Pull the ribs DOWNWARDS.
<p>Pull the ribs <strong><u>DOWNWARDS</u></strong>.</p>
Shortness of breath, rapid breathing, wheezing, and chest tightness.
<p>An <strong>abnormal</strong> or <strong>laboured breathing pattern</strong> and <strong><u>respiratory distress</u></strong>.</p>
<p>Pull the ribs <strong><u>UPWARDS</u></strong>.</p>
<p>Sternocleidomastoids</p><p>Scalenes</p><p>Pectoralis Minors.</p>
To pull the ribs closer together.
To assist in the mechanics of breathing by expanding and contracting the thoracic cavity.
<p>Abdominal Muscles.</p>
<p>Muscles that <strong>provide assistance</strong> to the <strong>main breathing muscles</strong>, <strong><u>when additional power is needed</u></strong>.</p><p>May occur in:</p><p>→ patients with <u>abnormal/ laboured breathing</u> = respiratory distress</p><p>→ patients who do <u>exercise</u> & <u>need to INC. ventilation</u></p>
<p>The <strong><u>elastic recoil</u></strong> of the lungs.</p>
It decreases pressure, allowing air to flow into the lungs.
<p>It <strong><u>PULLS RIBS DOWN</u></strong>, adding to the <strong><u>force</u></strong> <strong>against the diaphragm</strong>.</p>
Asthma, pneumonia, heart failure, and allergic reactions.
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/k7coxgPCtD9bdRqYUFxHwSOg.png" data-width="100%" data-align="center"><p></p>
<p>Ribs that <u>do not attach directly</u> to the sternum </p><p>(8th to 10th pairs).</p>
<p>The last two pairs of ribs that <strong><u>do not attach to the sternum at all</u></strong>.</p><p>(11th + 12th pair)</p>
<p>A condition characterised by <strong><u>difficulty in breathing</u></strong> or <strong><u>inadequate oxygenation</u></strong>.</p><p>Causing the need of accessory muscles.</p>
<p><strong>Intercostal muscles</strong> and the <strong>diaphragm</strong>.</p>
True ribs, false ribs, and floating ribs.
<p>Scalpae are <strong>fixed by trapezius muscles</strong>.</p><p>→ <span style="color: rgb(55, 65, 81)">Rhomboid muscles, levator scapulae, pectoralis minor, and serratus anterior raise the ribs</span></p>
<p><strong><u>PASSIVE </u></strong>process, with <strong>no direct muscle action.</strong></p><p><strong>Elastic Recoil </strong>is sufficient to drive air out of lungs</p><p>→ It involves <strong>INTERCOSTAL MUSCLES</strong> + <strong>DIAPHRAGM</strong></p>
Intercostal muscles.
<p>It <strong><u>INC. THORACIC VOLUME</u></strong> using the erector spinae.</p>
75%.
<p>They help <strong>expand the ribcage</strong> and <strong><u>prevent deformation</u></strong> (DEC. volume of thorax) of the tissue between the ribs. </p>
<p><strong>→</strong> <strong>INC. in Anteroposterior Diameter of Thorax</strong></p><p><strong>→</strong> in <strong>UPPER RIBS </strong>(1st-7th rib - but here, mainly 2nd-5th rib)</p><p><strong>→</strong> Thoracic Motion in <strong>SAGITTAL PLANE</strong></p><p>During inspiration: Movement of Upper Ribs <strong>pushes Sternum <u>FORWARDS</u> + <u>UPWARDS</u></strong></p><p>= Bending of Manubriosternal Joints</p><img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/fiF6pcs6VAEFdEOmqmv4QmHg.png" data-width="75%" data-align="center"><p></p>
<p><strong>→</strong> <strong>INC. in Transverse (lateral) Diameter of Thorax</strong></p><p><strong>→</strong> in <strong>LOWER RIBS </strong>(8th-10th rib)</p><p><strong>→</strong> Thoracic Motion in <strong>FRONTAL PLANE</strong></p><p>During inspiration: Movement of Upper Ribs <strong>pushes Sternum <u>OUTWARDS</u> + <u>UPWARDS</u></strong></p><p>= Widens infrasternal angle</p><img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/siORNbFn8oyja9KTNEIlp70K.png" data-width="75%" data-align="center"><p></p>
The anteroposterior, transverse, and vertical diameters change, resulting in changes in thoracic volume.
