Ribs motion testing

Note that side-bending on intersegmental motion testing is greatly restricted by the ribs... 

Palpation of the anterior chest wall may disclose elevated or depressed ribs. In the case of a depressed rib, die space between it and the rib below will be narrowed, while the space between it and the rib above will be widened. These differences are reversed for an elevated rib the space between it and the rib above will be narrowed, while the space between it and the rib below is widened. A single rib or a group of ribs may be elevated or depressed. Motion testing is necessary for diagnosis, as the findings on static palpation may be misleading. Generally, a depressed rib will restrict the motion of the ribs below and when inhalation occurs and an elevated rib will restrict the motion of the ribs above It when exhalation occurs. 

FIG. 70-2 Pump handle motion testing of the upper ribs. 

The individual ribs are tested in the manner just described for each level of ribs, but only one rib on each side is tested and compared. Individual ribs may be tested if one rib is painful or If restriction of motion is found on gross motion testing. If a group inhalation restriction has been found, usually the top rib in the group is responsible for the restriction. If a group exhalation restriction has been found, usually the lowest rib in the group is responsible. 

This section describes a general screening test for evaluating motion of groups of ribs. 

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