Ribs motion

Together, the costotransverse and costovertebral joints form a complex coupled joint. An imaginary line drawn between the two articulations is the axis that defines the direction of rib motion (Fig. 69-1). 

The term pump handle motion is derived from the similarity between the rib motion and that of an old-fashioned water pump. One end is fixed, and the free end describes an arc. The costovertebral-costotransverse axis of the upper ribs lies close to the coronal plane. As the ribs move about this axis, they increase the anteroposterior diameter of that portion of the rib cage. 

FIG. 69-4 Rib motions (A) Bucket handle motion (B) Pump handle mot on. (C) Caliper motion. 

There are several reasons for evaluating the thorax during a structural examination. The status of the rib cage is an important clue to the status of the respiratory mechanism. Free motion of the ribs is necessary for full expansion of the lungs. Conversely, pulmonary diseases cause secondary changes in rib motion and function. 

The thorax Is palpated to detect static asymmetries as well as asymmetries or restrictions of rib motion. Static asymmetries represent anterior or posterior ribs. Palpation for static asymmetries Is particularly helpful when localized pain Is caused by rib dysfunction. Ribs may be palpated along the posterior thorax at the angle of the ribs with the patient prone. A posterior rib on... 

Palpation of the costochondral junction elicits tenderness. There seldom is swelling. It must be differentiated from Tietze syndrome, which is similar in symptomatology. However, Tietze syndrome is generally more localized and swelling is usually present. Costochondritis must also be differentiated from somatic dysfunction, another cause of anterior chest wall pain. Evaluation of rib motion will usually allow a diagnosis however, motion may be restricted in the presence of costochondritis as well. 

It may be necessary to correct the rib motion restrictions to make an accurate diagnosis. The pain of somatic dysfunction should disappear or be markedly improved after treatment. If the... 

When evaluating the pulmonary patient, it is also important to evaluate all components involved in respiration, including rib motion, ability of the spine to straighten during inhalation and curve with exhalation, diaphragmatic motion, and accessory muscles of respiration such as the scalenes, sternocleidomastoids, and abdominal muscles. 

Musculoskeletal changes occur during the course of the disease. The chest assumes a barrel shape in which the anteroposterior (AP) diameter equals the transverse diameter. The accessory muscles of respiration gradually hypertrophy. Hypertrophic scalene muscles may impinge on neurovascular structures passing between or near them. Rib motion is markedly restricted and eventually contributes to the dyspnea. The thoracic spine becomes kyphotic and immobile. Motion of the diaphragm is restricted. 

Fig. 3.10 Variation of the spectrometer aperture as a function of the source motion for Mossbauer spectrometers operated in constant acceleration mode with triangular velocity profile, and the resulting nonlinear baseline distortion of the unfolded raw spectra. For simplicity a point-source is adopted, in contrast to most real cases (Rib mm active spot for Co in Rh)...

In the bottom of the fixed vessel is put about half a. hundredweight nf mercury, which lies to the depth of about half-an-inch, and when the machine is set in motion, the pounded mineral is constantly agitated and mixed with this fluid metal by means of the won ribs nailed to tlie bottom of the muller. The minute particles of gold are thus immediately dissolved and taken up hy the mercury, while those which escape combination in tlie first mil] are arrested and retained by tlie second, third, or fourth of the series. 

The small length seale of RIB relaxation eould imply that it is of the nature of P-relaxation due to side group motions. However, the P-relaxation relaxation times are mueh shorter than 1 s at 20 °C and above, while the RIB relaxation times ean exceed 10 ° s, comparable to that of the cooperative segmental relaxations (a-relaxation). This effectively... 

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