The relationship between various anatomical landmarks used for localizing the first RIB during surface palpation

Brian J. Loyd, Kerry K. Gilbert, Phillip S. Sizer, Lee T. Atkins, Stéphane Sobczak, Jean Michel Brismée, Timothy J. Pendergrass

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To assess the relationship between anatomical landmarks used to locate the first rib during surface palpation. One currently cited technique suggests locating the width of the transverse processes (TPs) of the first cervical vertebrae (C1) to determine the estimated width of the first thoracic vertebrae (T1) TP, allowing for subsequent palpation of the first rib laterally to the transverse process of T1. Based on anatomical structural relationships, the authors propose an additional method of locating the first rib, lateral to T1 TP, by palpating through the trapezius muscle at the width of the mastoid process (MP). Methods: Overlying tissue of the bilateral MP, C1 TPs, and T1 TPs of 28 cadavers were removed. Measurements of the left to right spans at the following structures were collected using a digital caliper: mastoid process, C1 TP, and T1 TP. Measurements were used to determine the agreement between each anatomical structural span. Results: The mean absolute difference (standard deviation, SD) between C1 TP span versus T1 TP span was 3·9 (±2·58) mm with an intraclass correlation coefficient (ICC) of 0·88 (95% CI = 2·9-4·9). The mean absolute difference between MP span and T1 TP span was 35·4 (±6·46) mm with an ICC of 0·71 (95% CI = 33·0-37·8). Discussion: This study confirms the anatomical accuracy and feasibility of using the C1 TP span to determine the general width of the T1 TP span while palpating for the first rib just lateral to the T1 TP. Additionally, this study demonstrates that the more easily palpated mastoid process serves as an effective landmark to identify a width sufficiently lateral to the T1 TP, appropriate for first rib palpation through the trapezius muscle.

Original languageEnglish
Pages (from-to)129-133
Number of pages5
JournalJournal of Manual and Manipulative Therapy
Volume22
Issue number3
DOIs
StatePublished - Aug 2014

Keywords

  • Bone morphology
  • First rib
  • Manual therapy
  • Reliability
  • Surface anatomy

Fingerprint

Dive into the research topics of 'The relationship between various anatomical landmarks used for localizing the first RIB during surface palpation'. Together they form a unique fingerprint.

Cite this