The sternum consists of the body and arm. Human chest anatomy. Pathology and trauma

Sternum

The sternum, sternum, is an unpaired elongated bone with a somewhat convex anterior surface and, accordingly, a concave posterior surface. The sternum occupies a section of the anterior chest wall. On it, a handle, a body and a xiphoid process are distinguished. All these three parts are interconnected by cartilaginous layers, which ossify with age.

The handle of the sternum, manubrium sterni, is the widest part, thick at the top, thinner and narrower at the bottom, has a jugular notch on the upper edge, incisura jugularis, easily felt through the skin. On the sides of the jugular notch are the clavicular notches, incisurae claviculares, - the junction of the sternum with the sternal ends of the clavicles.

Slightly lower, on the lateral edge, is the notch of the I rib, incisura costalis I, - the place of fusion with the cartilage of the I rib. Even lower there is a small depression - the upper part of the rib notch of the II rib; the lower portion of this notch is on the body of the sternum.

The body of the sternum, corpus sterni, is almost 3 times longer than the handle, but narrower. The body of the sternum is shorter in women than in men.

The anterior surface of the sternum has traces of the fusion of its parts in the process of embryopal development in the form of weakly expressed transverse lines.

The cartilaginous junction of the upper edge of the body with the lower edge of the arm is called synchondrosis of the sternum arm, synchondrosis manubriosiernalis, while the body and arm converge, forming a blunt, posteriorly open angle of the sternum, angulus slerni. This protrusion is at the level of the articulation of the II rib with the sternum and is easily felt through the skin.

On the lateral edge of the body of the sternum, there are four full and two incomplete costal notches, incisurae costales, - the places of articulation of the sternum with the cartilage of 11-VII ribs. One incomplete notch is located at the top of the lateral edge of the sternum and corresponds to the cartilage of the II rib, the other - at the bottom of the lateral edge and corresponds to the cartilage of the VII rib; four complete notches lie between them and correspond to ribs III - VI.

The sections of the lateral sections lying between two adjacent rib cuts are in the form of semilunar recesses.

The xiphoid process, processus xiphoideus, is the shortest part of the sternum, can be different in size and shape, with a forked apex or with a hole in the middle. The sharp or blunt apex faces either anteriorly or posteriorly. In the upper lateral part of the xiphoid process there is an incomplete notch articulating with the cartilage of the VII rib.

The xiphoid process forms with the body of the sternum a synchondrosis of the xiphoid process, synchondrosis xiphosternaiis. By old age, the xiphoid process, ossified, grows together with the body of the sternum.

Sometimes above the handle of the sternum, in the thickness of the sublingual muscle group or in the medial leg of the sternocleidomastoid muscle, 1-3 breast claws, ossa suprastemalia are located. They articulate with the sternum handle.

1 - jugular notch; A - I rib; B - II rib:
2 - clavicular notch; 1 - rib tubercle;
3 - sternum handle; 2 - rib angle;
4 - rib cuts; 3 - rib neck;
5 - the body of the sternum; 4 - rib head;
6 - xiphoid process 5 - rib body

The chest, compares thoracis, is made up of the thoracic spine, ribs (12 pairs) and the sternum.

The thorax forms a chest cavity, cavitas thoracis, in the form of a truncated cone facing downward with a wide base, and with a truncated apex upward, 8 the chest is distinguished by the anterior, posterior and lateral walls, the upper and lower opening, which delimit the chest cavity.

The anterior wall is shorter than the other walls, formed by the sternum and cartilage of the ribs. Situated obliquely, it protrudes more anteriorly with its lower sections than with its upper ones. The back wall is longer than the front, formed by the thoracic vertebrae and sections of the ribs from the heads to the corners; its direction is almost vertical.

