Ribs 1

diagnosis of respiratory rib SD comparing key rib via TP - locked up or locked down caliper ribs

may have tender points at the tips of ribs 11 and 12 and can be addressed by treating the quadratus lumborum tender point

middle scalene muscle o i

o= Transverse processes of C2-C7 i= rib 1

anterior scalene muscle o i

o= Transverse processes of C3-C6 i= rib 1

posterior scalene muscle o i

o= Transverse processes of C4-C6 i= rib 2

quadrates lumborum o i

o= medial part iliac crest i= rib 12 and lumbar transverse processes

pectoralis minor o i

o= rib 2-5 i= coracoid process scapula

serratus anterior o i

o= ribs 1-8/9 i= medial border scapula

latissimus dorsi o i

o= spinous processes of T6-T12 i= inter tubercular groove humerus, thoracolumbar fascia, iliac crest, ribs 9-12

atypical ribs

ribs 1,2, 10-12

rib motions pump handle number + motion

ribs 1-5 when you inhale anterior portion rib moves towards head -increases AP diameter of thorax

True ribs

ribs 1-7 vertebrosternal ribs<-- connect directly to sternum via costal cartilage

rib motions calipers number + motion

ribs 11-12 With inhalation, ribs move around a single articulation, analogous to internal and external rotation with a bit of "bucket and pump handle" motion -increase AP diameter slightly + increase transverse diameter ALOT

typical ribs

ribs 3-9 2 demifacts on each rib head -articulate with 2 thoracic vertebrae 1 articular facet on tubercle of rib articulates with transverse process of 1 vertebra

rib motions bucket handle number + motion

ribs 6-10 With inhalation, lateral aspect of rib moves cephalad, increasing the transverse diameter of the thorax - increase transverse diameter

false ribs 2 types rib numbers

ribs 8-12 1. vertebrochondral ribs - 8-10 connected to sternum via rib 7 cartilage 2. floating ribs -11-12 have no anterior articulation

diagnosis of respiratory rib SD diagnosis each group -calipers

Place hands laterally on the lower rib cage in the mid-axillary line while patient breathes deeply in and out No need to determine key rib

atypical ribs rib1 - makes unit w/? - vert connection - shape

-Broad and flat - Single facet that articulates with only one vertebra (T1) - Has a synchondrosis with the manubrium making T1, the 1st rib and the manubrium one unit

atypical ribs rib 2 -connection to? - tub for?

-Strong attachment with the sternum at the angle of Louis - Tuberosity for serratus anterior muscle attachment

Rib articulations anterior 2

-costochondral joints -chondrosternal joints

diagnosis of respiratory rib SD comparing key rib via TP -locked down and locked up

-locked down= anterior on mid axillary line -locked up= posterior on rib angles

rib motions 3

-pump handle -bucket handle -calipers

types of rib SD 2

-respiratory -structural

Function rib cage 3

1. Protection 2. Respiration 3 Circulation

Rib articulations posterior 2

1. costovertebral -ribs 1,10,11, and 12 = complete facets -ribs 2-9= demifacets 2. costotransverse

types of rib SD respiratory 2

1. locked up -rib moves easier towards inhalation than exhalation -rib will not go down during exhalation with other ribs 2. locked down -rib moves easier towards exhalation than inhalation -restricted motion during inhalation

diagnosis of respiratory rib SD 4

1. treat thoracic before diagnosing/ treating 2. diagnoses each group of ribs -pump handle -bucket handle -caliper 3. find key rib of dysfunction 4. confirm key rib by locating corresponding tender points

diagnosis of respiratory rib SD diagnosis each group -pump handle

Place hands along the sternal border of 1st to 5th rib while patient breathes deeply in and out - determine if locked up/down (be sure to ask permission, especially with females)

atypical ribs rib 10

Single facet on rib head that only articulates with T10

diagnosis of respiratory rib SD diagnosis each group -bucket handles

Spread fingers along as many ribs as possible along the mid-axillary line while patient breathes deeply in and out - determine if locked up/down

counting typical ribs

correspond with vertebra and the one above

locked down also called

exhalation SD

atypical ribs ribs 11 and 12

floating ribs One vertebral articulation posteriorly - Rib 11 with T11 only and rib 12 with T12 only

locked up also called

inhalation SD

diagnosis of respiratory rib SD finding key rib of dysfunction -locked up group of ribs

key rib inferior rib of SD

diagnosis of respiratory rib SD finding key rib of dysfunction -locked down group of ribs

key rib is superior of the SD