Review: Rib Counterstrain

Question 1

______ rib tenderpoints are usually indicative of a depressed rib

Answer 1

Anterior

Question 2

Posterior rib tenderpoints are usually indicative of ______ rib

Answer 2

Elevated

Question 3

Location and tx position of counterstrain point AR1

Answer 3

Inferior to clavicle on rib 1, lateral to manubrium (directly inferior to SC joint)

pt supine, doc head of table; F STRT [treats a depressed rib, inhalation restriction]

Question 4

Location and tx position of counterstrain point AR2

Answer 4

1.5” lateral to manubrium on rib 2, below midclavicular line; may also be found deep in axilla

pt supine, doc head of table; F STRT [treats a depressed rib, inhalation restriction] — same as AR1

Question 5

Location and tx position of counterstrain point AR3-6

Answer 5

Anterior axillary line on ribs 3-6 (slightly anterior to midaxillary line)

Pt seated, dr behind pt with knee under arm on unaffected side; F STRT [treats a depressed rib, inhalation dysfunction]

Question 6

Location and tx position of counterstrain point PR1

Answer 6

Posterior margin of rib head beneath margin of trapezius

Pt supine or seated; doc standing behind/to the side

If seated, doc may use pt’s arm over docs knees to fine tune SB, either same side as TP or opposite

E SRT (slight extension of head, use SB to fine tune toward/away)

Question 7

Location and tx position of counterstrain point PR2

Answer 7

Superior surface of angles of ribs, at medial border of scapula, about 2.5” lateral to midline

Pt seated, doc standing behind/to the side; doc places pts arm on side of dysfunction over knee; F SARA (trunk and head)

Question 8

Location and tx position of counterstrain point PR3-6

Answer 8

Superior surface of angles of ribs, at medial border of scapula, about 2.5” lateral to midline

Pt seated, doc standing behind/to the side; doc places pts arm on side of dysfunction over knee and grasps pts shoulder; F SARA (trunk)

Question 9

Which ribs have bucket handle motion?

Answer 9

Ribs 1, 7-10

Question 10

Which ribs have pump handle motion?

Answer 10

Ribs 1, 2-6

Question 11

Which ribs have caliper motion?

Answer 11

Ribs 11-12

Question 12

MET/ART tx of rib 1-10 inhalation SD

Answer 12

Depress key rib with exhalation

Question 13

MET/ART tx of rib 11-12 inhalation SD

Answer 13

Quadratus lumborum ME

Question 14

Muscles associated with ribs 1-12 exhalation SDs

Answer 14

Rib 1 — Ant/Med Scalene

Rib 2 — Post Scalene

Ribs 3-5 — Pectoralis minor

Ribs 6-8 — Serratus anterior

Ribs 9-10 — Latissimus dorsi

Ribs 11-12 — Quadratus lumborum