<p>→ <strong>Forward</strong> movement of the lower end of the sternum</p><p>→ <strong>Upward/outward</strong> movement of the ribs.</p>
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/lCSzE4xzvTZA4tlz4UP4JBYF.png" data-width="75%" data-align="center"><p></p>
<p>Diaphragm + Intercostal Muscles</p>
They assist during heavy breathing or respiratory distress.
<p>It <strong>contracts</strong> and <strong>flattens</strong></p><p><strong>= INC. volume of thorax = DEC. pressure</strong> (allows air into lungs)</p><p>= <strong>Abdominal wall RELAXES</strong></p><p>= <strong>Abdominal contents</strong> displaced <strong>DOWNWARDS</strong> as diaphragm flattens</p><p>.</p><p><strong>Intercostal muscles:</strong> (expand ribcage)</p><p>→ Forward movement of lower end of sternum</p><p>→ Upward + Outward movement of ribs</p><p>INTERCOSTAL MUSCLES HELP PREVENT DEFORMATION + PREVENT DEC. VOLUME OF THORACIC CAGE</p>
To facilitate gas exchange (oxygen and carbon dioxide).
<p><strong>Posterior Position of Rib:</strong> Connects to thoracic vertebra by its head and the articular part of a tubercle</p><p><strong>Facet of Head:</strong> fits into either…</p><p>→ facet on body of one vertebra (T1 only)</p><p>→ demifacets of 2 adjoining vertebrae</p><p><strong>Articular part of the tubercle:</strong> Articulates with the facet of the transverse process of the vertebrae</p><img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/iMnFuBGXa3jEdxngfGEMd-Kn.png" data-width="75%" data-align="center"><p></p>
<p><strong>Reverse movements</strong> occur</p><p><strong>DEC. anteroposterior and transverse diameters.</strong></p>
Rhomboid muscles, levator scapulae, pectoralis minor, and serratus anterior.
<p>It <strong><u>RELAXES</u></strong>, allowing abdominal contents to be displaced downwards.</p>
<p>They are <strong>MORE ACTIVE</strong> </p><p>→ <strong><u>raise the ribs to a far greater extent</u></strong> than in quiet inspiration.</p>
<p>It is <strong>attached to the <u>quadratus lumborum</u></strong></p><p>→ <u>allows forcible downward movement</u> of the diaphragm. <strong><u>(PULLS RIBS DOWN)</u></strong></p>
<p>By being <strong><u>FIXED</u></strong> (e.g., by holding the back of a chair), <strong>allowing the use of pectoralis major</strong>.</p>
<p>Cartilage that connects the ribs to the sternum.</p><img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/fuTYZBZEtat0232-uan9fgpB.png" data-width="50%" data-align="center"><p></p>
<p>Thoracic Skeleton<strong> </strong>- it is made up by:</p><p><strong>→ sternum</strong></p><p><strong>→ 12 pair of ribs</strong></p><p><strong>→ 12 thoracic vertebrae</strong></p><p><strong>→ interconnecting joints</strong></p>
<p>Intercostal spaces are in <strong>between every 2 adjacent ribs.</strong></p><p>→ there are <strong>11 in total</strong></p><p>→ each one <strong>contains <u>intercostal muscle</u> </strong>(external, internal + innermost) & <strong><u>intercostal neurovascular bundle </u></strong>(incl. veins, arteries, nerves)</p>
