Rib Biomechanics Flashcards
Which are the atypical ribs?
1 and 2
Which ribs are the true ribs?
1 to 7
Which ribs false ribs?
Ribs 8 to 12
Which ribs are the floating ribs?
Ribs 11 and 12
What is true for all ribs?
Costovertebral joints (gliding rotary motion) Costotransverse joints (gliding arcuate motion) Axis of motion thru the neck of the rib
What will all rib motion be influenced by?
Position and mobility of the thoracic vertebrae due to ligamentous attachments
What are the three types of rib motion?
Bucket handle
Pump handle
Caliper
Where would you see more bucket handle motion?
Lower ribs
What makes rib one atypical?
Broader and flatter
Attaches to sternum by a syncondrosis
Attached to scalene muscle and serratus anterior + subclavius
What structures pass over rib one?
Subclavian artery and brachial plexus
What are the normal mechanics for rib one?
Pump handle motion predominates
Describe the inhaled rib dysfunction of rib one.
Held in inhalation by hypertonic scalene muscles (anterior and middle)
What are the symptoms of an inhaled rib one dysfunction?
Tenderness over angle of rib posteriorly
Ulnar distribution pain and paresthesias
Arm swelling (compression of subclavian vein against clavicle)
Describe the exhaled rib one dysfunction.
Held in exhalation by hypertonic serratus anterior muscle
What are the symptoms of an exhaled rib one dysfunction?
Tenderness at costochondral junction anteriorly
Ulnar distribution pain and paresthesias
Arm muscle claudication due to subclavian artery compression
What would a dysfunction of an exhaled rib appear like?
Mid-cervical dysfunction sidebent and rotated to the side of the dysfunctional rib
Flexed occipito-atlantal dysfunction, sidebent to the side of dysfunctional rib
Describe rib two.
Atypical - broad and flat
Attaches to sternum by bicompartmental synocval joint at manubrio-sternal junction
Muscle attachments for posterior scalene and serratus anterior
What are the normal mechanics of rib two?
Pump handle motion
Describe the inhaled rib two dysfunction.
Held in inhalation by hypertonic posterior scalene muscle
What is the symptom of an inhaled rib two?
Tenderness over angle of rib posteriorly
Describe the exhaled rib two dysfunction.
Mayb be held in exhalation by hypertonic serratus anterior muscles
What are the symptoms for exhaled rib two dysfunction?
Tenderness at costochondral junction anteriorly
Neck pain and stiffness from passive traction on posterior scalene muscles
Describe ribs 3 through 7?
True ribs
Attach to sternum by synovial joints
Muscle attachments to iliocostalis cervicis and thoracis muscle posteriorly
Muscle attachment to pec minor anteriorly o ribs 3, 4, 5
Muscle attachment to serratus anterior laterally
What are the normal rib mechanics for ribs 3 through 7?
Pump handle motion predominates in the superior ribs, progressive inc to bucket handle motion when moving down ribs
Describe an inhaled rib 3 - 7.
Ribs 3 - 5 maybe be held in inhalation by hypertonic pec minor muscle
Ribs 3 - 7 maybe in inhalation by hypertonic iliocostalis thoracis muscles
What are the symptoms of an inhaled rib 3-7?
Tenderness at the angle of the rib posteriorly
Reduced thoracic sidebending due to hypertonic iliocostalis thoracis muscle
Describe an exhaled rib 3-7?
Held in exhalation by hypertonic iliocostalis cervicis muscles
What are the symptoms of exhaled ribs 3-7?
Tenderness at costochondral junction anteriorly
Restricted vertical sidebending contralaterally due to hypertonicitiy of iliocostalis cervicis muscles
Describe ribs 8-10.
False ribs
Attach to sternum by synovial joint to costal cartilage above
Muscle attachment to diaphragm and serratus anterior and iliocostalis thoracis and lumborum
What are the normal mechanics for ribs 8-10?
Bucket handle motion
Describe an inhaled rib 8-10 dysfunction.
Held in inhalation by hypertonic serratus anterior muscle or iliocostalis lumborum
What are the symptoms of an inhaled rib 8-10?
Rib angle tenderness posteriorly
Restricted lumbar sidebending from hypertonic iliocostalis lumborum muscles
Describe exhaled rib dysfunction 8-10.
Held in echalation by hypertonic iliocostalis thoracis
What are the symptoms of an exhaled rib 8-10?
Tenderness over costochondral junction anterolaterally
Describe ribs 11 and 12.
Atypical ribs
Floating ribs
No sternal attachment
No consotransverse articulation
What are ribs 11 and 12 attached to?
Respiratory diaphragm
Quadratus lumborum
What is the normal motion for ribs 11 and 12?
Caliper motion
Inhalation pulls ribs down and posterior
Exhalation draws ribs up and anteriorly
What anchors ribs 11 and 12 for a more effective diaphragmatic contraction?
Quadratus lumborum
