Ribs DSA

Question 1

What m elevate the 1st and 2nd ribs?

Answer 1

1st - Anterior and Middle Scalene

2nd rib - Posterior scalene

I get up at 1 AM 2 P

Question 2

What muscle do you use to treat exhalation sd for ribs 3, 4, 5?

Answer 2

pectoralis minor

also causes inhalation sd

Question 3

What muscle do you use to treat ribs 6-8?

Answer 3

serratus anterior

accessory m for inhalation

Question 4

What muscle do you use to treat ribs 9-10?

Answer 4

latissimus dorsi

Question 5

What muscle do you use to treat ribs 11-12?

Answer 5

Quadratus Lumborum

Question 6

What ribs move superiorly and laterally to increase transverse diameter?

Answer 6

ribs 1,2, 8-10

bucket handle

Question 7

What ribs more superiorly and anteriorly to increase anterior and posterior diameter?

Answer 7

ribs 3-7

pump handle

Question 8

how do ribs 11-12 move with inhalation?

Answer 8

downward and posterior, spread further apart

exhalation - upward and superior

caliper movement

Question 9

How does torsional movement impact breathing?

Answer 9

makes it harder to inhalation deeply

“take a deep breath facing forward, take another turned to the left”

Question 10

Explain how torsional movement effects rib T5 rotated to the left (on T6)

Answer 10

Left 6th
- posterior aspect turns externally

right 6th rib

• posterior aspect of the rib is more internal
• accentuates superior margin of the anterior extremity

articulation at inferior costal facet due to the rotation of the thoracic spine - its FIXED

Question 11

How does non-physiologic movement affect the ribs?

Answer 11

From trauma

rib subluxed anterior or posteriorly making them hypermobile

they end up becoming restricted in a SD

Question 12

What is it called when you have a symmetrical inhalation?

Answer 12

inhalation sd

more synonyms:
restricted in exhalation, elevated rib, moves inhaled

Question 13

What is it called when you have a fixed depressed rib?

Answer 13

exhalation dysfunction

more synonyms:
expired, symmetrical exhalation, inhalation restriction

Question 14

How do you know what key rib to treat in a group of ribs in dysfunctional motion?

Answer 14

BITE
bottom rib - inspiration sd
top rib - expiration sd

Question 15

Causes of rib dysfunction?

Answer 15

thoracic scoliosis/kyphosis
asymmetry - pectus excavatum and carinatum
osteoporosis OA
COPD
shoulder tensions and m issues
trauma
slumping aka med students at a desk

Question 16

What are the atypical ribs?

Answer 16

1, 2, 11, 12