<p>→ Heart</p><p>→ Lungs</p><p>→ Oesophagus</p><p>→ Tratchea & Main Bronchi</p><p>→ Thymus</p><p>→ Vagus & Phrenic Nerves</p><p>→ Sympathetic trunks & Ganglia</p><p>→ Thoracic Duct</p><p>→ Lymph Nodes </p><p>→ Major Systemic + Pulmonary Vasculature</p>
<p>Thorax has 2 major openings: <strong><u>Superior Thoracic Aperture</u></strong> & <strong><u>Inferior Thoracic Aperture</u></strong></p><p><strong>Superior Thoracic Aperture:</strong></p><p>→ opens towards neck</p><p>→ bounded by bones of upper thorax: manubrium of sternum, first pair of ribs, body of vertebrae T1</p><p><strong>Inferior Thoracic Aperture:</strong></p><p>→ almost completely covered by diaphragm</p><p>.</p><p><strong>Thoracic Skeleton </strong>- it is made up by:</p><p>→ sternum</p><p>→ 12 pair of ribs</p><p>→ 12 thoracic vertebrae</p><p>→ interconnecting joints</p><p>.</p><p>Between every 2 connecting ribs = <strong>INTERCOSTAL SPACES</strong></p><p>→ 11 total</p><p>→ each one contains intercostal muscles + intercostal neurovascular bundle</p><p></p>
<p>A <strong><u>flat bone</u></strong> located in the <strong>center</strong> of the <strong><u>anterior thoracic wall</u></strong>, connecting the ribs.</p><p><br>Contains 3 part:</p><p>→ <strong>Manubrium</strong> (superior)</p><p>→ <strong>Body</strong> (middle + largest)</p><p>→ <strong>Xiphoid Process</strong> (inferior)</p>
<p>→<strong> Flat, narrow bone</strong> located in the <strong>centre</strong> of the <strong>anterior thoracic wall</strong></p><p>→ Consists of <strong><u>3 parts</u></strong>: <strong>Manubrium</strong> (@ superior), <strong>Body</strong> (@ middle), <strong>Xiphoid Process</strong> (@ inferior)</p><p>→ <strong>STERNAL ANGLE: </strong>a junction connecting manubrium & body</p><p>→ <strong>JUGULAR NOTCH: </strong>Depression at the Superior Surface of Manubrium (lump)</p><p>→<strong> CLAVICULAR NOTCHES</strong>: Lateral to Jugular Notch; Articulates with medial ends of the clavicles to form Jugular Joints</p><p>→ <strong>Manubrium articulates with the costal cartilage</strong>s of the <u>1st + 2nd ribs</u></p><p>→ <strong>BODY</strong> of Sternum <strong>articulates directly/ indirectly with costal cartilages</strong> of <u>2nd to 10th ribs</u></p><p></p><img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/F8qxksyz8KmTHzvOmjQBeyQ6.png" data-width="75%" data-align="center"><p></p>
<p><strong>1st-7th pairs of ribs: <u>DIRECT</u> attachment to sternum</strong></p><p>→ <strong>“TRUE RIBS”</strong></p><p>→ Articulation between True Ribs + Sternum = “Sternocostal Joints”</p><p><strong>8th-12th pair of ribs: INDIRECT attachment to sternum</strong></p><p>→ <strong>“FALSE RIBS” </strong>= Vertebronchondral Ribs</p><p>→ 8th, 9th, 10th pair Ribs attach to one another, and then all attaches to 7th pair</p><p>→ 11th & 12th pair ribs = <strong>“FLOATING RIBS”.</strong> Their costal cartilages at anterior side do not attach to sternum at all. These ribs only attach posteriorly to thoracic vertebrae.</p><img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/uMysL0j1j39vy-LtBUoDjrnZ.png" data-width="75%" data-align="center"><p></p>
True ribs attach directly to the sternum, while false ribs do not.
