Ribs Flashcards
What does the head of a rib articulate with?
superior costal facet of its own vertebra; inferior costal facet of vertebra above it
What does the tubercle of a rib articulate with?
articulates w/ transverse process of corresponding vertebra
What makes up the costochondral joint? What is costochondritis?
Costochondral joint = rib attached to costal cartilage
Costochondritis = slippage between the 2 portions (friction causes pain)
What makes up the sternocostal joint?
costal cartilage attached to sternum
Which ribs only articulate w/ their own vertebra and not the one above them?
1, 10, 11, 12
Which ribs do not have tubercles and do not articulate w/ the transverse process?
11, 12
Which ribs are considered typical vs atypical? Which rib could be considered both?
Typical = 3-9
Atypical = 1, 2, 11, 12
10 could be both
Which ribs are considered true, false, and floating? What does each category mean?
True = cartilage attaches to sternum; ribs 1-7 False = cartilage attaches to costal cartilage of rib above; ribs 8-10 Floating = no anterior attachment; ribs 11-12
What is the angle of Louis?
Sternal angle; 2nd rib attachment to costal cartilage
Which muscles attach to and elevate rib 1?
anterior scalene and middle scalene
Which muscle attaches to and elevates rib 2?
posterior scalene
Which muscle has its origin on ribs 3, 4, 5?
pectoralis minor
Which muscle has its insertion on ribs 2-8?
serrates anterior
Which muscle has its origin on the lower 4 ribs?
latissimus dorsi
Which muscle is inserted into the inferior aspect of the 12th rib? What action does this cause?
quadrates lumborum -> fixes/stabilizes 12th rib in inhalation
What is the orientation and action of the external intercostal muscles?
oriented like putting hands in pockets; elevates ribs during inspiration
What is the orientation and action of the internal and innermost intercostal muscles?
oriented like crossing hands on chest; depression of ribs
What is the origin/insertion and action of the diaphragm?
Origin: xiphoid process, lower 6 ribs, L1-3
Insertion: central tendon
Action: descends during inspiration
What 3 things run along the inferior border of ribs and in what order?
Vein, Artery, Nerve (VAN)
Describe bucket handle respiratory motion? What diameter does this increase? What ribs have this motion?
during inspiration, ribs move superiorly and laterally; increases transverse diameter; ribs 1-2 and 8-10
Describe pump handle respiratory motion? What ribs have this motion?
during inspiration, ribs move superiorly and anteriorly; increases A/P diameter; ribs 3-7
Describe caliper/pincer motion in both inhalation/exhalation? What ribs have this motion?
Inhalation: downward and posteriorly
Exhalation: upward and anteriorly
Ribs 11-12
Describe torsional respiratory motion? Give an example
twisting or ribs due to rotated thoracic vertebrae; when vertebrae rotates left, posterior left rib tuns externally and the end will be flattened w/ a sharp inferior border; posterior right rib will turn internally and superior margin will be accentuated
What can cause non-physiologic respiratory movement?
trauma or repetitive micro-trauma
Describe both anterior and posterior subluxation
Anterior: anterior motion of both head of rib on vertebra and costochondral joint
Posterior: posterior motion of both head of rib on vertebra and costocondral joint
Describe anteroposterior compression
posterior motion of costochondral joint and anterior motion at vertebra -> squishes rib and lateral part moves out
Describe lateral compression
lateral rib compression from the side -> pushes costochondral joint anterior and vertebra posterior
Describe inhalation dysfunction. What is another name for it?
rib being held in position of inhalation
aka exhalation restriction
Describe exhalation dysfunction/ What is another name for it?
rib is held in position of exhalation
aka inhalation restriction
What is the key rib?
rib that maintains a group of ribs in dysfunctional motion -> treat that rib
What is the mnemonic for knowing what is the key rib?
BITE
Bottom Inhalation - treat bottom rib of group
Top Exhalation - treat top rib of group
Name 7 causes of rib dysfunction
- thoracic scoliosis/kyphosis
- pectus excavatum/carinatum (rib cage asymmetries)
- bony disease (osteoporosis)
- COPD/emphysema (increased chest wall diameter)
- abnormal tensions in cervical, rotator cuff, or shoulder musculature (if muscles attach to ribs)
- trauma
- lifestyle
In what way will ribs become dysfunctional w/ osteoporosis/osteoarthritis?
ribs become anteriorly depressed
