Rib Treatment Flashcards
Middle Ribs (3-6) Gross Motion Testing
Mixed pump and bucket, primarily pump
Patient supine
Doc at head of table
Thumbs or ulnar aspect of hands to palate costocondral articulations for pump handle
At midaxillary line for bucket handle
Lower Ribs (7-10) Gross Motion Testing
Primarily bucket
Patient supine
Doc at side of table
Thumbs palate costocondral articulations for pump handle
At midaxillary line with fingers for bucket handle
Ribs 11 and 12 Gross Motion Testing
Caliper
Patient prone
Doc at side of table
Thumbs and index fingers palpate shaft of rib
Inhalation Dysfunction
Rib won’t go down for exhalation
Treat inferior rib
Exhalation Dysfunction
Rib won’t go up into inhalation
Treat superior rib
Rib 1 Pump Handle Inhalation Dysfunction ME
Patient supine Doc at head of table Flex neck Contact superior aspect of rib 1 with thumb Resist motion at inhalation Push down during exhalation
Sternocleidomastoid
Rib 1 Bucket Handle Inhalation Dysfunction ME
Patient supine
Doc at head of table
Contact superior surface of first rib posteriolaterally
Flex head
Sidebend toward affected rib
Contact superior aspect of rib, resist motion with inhalation, push down during exhalation
Sternocleidomastoid
Ribs 2-10 Pump Handle Inhalation Dysfunction ME
Patient supine
Doc at head of table, knee behind affected rib
Contact superior aspect of rib on anterior chest wall - lateral to sternum
Resist motion with inhalation, push down with exhalation
Intercostal muscles and descent of diaphragm
Ribs 2-10 Bucket Handle Inhalation Dysfunction ME
Patient supine
Doc at head of table, knee at affected rib
Sidebend to affected rib
Contact superior aspect of rib at midaxillary line
Resist motion during inhalation, push down during exhalation
Intercostal Muscles and Decent of Diaphragm
Ribs 11 and 12 Inhalation Dysfunction ME
Patient prone
Doc opposite posterior rib on side
Legs brought towards doc
Arm on side of posterior rib abducted above head
Grasp ASIS on opposite side and posteriorly rotate
Contact posterior aspect of involved rib
Lateral distraction force as patient exhales and tries to bring hip down towards table
Quadratus lumborum
Rib 1 Pump Handle Exhalation Dysfunction ME
Patient supine Doc on side affected side Patient's hand on forehead Contact superior aspect of affected rib posteriorly Contact patient's hand Patient hold breath Inferior force on rib Posterior force on hand Patient lifts head Hold 3-5 secs Relax
Anterior Scalene Muscles
Rib 1 Bucket Handle Exhalation Dysfunction ME
Patient supine Doc on side of affected rib Patient's hand on side of affected rib on forehead Rotate head 30 degrees away from affected side Contact superior aspect of affected rib posteriorly Contact patient's hand Patient holds breath Interior force on rib Posterior force on hand Patient lifts head up Hold 3-5 secs Relax
Middle Scalene Muscles
Ribs 2-10 Pump Handle Exhalation Dysfunction ME
Patient supine Doc on side of affected rib Patient's hand on affected side on forehead Contact superior aspect of rib posteriorly Contact patient's hand Patient holds breathe Inferior force on rib Posterior force on hand Push hand toward ceiling Hold 3-5 secs Relax
Pectoralis and Serratus Anterior Muscles
Ribs 2-10 Bucket Handle Exhalation Dysfunction ME
Patient supine Doc side of affected rib Patient's hand on side of affected rib on forehead Contact superior aspect of rib posteriorly Contact hand Patient holds breathe Inferior force on rib Posterior force on hand Push hand up and laterally 45 degrees Hold 3-5 secs Relax
Lateral aspect of Serratus Anterior Muscle
Ribs 11 and 12 Exhalation Dysfunction ME
Patient prone Doc on side opposite affected rib Sidebend legs towards doc Leave arms at side Contact ASIS and rotate posteriorly Contact posterior aspect of rib Patient holds breathe Lateral distracting force at rib Patient tries to push hip to table Hold 3-5 secs Relax
Lateral aspect of Latissimus Dorsi and Quadratus Lumborum
