Rib Biomechanics

Question 1

Which are the atypical ribs?

Answer 1

1 and 2

Question 2

Which ribs are the true ribs?

Answer 2

1 to 7

Question 3

Which ribs false ribs?

Answer 3

Ribs 8 to 12

Question 4

Which ribs are the floating ribs?

Answer 4

Ribs 11 and 12

Question 5

What is true for all ribs?

Answer 5

Costovertebral joints (gliding rotary motion) 
Costotransverse joints (gliding arcuate motion) 
Axis of motion thru the neck of the rib

Question 6

What will all rib motion be influenced by?

Answer 6

Position and mobility of the thoracic vertebrae due to ligamentous attachments

Question 7

What are the three types of rib motion?

Answer 7

Bucket handle
Pump handle
Caliper

Question 8

Where would you see more bucket handle motion?

Answer 8

Lower ribs

Question 9

What makes rib one atypical?

Answer 9

Broader and flatter
Attaches to sternum by a syncondrosis
Attached to scalene muscle and serratus anterior + subclavius

Question 10

What structures pass over rib one?

Answer 10

Subclavian artery and brachial plexus

Question 11

What are the normal mechanics for rib one?

Answer 11

Pump handle motion predominates

Question 12

Describe the inhaled rib dysfunction of rib one.

Answer 12

Held in inhalation by hypertonic scalene muscles (anterior and middle)

Question 13

What are the symptoms of an inhaled rib one dysfunction?

Answer 13

Tenderness over angle of rib posteriorly
Ulnar distribution pain and paresthesias
Arm swelling (compression of subclavian vein against clavicle)

Question 14

Describe the exhaled rib one dysfunction.

Answer 14

Held in exhalation by hypertonic serratus anterior muscle

Question 15

What are the symptoms of an exhaled rib one dysfunction?

Answer 15

Tenderness at costochondral junction anteriorly
Ulnar distribution pain and paresthesias
Arm muscle claudication due to subclavian artery compression

Question 16

What would a dysfunction of an exhaled rib appear like?

Answer 16

Mid-cervical dysfunction sidebent and rotated to the side of the dysfunctional rib
Flexed occipito-atlantal dysfunction, sidebent to the side of dysfunctional rib

Question 17

Describe rib two.

Answer 17

Atypical - broad and flat
Attaches to sternum by bicompartmental synocval joint at manubrio-sternal junction
Muscle attachments for posterior scalene and serratus anterior

Question 18

What are the normal mechanics of rib two?

Answer 18

Pump handle motion

Question 19

Describe the inhaled rib two dysfunction.

Answer 19

Held in inhalation by hypertonic posterior scalene muscle

Question 20

What is the symptom of an inhaled rib two?

Answer 20

Tenderness over angle of rib posteriorly

Question 21

Describe the exhaled rib two dysfunction.

Answer 21

Mayb be held in exhalation by hypertonic serratus anterior muscles

Question 22

What are the symptoms for exhaled rib two dysfunction?

Answer 22

Tenderness at costochondral junction anteriorly

Neck pain and stiffness from passive traction on posterior scalene muscles

Question 23

Describe ribs 3 through 7?

Answer 23

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

Question 24

What are the normal rib mechanics for ribs 3 through 7?

Answer 24

Pump handle motion predominates in the superior ribs, progressive inc to bucket handle motion when moving down ribs

Question 25

Describe an inhaled rib 3 - 7.

Answer 25

Ribs 3 - 5 maybe be held in inhalation by hypertonic pec minor muscle
Ribs 3 - 7 maybe in inhalation by hypertonic iliocostalis thoracis muscles

Question 26

What are the symptoms of an inhaled rib 3-7?

Answer 26

Tenderness at the angle of the rib posteriorly

Reduced thoracic sidebending due to hypertonic iliocostalis thoracis muscle

Question 27

Describe an exhaled rib 3-7?

Answer 27

Held in exhalation by hypertonic iliocostalis cervicis muscles

Question 28

What are the symptoms of exhaled ribs 3-7?

Answer 28

Tenderness at costochondral junction anteriorly

Restricted vertical sidebending contralaterally due to hypertonicitiy of iliocostalis cervicis muscles

Question 29

Describe ribs 8-10.

Answer 29

False ribs
Attach to sternum by synovial joint to costal cartilage above
Muscle attachment to diaphragm and serratus anterior and iliocostalis thoracis and lumborum

Question 30

What are the normal mechanics for ribs 8-10?

Answer 30

Bucket handle motion

Question 31

Describe an inhaled rib 8-10 dysfunction.

Answer 31

Held in inhalation by hypertonic serratus anterior muscle or iliocostalis lumborum

Question 32

What are the symptoms of an inhaled rib 8-10?

Answer 32

Rib angle tenderness posteriorly

Restricted lumbar sidebending from hypertonic iliocostalis lumborum muscles

Question 33

Describe exhaled rib dysfunction 8-10.

Answer 33

Held in echalation by hypertonic iliocostalis thoracis

Question 34

What are the symptoms of an exhaled rib 8-10?

Answer 34

Tenderness over costochondral junction anterolaterally

Question 35

Describe ribs 11 and 12.

Answer 35

Atypical ribs
Floating ribs
No sternal attachment
No consotransverse articulation

Question 36

What are ribs 11 and 12 attached to?

Answer 36

Respiratory diaphragm

Quadratus lumborum

Question 37

What is the normal motion for ribs 11 and 12?

Answer 37

Caliper motion
Inhalation pulls ribs down and posterior
Exhalation draws ribs up and anteriorly

Question 38

What anchors ribs 11 and 12 for a more effective diaphragmatic contraction?

Answer 38

Quadratus lumborum