Rib Tx

Question 1

What are the primary motions of the ribs?

Answer 1

pump handle, bucket handle, and caliper

Question 2

What motion is felt at Rib 1? Rib 3? 10? 11?

Answer 2

rib 1: 50/50 bucket and pump
rib 3: primarily pump
rib 10: primarily bucket
rib 11: caliper

Question 3

Restriction of motion of the floating ribs is caused by what muscle?

Answer 3

Quadratus lumborum

Question 4

During inhalation, ribs 4-6 stop abruptly. What kind of dysfunction is this and which rib should you treat first?

Answer 4

exhalation dysfunction; treat most superior rib (in this case rib 4)

Question 5

What type of tx is ME? HVLA?

Answer 5

ME- active, indirect; HVLA- passive, direct

Question 6

During ME tx of bucket handle component of rib 1, what should you instruct the pt to do?

Answer 6

rotate head 30 degrees away from side of dysfunction and place the dorsum of hand on forehead

Question 7

During ME tx of the bucket handle component of rib 8, what should you instruct the pt to do?

Answer 7

pt dorsum of hand on forehead, raise hand against force, push out laterally at 45 degree angle

Question 8

What position should the pt be in for ME tx of ribs 11 and 12?

Answer 8

prone

Question 9

What is the difference between pump and bucket handle ME tx for inhalation dysfunctions of ribs 2-10?

Answer 9

pump handle tx: no sidebending, contact lateral to sternum

bucket handle tx: side bending toward affected side, contact midaxillary line

Question 10

What should the pt be doing with their arms during HVLA tx of a posterior rib head?

Answer 10

Pts dysfunctional side arm grasps ASIS, non-dysfunctional grasps opposite shoulder

Question 11

Which ribs can you use the chin pivot HVLA technique for?

Answer 11

Ribs 1-4 (upper ribs)

Question 12

What type of dysfunction can you use the J stroke for?

Answer 12

Rib 1 inhalation dysfunction