Ribs (9a-d) Flashcards
1
Q
ME for Rib 1 pump handle inhalation
A
- pt supine
- pt’s neck bent forward
- doc gets sup ant aspect of rib with thumb (b/w 2 heads of SCM)
- pt inhales deeply while doc resists
- doc continues to resist inhalation and exaggerates motion into exhalation
- repeated until motion of the rib is restores
2
Q
Rib 1 bucket handle ME inhalation
A
- contact rib posteriorlaterally
- sb head to relax the scalenes
- resist inhalation, encourage exhalation
- repeat until motion is restored
3
Q
Ribs 2-10 inhalation buck handle ME
A
- pt supine
- doc on df side
- pt sb toward df side until releif of tissue tension
- contact superior aspect of rib with 1st 2 digits, push into exhalation in midaxillary line
4
Q
Ribs 11 and 12 caliper inhalation ME
A
- Pt prone
- doc opp df
- pull legs toward doc (sb pt away from df)
- grab ASIS, pull posteriorly
- push on posterior aspect of involved rib… push into exhalation as the pt forcefully exhales
- repeat until motion of the rib is restored
5
Q
Rib 1 pump handle exhalation ME
A
- pt supine, hand on head
- doc on df side
- contact 1st rib posteriorly and other hand on pt’s hand
- on inhalation, push on the post part, and tell pt to raise their head off the table
- hold 3-5 sec, then relaxe
- 3-5 times or until motion of rib is restored
6
Q
Rib 1 bucket handle exhalation ME
A
- it’s kind like the same thing as pump handle except the pt rotates head 30 degrees away from the affected side and places hand, palm up, on forehead
- infero-lateral traction force on affected rib
- pt raises head off table, isometric contraction
- increase traction force on affectib rib with each cycle
7
Q
Ribs 2-10 pump handle exhalation ME
A
- pt supine, doc on df side facing cephalad
- palm on forehead for pt
- contact sup aspect of affected rib posteriorly, other hand on pt’s head
- inf traction force on affected rib
- patient raises HAND toward ceiling while inhaling deeply
- you know the rest…
8
Q
Ribs 2-10 bucket handle exhalation ME
A
- pt supine, doc on df side, pt hand on forehead
- same thing as before, but the pt raises hand up and out at 45 degrees while inhaling deeply
9
Q
Ribs 11 and 12 exhalation df ME
A
- pt prone
- doc opp df
- legs pulled toward doc
- pt’s arm abducted
- lateral traction as patient inhales deeply
10
Q
Posterior rib head HVLA (modified kirksville)
A
- pt supine, doc opp df
- pt crosses arms over body, arm on df side grabs opp ASIS, other arm grabs opp shoulder
- point of contact is the posterior rib angle
- thrust on exhalation
11
Q
Upper ribs 1-4 hvla, chin pivot
A
- pt prone, doc at head opp df
- pt cups chin w/ ipsilateral hand
- place hand at rib df
- move pt’s elbow cephalad until motion is felt at df
- rotate head toward the df into barrier
- anterolateral thrust at end of exhalation
12
Q
Seated rib 1 inhalation df (J stroke) HVLA
A
- pt seat, doc behind
- doc places foot on table opp df, pt drapes arm over knee
- sb head toward df rib
- apply thrust inferiorly/medially with exhalation
13
Q
Still technique for left posterior rib
A
- pt seated, doc on df side behind him
- abduct arm until motion felt at rib
- compression through left elbow
- adduct left arm across chest while maintaining compression and localization toward the rib head
- end with arm adducted across patient’s chest
14
Q
Exhalation anterior TP rib sd: right exhaled rib 6 still technique
A
- pt supine, doc on df side
- pull on arm inferiorly until you feel motion localized to the rib , ask pt to exhale
- then ask pt to inhale and flex pt’s arm while maintaining traction and localization (like the hand is above their head)
15
Q
Inhalation posterior rib sd: Right inhaled rib 6 Still technique
A
- ok, just start with their hand up (flexed)
- when they exhale, bring their arm down (extend)
- remember the traction thing
- return arm to near neutral
