Lecture 32 (Ribs 2)

Question 1

adequate respiration responsible for:

Answer 1

• movement of air
• venous and lymphatic circulation
• prevention of complications

Question 2

Acutely ill patients and their ribs:

Answer 2

Few do NOT warrant a focused exam of the respiratory mechanism

Question 3

reduction of the inhalation phase due to

Answer 3

May be due to consolidation from pneumonia, CHF

Question 4

reduction of the exhalation phase due to

Answer 4

May be due to asthma or other obstructive dz.

Question 5

If the present exacerbation is due primarily to CHF there will be restriction of the

Answer 5

lower thorax to inhalation

Question 6

If the present exacerbation is due primarily to COPD - Dramatic limitation to

Answer 6

Dramatic limitation to exhalation, and exhalation phase will be active (patient is working to get air out)

Question 7

primary causes of rib pain

Answer 7

• costochondral separation
• costochondritis
• somatic dysfunction

Question 8

secondary causes of rib pain

Answer 8

A lot of things, organs, infections, aneurysms, pneumonia

Question 9

Costochondral separation caused by and phys exam reveals and associated with?

Answer 9

• Caused by blunt trauma, violent coughing, landing hard on your feet
• Physical exam reveals tenderness over the costochondral junction
• Often associated with rib fracture
• Why we span the costochondral jxn. with our hands when treating the Inhalation S.D

Question 10

Costochondritis:

Answer 10

-Pain and inflammation within the costochondral or chondrosternal joints
-Swelling is usually NOT associated
Typically multiple joints involved
-In the ddx for Chest Pain in clinic or ED. Often requires further w/u to r/o cardiac etiology

Question 11

Tietze Syndrome:

Answer 11

• Pain and inflammation within one or more costochondral joint(s)
• Swelling (palpable) is associated with pain and inflammation
• Labs: may have elevated Sed rate (ESR), and/or CRP

Question 12

Respiratory S.D. are related to

Answer 12

inhalation/ exhalation

Question 13

Structural S.D. due to

Answer 13

• Posterior rib
• Anterior rib
• Anterior-posterior rib compression
• Lateral rib compression

Question 14

OMM is used to improve:

Answer 14

• Sympathetic and parasympathetic factors: Decrease sympathicotonia
• Spinal and rib mechanics: (OMT is) designed to increase motion of the costal cage
• Diaphragm function: Restore motion, freeing the diaphragm for better excursion
• Vascular and lymphatic flow: Assist the body in mobilizing the immune system