00:00
We're going to talk now about inhalation dysfunction and osteopathic lesions, restrictions and
abnormalities. The most common is when the rib is held in inspiration and the person cannot fully
exhale. So if you take a deep inhalation and you have an inhalation dysfunction, you exhale, it
doesn't go down. That's not normal. That's something we can treat and make people feel better for.
00:29
So we're going to name it in terms of the easy direction. It’s an inhalation dysfunction. You
take in inhalation, that's easy that happens and then you can't exhale. So there is a rib inhalation
dysfunction. The restriction where it’s not going is an exhalation and typically this starts off
with a single rib and then it goes either above or below, more typically above. Group rib dysfunction
usually occurs overtime and is part of the process of a rib somatic dysfunction. An exhalation
dysfunction is when you exhale, it comes down, you inhale and you don't get the full pump handle
motion, you may get some pump handle more so than bucket handle, you're going to get some motion,
you're going to get the inhalation but the exhalation dysfunction is not allowing for the full
expansion and the full functioning of the breathing and if you look along the transverse line you
will see it much better than if you're looking centrally. So you have to observe a little bit lateral
and check the motion of the spine. Watch particularly the ends of inspiration and expiration to get
a sense of when the issue is going to develop and a rib with an exhalation dysfunction and
inhalation restriction will stop short of the full motion. So you're going to see blunted motion
and you're going to see a lack of full motion and a lack of ease of motion. That is the somatic
dysfunction that we're really working on finding. The key rib is the top rib or the bottom rib of a
group of ribs that are held near inhalation or exhalation. The key to the major rib dysfunction is
which rib is the first one. For an inhalation dysfunction, the key rib is usually the bottom rib. So
when you have an inhalation dysfunction, check the bottom rib and then start going up. For an
exhalation dysfunction, the key rib is often the top rib in the group. That is another high yield
fact that needs to be remembered. Inhalation dysfunction, the key rib is generally the bottom
rib. Exhalation dysfunction, the key rib is the top rib. Rib 11th and 12th, which are floating ribs,
move more posteriorly and inferiorly opposite to the chest wall cavity and it’s just something to be
aware of. You can measure this better if somebody is laying prone and check out the motion
with inhalation. It’s not easy to see, so you need to actively examine rib 11 and 12, less often
involved in inhalation and exhalation lesions.