
Describe an exhalation dysfunction
- Rib stuck upward during exhalation
- Rib stuck downward during inhalation
What is respiratory vs structural SD?
Respiratory: Inhalation/Exhalation SDs ribs is unable to move in normal physiologic motion (whether it’s bucket handle, pump or caliper)
Structural: torsional and non-physiological SDs
What does the BITE mnemonic mean?
BI: Treat bottom rib if inhalation SD (bottom rib preventing the other ribs from going downward_
TE: Treat top rib if exhalation SD (top rib preventing the other ribs from going upward)
Typical causes of rib dysfunction (There’s a lot)
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)