<p><strong><u>HEAD:</u> </strong>at posterior end of the rib. <strong>Contains a pair of articular facets </strong>(superior + inferior)</p><p><strong><u>FACET of head:</u> </strong>may fit into facet of body, or demifacets of 2 adjoining vertebrae, forming vertebrocostal joint.</p><p><strong><u>NECK:</u></strong> Lateral to head. <strong>Have different lengths.</strong></p><p><strong><u>TUBERCLE:</u></strong> <strong>Knoblike structure</strong> @ posterior. Allows neck to join body.</p><p>→<strong> Lateral Costotransverse Ligament:</strong> Non-articular part of tubercle, attaches to transverse process of vertebra.</p><p><strong><u>VERTEBROCOSTAL JOINTS:</u></strong> Formed via articulation of Tubercle and Facet of Transverse Process of Vertebra.</p><p><strong><u>BODY:</u></strong> <strong>Main Part of Rib</strong></p><p><strong><u>COSTAL ANGLE:</u></strong> Causes <strong>abrupt change of body</strong></p><p><strong><u>COSTAL GROOVE:</u></strong> Inner surface of Rib. <strong>Protects intercostal vessel + small nerve.</strong></p><img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/ZmYdfQbfsdks47jSSwnYQWPV.png" data-width="75%" data-align="center"><p></p>
<p><strong>Posterior Position of Rib:</strong> Connects to thoracic vertebra by its head and the articular part of a tubercle</p><p><strong>Facet of Head:</strong> fits into either…</p><p>→ facet on body of one vertebra (T1 only)</p><p>→ demifacets of 2 adjoining vertebrae</p><p><strong>Articular part of the tubercle:</strong> Articulates with the facet of the transverse process of the vertebrae</p><img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/5cbypX4S-88xqv2bhVmcd_xv.png" data-width="75%" data-align="center"><p></p>
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/wU3YoK8PAuMzRHIkysXYvKzB.png" data-width="100%" data-align="center"><p></p>
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/ShCB2wGyVbtcxLdnUJL3pc4K.png" data-width="100%" data-align="center"><p></p>
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/8wvYQFQoqfhGAycwgMP060pp.png" data-width="100%" data-align="center"><p></p>
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/3TDGNcTgthzWrhnW8wW7dLdp.png" data-width="100%" data-align="center"><p></p>
<p><strong>1st-7th pair of Ribs:</strong> have <strong>DIRECT</strong> anterior attachment to sternum <strong>VIA HYALINE CARTILAGE</strong> (costal cartilage)</p><p>→ provides elasticity</p><p>→ helps protect from fracture</p><p>.</p><p><u>“TRUE RIBS”</u> = ribs attach <u>directly</u> to the sternum.</p><p>→ Articulations formed = Sternocostal Joints</p><p>.</p><p><strong>8th-12th pair of Ribs:</strong> have <strong>INDIRECT</strong> anterior attachment to sternum</p><p><u>“FALSE RIBS”</u> - either have INDIRECT attachment to ribs or DO NOT ATTACH AT ALL.</p><img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/Uh4FQMRQWcpDvu7qVHh_mu7q.png" data-width="75%" data-align="center"><p></p>
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/J07_Sv7G6gFH2HInEzyVRgih.png" data-width="100%" data-align="center"><p></p>
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/4FmxVXOYERL0P2azQvpCpsQb.png" data-width="100%" data-align="center"><p></p>
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/IE_vA232OwPcsV_23v-3Sk6h.png" data-width="75%" data-align="center"><p></p>
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/lSsLAitDp2pzegOEoQZjPFZN.png" data-width="100%" data-align="center"><p></p>
<p>It lowers intrapleural pressure, causing <strong>air to be drawn into the lungs.</strong></p>
<p><strong>Scalene</strong> muscles & <strong>sternocleidomastoids</strong>.</p><p>→ produces movement at the <strong>manubriosternal joint</strong></p>
<p>Elastic Recoil reinforced by <strong><u>CONTRACTION</u></strong> of muscles of abdominal wall.</p><p>= forces abdominal contents against diaphragm</p><p>= displacing diaphragm UPWARDS</p><p>.</p><p><strong>Quadratus Lumborom - PULLS RIBS DOWN</strong></p><p>→ adds force = abdominal contents pushed against diaphragm</p><p>.</p><p><strong>Intercostal Muscles - PREVENT DEFORMATION </strong>between ribs</p>
<img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/-6wrZIEFRBe30CzXeTjqDqrc.png" data-width="100%" data-align="center"><img src="https://gkfeqerieuvmtwfjnifi.supabase.co/storage/v1/object/public/tiptap-images/699c160f-6a51-482a-bbd2-47eca489ab5f/xaED9G_ilLjXbO9KO5i7BNH-.png" data-width="50%" data-align="center"><p></p><p></p>
