etc

Question 1

pectorialis m

Contraction can cause _________. rib dysfunction.

Engaging pec minor can help treat __________ rib dysfunctions

Answer 1

Contraction can cause anterior (inhalation) rib dysfunction

Engaging pec minor can help treat exhalation rib dysfunctions

Question 2

Accessory muscle of inhalation when scapula is fixed in place

(Ex: COPD patient grasping bedrail)

Answer 2

Serratus anterior muscle

Question 3

If one rib stops moving before the other rib during exhalation, that rib has an ____________ restriction, therefore an ________ dysfunction

Answer 3

If one rib stops moving before the other rib during exhalation, that rib has an exhalation restriction, therefore an inhalation dysfunction

Moves into inhalation position, restricted to exhalation position

Question 4

If one rib stops moving before the other rib during inhalation, that rib has an __________ restriction, therefore an ___________ dysfunction.

*Moves into exhalation position, restricted to inhalation position

Answer 4

If one rib stops moving before the other rib during inhalation, that rib has an inhalation restriction, therefore an exhalation dysfunction.

*Moves into exhalation position, restricted to inhalation position

Question 5

Rib 1 (Inhalation) SD

Answer 5

flexion, sidebent towards and rotated away from dysfunctional rib

push down on exhalation

resist on inhalation

Question 6

Ribs 2-6 (Inhalation)

Answer 6

Patient: supine with dysfunctional rib resting on doctors

knee, sidebent towards dysfunctional rib

Doctor: standing with flexed knee ipsilateral to

dysfunctional rib on the table Hand Position

Question 7

Ribs 7-10 (Inhalation) SD

Answer 7

supine with ipsilateral shoulder adducted

Question 8

Ribs 11-12 (Inhalation) SD

Answer 8

Patient: prone with legs sidebent 15-20 towards the dysfunction (decrease tension on quad. lumborum m.)

 Doctor: stands opposite the dysfunctional rib

Cephalad hand – hypothenar eminence medial and inferior to the angle of the dysfunctional rib

 Caudad hand – grasps ASIS ipsilateral to dysfunction to

shorten quadratus lumborum

Question 9

Ribs 1-2 (Exhalation) SD

Answer 9

 Patient: supine, head rotated 30 away from

dysfunctional rib with dorsum of ipsilateral wrist on

forehead

Cephalad hand – placed on top of patients hand on

forehead

 Caudad hand – grasps the superior angle of the

dysfunctional rib

Question 10

Ribs 3-5 (Exhalation)

Answer 10

Patient: supine with arm ipsilateral to dysfunctional rib

fully flexed

 Doctor: contralateral to dysfunctional rib

Hand Position

 Cephalad hand – rests on patients arm

 Caudad hand – grasps the superior angle of the

dysfunctional rib

Question 11

Ribs 6-8 (Exhalation)

Answer 11

Position

 Patient: supine with ipsilateral shoulder flexed to 90

 Doctor: ipsilateral to dysfunctional rib

Hand Position

 Cephalad hand – grasps the superior angle of the

dysfunctional rib

 Caudad hand – maneuvers elbow

Technique

 While exerting caudad, lateral traction with cephalad

hand, instruct patient to push elbow towards the ceiling

(scapular protraction) and apply counterforce

 Maintain isometric contraction 3-5 seconds then have

patient relax

 Increase caudad, lateral traction and repeat steps of MET

Question 12

Ribs 9-10 (Exhalation)

Answer 12

Position

 Patient: supine with arm on dysfunctional side abducted

 Doctor: ipsilateral to dysfunctional rib

Hand Position

 Cephalad hand – abducts ipsilateral shoulder to 90 and

stabilizes elbow

 Caudad hand – grasps the superior angle of the

dysfunctional rib Technique

 Instruct patient to push their elbow caudally (into adduction) and apply counterforce

 Maintain isometric contraction 3-5 seconds then have patient relax

 Increase caudad, lateral traction and repeat steps of MET

Question 13

Ribs 11-12 (Exhalation) SD

Answer 13

Position

 Patient: prone with legs sidebent 15-20 AWAY from dysfunction (increase tension on ipsilateral quadratus lumborum)

 Doctor: stands contralateral to dysfunctional rib

Hand Position

 Cephalad hand – stabilizes rib superior to the

dysfunctional rib

 Caudad hand – grasps iliac crest ipsilateral to

dysfunctional rib (increase tension on ipsilateral

quadratus lumborum) Technique

 Cephalad hand exerts cephalad pressure while patient pulls iliac crest ipsilateral to the dysfunction towards the ipsilateral shoulder while physician applies counterforce

 Maintain isometric contraction 3-5 seconds then have patient relax

 Increase caudad, lateral traction and repeat steps of MET