The human chest is called the frame, which consists of the sternum, vertebrae and twelve pairs of ribs. Such a frame should normally be slightly flattened in front and expanded in the transverse direction.
Ribs are flat, arched, curved bones no more than 5 mm thick, which have cartilaginous and bony parts. If the bony parts are represented by long spongy bones, consisting of a neck, head, tubercle, then the short anterior part is called cartilaginous.
The main functions of the ribs are divided into protective and frame. The first function is that the ribs protect large vessels and internal organs from injury. The second function helps keep the heart and lungs in the correct position.
Rib anatomy
The ribs in humans are represented by curved and narrow plates, which largely consist of long bone filled with spongy substance. Their shorter anterior part is represented by cartilaginous tissue. Each bone consists of an anterior end, a body and a posterior end, on which there is a small thickening - the head of the rib. Adjacent to it is the articular surface, through which the ribs are connected to the spine.
A number of authors in the structure of the rib distinguish the neck, the narrow part after the head, and the tubercle - a small thickening that comes into contact with the transverse processes of the thoracic vertebrae. This anatomical structure is absent in the 11th and 12th ribs, since they do not articulate with the spine.
On the front and back surfaces of the bones there are special notches for blood vessels and tuberosities - places for muscle attachment. According to the numbering, there are 12 pairs of ribs (for both women and men). The first 7 are considered true, since their anterior ends are connected to the sternum. The next three (8, 9 and 10) are false, since they are attached not to the sternum, but to the cartilaginous ends of the previous ribs. 11 and 12 are called wandering and are free, not attached to anything.
Number of ribs for men, women and children
The structure of the adult human skeleton includes 12 pairs of ribs.
The structure of the ribs of humans differs from other mammals. However, the skeleton, like all vertebrates, undergoes some changes as it ages.
In a child, all the ribs are in a state of mobile cartilage; complete ossification occurs only by the age of 20. Healing of damaged tissue at this age occurs easier and faster, but there is a possible risk of malunion.
In adult men and women, the rib system is no different - 12 pairs, or 24 ribs per organism. In rare cases, there are exceptions with less or more.
A child who has not yet been born initially develops as many as 29 pairs of bones, but over time they atrophy and grow into other skeletal elements. Only 12 pairs are preserved, which are responsible for the chest frame. It happens that during development, the 13th pair is formed, located at the level of the 7th or 8th cervical vertebra. Even more rarely, one rudimentary rib appears in this zone.
Such an “upgrade” does not do anything good for an adult. As they ossify, these pairs fuse with one part of the thoracic ribs or can change the structure of the neck. This leads to diseases, chronic pain and other abnormalities.
Adam's rib syndrome
A person's ribs are not always represented in 12 pairs. In medical practice, there are cases when a person develops one more pair of ribs. But this has nothing to do with gender, although the anatomical disorder has such a specific name.
Women are more susceptible to this deviation than men. During the formation of the skeletal system, even during intrauterine development, a failure may occur, which leads to the formation of an additional rib or an entire pair.
Doctors recommend eliminating the deviation as soon as it is detected, since Adam’s rib syndrome can cause pinched nerve endings, which leads to numbness of the limbs. There are other consequences of this condition related to the functioning of internal organs.
Rib cage
In the anatomy of the chest, in addition to the ribs, there is a sternum, a flat bone that is shaped like a dagger, and the thoracic vertebrae. The sternum itself consists of the manubrium, body and xiphoid process. The latter structure may be bifurcated, have a hole, or be tilted to the side; many scientists consider it a vestige.
The structure of the chest is shown in the photo. Inside the sternum there is a significant amount of spongy substance, red bone marrow and blood vessels. Where a person’s 8th rib is located, the thoracic aperture (expanded part) begins.
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There are three main types of chest:
- Normosthenic. The chest has the shape of a truncated cone, the ribs are angled, and the angle between the xiphoid process and the costal arch is 90°.
- Hypersthenic. The shape of the chest is cylindrical, the ribs run more horizontally, and the angle is greater than 90°.
- Asthenic. It is characterized by the fact that the chest has the appearance of a flat, elongated cone with wide intercostal spaces.
Structure
The ribs are curved osteochondral plates, the thickness of which reaches 5 mm. The chest consists of 12 pairs of ribs, numbered from top to bottom. You can see what these bones look like in the photo.
The bone part of the plates consists of 3 sections: head, neck and body. Using the head and neck, they are securely attached to the spine, creating a movable articular connection. The body of the first 7 pairs of ribs in front passes into cartilaginous tissue, with the help of which they are attached to the sternum. The cartilage joint is also movable.
The first 7 pairs of bone plates are true ribs. The plates 8, 9, and 10 pairs in front are attached by a cartilaginous connection to the previous rib; they are called false. The last 2 pairs are attached only to the spine and are called free ribs.
