Which ribs are true. Rib fracture: symptoms, treatment, at home, chest. How many ribs does a person have and what is their structure? Diseases associated with them and their treatment

The ribs are the main component of the chest, they are located symmetrically with respect to the spine. In a school biology course, the structure and number of these bones are analyzed in detail, but knowledge is forgotten, and adults often ask questions: how many ribs a person has, and whether their number differs in men and women.

The ribs are part of the chest

Where are the ribs?

The ribs are located in the upper part of the body and, together with the thoracic spine at the back and the sternum at the front, form, inside which the vital internal organs are located.

The chest is adjacent, first of all, to the lungs. It is this paired organ that occupies almost its entire volume. Also in the chest are the heart, thymus gland, diaphragm and the most important blood arteries.

Structure

The ribs are curved bone-cartilaginous plates, the thickness of which reaches 5 mm. The chest is made up of 12 pairs of ribs, numbered from top to bottom. How these bones look can be seen in the photo.

The bone part of the plates consists of 3 sections: head, neck and body. With the help of 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 cartilaginous joint is also mobile.

The first 7 pairs of bone plates are true ribs. Plates 8, 9, and 10 pairs are attached in front 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 the entire length there is a groove in which the vessels and nerve fibers are located.

At birth, a person's ribs are almost entirely composed of cartilaginous tissue, the ossification of the chest frame is completed only by the age of 20.

Edge functions

Paired bones create a strong frame that performs the following functions:

Protection of internal organs from external danger, minimizing the possibility of mechanical damage to soft tissues.
Maintaining the necessary position of organs and muscles. The chest frame does not allow the organs to move relative to each other, holds the muscles and the diaphragm.

The number of ribs in a person

The skeleton of an adult man and woman does not differ in structure. Both in the male and in the female body there is the same number of ribs, namely 24. However, there are exceptions.

Initially, 29 pairs of ribs are laid in the embryo. With the growth of the fetus, only 12 pairs form the chest frame, the rest disappear during the formation of the skeleton. But with developmental disorders, an additional pair of bone plates appears, which are formed at the level of the 7th or 8th cervical vertebrae, and sometimes only 1 rudimentary rib appears at this place. Such bone processes partially fuse with 1 pair of thoracic ribs, change the anatomy of the neck and in 10% of cases cause severe harm to human health.

Skeleton structure

Usually, extra bone plates do not stick out, and it will not work to count your breast bones in order to identify additional ones. They are only found on chest X-ray. This pathology occurs in about 0.5% of the inhabitants of the planet and is usually inherent in women.

Today, operations to remove 12 pairs of bones to form a thin waist are popular. After such an operation, only 11 pairs of breast bones remain in the woman's body.

Diseases of the ribs

Pathologies associated with the bones of the chest are not uncommon, the most common of them is fractures.

Due to their curved shape, these bones are very elastic and rarely subject to fractures, but with a strong mechanical impact, injury cannot be avoided. Most often, those parts of the bone that form the sides of the chest are subjected to integrity violations. In this very curved part, damage occurs.

The most common disease of the ribs is a fracture

As a result of fractures, internal organs also suffer:

they are not protected from external influences as before;
after a fracture, the chest cannot fully ventilate the lungs;
as a result of a displaced fracture, the integrity of the tissues of the lungs and the most important blood vessels can be lost.

Fractures heal differently: single cracks heal within a month, fractures with displacement heal, depending on the severity of the injury, up to 2-3 months.

Rib fractures are most common in the elderly.

Bones are also prone to such pathologies:

Osteoporosis. The disease affects all the bones in the body and contributes to a change not only in the internal structure of the bone plates, but also in their location. Osteoporosis contributes to a decrease in the distance between the ribs due to a change in the length of the spine. Pathologies are most often affected by women aged 50-55 years. During the period of hormonal restructuring, the bones actively lose minerals and become very fragile. It is progressive osteoporosis that often causes fractures of the bones of the chest.
Osteomyelitis. Purulent inflammation of the bone tissue. Costal osteomyelitis develops against the background of trauma with simultaneous infection of the tissues of the bone plates.
Bulging. There are times when one of the ribs sticks out more than the other, giving the chest an unhealthy look. In most cases, a bone protruding from the chest is a hereditary feature of the skeletal structure, which is not a pathology. Less commonly, a protruding bone (or several) signals rickets or curvature of the spine. Usually this phenomenon occurs in children.
Crayfish. Often, the ribs are affected by a tumor (osteosarcoma) or metastases from cancer of the internal organs. A symptom of an oncological lesion of bone tissue is pain when breathing, sneezing, coughing. Lesions, even at an early stage, can be diagnosed in the ultrasound room.
Perichondritis. This is an inflammatory disease of cartilage. It develops due to trauma to the cartilage with infection entering the tissue. Perichondritis is accompanied by pains of varying intensity during body movements and deep breathing.

Cartilage inflammation

The ribs are the most important part of the skeleton, the functioning of which depends on the safety of vital human organs. To keep your chest frame healthy and strong, exercise regularly, eat a balanced diet, take vitamin supplements, do not ignore the symptoms of chest pain - consult a doctor.

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 - flat, arched curved bones with a thickness of not more than 5 mm, which have cartilaginous, bone parts. If the bone 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, internal organs from injury. The second function helps to keep the heart and lungs in the correct position.

Structure

There are the following 3 groups:

True - 7 pairs on top.
False - the next 3 pairs.
Wavering - the last 2 pairs.

The ribs consist of a long bony, short cartilaginous, anterior parts. The upper part of the chest has 7 true pairs. They are connected to the sternum by cartilage. Below are 3 more false pairs. They are connected by cartilage with the help of syndesmosis.

