Ribs Supplement Flashcards
What does the head of the rib articulate with?
- Inferior costal facet of the vertebra above
- Superior costal facet of its own vertebra
(Only ribs 2-9)
What does the tubercle of the rib articulate with?
The transverse process of the corresponding vertebra
(Only ribs 1-10)
Which ribs only articulate with their own vertebra and not the one above?
Ribs 1, 10, 11, 12
Which ribs do not have tubercles and cannot articulate with transverse processes of the corresponding vertebrae?
Ribs 11, 12
Which ribs are atypical?
Ribs 1, 2, (maybe 10), 11, and 12
Which ribs are typical?
Ribs 3-9
Sometimes 10
Which ribs are true ribs?
Why are they called true ribs?
Ribs 1-7
Cartilage attaches to sternum
Which ribs are false ribs?
Why are they called false ribs?
Ribs 8-12
Cartilage attaches to the costal cartilage of the rib above
What are the floating ribs?
Ribs 11-12
No anterior attachment
What muscles insert onto the first rib and are responsible for elevating it?
Anterior Scalene
Middle Scalene
What muscle inserts onto the second rib and elevates it?
Posterior scalene
What muscle are found on rib 3-5?
Pectoralis Minor Muscle
- Origin: Anterior superior surface of ribs 3-5
- Insertion: Medial pectoral nerve
What is the action of the pectoralis minor muscle?
Stabilizes the scapula, drawing it inferiorly and anteriorly
What muscles correspond with ribs 6-8?
Serratuos Anterior
- Origin: Anterior surface of the medial border of scapula
- Insertion: superior lateral surface of ribs 2-8
What is the action of the serratus anterior muscle?
Protracts the scapula
What muscles correspond to ribs 9-10?
Latissimus Dorsi Muscle
- Origin: Spinous processes of T7-S3 and lower 4 ribs
- Insertion: intertubercular/bicipital groove of the humerus
What is the action of the Latissmus Dorsi Muscle?
Extends, adducts, medially rotates the humerus
What muscles correspond to ribs 11-12?
Quadratus Lumborum
- Origin: Iliac crest and iliolumbar ligament
- Insertion: inferior aspect of rib 12, TPs of L1-4
What is the action of the Quadratus Lumborum Muscle?
Fixes the 12th rib in inhalation
Extends and laterally flexes the vertebral column
What does the external intercostal muscles do?
Forced and quiet inhalation by elevating ribs
What is the action of internal and innermost intercostal muscles?
Fored exhalation via depression of ribs
What is the role of the diaphragm?
Descends during inspiration
Where are the intercostal vessels found and how are they oriented?
Located between internal and innermost intercostal muscles on inferior side of the rib
- Vein: most superior
- Artery: middle
- Nerve: inferior
Which ribs have bucket handle motion?
Describe the motion.
- Ribs 1-2, 8-10
- Moves superiorly and laterally, increasing transverse diamater on AP axis.
What are the 5 motions of the ribs?
- Bucket Handle
- Pump Handle
- Caliper
- Torsional
- Non-physiologic
Which ribs have pump handle motion?
Describe the motion.
- Ribs 3-7
- Moves superiorly and anteriorly, increasing AP diameter on transverse axis
What motion is performed by Ribs 11-12 during respiration?
Describe the motion.
Caliper
- Inhalation: down and posterior
- Exhalation: up and anterior
What occurs during torsional movement of the ribs?
Respiration is restricted on the side the vertebra is rotated towards because ribs have been flattened
What causes non-physiologic motion of the ribs?
- Trauma/repetitive microtrauma
- Rib becomes subluxed anterior/posterior or laterally compressed
- create abnormally hypermobile ribs with the rib being carried more either anteriorly or posteriorly along the axis of motion between the costovertebral and the costotransverse articulations
- One or more ribs lose the usual plasticity and become restricted in a defromed state
What is subluxation?
Incomplete or partial dislocation of joint or organ
What are the respiratory motions that can cause rib somatic dysfunction?
Inhilation restriction and exhalation restriction
- Bucket handle
- Pump handle
- Caliper
What are the structural motions that can cause rib somatic dysfunction?
Anterior and posterior subluxation
Superior subluxation of the first rib
Anteroposterior compression
Lateral compression
Torsion
- Torsional
- Non-physiologic
Describe inahlation somatic dysfunction.
Ribs are a in a position where motion toward inhalation is more free and motion toward exhalation is restricted.
Describe exahlation somatic dysfunction.
Ribs are a in a position where motion toward exhalation is more free and motion toward inhalation is restricted.
When treating a grouped inhalation somatic dysfunction, which rib is the key rib for treatment?
Bottom rib
When treating a grouped exhalation somatic dysfunction, which rib is the key rib for treatment?
TOp rib
What are some typical causes of rib dysfunction?
- Thoracic scoliosis/kyphosis
- Rib cage asymmetry (pectus excavatum/carinatum)
- Osteoporosis/osteoarthritis
- Increased chest wall diameter associated with illness such as COPD
- Abnormal tension in cervical, rotator cuff, or shoulder girdle musculature
- Lifestyle (slumping and depression)
What are the two muscle energy principles used to treat rib somatic disfunctions?
Respiratory assistance
- muscular forces involved in these techniques are generated by the simple act of breathing. Physician applies a fulcrum against which the respiratory forces can work
Using muscle forces to move one region of the body achieve movement of another bone or region
- stabilizing one attachment, the other attachment pulls superiorly on clavicle, alleviating the SD
When T5 is rotated to the left (on T6)
Left 6th rib:
- Posterior aspect turns externally
- Anterior extremity more flat with its inferior border sharp
Right 6th rib:
- Posterior aspect rib turns internally
- Anterior extremity having its superior margin accentuated
Caused by articulation at the inferior costal facet
