Rib Region

Question 1

Rib 1 (Inhalation SD)

Answer 1

• Pt supine, Dr at head of table

- SB towards, Rotate away (StRa)

Question 2

Rib 2-6 (Inhalation SD)

Answer 2

• Pt supine, Dr has dysfunctional rib on their knee

- SB towards

Question 3

Rib 7-10 (Inhalation SD)

Answer 3

• Pt supine, ipsilateral arm is abducted
• Dr on side of dysfunctional rib
• SB towards

Question 4

Rib 11-12 (Inhalation SD)

Answer 4

• Pt prone, legs SB 15-20 degrees TOWARDS SD
• Dr stands opposite to dysfunctional rib
• One hand below angle of rib, other hand grasps ASIS
• Apply lateral and cephalad traction to dysfunctional rib

Question 5

Ribs 1-2 (Exhalation SD)

Answer 5

Rib 1= anterior, middle scalenes
Rib 2= posterior scalene
-Pt supine, head rotated 30 degrees away from dysfunctional rib, pt has hand on forehead
-Dr stands opposite side of dysfunctional rib
-Dr puts one hand on top of pt’s hand, other hand grasps the superior angle of the dysfunctional rib, apply caudal, lateral traction
-Have pt try to flex head and neck, hold for 3-5s

Question 6

Ribs 3-5 (Exhalation SD)

Answer 6

Rib 3-5= pectoralis minor

• Pt supine, arm on side of dysfunctional rib is fully flexed
• Dr stands opposite side of dysfunctional rib
• Dr puts one hand on pt’s arm, the other hand grasps the superior angle of the dysfunctional rib
• Apply a caudal, lateral pressure on rib while pt pushes their elbow against dr’s hand for 3-5s.

Question 7

Ribs 6-8 (Exhalation SD)

Answer 7

Rib 6-8= serratus anterior

• Pt supine with arm and shoulder flexed to 90, Dr is on same side
• Dr puts one hand on the elbow, the other hand on superior angle of dysfunctional rib
• Exert caudad, lateral traction with one hand, have pt try to push elbow towards ceiling for 3-5s

Question 8

Ribs 9-10 (Exhalation SD)

Answer 8

Rib 9-10= latissimus dorsi

• Pt supine, abducts ipsilateral shoulder to 90 and Dr uses one hand to stabilize the elbow, Dr uses other hand to grasp the superior angle of the dysfunctional rib
• Have pt push against their elbow into adduction for 3-5s

Question 9

Ribs 11-12 (Exhalation SD)

Answer 9

Rib 11-12= quadratus lumborum

• Pt supine with legs SB 12-20 degrees AWAY from dysfunction, Dr stands on opposite side
• Dr puts one hand on iliac crest, the other hand inferior to dysfunctional rib
• Pt tries to pull ipsilateral iliac crest towards ipsilateral shoulder

Question 10

AR 1-2

Answer 10

AR1= inferior to clavicle on rib 1 (lateral to manubrium)
AR2= 1.5” lateral to manubrium on rib 2
Tx: Pt supine or seated, F StRt (flexed neck, sidebend towards. rotated towards)

Question 11

AR 3-10

Answer 11

Anterior axillary line on ribs 3-10, slightly anterior to mid-axillary line
Tx: Pt seated, Dr behind pt with knee under arm on unaffected side F StRt (trunk flexed, sidebend towards, rotated towards)

Question 12

PR 1

Answer 12

PR1= posterior margin of rib head beneath margin of trapezius
Tx: Pt supine or seated, Dr stands behind/ at head of table
E SaRt (extend head, Sidebend away, rotate towards)

Question 13

PR 2

Answer 13

PR2= superior surface of angles of ribs, at medial border of scapula, about 2.5" lateral to midline
Tx: Pt seated, Dr standing behind
F SaRa (trunk flex, sidebend away, rotate away)

Question 14

PR 3-10

Answer 14

PR3-10= superior surface of angles of ribs, at medial border of scapula, about 2.5” lateral to midline
Tx: Pt seated, Dr standing behind, Dr places pt’s arm on side of dysfunction on knee, grasps pt’s shoulder or braces head F SaRa (flex trunk, sidebend away, rotate away)