Lecture 8: Ribs

Question 1

What ribs perform primarily pump handle motion?

Answer 1

2-5

Question 2

What is the motion of the 1st rib?

Answer 2

50% pump/50% bucket

Question 3

What does BITE stand for?

Answer 3

Bottom Inhalation/Top Exhalation

Question 4

What muscles attach to the first rib?

Answer 4

Anterior and MIddle scalenes

Question 5

What muscle attaches to rib 2?

Answer 5

Posterior scalene

Question 6

What muscle attaches to ribs 3-5?

Answer 6

Pectoralis minor

Question 7

What muscle attaches to ribs 6-9?

Answer 7

Serratus anterior

Question 8

What muscle attaches to ribs 10-11?

Answer 8

Latissimus dorsi

Question 9

What muscle attaches to rib 12?

Answer 9

Quadratus lumborum

Question 10

What innervates the diaphragm?

Answer 10

C3/4/5 keeps the diaphragm alive!

Question 11

What structure pierces through Simpons’s fascia twice during its course?

Answer 11

the thoracic duct

Question 12

What is the sympathetic innervation of the lungs?

Answer 12

Approx. T 2-7

Question 13

Where are the crura of the diaphragm located?

Answer 13

L1-L3

Question 14

Where are the respiratory centers located in the brain?

Answer 14

Medulla, dura

Question 15

Where are the Chapman points for the bronchus located? (anterior and posterior)

Answer 15

Ant: 2nd intercostal space near sternum, bilateral
Post: In soft tissue between spinous process of T2 and transverse process of T3, bilateral

Question 16

Where are the Chapman points for the Upper Lung located? (Anterior and posterior)

Answer 16

Ant: 3rd intercostals space near sternum, bilateral.
Post: In soft tissue between spinous process of T3 and transverse process of T4, bilateral.

Question 17

Where are the Chapman points located for the lower lung?

Answer 17

Ant: 4th intercostals space near sternum, bilateral.
Post: In soft tissue between spinous process of T4 and transverse process of T5, bilateral.

Question 18

Who “discovered” counterstrain?

Answer 18

Dr. Lawrence Jones

Question 19

What is the first thing you have to do when treating a tender point?

Answer 19

Monitor the point with one finer and establish a 10/10 pain scale

Question 20

What is the most important thing to remember when assessing a tender point?

Answer 20

Maintain finger contact with the point!

Question 21

What is the reduction goal of counterstrain?

Answer 21

70% reduction or below a 3 on the pain scale

Question 22

Where is AR 1 located?

Answer 22

Sternoclavicular Joint

Question 23

Where is AR 2 located?

Answer 23

2nd rib at the midclavicular line

Question 24

Where are AR 3-6 located?

Answer 24

Anterior Axillary Line for 3rd-7th ribs

Question 25

What is the treatment for ALL Anterior points??

Answer 25

Seated, flexed neck F-STRT

Question 26

Mermaid position: Are the pt’s feet on the same of opposite side of the tender point?

Answer 26

SAME SIDE

Question 27

Where is the physician’s leg?

Answer 27

OPPOSITE SIDE

Question 28

Where is the location of PR 1?

Answer 28

Posterior portion of rib 1

Question 29

Where is the location of PR 2-6?

Answer 29

Superior surface of the rib angles 2-6

Question 30

How do you Tx PR 1?

Answer 30

Seated, Extended neck, SART

One finger on point, one is extending the head.
Physician’s knee is up under the armpit opposite the Dx. Wrap them around the point.

Question 31

How do do you Tx PR 2-6?

Answer 31

Seated, Flexed Neck, SART

Pt is mermaid style with legs OPPOSITE the Dx. Physician’s foot goes on the table on the SAME SIDE as the tender point

Question 32

What type of dysfx do the anterior points indicate?

Answer 32

Depressed rib

Question 33

What type of dysfx do the posterior points indicate?

Answer 33

Elevated rib