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![Pump handle movement
• On of the most important functions
of ribs and diaphragm, is the change in
volume of thorax that
helps inspiration and expiration.[2]
• In general, the ribs move around two axes.The
anterior end of the rib is lower than the
posterior end, therefore, during elevation of
the rib, the anterior end also moves forward](https://image.slidesharecdn.com/ribs-221112131905-1a22e7fd/85/RIBS-pptx-53-320.jpg)
![• Movement at costovertebral joints 2 to 6
about a side-to-side axis results in raising and
lowering the sternal end of the rib, the
"pump-handle" movement.
• This occurs mostly in the vertebrosternal ribs.
In elevation, this increases the anteroposterior
diameter of the thorax.[4][](https://image.slidesharecdn.com/ribs-221112131905-1a22e7fd/85/RIBS-pptx-54-320.jpg)
![Pump handle movement
• On of the most important functions
of ribs and diaphragm, is the change in
volume of thorax that
helps inspiration and expiration.[2]
• In general, the ribs move around two axes.The
anterior end of the rib is lower than the
posterior end, therefore, during elevation of
the rib, the anterior end also moves forward](https://image.slidesharecdn.com/ribs-221112131905-1a22e7fd/75/RIBS-pptx-53-2048.jpg)
![• Movement at costovertebral joints 2 to 6
about a side-to-side axis results in raising and
lowering the sternal end of the rib, the
"pump-handle" movement.
• This occurs mostly in the vertebrosternal ribs.
In elevation, this increases the anteroposterior
diameter of the thorax.[4][](https://image.slidesharecdn.com/ribs-221112131905-1a22e7fd/75/RIBS-pptx-54-2048.jpg)
More Related Content
RIBS.pptx
- 1.
- 2. TheRibs • The ribsare curved strips of bone, stretches posteriorly from thoracic vertebrae to the anterior lateral edges of the sternum. • They are ribbon like, elastic bony arches and flat in shape. Coastal cartilages are joined to the anterior ends. • The costal cartilage and ribs together makes the costa. • The large part of the thoracic skeleton is created by the ribs and their costal cartilages. • Normally there are 12 pairs of ribs.
- 3. Embryology • Ribs apperaras mesenchymal condensation in the somatopleure. • Chondrification starts immediately. • Ossification begins towards the back and spreads rapidly forward. • A segment remains unossified, persists as costal cartilage.
- 4. Thoracic Cage • ThoracicCage is a skeletal framework which supports the thorax. • It’s nature is osteocartilaginous and elastic. • The thoracic vertebrae, ribs, costal cartilages, and sternum form the thoracic cage. • It gives protection for the internal organs of the thoracic cavity and supports the superior trunk, pectoral girdle, and upper limbs. • It has a significant role play for raising or reducing the intrathoracic pressure to ensure mechanism of respiration
- 5. • The ribsare a set of twelve bones which form the protective ‘cage’ of the thorax. • They articulate with the vertebral column posteriorly, and terminate anteriorly as cartilage (known as costal cartilage).
- 7. CATEGORIZATION ACCORDING TO FEATURES 1. Typicalribs: 3rd-9th. 2. Atypical ribs: 1st, 2nd, 10th, 11th, and 12th. The normal ribs have same general features, on the other hand theatypical ribs have special features and thus can be discerned from the rest of the ribs. ACCORDING TO RELATIONSHIP WITH THE STERNUM 1. True ribs: lst-7th (i.e., upper 7 ribs). 2. False ribs: 8th-12th (i.e., lower 5 ribs). True ribs articulate with the sternum anteriorly, on the other hand false ribs don’t articulate with the sternum anteriorly. ACCORDING TO ARTICULATION 1. Vertebrosternal ribs: lst-7th. The vertebrosternal ribs joint posteriorly with vertebrae and anteriorly with the sternum. 2. Vertebrochondral ribs: 8th-10th. The vertebrochondral ribs joint posteriorly with vertebrae and anteriorly their cartilages join the cartilage of the higherrib. 3. Vertebral (floating) ribs: 11th and 12th. The vertebral or floating ribs joint posteriorly with the vertebrae but their anterior ends are free.
