Ribs DSA

Question 1

What does the head of a rib articulate with?

Answer 1

articulates with vertebral body above (inferior costal facet) & with its own vertebra (superior costal facet)

Question 2

What is the neck of the rib?

Answer 2

area between the head & the tubercle

Question 3

What does the tubercle of the rib articulate with?

Answer 3

articulates with the transverse process of the corresponding vertebra

Question 4

What is the angle of the rib?

Answer 4

costal angle is the abrupt change in rib curvature

Question 5

Name the parts of the typical rib

Answer 5

head
neck
tubercle
angle
body

Question 6

Describe the costochondral joint

Answer 6

between rib & its costal cartilage

Question 7

Describe the sternocostal joint

Answer 7

between the costal cartilage & body of the sternum

Question 8

Why are ribs 1, 10, 11, and 12 atypical?

Answer 8

only articulate with their own vertebrae

Question 9

Ribs 11 & 12

Answer 9

do NOT have tubercles (do not articulate w/ transverse processes)

Question 10

Which ribs are typical?

Answer 10

ribs 3-9

Question 11

True ribs

Answer 11

ribs 1-7

cartilage attaches to sternum

Question 12

False ribs

Answer 12

ribs 8-12

8-10 have cartilage that attach to costal cartilage of rib above

Question 13

Floating ribs

Answer 13

ribs 11-12

no anterior attachment

Question 14

Parts of the sternum

Answer 14

Manubrium

Sternal Angle (rib 2 costal cartilage)

Body

Xiphoid process

Question 15

Action of external intercostal ms

Answer 15

elevate ribs during forced inspiration

starts from spine around to costal cartilage

Question 16

Action of internal & innermost intercostal ms

Answer 16

depression of ribs

internal: starts from rib angle to sternum
innermost: starts from rib angle to costal cartilage

Question 17

Anterior Scalene M

Answer 17

inserts on superior surface of 1st rib

elevates 1st rib

Question 18

Middle Scalene M

Answer 18

inserts on superior surface of 1st rib

elevates 1st rib

Question 19

Posterior Scalene M

Answer 19

inserts on 2nd rib

elevates 2nd rib

Question 20

Pectoralis minor m

Answer 20

O: anterior superior surface of ribs 3, 4, 5

I: coracoid process of scapula

stabilizes scapula by drawing it inferiorly & anteriorly

Question 21

Serratus anterior m

Answer 21

O: ant surface of medial border of scapula

I: superior lateral surface of ribs 2-8

protracts the scapula

Question 22

Lattissimus dorsi m

Answer 22

O: SP of T7-S3, lower 4 ribs

I: intertubercular groove of humerus

extends & adducts & medially rotates humerus

Question 23

Quadratus lumborum m

Answer 23

O: iliac crest & iliolumbar ligament

I: inferior aspect of rib 12

extends & laterally flexes vertebral column

**fixes the 12th rib in inhalation

Question 24

Where does the neurovascular bundle of ribs run?

Answer 24

along costal groove on inferior side of rib

found between internal & innermost intercostal m

Question 25

Rib Motion Axes

Answer 25

Bucket handle: anterior to posterior

Pump handle: transverse

Question 26

Bucket handle

Answer 26

ribs move superiorly & laterally

increase transverse diameter

ribs 1-2, 8-10

Question 27

Pump handle

Answer 27

ribs move superiorly & anteriorly

increase AP diameter

ribs 3-7

Question 28

Respiratory motion

Answer 28

downward & posterior w/ inhalation

upward & superior w/ exhalation

by ribs 11 & 12

Question 29

Torsional movement

Answer 29

when T5 is rotated to the right (on T6)-due to rotation of thoracic spine

post aspect of right 6th rib turns externally

post aspect of left 6th rib turns internally

ant extremity of right 6th rib becomes more flat

ant extremity of left 6th rib having its superior margin accentuated

Question 30

Non-physiologic movement

Answer 30

due to trauma or repetitive micro-trauma

rib becomes subluxed anteriorly or posteriorly

1 or more ribs lose usual plasticity & become restricted in deformed state

Question 31

Respiratory rib dysfunction

Answer 31

inhalation restriction
exhalation restriction

rib is unable to move in its normal physiologic motion

Question 32

Structural rib dysfunction

Answer 32

anterior or posterior subluxation
superior subluxation of 1st rib
anteroposterior compression
lateral compression
torsion

Question 33

Inhalation SD

Answer 33

rib being held in position of inhalation such that motion toward inhalation is more free & motion toward exhalation is restricted

Question 34

Exhalation SD

Answer 34

rib being held in position of exhalation such that motion toward exhalation is more free & motion toward inhalation is restricted

Question 35

What is the key rib?

Answer 35

rib that maintains a group of ribs in dysfunctional motion

treat this rib first!

Question 36

Key rib in inhalation SD

Answer 36

bottom of group is key rib

Question 37

Key rib in exhalation SD

Answer 37

top of group is key rib

Question 38

How to diagnose inhalation SD

Answer 38

key rib is @ bottom of group

assessment made as to whether pump handle or bucket handle component is most restricted

Question 39

How to diagnose exhalation SD

Answer 39

key rib is @ top of group

assess if pump handle or bucket handle component is more restricted

Question 40

Causes of rib dysfunction

Answer 40

Thoracic scoliosis
Rib cage asymmetries (pectus excavatum or pectus carinatum)
Bony diseases
Increased chest wall diameter b/c illness
Abnormal tensions in cervical, rotator cuff or should m
Trauma to rib cage
Lifestyle & affective states

Question 41

Osteoporosis/OA presentation

Answer 41

ribs become anteriorly depressed b/c deterioration of vertebral support