The upper surface of the bone plates has a rounded shape, the lower surface is sharp. In the lower part of the plate along its entire length there is a groove in which blood vessels and nerve fibers are located.
At birth, a person’s ribs consist almost entirely of cartilaginous tissue; ossification of the thoracic frame is completed only by the age of 20.
Functions
In addition to the fact that the chest is a strong frame for internal organs, it performs a number of important functions in the human body:
- protects the heart, lungs, large vessels, thymus gland and esophagus from injury and excessive shock;
- participates in the act of breathing, maintains its normal regular rhythm, does not allow the lungs to escape;
- provides full movement of the shoulder girdle and arms;
- This anatomical structure creates negative thoracic pressure, which ensures sufficient pumping function of the heart and promotes the outflow of venous blood from the lower parts of the body into the vena cava.
Thus, the ribs and the rib cage as a whole are an important skeletal structure in the human body that performs many useful functions.
Diagnosis of damage
In order to protect the patient’s life from potential danger, immediate diagnostic testing is required. Receiving qualified assistance is possible by visiting a specialist - an orthopedist.
A diagnostic set of measures to determine potential damage includes the following stages in its structure:
Visual examination, collection of complaints, study of anamnesis:
- The damaged area is palpated to determine the presence of bone fragments;
- The patient may need to take a deep breath;
- If there is a fracture, this will be almost impossible to achieve as a result of unbearable pain;
Implementation of Payra's method:
- The patient should lean to the side that is opposite to the damaged area;
- Given the lack of bone integrity, such an action will be difficult to perform.
The following diagnostic options can be used as additional methods:
- Ultrasound examination of the chest;
- CT;
- X-ray.
What diseases are associated with ribs?
Damage to the ribs and other bones of the chest is not a rare occurrence and can occur in various somatic and infectious diseases. The most common of them:
- split;
- chondritis, osteomyelitis;
- syphilis, tuberculosis;
- echinococcosis, actinomycosis, candidiasis;
- Tietz's disease;
- coarctation of the aorta, rickets;
- malignant tumors.
Structural anomalies
Split ribs are understood as a congenital structural anomaly, which rarely causes any complaints and is an x-ray finding. There are also additional and fused ribs, or their absence is possible.
Clinical signs appear in the presence of a cervical rib on one or both sides, which is attached to the transverse process of the 6th cervical vertebra. In this case, neurological symptoms most often appear: headache, dizziness, fainting, etc.
Much less common are congenital bone islands, which sometimes have to be distinguished from metastases and calcifications.
Osteomyelitis and chondritis of the ribs
Osteomyelitis is a purulent infectious inflammation of the bones, which mainly spreads hematogenously (through the bloodstream). It most often occurs in children after injuries and affects the first three pairs of ribs. The patient experiences severe chest pain and severe intoxication syndrome:
- high fever;
- chills;
- weakness, sweating;
- paleness of the skin.
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Chondritis is understood as an acute purulent process in which the cartilaginous parts of the bones are involved. Pathology occurs rarely after surgical interventions. In the absence of treatment (detoxification therapy, use of systemic antibiotics), fistulas with purulent discharge may appear.
Tuberculosis and syphilis
Tuberculosis of the ribs is a specific inflammation of the bones, which is a consequence of dissemination (spread) from the lung tissue. When the ribs are affected, swelling, local pain and the formation of fistulas occur. As the tuberculosis process progresses, cysts and foci of destruction appear in the bones.
Syphilitic damage to these bones is extremely rare and is manifested by the appearance of swelling on the ribs, which periodically cause pain. Both pathologies are confirmed x-ray, using bacteriological tests for acid-fast bacteria and antibodies to Treponema pallidum.
Parasitic and fungal pathologies
When actinomycosis spreads to the structures of the chest, the edges of the ribs become deformed, and signs of periostitis appear - inflammation of the periosteum. This causes discomfort and pain in the upper torso.
Echinococcal (parasitic) cysts can occur in the area of the ribs, causing their deformation and local compaction. They are detected by computed tomography and pose a threat of rupture with the release of parasites and their metabolic products into the chest cavity.
Tietz disease
It is also called thoracochondralgia. The pathology is characterized by the appearance of spindle-shaped compactions on the first 6 ribs in the area of their cartilaginous ends. The main complaint of such patients is pain, which may be aggravated by coughing, deep breathing and shortness of breath.
Less common are isolated swellings without pain. The diagnosis is made clinically, treatment is carried out using hormonal drugs and painkillers.
Rickets and coarctation of the aorta
In the first case, there is a metabolic disease, which is based on vitamin D deficiency. In addition to pathological changes in the lower extremities, skull, sweating, specific changes in the peripheral blood (lack of calcium and phosphorus) in asthenic children, the doctor can palpate the costal rosary - compactions in the place of transition of the bone part into the cartilaginous part.