On the outer surface of the posterior wall of the chest, between the spinous processes of the vertebrae and the corners of the ribs, two grooves form on both sides - dorsal grooves; The deep muscles of the back lie on the peak. On the inner surface of the chest, between the protruding bodies of the vertebrae if the pefiep coals, there are also two grooves - pulmonary grooves, sulci pulmonales; they are adjacent to the vertebral part of the costal surface of the lungs.

The side walls are longer than the front and back, are formed by the bodies of the ribs and are more or less convex.

The spaces bounded above and below by two adjacent ribs, in front by the lateral edge of the sternum and behind by the vertebrae, are called intercostal spaces. spatia intercostalia; they are made by ligaments, intercostal muscles and membranes.

The chest, compares thoracis, bounded by these walls, has two openings - the upper and lower, which are called apertures.

The upper aperture of the chest, area thoracis superior, is smaller than the lower one, bounded in front by the upper edge of the handle, from the sides by the first ribs and behind by the body of the I thoracic vertebra. It has a transverse oval shape and is located in a plane inclined from back to front and downward. The upper edge of the chest ™ handle is at the level of the gap between the II and III thoracic vertebrae.

The lower aperture of the chest, apertura thoracis inferior, is bounded in front by the xiphoid process and the costal arch formed by the cartilaginous ends of the false ribs, from the sides - by the free ends of the XI and XII ribs and the lower edges of the XII ribs, behind - by the body of the XII thoracic vertebra.

The costal arch, arcus costalis, at the xiphoid process forms an open sub-sternum angle, angulus infrasternal "is.

The shape of the chest varies from person to person (flat, cylindrical, or conical). In persons with a narrow ribcage, the belly angle is sharper and the intercostal space is wider, while the ore cage is longer than in persons with a wide ribcage. The ribcage in men is longer, wider and more conical than in women. from age.

The human body is very fragile. There are special protective structures to ensure the safety of vulnerable areas. One of these systems is the chest. Its special structure serves as a shield for the cardiovascular system, respiratory system, spinal cord and brain.

An interesting feature of the chest is its mobility. Due to breathing movements, it is forced to constantly change size and move, while maintaining its protective properties.

The structure of the human chest

The structure of the chest is simple - it consists of several types of bones and soft tissues. A large number of ribs, sternum and part of the spine add volume to the chest cavity. In terms of size, it is in the second place. Its interesting structure is due to the participation in respiration and support of the human body.

A complex of joints gives mobility to such a complex system. All bones are connected to each other with their help. In addition to joints, muscle tissue plays an important role in mobility. Such a comprehensive solution provides high protection for the cardiac and respiratory systems.

Borders

Most of the population is unfamiliar with human anatomy and does not know the exact boundaries of the chest. It is a delusion that only the chest area applies to her. Therefore, it is necessary to tell in more detail about its boundaries.

1. The uppermost border is at shoulder level. The first pair of ribs begins under them;
2. The bottom border has no clear line. It resembles a pentagon. On the sides and back, the border runs at the level of the lower back. The anterior cavity ends along the edge of the ribs.

Sternum

The sternum is responsible for the correct formation of the front part of the chest. Most of the cartilage joins the sternum and serves as a cushion between the bone and the ribs. Outwardly, it looks like a plate, vaguely similar to a shield, convex on one side, and slightly concave on the side of the lungs. Consists of three connecting parts. Tight straps hold them together. The division into three parts provides a rather rigid bone with mobility, which is necessary due to the expansion of the cavity during breathing.

Together they provide a protective function. But each part has its own purpose and specificity.

• Lever. This is the part on top that is the most voluminous. It has the shape of an irregular quadrangle, whose lower base is smaller than the upper one. Along the edges of the upper base, there are pits for attaching the clavicles. On the same base, one of the largest muscles of the cervical spine is attached - the clavicular-sterno-mastoid;

• The body - the middle section of the sternum, is attached to the handle at a slight angle, which gives the sternum a convex curve. The lower part is wider, but the bone begins to taper towards the junction with the handle. This is the longest part of the sternum. It resembles an elongated quadrangle in shape
• The process is the lower segment of the sternum. Its size, thickness and shape are individual for each person, but in most cases it resembles an inverted triangle. The most mobile part of the bone.