- 8. ARRANGEMENT AND GENERALOUTLINE The ribs are arranged one below the other and the gaps between the adjacent ribs are termed intercostals spaces. The length of ribs increases from 1st to 7th rib and after that slowly falls; therefore, seventh rib is the longest rib The transverse diameter of thorax increases progressively from 1st to 8th rib, thus 8th rib has the best lateral projection. The ribs are arranged obliquely, i.e., their anterior ends be located at lower level than their posterior ends. The obliquity of ribs rises progressively from 1st to 9th rib, for this reason 9th rib is most obliquely set. The width of ribs slowly reduced from above downward.
- 9. Costal Cartilages • Theanterior ends of first 7 ribs are joined to the sternum via their costal cartilages. • The cartilages at the anterior ends of 8th, 9th, and 10th ribs are joined to the next higher cartilage. • The anterior ends of 11th and 12th ribs are free and hence named floating ribs.
- 10. SIDE CONCLUSION ANDANATOMICAL POSITION The side of the rib can be figured out by holding it in this type of style that its posterior end having head, neck, and tubercle is directed posteriorly, its concavity faces medially and its sharp border is directed inferiorly. In an anatomical position, 1. The anterior end bears a cup shaped depression and posterior end bears head, neck & tubercle
- 11. 2. The shaftis curved & twisted , so that the posterior end lies above than the anterior end. 3. Posterior end lies near the midline and anterior end lies away from the midline 4. Concavity of the rib directed medially 5. Lower margin of the inner surface is marked by a smooth depression, named “Costal groove”.
- 12. 3 Characteristic Featuresof Typical Rib • It is curved along its whole extent • It is angulated, i.e. presents 2 curves 1.5 cm in front of tubercle and 1.2 cm behind the anterior end • It is twisted, in such order that both ends of the rib can not contact the same horizontal plane • (Mnemonic: CAT – Curve, Angle, and Twisted)
- 13. Parts of aTypical Ribs • Every rib has 3 parts: • (a) The anterior end, • It carries a small cup shaped depression, which joins the corresponding costal cartilage to create a primary cartilaginous costochondral joint. • The anterior end bears a concave depression. • (b) The posterior end is composed of: – Head , – Neck , – Tubercle • (c) shaft. – The shaft is the longest part and goes between anterior and posterior ends.
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- 17. The Head ofTypicalRibs • The head is wedge shaped, and has two articular facets separated by a wedge of bone. • It has 2 articular facets: – lower and upper. • The lower bigger facet articulates with the body of numerically corresponding vertebra. • The upper smaller facet articulates with the next higher vertebra. • The crest separating the 2 articular facets is located opposite the intervertebral disc. • The head is connected to these structures by “triradiate ligaments”
- 18. The Neck ofTypical Ribs • The neck contains no bony prominences, but simply connects the head with the body. • It is located in front of the transverse process of the corresponding vertebra. • The neck has 2 borders – Superior and inferior. • 2 surfaces– Anterior and posterior. • The upper border is sharp crest like, on the other hand the lower border is rounded. • The posterior surface is rough and pierced by foramina.
- 20. The Body ofTypical Rib It is thin and flattened. • It presents 2 surfaces :– –Outer –Inner. • 2 borders: – –Upper –Lower. • 2 angles :– –Posterior –Anterior .
- 21. Surface of thebody • Outer Surface – It is smooth and convex, and presents 2 angles:– • Posterior and anterior. – The posterior angle (typically referred to as only angle) is marked by an oblique ridge. – The anterior angle is marked by an indistinct oblique line.
- 22. • Inner Surface –It’s smooth and concave. It presents a costal groove near its lower border. The costal groove becomes unrecognizable in the anterior part. – The costal groove lodges from above downwards, as follows (Mnemonic: VAN):. • Intercostal Vein. • Intercostal Artery. • Intercostal Nerve. • The internal intercostal muscle is connected to the floor of the groove (interceding between intercostal nervesand vessels, and bone). • The intercostalis intimus is connected to the upper border of the costal groove.
- 23. Borders of thebody Superior Border • The superior border is thick and rounded, and presents outer and inner lips: • The outer lip gives connection to the external intercostal muscles. • The inner lip gives connection to the internal intercostal and innermost intercostal muscles. Lower Border • The lower border is sharp and creates the lower border of the costal groove, and gives origin to the external intercostals muscle.
- 24.
- 27. Articulations • The majorityof the ribs have an anterior and posterior articulation. Anterior attachments of ribs The anterior attachment of the ribs vary: • Ribs 1-7 attach independently to the sternum. • Ribs 8 – 10 attach to the costal cartilages superior to them. • Ribs 11 and 12 do not have an anterior attachment and end in the abdominal musculature. Because of this, they are sometimes called ‘floating ribs’.
