| Question | Answer |
| Rib 1 Movement | elevation and depression |
| Rib 2-5 | Pump handle inhalation and exhalation |
| Ribs 11-12 | Caliper type inhalation and exhalation |
| Ribs 6-10 | Bucket handle inhalation and exhalation
lateral and superior motion with inhalation |
| 5 Articulation on ribs | 2 demifacets on costovertebral (ribs 2-9)
costotransverse
costochondral (except rib 11-12)
chondrosternal (except ribs 8-12) |
| Rib 1 somatic dysfunction | elevation or depression
tender point |
| Ribs 2-10 | inhalation or exhalation
anterior or posterior subluxation
tender points |
| Ribs 11-12 | inhalation or exhalation
tenderpoints |
| Posteror Subluxation | pushes rib angle more posterior |
| Anterior Subluxation | pushes rib angle more anterior |
| Posterior Rib tender points | rib angles |
| Anterior rib tender points | palpate rib shaft |
| Assessing subluxations | Palpate rib angles |
| Prominent subluxations | posterior subluxation |
| Depression subluxations | anterior subluxation |
| Rib Treatment Guidelines (4) | 1. First treat related thoracic dysfunctions
2. Treat subluxations if symptomatic
3. Treat key rib for remaining respiratory dysfunctions
4. Consider pathology and viscerosomatic reflexes |
| Posterior rib counter strain | lean into tenderpoint |
| Anterior rib counter strain | lean away from tenderpoint |
| Rib OMT indications | Chest wall pain
back pain
tension headache
Thoracic outlet syndrome
shortness of breath/cough
postural problems
congenital anomalies |
| Causes of Chest Wall pain | scapula pain syndromes
Rib pain syndromes |
| Scapula Pain Syndromes | Snapping Scapula
Scapulocostal syndrome |
| Scapulocostal syndrome | Insidious onset of pain in the superior and posterior aspect of the scapula
Pain radiates to the shoulder girdle, neck and chest wall
Trigger points on the chest wall and medial and deep to the scapula |
| Rib Pain Syndromes | pectoralis trigger point
sternalis trigger point
xiphoidalgia
costochondritis
rib tip syndrome |
| Rib tip syndrome | Lancinating pain chondral mass of ribs 8-10
reproducible clicking at painful area |
| Myofacial release used to treat | subluxations and respiratory restrictions |