Ribs

Ribs are curved bony structures. The posterior edge has a smoother and more rounded surface to attach to the spine. The anterior edge has a sharp, sharp edge that connects to the sternum with cartilage.

The ribs have the same structure, and the only difference is their size. Depending on the location, the ribs are divided into:

• True (7 pairs). These include ribs, which are attached with cartilage to the sternum;

• False (2-3 pairs) - are not attached by cartilage to the sternum;
• Free (11 and 12 pairs of ribs are free). The adjacent muscles keep their position.

Spine

The spine is the supporting part of the chest. The atypical structure of the joints that connect the ribs and vertebrae allows them to participate in the narrowing and expansion of the chest cavity during breathing.

Chest soft tissue

An important role in the formation of the chest cavity is played not only by bone structures, but also by more plastic elements. For the proper functioning of the respiratory system, the chest region is supplied with many muscle tissues. They also help the bones in their protective functions: by covering them and blocking the gaps, they turn the chest into a single system.

Depending on the location, they are divided into:

• The diaphragm. It is an anatomically important and essential structure that separates the chest from the abdominal cavity. It looks like a wide, flat matter that is shaped like a hill. By straining and relaxing, it affects the pressure inside the chest and the correct functioning of the lungs;
• Intercostal muscles are elements that take a large part in the respiratory function of the body. They serve as a connecting element for the ribs. They consist of two layers with different directions, which narrow or expand when breathing.

Part of the muscles in the shoulder region is attached to the ribs and is responsible for their movement. The body does not use them in everyday life, but only during periods of severe physical or emotional stress for more intense breathing.

What are the normal chest shapes?

The rib cage is an important part of the body's defense. Its form has been formed over the course of long millennia of evolution, and is the most suitable for fulfilling the tasks assigned to it. The shape is influenced by the growth, heredity, diseases and physique of a person. There are many options for the shape of the chest. But still, there are certain criteria that make it possible to attribute it to the norm or pathology.

The main types are:

• Conical or normosthenic shape. Typical for people of average height. Small gap between ribs, right angle between neck and shoulder, front and back planes wider than lateral ones;
• The hypersthenic chest resembles a cylinder. The width at the sides almost corresponds to the front and back of the ribcage, the shoulders are significantly larger than in people with a tapered shape. More often found with growth, below the average. The ribs are parallel to the shoulders, almost horizontal. Musculature is well developed;

• Asthenic is the longest variant of the norm. The structure of the chest of a person of the asthenic type is distinguished by a small diameter: the cage is narrowish, elongated in length, the clavicular bones and ribs are pronounced, the ribs are not horizontal, the gap between them is wide enough. The angle between the neck and shoulders is obtuse. The muscular system is poorly developed. Occurs in people with tall stature.

Chest deformity

Deformity is a change in the physiological plan that affects the appearance of the chest. Violation of the structure of the chest affects the quality of protection of internal organs, and in some types of deformity, it can itself be a threat to life. It arises due to the complex course of the disease, burns, trauma, or may be initial, from birth. In this regard, several types of deformation are distinguished.

• Congenital - abnormal or incomplete development of the ribs, sternum or spine;
• Acquired, acquired throughout life. Is the result of illness, injury or improper treatment.

Diseases causing deformation:

• Rickets is a childhood disease when the body grows too quickly, which leads to impaired bone formation and a decrease in the flow of nutrients;
• Bone tuberculosis is a disease that affects adults and children and develops after direct contact with a carrier of the disease;
• Respiratory system diseases;
• Syringomyelia is a disease associated with the formation of extra spaces in the spinal cord. The disease is chronic;
• Scoliosis is a violation of the shape of the spinal column.

Severe burns and injuries also cause deformation.

