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