- 28. Articulations Posterior • All ofthe twelve ribs articulate posteriorly with the vertebrae of the spine. • Each rib forms two joints: – Costotransverse joint – Between the tubercle of the rib, and the transverse costal facet of the corresponding vertebrae. – Costovertebral joint – Between the head of the rib, superior costal facet of the corresponding vertebrae, and the inferior costal facet of the vertebrae above.
- 29. Atypical Ribs • Ribs 1,2, 10 11 and 12 are ‘atypical’ as they have features that are not common to all the ribs. • Rib 1 is shorter and wider than the other ribs. It only hasone facet on its head for articulation with its corresponding vertebrae (there isn’t a thoracic vertebrae above it). The superior surface is marked by two grooves, which make way for the subclavian vessels. • Rib 2 is thinner and longer than rib 1, and has two articular facets on the head as normal. It has a roughened area on its upper surface, where the serratus anterior muscle attaches. • Rib 10 only has one facet – for articulation with its numerically corresponding vertebrae. • Ribs 11 and 12 have no neck, and only contain one facet, which is for articulation with their corresponding vertebrae.
- 30. First rib a) Highest, b)Shortest , c) Strongest , d) Flattest , e) Most curved, f) Most fixed & g) Broadest • The shaft of the very first rib slopes obliquely downwards and forwards to its sternal end. • It only has one facet on its head for articulation with its corresponding vertebrae (there isn’t a thoracic vertebrae above it). • The upper surface has two grooves for the subclavian artery and subclavian vein, separated by the scalene tubercle for the attachment of the scalene anterior muscle • It has no angle. • There is no costal groove.
- 31. Rib I It slopesobliquely downwards and forwards to its sternal end. The obliquity of the first ribs accounts for the appearance of pulmonary and pleural apices in the neck.
- 32.
- 33. Side Decision of1st rib • Side of the very first rib can be figured out by supporting the rib in this manner that: • Its bigger end is directed anteriorly and its smaller end is directed posteriorly • The surface of its shaft having 2 grooves divided by a ridge is directed superiorly • Its concave border is directed inwards and its convex border is directed outwards
- 35. Features of 1strib • Inner Border • It presents a scalene tubercle about its middle. Tubercle and adjoining part of the upper surface gives connection to the scalenus anterior muscle • It gives connection to the Sibson’s fascia (suprapleural membrane) • Outer Border • It gives origin to the first digitation of serratus anterior about its middle, just behind the groove for the subclavian artery.
- 36. Surfaces of 1strib • Superior (Upper) Surface • It is crossed obliquely by 2 shallow grooves (anterior and posterior) divided by a little ridge. • The ridge is constant with the scalene tubercle for insertion of scalenus anterior. • The anterior groove lodges subclavian vein, while posterior groove lodges the subclavian artery and lower trunk of the brachial plexus – The area behind posterior groove up to the costal tubercle gives connection to the scalenus medius muscle – The area in front anterior groove and near the anterior end gives connection to subclavius muscle (anteriorly) and costoclavicular ligament (posteriorly) • Lower Surface • It is related to the costal pleura.
- 37. Neck of 1strib • It is elongated and pointed upwards, backwards, and laterally. • The subsequent structures create anterior relationships of neck from medial to lateral side – Sympathetic chain(inferior cervical sympathetic ganglion) – First posterior intercostal Vein – Superior intercostal Artery – Ventral ramus of first thoracic Nerve • Memory apparatus: Chain pulling the VAN
- 38.
- 39. Distinguishing Features of2nd rib • Rib 2 is thinner and longer than 1st rib (twotimes). • It has two articular facets on the head as normal. It has a roughened area on its upper surface, where the serratus anterior muscle attaches. • Its shaft is sharply bent not twisted; thus both the ends of rib touch the table top when put on it. • Near its middle, the outer convex surface of shaft presents a rough impression or tubercle, which gives connection to the serratus anterior muscle (lower part of first and whole of 2nd digitation) • Posterior part of internal surface presents a short costal groove poorly developed) • The upper border and adjoining part of upper surface supply connection to the scalenus posterior and serratus posterior superior muscles
- 40. TENTH RIB • DistinguishingFeatures • It is single articular facet on its head, which articulates with the body of corresponding thoracic vertebra • It is somewhat shorter in relation to the conventional rib.
