Ribs Flashcards

1
Q

Typical

A

3-9 Similar in structure Each rib head to 2 facets Costotransverse articulation

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2
Q

Atypical

A

1, 2, 10, 11, 12 #1 –most curved, flat, no angle or groove, single facet with vertebral body #2 –demifacetswith T1 & T2 bodies, structure similar to #1 #10 –single facet with T10 body #11 & 12 –no tubercles, tapered ends, single facets w/ bodies (no costotransversearticulatios)

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3
Q

True

A

1-7 Attaches to sternum directly

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4
Q

False

A

8-10 Cartilage unites w/ that of rib 7 to attach to the sternum

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5
Q

Floating

A

11-12 Lack cartilage Float freely w/ muscle fibers

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6
Q

Pump Handle

A

Ribs 1-5 Transverse processes extend laterally Creates more of a TRANSVERSE AXISBucket

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7
Q

Bucket Handle

A

Ribs 6-10 Transverse processes angle back (posteriorly) Creates more of an AP AXIS

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8
Q

Caliper

A

Ribs 11 and 12 Vertical Axis (more or less)

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9
Q

Somatic Dysfunction: named for direction

A

of ease Inhaled vs Exhaled BITE Mnemonic (used to aid treatment) B –Bottom I –Inhaled T –Top E –Exhaled

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10
Q

Major Muscles of Inspiration

A

Diaphragm Ext Intercostals Levator Costarum

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11
Q

Accessory Muscles of Inspiration

A

Scalenes SCM Pectoralis Latissimus Dorsi Serratus Anterior Serratus Post. Sup. QL

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12
Q

Major Muscles of Expiration

A

Passive Recoil Int Intercostals

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13
Q

Accessory Muscles of Expiration

A

Transversus thoracis Rectus abdominis Internal oblique Transversus abdominis SerratusPost. Inf.

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14
Q

“Take my breath away”

A

•QuadratusLumborum •Origin •Post. Iliac Crest •Iliolumbarligament •Insertion •Rib 12 •TP of L1-4 •Action •Fixation of rib 12 during respiration •Lateral flexion (side-bending) of the trunk

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15
Q

The ribs attach to the vertebral segments at the same level and

A

above (for example, rib 3 attaches at T2 and T3).

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16
Q

Anterior Rib Assessment

A

Can be in the seated or supine position (we will do supine today)  Observe global breathing patterns Chest v abdominal breathing Rate, rhythm, ease of breathing Assess motion of the following areas: Ribs 1-5 (Pump handle motion) Ribs 6-10 (Bucket handle motion) Assess for the anterior counterstrain points

17
Q

Rib Anterior Counterstrain Points

18
Q

Posterior Rib Assessment

A

Best done in the prone position

Assess

Ribs 11-12 (Caliper motion)

Posterior counterstrainpoints

19
Q

Rib Posterior Counterstrain Points

21
Q

Anterior Rib Counterstrain

A
  • Found along the mid clavicular line, or along the mid axillary line
  • Often associated with exhaled sd
  • Treated
  • Knee contralateral
  • flexion and side bending towards the tender point (more flexion with anterior points and more side bending with lateral points)
  • Rotation is usually towards the tender point.
22
Q

Posterior Rib Counterstrain

A
  • Found along the posterior rib angles
  • Often associated with inhaled sd
  • Treated
  • Knee ipsilateral
  • slight extension, side bending away to elevate the posterior part of the rib,
  • Rotation usually away from the rib tender point.
23
Q

With MET and pump handle ribs add more

24
Q

with MET and bucket handle ribs add more

A

side-bending

25
MET for exhaled rib 1
anterior and middle scalenes
26
MET exhaled Rib 2
27
MET exhaled ribs 3-5
pec minor
28
MET exhaled Ribs 6-10
lat dorsi
29
Muscle Energy: Inhaled caliper ribs
* Caudadhand over ASIS * Cephaladhand over posterior lateral aspect of ribs 11 or 12 * Anterior lateral vector Iliopsoas?
30
Muscle Energy:Exhaled ribs 11-12
* Caudadhand over ASIS * Cephaladhand over posterior medial ribs 11 or 12 * Anterior vector
31
Muscle Energy: Inhaled pump and bucket handle ribs
32
Ribs and Sympathetics
The sympathetic chain ganglia run along the anterior aspect of rib heads The sympathetic chain ganglia continue along the transverse processes b/l to L2 A somatic dysfunction of a rib can affect the sympathetic nervous system So… Treating that area can "balance" the sympathetic tone
33
Rib Raising Indications
Hyper-sympathetic tone Restricted respiratory excursion of ribs Decreased lymphatic drainage \*\*Good for "delicate" or hospitalized patients
34
Rib Raising Contraindication
Rib fracture Spinal cord injury/surgery Malignancy (relative)
35
Supine Rib Raising
Patient: Supine Physician (you!!): Seated at one side of table Technique: Slide both hands under patient, can "roll" patient in order to position hands properly Finger pads should contact costotransverse articulations Lift anterior and draw fingers toward you Use forearms as fulcrum Constant pressure is inhibitory Decreased sympathetic tone Kneading is stimulatory Increased sympathetic tone OVERALL GOAL IS TO "BALANCE" AUTONOMIC TONE!!!!!!
36
Seated Rib Raising
Patient: Sitting Physician (you!!): Standing, facing patient Technique: Have patient cross arms in front of them with forearms overlapping and instruct them to lean forward so that their arms rest on you Contact rib tubercles with fingerpads and apply anterolateral pressure Use your body and lean back
37