Omm Ribs

Front 1

What heart arrhythmia can you expect with a right-sided cervical spine dysfunction

Back 1

sinus brady arrhythmia

Front 2

What heart arrhythmia can you expect with a left sided cervical spine dysfunction?

Back 2

Left side is going to manifest as 1st, 2nd, and 3rd degree AV block

Front 3

What heart arrhythmia can you expect with a left sided thoracic dysfunction?

Back 3

Left Sided problems with the heart leads to rapid heart rate from the AV node and below --> V fib, V tach

Front 4

What heart arrhythmia can you expect with a right sided thoracic dysfunction?

Back 4

Right sided problems with the heart or thorax leads to rapid heart rate but is coming from the SA node down to AV node --> Sinus tachycardia

Front 5

How do you treat 1st, 2nd, and 3rd degree AV block?

Back 5

Transcutaneous (External ) pacing

Front 6

Which ribs are the true ribs

Back 6

True ribs: 1-7
Attach directly to the sternum via costochondral cartilage

Front 7

which ribs are the false ribs

Back 7

False ribs: 8-10
Attach via a synchondroses to the costochondral cartilage of rib 7

Front 8

Tightness of which muscle can cause restriction of the diaphragm

Back 8

Psoas
The psoas get tight with appendicitis and kidney stone in the ureter

Front 9

Which group of ribs are primarily bucket handle?

Back 9

6-10

Front 10

Which group of ribs are primarily pump handle?

Back 10

Ribs 1-5

Front 11

what is the primarily muscle of inspiration?

Back 11

Diaphragm

Front 12

What other muscles can assist with inspiration?

Back 12

External intercostals
Interchondral portion of the internal intercostals
SCM
Scalenes (ant, middle, post)

Front 13

Should you treat a pre-op patient with a C3-5 dysfunction? Why?

Back 13

Yes
If you are examining someone preop and you find a dysfunction C3-5, you should treat that because it could lead to post op atelectasis.
The alveoli could collapse with a shallow breather and be a cause of fever
You can also decrease the risk of atelectatic pneumonia

Front 14

What is the attachment point of the Diaphragm?

Back 14

Diaphragm (The primary respirator)
Attaches to the lower 6 or seven ribs
Pulls these ribs inferiorly and flattens abdominal contents

Front 15

what muscles help with quiet breathing?

Back 15

None
It results from passive recoil of the lungs

Front 16

Why can a pelvic visceral dysfunction affect breathing?

Back 16

If you have a pelvic somatic dysfunction which affects quadratus lumborum you can have a 12th rib dysfunction

Front 17

What muscles help with active breathing?

Back 17

Intercostalis int.
Rectus abdominis
Obliques, int. & ext.
Transversus abdominis

Front 18

Diaphragmatic contraction increases relative______ pressure of thoracic cage and increases relative _______ pressure in abdomen

Back 18

negative
positive
We want this pressure gradient to allow lymphatic and venous fluids to flow from the body to the upper thoracic area.

Front 19

What nerve roots innervate the diaphragm?

Back 19

C 3-5

Front 20

At what level does the IVC, Aorta, And esophagus pass through the diaphragm?

Back 20

IVC T8
Esophagus T10
Aorta T12

Front 21

What is the position of the intercostal nerves?

Back 21

Lie on inferior portion of rib in the costal groove

Front 22

Define structural rib dysfunctions?

Back 22

rib dysfunctions associated with the intercostal space are structural rib dysfunctions. They contribute to restriction of the rib cage respiratory activity. They are found primarily as dysfunctions associated with chest wall pain.

Front 23

how can a thoracic somatic dysfunction trigger a viscerosomatic reflex?

Back 23

Any thoracic somatic dysfunction can put pressure on the sympathetic chain ganglia lead to facilitated segments (viscerosomatic reflexes)
An irritated nerve that has high preexcitation levels ( it has a lower threshold for pain) the pain will also manifest in the area of the affected ganglia

Front 24

Which ribs have at least some pump handle action?

Back 24

Remember that ribs 1-10 all have some pump handle action

Front 25

Where is the bucket handle motion primarily found?

Back 25

Predominantly ribs 6-10

Front 26

What axis is the bucket handle motion representing?

Back 26

From costosternal junction to costovertebral junction is almost A-P axis in a frontal (coronal ) plane

Front 27

Where can you best palpate for the bucket handle motion?

Back 27

In the midaxillary line

Front 28

The bucket handle motion _____ the transverse diameter of rib cage

Back 28

increases

Front 29

Which ribs primarily have the pump handle motion?

Back 29

Predominantly ribs 1-5

Front 30

Where are pump handle ribs best palpated?

Back 30

in the midclavicular line

Front 31

What is the axis of motion of the pump handle ribs?

Back 31

The axis of motion is transverse and in predominantly the sagittal plane

Front 32

In inspiration what is the movenment of the anterior rib and the posterior rib

Back 32

As inspiration occurs the anterior rib moves cephalad
and The posterior rib moves caudad

Front 33

What motion is predominantly ribs 11 and 12?

Back 33

Motion predominantly in transverse plane

Front 34

With inspiration, what motion do we expect from ribs 11 and 12?

Back 34

When you inhale they abduct and exhalation they adduct

Front 35

What causes the separation of ribs 11 and12

Back 35

tend to separate as 11 is pulled superior by latisimus dorsi and 12 is pulled inferiorly by quadratus lumborum

Front 36

Where are ribs 11 and 12 best palpated?

Back 36

Best palpated 3-5 cm lateral to transverse processes

Front 37

When does a patient complain of pain with an inhaled rib dysfunction?

Back 37

Pt complains of pain on exhaling for an inhalation rib dysfunction

Front 38

What is the key rib in an inhaled rib dysfunction?

Back 38

BITE
Inhaled ribs –work on bottom ribs --> the bottom rib is the key rib in the inhalation dysfunction
Exhaled ribs work on the top ribs

Front 39

What forms the borders of the anatomical thoracic inlet?

Back 39

Anatomical inlet is the manubrium 1st rib and T1

Front 40

what forms the borders of the functional thoracic inlet?

Back 40

Functional inlet is the manubrium with angle of Louis with 1st two ribs bilaterally and T1-4

Front 41

What is the first zone of entrapment in thoracic outlet syndrome?

Back 41

Entrapment between the Scalenus anterior and medius

Front 42

What is the second zone of entrapment in thoracic outlet syndrome?

Back 42

Entrapment between the clavicles and the first rib (costoclavicular space)

Front 43

What is the third zone of entrapment in thoracic outlet syndrome

Back 43

Entrapment between tendon of Pectoralis minor and ribs

Front 44

What muscle do you target for ME on the first rib?

Back 44

Anterior and Middle Scalene

Front 45

What muscle do you target for ME on the second rib?

Back 45

Posterior Scalene

Front 46

What muscle do you target for ME on ribs 3-5?

Back 46

Pectoral Minor

Front 47

What muscle do you target for ME on ribs 6-9?

Back 47

Serratus anterior

Front 48

What muscle do you target for ME on ribs 10- 12

Back 48

Latissimus dorsi