Rib raising lab

Question 1

what is rib raising utilized for

Answer 1

trying to reduce increased sympathetic tone or spinal facilitation

Question 2

what is the technique for supine rib raising

Answer 2

slide both hand under patients back and contact the rib tubercles/costotransverse articulation

apply gentle ANTEROLTERAL pressure

reposition hands either further inferior or superior and repeat

(easiest to start at the cervico-thoracic junction and move inferiorly toward the sacrum)

Question 3

what is the technique for seated rib raising

Answer 3

instruct patient to cross their arms in front of them with their forearms overlapping
instruct patient to lean forward resting their forearms on your chest or one shoulder

contact the rib tubercles bilaterally with your finger pads starting at the upper ribs

apply anterolateral pressure 1

Question 4

what is the osteopathic hug

Answer 4

for diaphragm restrictions

myofascial release

Question 5

what are the functions of the diaphragm

circulation? respiration

Answer 5

Primary muscle of respiration

Modulator of pressure differential between abdominal cavity and thoracic cavity

Major driver of circulatory and lymphatic return to the heart

Question 6

where does the diaphragm attach

Answer 6

Attaches to the Xiphoid process and 6 lower ribs along costal arch anteriorly

Attaches to the T/L junction, vertebral bodies of L1-L3, and rib 12 posteriorly

Question 7

which structures pass through the diaphragm

Answer 7

Inferior Vena Cava (T8)
Esophagus (T10)
Descending Aorta (T12)
Lymphatic Duct (with aorta)
Greater, Lesser, and Least Thoracic Splanchnic Nerves (from lateral sides of the crus
Sympathetic Chain (under medial arcuate lig)

Question 8

what are the posterior muscular attachments to the ribs

Answer 8

Posterior musculature: Serratus posterior superior, serratus posterior inferior, levatores costarum (breves and longus), ileocostalis, longissimus, QL

Question 9

what are the anterior muscles that attach to the ribs

Answer 9

Serratus anterior, pectoralis minor, pectoralis major, transversus thoracis, scalenes, rectus abdominis, internal and external obliques, transversus abdominis, subclavius

Question 10

what is the ultimate goal of manipulation of ribs

Answer 10

balancing sympathetic tone

contact rib heads through stimulation or inhibition

Question 11

where does the sympathetic chain ganglia sit

Answer 11

Lie anterior to rib heads of ribs 1-12

Continues to sacrum lying anterior to the transverse processes of Lumbar vertebrae.