Ribs

Question 1

How do you diagnose Atypical Rib SD?

Answer 1

TART

Ribs 1, 11, 12

• Look for asymmetry
• Palpate for asymmetry, tenderness, tissue texture abnormalities
• Active Range of Motion (without breathing)
• Passive Range of Motion (with Breathing)

Rib 1:

• Stand behind seated patient
• Let them know what you are doing
• Have hands palpate the first rib
• Do springing to assess whether Superior Rib is elevated

Ribs 11 and 12:

• Have Pt lying prone
• Monitor ribs 11 and 12 with hands
• Monitor through respiration
• Determine if dysfunction is Inhalation or Exhalation

Question 2

How do you diagnose Typical Rib SD?

Answer 2

TART

Ribs 2-10

• Look for asymmetry
• Palpate for asymmetry, tenderness, tissue texture abnormalities
• Active Range of Motion
• Passive Range of Motion

Look for INHALATION SD
- Likes to stay in superior position on exhalation

Question 3

How do you do a direct treatment for Rib 1 Inhalation SD?

Answer 3

Have pt lie supine

Physician sitting at head with ipsilateral had to the dysfunctional rib monitoring the rib

Physicians other hand maneuvers head into FLEXION, Rotated AWAY, Sidebent TOWARD

(FRAST)

Follow rib down and forward into exhalation

As pt inhales, resist the motion of the dysfunctional rib

Repeat 3-5 times

Reassess

Question 4

How do you do a direct treatment for Ribs 11 and 12?

Answer 4

Have pt lie prone, with legs sidebent TOWARD dysfunctional rib (15 degrees)

Doc stands opposite dysfunctional rib

Cephalad hand is positioned medial and inferior to angle of the rib

Caudad hand grasps the ASIS ipsilateral to the dysfunction

Aplpy sustained lateral and cephalad traction to dysfunctional rib

During exhalation: exagerate the motion

During Inhalation: resist the motion

Repeat 3-5 times

Reassess

Question 5

How do you do a direct treatment for typical Ribs 2-6 inhalation SD?

Answer 5

Have patient lie supine with dysfunctional rib resting on doc’s knee and sidebent TOWARD dysfunctional rib

Hand placed on intercostal space of the most superior of the dysfunctional ribs

During exhalation, doc exagerates motion
During inhalation, doc resists motion

Repeat 3-5 times

Reassess

Question 6

How do you do direct treatment for Typical ribs 7-10 inhalation SD?

Answer 6

Have patient lie supine with ipsilateral shoulder ADDUCTED and have pt Sidebend TOWARD dysfunction

Doc on side of dysfunction

Ipsilateral thumb and index finger on superior surface of dysfunctional rib

During exhalation, exaggerate motion

During Inhalation, resist motion

Repeat 3-5 times

Reassess