The OMT Rib Somatic Dysfunction provides High Yield information that is needed for the COMLEX Level 1, 2, and 3, Medical School, Residency, and as practicing Physician.
Table Of Contents
Rib Type
Rib Type | Rib # |
True Ribs | 1-7 |
False Ribs | 8-12 |
Floating Ribs | 11-12 |
Typical Ribs | 3-9 Features: – Rib head has 2 facets at the neck and tubercle. – Body arcs at the rib angle – Body is thin and flat with a costal groove inferiorly |
Atypical Ribs | 1, 2, 10, 11, 12 – all have a 1 or 2 in the name |
Rib Motion
Ribs | Motion |
Ribs 1-5 | Pump handle |
Ribs 5-10 | Bucket handle |
Ribs 11-12 | Caliper |
Inhalation/Exhalation Somatic Dysfunction
Inhalation SD | RIb Stuck Up in front, down in back |
Exhalation SD | Rib Stuck Down in front, up in back |
BITE | Tx Bottom in Inhalation Tx Top in Exhalation |
Rib Somatic Dysfunction Techniques
Muscle Energy (Ribs) Inhalation Dysfunctions
Ribs # | OMT |
Ribs 1 | Head RaSt, Push down on first rib |
Ribs 2-6 | SB toward and knee under shoulder Push down |
Ribs 7-10 | SB toward and push down on ribs |
Ribs 11-12 | SB toward, Pull up on ASIS Push up on Inhaled rib with exhalation |
Muscle Energy (Ribs) Exhalation Dysfunctions
Ribs | Placement | Muscles | Summary |
Rib 1- 2 | Place your hand at the superior rib angle Have patient put hand on their forehead; you put your hand on their hand and ask them to flex their head | Rib 1 = Anterior + Middle Scalene Rib 2 =Posterior scalene | Pt Hand on Head |
Rib 3-5 | Place your hand at the superior rib angle Have patient put their hand under their neck and try to ADduct their elbow (move toward opposite peck); you will be resisting the Adduction | Rib 3-5 = Pec minor | Pt Hand Above Head |
Rib 6-8 | Place your hand at the superior rib angle Have patient put arm over neck touch their other shoulder (pointy elbow); have the patient push the elbow into your hand | Rib 6-8 = Serratus anterior | Elbow pointed Up |
Rib 9-10 | Have the patient stick their arm out to their side; and have them push it against your leg | Rib 9-10 =Latissimus Dorsi | Arm out to side 90 degrees |
Rib 11-12 | Rib 11-12 = Quadratus Lumborium | Pt Pulls Hip Cephalad |
FPR (Ribs)
Rib Location/Type | Placement |
Anterior Rib FPR (Costochondral) | Sit up straight Compress through spine Rotate Toward rib side. |
Posterior Rib FPR | Straight, Compress spine Flex, Rt, SBt. |
Inhalation/Exhalation FPR | Side of pt. Head Ra, Body leaning toward. |
HVLA (Ribs)
Rib | Placement |
Ribs 1-4 Chin Pivot HVLA | Doc Contralateral, Pt Prone. Cups chin with arm of effected side. Anterolateral thrust with exhalation. |
Kirksville Crunch
Inhalation SD | Ribs 3-10 Bucket Handle HVLA Thenar at Posterior/Superior angle Apply posterior thrust |
Exhalation SD | Ribs 3-10 Bucket Handle HVLA Thenar Posterior/Inferior angle Slightly Caudal Posterior thrust. |
Stills (Ribs)
Rib location | Placement |
Stills, Posterior Rib | Elbow lifted and compressed to localize. Arm Adducted across front of patient. |
Stills Exh/Ant. Tender point Rib | Supine, Arm starts next to patient with exhalation. Upon Inhalation, Arm is fully flexed. |
Stills Inh/Post. Tender Point Rib | Supine. Arm is flexed with traction. upon exhalation, arm is brought to extension. |
Counterstrain (Ribs)
Rib Tender Points
AR 1 | 1st Costochondral Articulation Treatment: F STRT |
AR 2 | Midclavicular line, Rib 2 Treatment: F STRT |
AR 3-6 | Midaxillary line of corresponding rib Treatment: F STRT |
PC Inion | 2 cm inferior from the Inion Treatment: F |
PR1 | Cervicothoracic angle just anterior to trapezius Treatment: E SART |
PR2-PR10 | Superior surface of respective rib angles Treatment: F SARA |
OMT Rib Somatic Dysfunction Quiz 1
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