Acquired changes are:

• Emphysematous - a barrel chest. Pathology develops after suffering a severe form of lung disease. The front plane of the chest begins to grow;

• Paralytic when the diameter of the chest decreases. The scapula and clavicle bones are clearly defined, there is a large gap between the ribs, when breathing, it is noticeable that each scapula moves in its own rhythm. Paralytic deformity occurs in chronic diseases of the respiratory system;
• Scaphoid. Begins to develop in people with syringomyelia. A rook-shaped fossa appears in the upper part of the chest;
• Kyphoscoliotic. The disorder is typical for people with diseases of the bones and spine, such as bone tuberculosis. There is no symmetry in the chest, which interferes with the normal functioning of the heart and lungs. The disease progresses rapidly and is poorly treated.

Birth defects

The most common cause of deformity in children is a disturbance in the work of the gene material. The genes initially contain an error that predetermines the incorrect development of the organism. This is usually expressed in the atypical structure of the ribs, sternum or in their complete absence, in poor development of muscle tissue.

Types of chest cells for congenital pathologies:

• Funnel-shaped. Ranks first in the frequency of manifestations among congenital chest pathologies. Prevalent among the male population. The sternum and adjacent ribs bend inward, there is a decrease in the diameter of the chest and a change in the structure of the spine. Pathology is often inherited, which gave reason to consider it a genetic disease. Affects the lungs and cardiovascular system. In severe cases of the disease, the heart may be out of place.

Depending on the degree of complexity of the disease, there are:

• First degree. The cardiac system is not affected, and all organs are located in anatomically correct places, the depression is not more than 30 millimeters long;
• The second degree, when there is a displacement of the heart muscle up to 30 millimeters and the depth of the funnel is about 40 mm;
• Third degree. At grade 3, the heart is displaced by more than 30 millimeters, and the funnel is more than 40 mm deep.

The organs suffer most on inspiration, when the chest is closest to its back and, accordingly, the funnel too. With age, the deformity becomes more visible, and the degree of the disease progresses. The disease begins to progress at a rapid pace from the age of three. Such children suffer from circulatory disorders and develop more slowly than their peers. Their immune systems cannot function at full capacity, which is why they often get sick. Over time, the funnel gets bigger, and health problems grow with it.

• Keel-shaped - a pathology associated with an excess of cartilage tissue in the ribs and sternum. The rib cage is strongly prominent and looks like a keel. With age, the condition worsens. Despite the outwardly scary picture, the lungs are not damaged and work normally. The heart slightly changes its shape and copes worse with physical activity. Possible shortness of breath, lack of energy and tachycardia;
• The flat chest is characterized by less volume and does not require treatment. It is a variant of the asthenic type, does not affect the work of internal organs;

• The sternum is cleft. The cleft is divided into complete and incomplete. Appears during pregnancy. With age, the gap in the sternum grows. The larger the lumen, the more vulnerable the lungs and the heart with the adjacent vessels become. Surgery is used for treatment. If the operation is performed on a child under one year old, then you can simply do with suturing the sternum. At this age, bones are flexible and easily adaptable. If the child is older, then the bone is expanded, the cleft is filled with a special implant, and fixed with a titanium alloy plate;
• The concave deformation is a very rare and poorly studied species. A protruding line forms in the upper chest region. It is only an aesthetic problem, and does not affect the health of the body;
• Poland's syndrome is an inherited genetic disorder associated with retraction of the chest. The disease affects all parts of the chest: ribs, sternum, vertebrae, muscle tissue and cartilage. Corrected with surgery and prosthetics.

The fracture and its consequences

The fracture of the chest is most often due to a strong blow or from a fall. It is diagnosed with a bruise and hematoma in the area of \u200b\u200bdamage, as well as severe pain, swelling and possible deformation of the chest. If as a result of the impact only the bones have suffered, then with a high probability everything will heal quickly. It is worth worrying if there is a suspicion of a bruise or damage to the lung. Shrapnel or a sharp edge at the fracture site may pierce the lung. This is fraught with complications and long-term rehabilitation.

