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Rib Somatic Dysfunction and Chest Wall pain

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Question
Answer
Rib 1 Movement   elevation and depression  
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Rib 2-5   Pump handle inhalation and exhalation  
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Ribs 11-12   Caliper type inhalation and exhalation  
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Ribs 6-10   Bucket handle inhalation and exhalation lateral and superior motion with inhalation  
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5 Articulation on ribs   2 demifacets on costovertebral (ribs 2-9) costotransverse costochondral (except rib 11-12) chondrosternal (except ribs 8-12)  
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Rib 1 somatic dysfunction   elevation or depression tender point  
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Ribs 2-10   inhalation or exhalation anterior or posterior subluxation tender points  
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Ribs 11-12   inhalation or exhalation tenderpoints  
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Posteror Subluxation   pushes rib angle more posterior  
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Anterior Subluxation   pushes rib angle more anterior  
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Posterior Rib tender points   rib angles  
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Anterior rib tender points   palpate rib shaft  
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Assessing subluxations   Palpate rib angles  
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Prominent subluxations   posterior subluxation  
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Depression subluxations   anterior subluxation  
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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  
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Posterior rib counter strain   lean into tenderpoint  
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Anterior rib counter strain   lean away from tenderpoint  
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Rib OMT indications   Chest wall pain back pain tension headache Thoracic outlet syndrome shortness of breath/cough postural problems congenital anomalies  
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Causes of Chest Wall pain   scapula pain syndromes Rib pain syndromes  
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Scapula Pain Syndromes   Snapping Scapula Scapulocostal syndrome  
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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  
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Rib Pain Syndromes   pectoralis trigger point sternalis trigger point xiphoidalgia costochondritis rib tip syndrome  
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Rib tip syndrome   Lancinating pain chondral mass of ribs 8-10 reproducible clicking at painful area  
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Myofacial release used to treat   subluxations and respiratory restrictions  
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Created by: tjamrose
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