Ribs Supplement Flashcards by Evan Esfahani

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)

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What does the tubercle of the rib articulate with?

The transverse process of the corresponding vertebra

(Only ribs 1-10)

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Which ribs only articulate with their own vertebra and not the one above?

Ribs 1, 10, 11, 12

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Which ribs do not have tubercles and cannot articulate with transverse processes of the corresponding vertebrae?

Ribs 11, 12

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Which ribs are atypical?

Ribs 1, 2, (maybe 10), 11, and 12

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Which ribs are typical?

Ribs 3-9

Sometimes 10

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Which ribs are true ribs?

Why are they called true ribs?

Ribs 1-7

Cartilage attaches to sternum

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Which ribs are false ribs?

Why are they called false ribs?

Ribs 8-12

Cartilage attaches to the costal cartilage of the rib above

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What are the floating ribs?

Ribs 11-12

No anterior attachment

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What muscles insert onto the first rib and are responsible for elevating it?

Anterior Scalene

Middle Scalene

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What muscle inserts onto the second rib and elevates it?

Posterior scalene

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What muscle are found on rib 3-5?

Pectoralis Minor Muscle

Origin: Anterior superior surface of ribs 3-5
Insertion: Medial pectoral nerve

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What is the action of the pectoralis minor muscle?

Stabilizes the scapula, drawing it inferiorly and anteriorly

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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

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What is the action of the serratus anterior muscle?

Protracts the scapula

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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