Ribs_Diaphragm_sternum

Question 1

sequence of diaphragm contraction

Answer 1

1) central tendon (insertion point) drops down
2) increases AP and transverse diameters of the thoracic cage due to up and out pull on the ribs

*inhalation dilates vena caval aperture
contracts the esophageal hiatus

Question 2

attachments of the diaphragm

Answer 2

1) lower 6 ribs b/l
2) xiphoid
3) Crura: L1-3 R, L1-2 L

Question 3

True vs false ribs

Answer 3

1-7=true
8-12= false
3-9=typical
1 2 10 11 12= atypical

Question 4

Pump handle

Answer 4

ribs 1-5
transverse axis
TPs extend laterally 
increase AP diameter 
ribs move anterior, superior, and lateral

Question 5

Bucket handle

Answer 5

ribs 6-10
AP axis 
TPS angle posteriorly 
increases transverse diameter 
ribs move superior and inferior/ lateral

Question 6

Caliper motion

Answer 6

antero media and posterio-lateral
evident in ribs 11 and 12
vertical axis

Question 7

exhalation SD

Answer 7

down in front up in back

resists inhalation

Question 8

inhalation SD

Answer 8

up in front and down in back

resists exhalation

Question 9

rib landmarks

Answer 9

1=manubrium 
2=sternal angle
3=posterior with T3 at spine of scapula
7= posterior with T7 at inferior angle of scap
12=superior to iliac crest

Question 10

movement of sternum with inhalation

Answer 10

with deep inhalation the sternum glides superior and the caudal ends moves anterior

Question 11

movement of sternum with exhalation

Answer 11

entire sternum glides inferior and inferior end moves posterior

Question 12

increasing sternal angle

Answer 12

M BB

B FB

Question 13

decreasing sternal angle

Answer 13

M FB

B BB

Question 14

Direct method for treating the sternum

Answer 14

one hand articulates the sternum at the angle while the other holds the thoracic spine and provides a counterforce

or rhythmically articulate both the body and manubrium

Question 15

Indirect method for treating sternum

Answer 15

with hands covering the entire body of the sternum, push the body in the direction of ease while having pt breathe

or if supine have one hand on the thoracic spine while the other tests motion and does the “stacking” method of muscle energy

Question 16

movements of the clavicle

Answer 16

abduction: proximal clavicle moves inferior with external rotation (i.e. shrug)

adduction : proximal clavicle moves superior with internal rotation

Flexion: distal moves anterior, proximal moves posterior

Question 17

coracoclavicular ligament

Answer 17

conoid portion prevents anterior movement of clavicle

trapezoid portion prevents posterior movement of the clavicle

Question 18

attachments for Sibson’s fascia

Answer 18

O: deep cervical fascia
1st rib, contiguous with axillary sheath and endothoracic fascia, over the cupula of the lung

**like an ox yolk: influence the contralateral side