- 41. ELEVENTH RIB • DistinguishingFeatures • It is single large, articular facet on its head. • It is no neck and no tubercle. • Its anterior end is pointed and tipped with cartilage. • It is little angle and a shallow costal groove. • Its inner surface is pointed upwards and inwards.
- 42.
- 43. Distinguishing Features • The12th rib has identical features as the 11th with the exception of that: • It has no neck, no angle, no tubercle, no costal groove. • It is considerably shorter than 11th( so short in females). • It is as short as 1st rib. • Side Conclusion • The side of 12th rib can be figured out by keeping the rib in this style that: • Its pointed anterior end is directed anterolaterally and its wider end posteromedially. • Its somewhat concave surface faces inwards and upwards. • Its sharper border is directed inferiorly.
- 44. Attachments of 12thrib • Outer Surface • Near the tip, it gives connection to the latissimus dorsi muscle above and external oblique muscle below. • Its medial half gives connection to the erector spinae muscle. • Inner Surface • An oblique line crossing the middle of the surface indicates the line of pleural reflection. • Lower part of medial half gives connection to the quadratus lumborum muscle. • Middle two fourth near the upper border gives connection to the internal intercostal muscle. • Upper part of sidelong quarter near the tip gives connection to the diaphragm. • Lower Border • Close to head it gives connection to the lumbocostal ligament, which stretches from transverse process of LI vertebra. • Lateral arcuate ligament is connected to it just lateral to the quadratus lumborum. • Upper Border • The upper border gives connection to the external and internal intercostal muscles.
- 45. Rib Fractures • Ribfractures most commonly occur in the middle ribs, as a consequence of crushing injuries or direct trauma. A common complication of a rib fracture is further soft tissue injury (the lungs, spleen or diaphragm). • If two or more fractures occur in two or more adjacent ribs, the affected area is no longer under control of the thoracic muscles. It displays a paradoxical movement during lung inflation and deflation. • This condition is known as flail chest. It impairs full expansion of the ribcage, thus affecting the oxygen content of the blood. Flail chest is treated by fixing the affected ribs, preventing their paradoxical movement.
- 46. CERVICAL RIB • Thecostal component of the C7 vertebra may elongate to create a cervical rib in about 5% people. • The state might be unilateral or bilateral. It takes place more commonly unilaterally and somewhat more frequently on the right side. • The cervical rib might have a blind tip or the tip might be joined to the 1st rib by fibrous group or cartilage or bone. It might compress the lower trunk of brachial plexus and subclavian artery. • The compaction generates: (a) pain along the medial side of forearm and hand and (b) interference in the circulation of the upper limb.
- 47. LUMBAR RIB (GORILLARIB) • It grows from the costal component of L1 vertebra. • Its prevalence is much more common than the cervical rib, but stays undiagnosed as it normally doesn’t cause symptoms. • It might be mistaken with the fracture of transverse process of L1 vertebra.
- 49.
- 50. BUCKET HANDLE MOVEMENT •One of the most important functions of ribs and diaphragm, is the change in volume of thorax that helps inspiration and expiration. In general, the ribs move around two axes.As the anterior end of ribs is about 4 cm lower than the posterior end, the middle part of rib is lower than anterior and posterior ends.
- 51. BUCKET HANDLE MOVEMENT Movementat costovertebral joints 7 to 10 about an anteroposterior axis results in raising and lowering the middle of the rib, the Bucket-handle movement. In elevation, this increases the transverse diameter of the thorax.
- 53. Pump handle movement •On of the most important functions of ribs and diaphragm, is the change in volume of thorax that helps inspiration and expiration.[2] • In general, the ribs move around two axes.The anterior end of the rib is lower than the posterior end, therefore, during elevation of the rib, the anterior end also moves forward
- 54. • Movement atcostovertebral joints 2 to 6 about a side-to-side axis results in raising and lowering the sternal end of the rib, the "pump-handle" movement. • This occurs mostly in the vertebrosternal ribs. In elevation, this increases the anteroposterior diameter of the thorax.[4][
- 56. Mechanism of respiration Thoracicwall and mechanism of respiration
- 57. Intervertebral Symphysis (second-ary cartilaginous) CostotransverseSynovial plane joint Articulation of tubercle of rib with transverse process of corresponding vertebra. Costochondral Primary cartilaginous joint. Interchondral Synovial plane joint. Manubriosternal Secondary cartilaginous joint (symphysis). Xiphisternal Primary cartilaginous joint (synchondrosis)