If you suspect lung damage, see your doctor. The patient will begin to accumulate air in the cavity, which will interfere with the breathing process, until it stops completely. You will not be able to cope with the consequences on your own.

Fractures are divided into open and closed. With an open fracture, the integrity of the skin is violated, the risk of infection increases. A closed fracture is characterized by no open wounds in the skin, but there may be internal bleeding.

What is a bruise?

Contusion is a closed type injury. If during a bruise a bone fracture or damage to the internal systems of the body did not occur, then it is diagnosed with a number of symptoms.

• Severe tissue swelling due to damage to the blood vessels;
• Pain localized at the site of the injury, aggravated by a deep breath;
• Bruises and hematomas.

Most often, a bruise occurs due to a strong blow or collision. Common reasons include:

• road traffic accidents when the steering wheel, belt or airbag is injured;
• professional competitions or fights;
• fight or attack;
• you can also get a bruise by slipping and falling on an object or uneven surface, which will make the bruise worse.

A common consequence is the lungs are bruised, resulting in hemorrhage, leading to edema. Symptoms are similar to ordinary bruises, but coughing up blood is added, painful sensations when trying to change the position of the body.

Sternum, sternum, - an unpaired elongated bone with a slightly convex anterior surface and, accordingly, a concave posterior surface. The sternum occupies a section of the anterior chest wall. On it, a handle, a body and a xiphoid process are distinguished. All these three parts are interconnected by cartilaginous layers, which ossify with age.

Sternum handle, manubrium sterni, - the widest part, thick at the top, thinner and narrower at the bottom, has a jugular notch on the upper edge, incisura jugularis, easily palpable through the skin. On the sides of the jugular notch are the clavicular notches, incisurae claviculares, - the junction of the sternum with the sternal ends of the clavicles.

Sternum video

Slightly lower, on the lateral edge, is the notch of the I rib, incisura costalis I, - the place of fusion with the cartilage of the I rib. Even lower there is a small depression - the upper part of the rib notch of the II rib; the lower portion of this notch is on the body of the sternum.

The body of the sternum, corpus sterni, is almost 3 times longer than the handle, but narrower. The body of the sternum is shorter in women than in men.

The anterior surface of the sternum has traces of the fusion of its parts in the process of embryonic development in the form of weakly expressed transverse lines.

The cartilaginous connection of the upper edge of the body with the lower edge of the handle is called synchondrosis of the sternum arm, synchondrosis manubriosternalis, while the body and the handle converge, forming an obtuse, open posterior angle of the sternum, angulus sterni. This protrusion is at the level of the articulation of the II rib with the sternum and is easily felt through the skin.

On the lateral edge of the body of the sternum, there are four complete and two incomplete costal notches, incisurae costales. - the junction of the sternum with the cartilage of the II-VII ribs. One incomplete notch is located at the top of the lateral edge of the sternum and corresponds to the cartilage of the II rib, the other - at the bottom of the lateral edge and corresponds to the cartilage of the VI rib; four complete notches lie between them and correspond to III-VI ribs.

The sections of the lateral sections lying between two adjacent rib cuts are in the form of semilunar recesses.

Xiphoid process, processus xiphoideus, - the shortest part of the sternum, can be different in size and shape, with a forked apex or with a hole in the middle. The sharp or blunt apex faces either anteriorly or posteriorly. In the upper lateral part of the xiphoid process there is an incomplete notch articulating with the cartilage of the VII rib.

The xiphoid process forms with the body of the sternum synchondrosis of the xiphoid process, synchondrosis xiphosternalis. By old age, the xiphoid process, ossified, grows together with the body of the sternum.

