What does the rib’s head articulate with? tubercle?
- a. the superior costal facet of its own vertebra
b. the inferior costal facet of the vertebra above - TP of the corresponding vertebra
What is unique about the articulations of ribs 1, 10, 11, 12? just 11 and 12?
- only articulate with their own vertebra (not the one above)
- don’t have tubercles (so no TP articulation)
What are the atypical ribs?
1, 2, 11, 12
*10 is sometimes atypical, and sometimes typical
What ribs are true? false? floating?
- 1-7 - cartilage attaches to the sternum
- 8-12
a. 8-10 - cartilage attaches to the costal cartilage of the rib above
b. 11-12 - no anterior attachment
Anterior Scalene
- Insertion
- Action
- Superior surface of rib 1
2. Elevates rib 1 (SB and rates neck unilaterally, flexes neck bilaterally)
Middle Scalene
- Insertion
- Action
- Superior surface of rib 1
2. Elevates rib 1 (lateral flexion of neck)
Posterior Scalene
- Insertion
- Action
- 2nd rib
2. Elevates 2nd rib (lateral flexion of neck)
Pectoralis Minor
- Origin
- Action
- Anterior, superior surface of ribs 3-5
2. Stabilizes scapula, drawing it inferiorly and anteriorly
Serratus Anteior
- Insertion
- Action
- Superior, lateral surface of ribs 2-8
2. Protracts the scapula
Latissimus dorsi
- Origin
- Action
- Lower 4 ribs (and other places)
2. Extends, adducts, medially rotates the humerus
Quadratus Lumborum
- Insertion
- Action
- Inferior aspect of rib 12
2. Fixes the 12th rib in inhalation
External Intercostals
- Origin
- Insertion
- Action
- inferior border of ribs
- superior border of ribs
- elevate ribs during forced inspiration
Internal/Innermost Intercostals
- Origin
- Insertion
- Action
- inferior border of ribs
- superior border of ribs
- depression of ribs
Diaphragm
- Origin
- Insertion
- Action
- xiphoid process, lower 6 ribs, L1-3
- central tendon
- descends during inspiration
Where doe the intercostal N, V, and A run?
along the costal groove on the inferior side of the rib
*VAN (superior –> inferior)
Which ribs move in the bucket handle motion? pump handle?
- 1-2, 8-10 (change in transverse diameter)
2. 3-7 (change in A/P diameter)
What happens with non-physiologic movement?
ribs become sublimed anteriorly or posteriorly, or one or more ribs lose the usual plasticity and become restricted in a deformed state
*due to trauma
What happens with torsional movement when T5 is rotated left on T6?
When T5 is rotated left on T6…
- Left 6th rib
a. posterior aspect turns externally
b. anterior extremity more flat with its inferior border sharp - Right 6th rib
a. poster aspect rib turns internally
b. anterior extremity having its superior margin accentuated
*due to rotation of the thoracic spine
What is an inhalation SD? exhalation SD?
- rib is held in position of inhalation (can’t fully exhale)
- rib is held in position of exhalation (can’t fully inhale)
What is the key rib?
the rib that maintains a group of ribs in dysfunction motion
*should be treated first
What does BITE stand for?
Bottom Inhalation - Top Exhalation
*tells you what rib will be in the “key rib”
Synonyms for “Inhalation Dysfunction”
- inhaled
- inspired
- moves inhaled
- symmetrical in inhalation
- doesnt move in exhalation
- elevated rib
- exhalation restriction
- restricted in exhalation
Synonyms for “Exhalation Dysfunction”
- exhaled
- expired
- moves exhaled
- symmetrical in exhalation
- doesn’t move in inhalation
- depressed rib
- inhalation restriction
- restricted in inhalation
