Ribs

Question 1

What does the head of a rib articulate with?

Answer 1

superior costal facet of its own vertebra; inferior costal facet of vertebra above it

Question 2

What does the tubercle of a rib articulate with?

Answer 2

articulates w/ transverse process of corresponding vertebra

Question 3

What makes up the costochondral joint? What is costochondritis?

Answer 3

Costochondral joint = rib attached to costal cartilage

Costochondritis = slippage between the 2 portions (friction causes pain)

Question 4

What makes up the sternocostal joint?

Answer 4

costal cartilage attached to sternum

Question 5

Which ribs only articulate w/ their own vertebra and not the one above them?

Answer 5

1, 10, 11, 12

Question 6

Which ribs do not have tubercles and do not articulate w/ the transverse process?

Answer 6

11, 12

Question 7

Which ribs are considered typical vs atypical? Which rib could be considered both?

Answer 7

Typical = 3-9
Atypical = 1, 2, 11, 12
10 could be both

Question 8

Which ribs are considered true, false, and floating? What does each category mean?

Answer 8

True = cartilage attaches to sternum; ribs 1-7
False = cartilage attaches to costal cartilage of rib above; ribs 8-10
Floating = no anterior attachment; ribs 11-12

Question 9

What is the angle of Louis?

Answer 9

Sternal angle; 2nd rib attachment to costal cartilage

Question 10

Which muscles attach to and elevate rib 1?

Answer 10

anterior scalene and middle scalene

Question 11

Which muscle attaches to and elevates rib 2?

Answer 11

posterior scalene

Question 12

Which muscle has its origin on ribs 3, 4, 5?

Answer 12

pectoralis minor

Question 13

Which muscle has its insertion on ribs 2-8?

Answer 13

serrates anterior

Question 14

Which muscle has its origin on the lower 4 ribs?

Answer 14

latissimus dorsi

Question 15

Which muscle is inserted into the inferior aspect of the 12th rib? What action does this cause?

Answer 15

quadrates lumborum -> fixes/stabilizes 12th rib in inhalation

Question 16

What is the orientation and action of the external intercostal muscles?

Answer 16

oriented like putting hands in pockets; elevates ribs during inspiration

Question 17

What is the orientation and action of the internal and innermost intercostal muscles?

Answer 17

oriented like crossing hands on chest; depression of ribs

Question 18

What is the origin/insertion and action of the diaphragm?

Answer 18

Origin: xiphoid process, lower 6 ribs, L1-3
Insertion: central tendon
Action: descends during inspiration

Question 19

What 3 things run along the inferior border of ribs and in what order?

Answer 19

Vein, Artery, Nerve (VAN)

Question 20

Describe bucket handle respiratory motion? What diameter does this increase? What ribs have this motion?

Answer 20

during inspiration, ribs move superiorly and laterally; increases transverse diameter; ribs 1-2 and 8-10

Question 21

Describe pump handle respiratory motion? What ribs have this motion?

Answer 21

during inspiration, ribs move superiorly and anteriorly; increases A/P diameter; ribs 3-7

Question 22

Describe caliper/pincer motion in both inhalation/exhalation? What ribs have this motion?

Answer 22

Inhalation: downward and posteriorly
Exhalation: upward and anteriorly
Ribs 11-12

Question 23

Describe torsional respiratory motion? Give an example

Answer 23

twisting or ribs due to rotated thoracic vertebrae; when vertebrae rotates left, posterior left rib tuns externally and the end will be flattened w/ a sharp inferior border; posterior right rib will turn internally and superior margin will be accentuated

Question 24

What can cause non-physiologic respiratory movement?

Answer 24

trauma or repetitive micro-trauma

Question 25

Describe both anterior and posterior subluxation

Answer 25

Anterior: anterior motion of both head of rib on vertebra and costochondral joint
Posterior: posterior motion of both head of rib on vertebra and costocondral joint

Question 26

Describe anteroposterior compression

Answer 26

posterior motion of costochondral joint and anterior motion at vertebra -> squishes rib and lateral part moves out

Question 27

Describe lateral compression

Answer 27

lateral rib compression from the side -> pushes costochondral joint anterior and vertebra posterior

Question 28

Describe inhalation dysfunction. What is another name for it?

Answer 28

rib being held in position of inhalation

aka exhalation restriction

Question 29

Describe exhalation dysfunction/ What is another name for it?

Answer 29

rib is held in position of exhalation

aka inhalation restriction

Question 30

What is the key rib?

Answer 30

rib that maintains a group of ribs in dysfunctional motion -> treat that rib

Question 31

What is the mnemonic for knowing what is the key rib?

Answer 31

BITE
Bottom Inhalation - treat bottom rib of group
Top Exhalation - treat top rib of group

Question 32

Name 7 causes of rib dysfunction

Answer 32

• thoracic scoliosis/kyphosis
• pectus excavatum/carinatum (rib cage asymmetries)
• bony disease (osteoporosis)
• COPD/emphysema (increased chest wall diameter)
• abnormal tensions in cervical, rotator cuff, or shoulder musculature (if muscles attach to ribs)
• trauma
• lifestyle

Question 33

In what way will ribs become dysfunctional w/ osteoporosis/osteoarthritis?

Answer 33

ribs become anteriorly depressed