Torso skeleton:

Vertebral column

· rib cage:

- 12 pairs of ribs

- sternum

- thoracic spine

Spinal column consists of 32-34 vertebrae. Spinal column:

- the cervical spine contains 7 vertebrae

- thoracic region - 12 vertebrae

- lumbar spine - 5 vertebrae

- sacrum - 5 fused vertebrae

- tailbone - 3-5 vertebrae

The vertebrae are divided into typical and atypical.

Typical vertebra has a body, an arch, 2 upper articular processes, 2 lower articular processes, 2 transverse processes, spinous process, vertebral foramen.

Atypical vertebrae:

- 1 cervical vertebra (atlas) - has no body; allocate the anterior arch, the posterior arch,

lateral masses, superior glenoid fossa, inferior glenoid fossa;

- 2 cervical vertebra (axial) - has a tooth on the upper surface of the body.

Spine bends:

· Kyphosis - posteriorly (thoracic and sacral spine);

· Lordosis- anteriorly (cervical and lumbar spine);

· Scoliosis - to the sides, left or right.

Chest skeleton:

Consists of the thoracic vertebrae, 12 pairs of ribs and the sternum. Their connections make up the skeleton of the chest.

Edge. In the rib, the bone part is isolated (attached from the back by the joints to the vertebrae) and the cartilaginous part (attached to the front of the sternum). The top seven pairs are called true, 8-9-10 pairs are false, 11-12 pairs are hesitant.

Sternum. Flat bone. It has an arm, body, xiphoid process, jugular notch. On the lateral surface there are clavicular notches and costal notches.

Skull skeleton.

Contains cerebral skulland facial skull.

The composition of the cerebral skull includes:

- frontal bone;

- 2 parietal bones;

- 2 temporal bones;

- the occipital bone;

- sphenoid bone;

- ethmoid bone.

The facial section includes:

- upper jaws;

- lower jaw;

- palatine bones;

- lacrimal bones;

- the inferior turbinates;

- cheekbones;

- nasal bone;

- opener;

- the hyoid bone.

Brain skull

Parietal bone. Has two surfaces, four edges, four corners. The parietal tubercle protrudes on the outer surface.

Frontal bone. Has: frontal scales, frontal tubercles, under them - superciliary arches.

Occipital bone.It has scales, the lateral part (lateral), where the occipital condyle is located for articulation with the atlas; the main part, behind which is a large occipital foramen, which connects the cranial cavity with the spinal canal.

Sphenoid bone.Has the shape of a butterfly.

Ethmoid bone. It has a horizontal lattice plate with fine holes, a perpendicular plate; lattice labyrinths, consisting of many lattice cells filled with air;

Temporal bone. In it, a scaly part, a stony part, a tympanic part, an external auditory opening are distinguished.

Facial skull

Upper jaw- paired bone, participates in the formation of the walls of the nasal and oral cavities and the orbit. On it, the body and processes are distinguished. In the body there is an air cavity - the maxillary (maxillary) sinus, which opens into the middle nasal passage.

Lower jaw -unpaired bone. It has a body and two branches extending upward from it. Each branch of the lower jaw ends in two processes: the coronoid, located in front, and the posterior - condylar.

Limb skeleton

The skeleton of the upper limb.

Collarbone. Has a body, acromial end

(connects to the shoulder blade) and sternal end.

Scapula.Triangular flat bone. Allocate the spine of the scapula,

passing into the brachial process (acromion); upper corner;

bottom corner; lateral angle where there is a glenoid cavity

Brachial (the shoulder joint is formed) and the coracoid process.

Joint

Brachial bone.Long tubular bone.

Has a body, upper and lower ends;

Elbow joint

The ulna and

forearm

Radius. Long tubular bones.

Have a body, upper and lower ends;

Wrist

Joint

Wrist bones - 8 small bones

arranged in two rows

Metacarpal bones -5 small bones

forming the palm brush

Finger bones have 3 phalanges

(1 finger consists of two phalanges,

does not have a middle phalanx)