Rib Inhalation Dysfunction

by Tyler Cymet, DO, FACOFP

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    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.

    About the Lecture

    The lecture Rib Inhalation Dysfunction by Tyler Cymet, DO, FACOFP is from the course Osteopathic Diagnosis of the Ribs.

    Included Quiz Questions

    1. 7th rib (the bottom rib)
    2. 6th rib
    3. 5th rib (the middle rib)
    4. 4th rib
    5. 3rd rib (the top rib)
    1. 4th rib (the top rib)
    2. 5th rib
    3. 6th rib
    4. 7th rib (the middle rib)
    5. 8th rib (the bottom rib)

    Author of lecture Rib Inhalation Dysfunction

     Tyler Cymet, DO, FACOFP

    Tyler Cymet, DO, FACOFP

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