Coarctation of the aorta is a congenital abnormality of the largest vessel leaving the heart, which is characterized by narrowing of the descending aorta. The lower edge of the ribs becomes uneven due to the pressure of tortuous and overly dilated arteries.
Malignant neoplasms
Malignant lesions of the ribs also occur. It may be a primary disease or a consequence of a metastatic process. There are osteomas, osteosarcomas, and osteoblastomas. The diagnostic criterion for the terminal stage of osteosarcoma of any localization is the appearance of usurations (depressions) on the ribs.
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The pathology is characterized by a variety of symptoms: pain, weakness, pathological fractures, fever.
Damage classification
Injury to the chest manifests itself in the form of a fracture of the 7th, 8th, 9th ribs, as well as the 5th and 6th links. There is the following classification of damage:
Depending on the skin lesions:
- Open appearance (the structure of the skin and tissues is damaged);
- Closed view (no skin damage, deep soft tissue damage);
- Depending on the bone damage:
- Complete (bone integrity is completely broken);
- Subperiosteal (there is damage only to bone tissue);
- With a cracked rib (there is no fracture at all, there is only a violation of tissue integrity);
- Bruised rib;
Depending on the fault:
- Single (for example, there may be a fracture of the 7th rib or only a fracture of the 8th rib);
- Multiple (for example, there is a fracture of the 5th and 7th ribs or a fracture of the 7th and 9th ribs);
Depending on the violation:
- On the one hand (for example, a fracture of the 7th rib on the left and a fracture of the 8th rib on the left are diagnosed);
- On both sides (for example, there is a fracture of the 8th rib on the right and a fracture of the 9th rib on the left).
Diagnosis and treatment
Various imaging methods are used to study the human skeleton and ribs:
- radiography in several projections;
- computed tomography, scintigraphy;
- puncture biopsy.
Treatment depends on the cause and duration of the disease. Antibiotics, steroidal or non-steroidal anti-inflammatory drugs, and cytostatics can be used. In some cases, surgical treatment is resorted to (removal of tumors, cysts, correction of heart defects).
Providing medical care
In the event that there is a fracture of 7-9 ribs or other structural elements, first aid is expected.
The victim is given a painkiller. In most cases, the drug Ibuprofen is used.
A fixing bandage is applied to the existing rib fracture. If there is damage to 6 ribs, then it is necessary to apply a towel and then fix it.
A prerequisite for successful emergency care is to provide the affected area with cold treatment in the form of an ice compress.
It is important to remember to comply with the conditions for safe transportation of the patient. If necessary, circular and occlusive dressings can be used, and a transport splint can be used. The recommended position for moving the victim is a semi-sitting position.
Injuries to the ribs and chest
The most common chest injuries are:
- bruises and concussions;
- fractures of the sternum and ribs;
- compression.
They can appear as a result of a fall, direct and indirect impacts, or jumps. With concussions and bruises, aching pain appears in the area of swelling during breathing, and hematomas are common. Treatment consists of rest, taking painkillers and applying compresses and ointments, if necessary.
With fractures, there is a sudden sharp pain in the chest, which intensifies with deep breathing, coughing, and movement. The affected part of the chest is deformed and breathing may be somewhat delayed due to pain; crepitus is felt on palpation.
Fractures occur with the formation of bone fragments, which can injure blood vessels, lung tissue and the heart, thereby causing life-threatening complications.
Treatment of rib fractures
For rib fractures, in most cases, fixation is not required, with the exception of complicated and multiple fractures, which should be treated only in a hospital setting.
Fixation of the chest without indications can lead to even greater limitation of breathing, which in turn contributes to the development of congestion, including congestive pneumonia.
The average treatment period for uncomplicated rib fractures is about one month, and the treatment period for multiple and complicated fractures depends on the general condition and the severity of the complications that arise.
Which doctors should I contact to examine my ribs?
With primary complaints, patients should contact a pediatrician or therapist, who will refer for consultation to other specialists if necessary. It can be:
- neurologist;
- cardiologist;
- surgeon, traumatologist;
- rheumatologist, etc.
Treatment of rib fractures
For uncomplicated fractures, treatment consists of applying a special non-pressure bandage, using analgesics and regular examination. The presence of complex fractures with displacement, wandering fragments or complications forces one to resort to surgical treatment for open reposition of bones and relief of emergency conditions.
Age-related changes
If we analyze age-related changes in different generations of people, it is obvious that in infants the sagittal size of the chest is larger than the frontal one. In other words, in infancy the sternum bones occupy a horizontal position, and with age they become almost vertical.
With age, various pathologies of the thoracic spine are often observed, which lead to deformation of the frame. In this case, prevention will help. The main rule is to maintain a healthy lifestyle. This includes daily exercise, rest, proper and regular nutrition and, of course, the elimination of all bad habits. Doctors all over the world claim that physical education helps people establish metabolic processes in their bodies and keep all muscles toned.
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