Hazzard Chapter 7

Question 1

What is the primary focus of osteopathic treatment of the thorax?

Answer 1

Restoration of the ribs and other bony portions to correct mechanical relations

Includes work on ligamentous, cartilaginous, and muscular lesions, which are usually secondary to bony lesion.

Question 2

How does osteopathic treatment of the thorax relate to surrounding tissues?

Answer 2

Affects muscles, ligaments, nerves, vessels, centers, and viscera

Treatment is not limited to the ribs but considers the entire thoracic area.

Question 3

What anatomical relationship makes thoracic treatment inseparable from spinal work?

Answer 3

Intimate anatomical relations of the thorax and spine

Question 4

What principle underlies many methods of setting ribs?

Answer 4

The head of the rib is the fixed point, and pressure on the angles moves them around this fixed point

This method may be aided by arm elevation or shoulder rotation.

Question 5

In some treatments, which part of the rib is used as the fixed point?

Answer 5

The sternal end

Question 6

What are some principles applied to rib treatment?

Answer 6

Exaggeration of lesion, fixing of a fulcrum, traction upon attached tissues, rotation of related parts

Question 7

What actions must the practitioner take while setting a rib?

Answer 7

Continue efforts with varying traction, pressure, rotation, etc.

The practitioner’s hands must be in position and the parts under control.

Question 8

What movements can contribute to the relaxation of the parts when setting a rib?

Answer 8

Bending, turning, raising the parts

Movements of the patient’s whole trunk may aid in the process.

Question 9

In what direction are the FIRST AND SECOND RIBS usually luxated?

Answer 9

Upwards

They may also be displaced downwards.

Question 10

What is the first step in the technique for upward displacements?

Answer 10

Relax and stretch the scaleni muscles

The scaleni muscles are important for neck movement and stability.

Question 11

What type of pressure is applied to the ribs during treatment?

Answer 11

Direct downward pressure on the upper margin of the ribs

Question 12

What is the role of the practitioner’s thumb during the rib treatment?

Answer 12

Press down upon the upper margin of the first rib

Question 13

What does relaxing the tissues at the side of the neck help with?

Answer 13

Elevating the clavicle

Question 14

How can pressure be applied to the rib?

Answer 14

Anywhere along the upper margin of the rib

Question 15

What effect does the initial movement have on the spinal column?

Answer 15

It swerves the spinal column, exaggerating the lesion

Question 16

Where does the practitioner apply pressure during the treatment for downward displacements?

Answer 16

On the inferior margin of the first or second rib

Question 17

What muscle is involved in bringing traction on the anterior end of the first rib?

Answer 17

Scalenus anticus

Question 18

What is the purpose of the treatment described for the first and second ribs?

Answer 18

To elevate either rib

Question 19

Which muscles are involved in bringing traction on the posterior ends of the first and second ribs?

Answer 19

Scalenus medius and scalenus posticus

Question 20

What is the treatment for anterior protrusion of the cartilages?

Answer 20

Pressure may be brought upon them while treatment I is being given

Question 21

What is used to form a fulcrum beneath the two ribs?

Answer 21

A hand slipped beneath the shoulder

Question 22

What is the effect of raising and bending the patient’s arm across the anterior chest?

Answer 22

Drives the two ribs sternum-ward and separates them anteriorly

Question 23

Fill in the blank: The intercostal space is wider at its _______ end than at the other.

Answer 23

anterior

Question 24

What is the second method of stretching the quadratus lumborum?

Answer 24

Grasping the crest of the ilium and drawing it diagonally forward while pushing the bent arm

This action gives the opposite diagonal stretch to the quadratus lumborum.

Question 25

What are the three points to manipulate the eleventh or twelfth rib?

Answer 25

* The head remains a fixed point * Pressure on the outer aspect of the rib can move it * The free end can be moved by finger pressure ## Footnote These points allow for upward or downward manipulation of the rib.

Question 26

How can the eleventh or twelfth rib be rotated about its horizontal axis?

Answer 26

By applying pressure at the angle and moving the free end upward or downward ## Footnote The thumb presses the free end while fingers apply opposite pressure.

Question 27

What is the role of the thumb when manipulating the rib?

Answer 27

The thumb is pressed against the free end of the rib ## Footnote This allows for upward or downward movement of the rib.

Question 28

True or False: The quadratus lumborum can only be stretched in one direction.

Answer 28

False ## Footnote It can be stretched in multiple directions depending on the manipulation techniques used.

Question 29

What occurs during upward displacements of the ribs?

Answer 29

The anterior ends of the ribs are upward under the rib above. ## Footnote This condition requires manipulation to restore proper rib position.

Question 30

What technique is used for luxation between the first and second parts of the sternum?

Answer 30

Traction is brought upon the first part through the deep cervical tissues and the sterno-mastoid muscle while rotating the head backward and to one side. ## Footnote Pressure is applied to the prominent end of the first or second part to reduce it.

Question 31

What happens to the costo-clavicular space when the shoulder is elevated?

Answer 31

It widens, allowing the fingers to be brought well forward toward the sternal end. ## Footnote This is crucial for effectively manipulating the clavicle.

Question 32

What is the effect of rotating the arm outward during clavicle restoration?

Answer 32

It increases the distance between the sternal and acromial attachments of the bone, drawing it down hard upon the fingers. ## Footnote This helps to force the clavicle upward from dislocation.

Question 33

What occurs if the sternal end has been dislocated upward on the sternum?

Answer 33

The motion would involve outward rotation of the arm with pressure applied above the sternal end to force it downward. ## Footnote This describes a specific method for correcting an upward dislocation of the sternal end.

Question 34

How is the acromial end treated if it has been displaced downward or upward?

Answer 34

The same motion is applied with the operating hand directed to that end of the bone, grasping it between the fingers behind and the thumb in front to move it upward or downward from its displacement. ## Footnote This illustrates the technique for handling displacements at the acromial end.

Question 35

What is less probable to accomplish the work in the treatment of bone displacement?

Answer 35

A single set motion is less probable than insistent, though not violent, traction, pressure, rotation, etc. ## Footnote This highlights the need for varied techniques in treating bone displacements.

Question 36

What happens to the posterior margin of the clavicle in certain conditions?

Answer 36

It may be tipped upward, widening the space between its outer end and the scapula, leading to tenderness in the tissues at that point. ## Footnote This condition can affect shoulder mobility and comfort.