The xiphoid process - also called "Processus Xyphoideus" - is the lowest part of the sternum. The breastbone (sternum) can be divided into three parts. It is quite similar to a sword. Above, between the clavicles, lies the handle (Manubrium sterni). The middle part, where the second to sixth ribs attach to cartilage, is called the body (corpus sterni). The lowest part, where no more ribs start and which runs down sharply, is the xiphoid process.
Anatomy of the xiphoid process
The sternum is one of the flat bones. Strictly speaking, the sternum is composed of three separate parts, which are still connected via cartilage in childhood. These connections ossify with time. Listed from top to bottom are the three parts of the sternum handle (Manubrium sterni), the sternum body (Corpus sterni) and the xiphoid process (Process xyphoid).
The xiphoid process is thus located at the lowest end of the breastbone and lies, like the entire sternum, directly under the skin. Its shape is usually pointed downwards, but it can also be split or perforated.
The severe process forms with the lowest rib arches and the 12th thoracic vertebrae the lower boundary of the chest body. The inside of this lower boundary of the chest, so among other things the back of the xiphoid process, is the approach surface for the diaphragm. The right abdominal muscle, the rectus abdominis, also adheres to the xiphoid process with a few fibers. To the outside is above the xiphoid process only skin with the associated fatty tissue. On the inside of this lower boundary of the chest, put on the diaphragm. It forms a dome inside the body, separating the trunk into the thoracic and abdominal cavities.
What is the function of the xiphoid process?
The sternum is, so to speak, the capstone in the rib cage. Here the right and left ribs collide. As a result, the sensitive organs, lungs and heart, are protected by the bones. The xiphoid process itself no longer uses ribs. It forms the last small bone plate that protrudes towards the abdominal cavity.
Illustration of the xiphoid process
Xiphoid process - Xiphoid process
Sternum handle - Manubrium sterni
Sternum body - Corpus sterni
Fibrocartilage joint - Symphysis xiphosternalis
White line - Linea alba (Interweaving the Aponeurosis)
An overview of all pictures by Dr-Gumpert can be found at: medical pictures
Pain and swelling of the xiphoid process
The xiphoid process may cause swelling as a result of surgery with a thoracic opening. Also, a physical overload occasionally leads to a xiphoid swelling or sternum swelling. This is based on micro fractures of the bones.
Pain in the sternum should also be thought of, inter alia, heart attack, angina pectoris and other organs such as the esophagus.
From the outside, the swelling with a redness in the area of the chest and rib area can be seen. A sternum swelling is characterized mainly by pain during inhalation and exhalation and increased heart rate. Those affected speak of a "burning pain" in the chest and a feeling of heat. Often middle-aged people are affected, with the symptoms getting worse with age. But it can also occur in children to a sternum swelling.
If there is a fracture of the sternum, so this is always an indication of other injuries.
Pain in the area of the sternum can also be projections of other organs. For example, angina, myocardial infarction or esophageal disease cause pain behind the sternum. But the pain of a gastric ulcer can spread to the sternum.
Another cause is the so-called costochondritis, in which the cartilage between the ribs and sternum is inflamed. Costochondritis is rather rare and occurs mostly in the course of systemic diseases (for example, Reiter's disease) .
Some babies have an innate hole in the sternum, which is usually on the right side.
Among the pathological changes of the sternum is the so-called funnel chest. In this case, the cartilaginous connections between ribs and sternum change and the anterior part of the ribcage sinks.
Another deformation is the keel or chicken breast. Here, the sternum is arched like a kiel, which is particularly stressful for those affected. The cause of this is believed to be a strong growth of the cartilage, causing a protrusion of the sternum.
If the sternum is twisted in the longitudinal axis, it is called a Harrenstein deformity. The ribs protrude on one side of the sternum, but on the other side they are lowered.
The diagnosis of a sternum swelling is usually done by a pressure test. Therapy with painkillers, which can be injected in severe pain directly into the spinal cord. Other treatments for relieving pain include acupuncture, physiotherapy and muscle relaxant medications. Also, heat or cold therapy can help.
Cracking on the xiphoid process
Cracking around the sternum can have a variety of causes.
Wrong posture: Someone who sits a lot and works on the PC and often uses his elbow to train himself on a wrong posture. In this way, the sternum is misloaded. If you stretch out after a long while, it will crack in the breastbone. Stretching will stretch the ribs of the sternum again, and the muscles will also tighten on the ribs and sternum.
In addition, for cracking in the sternum and a blockage in the cervical or thoracic spine in question. Again, the cracking occurs after prolonged incorrect posture, when then suddenly the position is changed. In most cases, cracking also releases the feeling of pressure in the sternum and the pain.
If this feeling of pressure does not dissolve despite the cracking in the sternum, you should consult a physiotherapist or an osteopath.
What is the Tietze syndrome?
Tietze syndrome is a rare disease of the sternum. This causes swelling in the area of the ribs on the sternum. In this area is the costal cartilage, which connects ribs and sternum together as a joint. This swelling can be palpable and visible and is often associated with pain. The cause of this swelling is not yet clear.
Often the pain occurs spontaneously without any apparent cause. However, the pain usually increases with physical activity and stress. This can be explained by the fact that physical exertion leads to intensified and deepened inhalation, which puts more strain on the costal cartilages.
Since the Tietze syndrome most often affects the upper 3 ribs, the syndrome is rather not associated with pathological changes of the xiphoid process.