And the peculiarity of the lower, last 2 oscillating pairs is that they are not connected to the sternum. In addition, the cartilaginous parts of the last 2 pairs end in the muscles of the abdominal wall.

The general framework of an adult is almost motionless, while in infants it consists of cartilage tissue.

Only over the years in infants there is a gradual ossification of all segments of the frame. In a teenager and an adult, over the years, the volume of the frame becomes larger, which subsequently forms their posture. So you should be very careful about the posture of children at the table, when walking.

Structure

Each of the 24 flat, arched, curved bones is made up of:

back.
Front.
Bodies.

The back part has a head, neck, longitudinal scallop, tubercle. If the front part gradually turns into cartilaginous, then the body has a convex and concave surface. In turn, these surfaces are limited by 2 edges: the top and bottom. If the top edge is rounded, then the bottom edge is sharp.

The diagram clearly shows the structure of the ribs. Their twelve pairs have a curved, narrow shape, and at the rear end of all plates there is a head. In the plates, starting from the first and ending with the tenth pair, the head is connected to the bodies of 2 thoracic vertebrae. The plates, starting from the second pair and ending with the tenth, have a ridge that divides the head into two parts.

1, 9, 12 pairs are connected on the vertebral bodies (with full fossae), while the rear ends of the ribs become narrower behind the head and a neck is formed. In turn, the neck passes directly into the body. Between the neck and the body there is a tubercle, which is divided into 2 elevations. If one of them forms the articular surface and is lower, then the second lies higher, ligaments are attached to it.

There are no articular surfaces on tubercles of 11-12 pairs, sometimes there is no elevation. All ribs have both inner and outer surfaces, as well as an edge. If you pay attention to the longitudinal part, then the shape of the ribs is slightly curved in the anterior part of the tubercle, and slightly twisted relative to the longitudinal axis. This area is called the corner. Inside the body is a furrow. It contains both blood vessels and nerves. There is a fossa in front, which has a rough surface.

Attached to all ribs are the anterior, middle, and posterior scalene muscles. Thanks to the first type of muscles, inspiration occurs. The function of the second type of muscle is to raise the first pair of plates. Thanks to the posterior scalene muscle, the movement of the second pair of plates occurs. In addition, all three muscles are involved in the forward tilt of the cervical spine.

The structure of the ribs is unique. Thanks to him, the entire structure of the human body is reliably protected from various damages. If there are pathological changes in any vertebrae, then deformation of the chest itself is possible. Such a process is quite dangerous for human health, as there is a large load on the internal organs.

chest shape

The frame of the chest of an adult to have a convex shape is a delusion. In fact, this fact is typical only for babies.

Over the years, people develop a flat, wide chest frame, only deviation from the norm is considered a pathology. Too wide or flat view of the chest is a sign of pathology. Various deformations of the bone structure are observed with tuberculosis, scoliosis,.

The shape of the frame may differ depending on the gender of the person. In men, the frame has a fairly steep bend in the rib. Compared to the female ribcage, males have less plate twisting and a larger and less flat frame. Thus, in women, chest breathing is observed, and in men, abdominal breathing.

In addition, there are similar differences in people of different heights. The chest is wider and shorter in people of short stature. The situation is radically opposite in tall men and women. They have a longer and flatter frame.

radiograph

On the radiograph, several points of ossification of the sternum in the handle, body can be observed. Inferior ossification can appear even before the birth of the baby, as well as in the first year of life. From six to twenty years of age, ossification is already observed in the xiphoid process, and at the age of thirty it grows to the body. The handle grows to the body after thirty years of life, but there are exceptions. Not earlier than at the age of sixteen, the lower segments of the body can grow together.

The ribs may become ossified at the following points:

Angle area.
epiphysis
Apophysis.

Apophysis appears only after fifteen years of life. If we compare adults with small people, then in the first, all twelve pairs of plates are clearly visible on the anterior radiographs. Only their front parts seem to be layered on the back, and also intersect with each other.

Age 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 bones of the sternum take a horizontal position, and with age, 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 rest, proper and regular nutrition and, of course, the exclusion of all addictions. All over the world, doctors say that it is physical education that helps people to establish metabolic processes in their body and keep all muscles in good shape.

A person may experience various injuries to the trunk and spine. Some of them can be mild (bruises, abrasions), while others, on the contrary, are severe (fractures with varying degrees of severity). Rib fractures are the most common.

According to studies in medicine, this type of injury accounts for 15% of known cases of fractures. Its main danger is that, in addition to bone damage, vital organs that are nearby - the heart, lungs, and important vessels - can be affected.

Features of the structure of the chest

The chest is a system that includes 12 vertebrae. It is they who serve as a stable support for 12 pairs of costal bones. The anterior portion of the ribs is entirely cartilaginous and communicates with the sternum.

Rib bones are usually divided into several categories:

primary. It includes rib pairs numbered 1 and 7;
false. This includes 8 and 10 pairs;
hesitant. This category includes 11 and 12 pairs.

The primary rib pairs are connected to the thorax by cartilage. But false pairs do not have an actual connection with the sternum. Costal pairs numbered 8, 9, 10 are attached to the overlying ribs with the help of cartilaginous plates. But the 11th and 12th rib pairs are located in a free position, for this reason they are called oscillating.

The reasons

A rib fracture can occur as a result of various reasons, while a fracture of the 1st or 10th rib may not differ in any way and occur simultaneously. Usually, the factors that cause these types of injuries are divided into two varieties - natural and pathological.

Natural causes include the following:

traffic accidents. Often, a fracture of 10, 11, 12 ribs occurs precisely in emergency situations on the road. These injuries usually occur to the driver during a chest impact on the steering wheel in a collision. Pedestrians can also suffer, they can collide with a car or fall onto the asphalt, which will provoke a strong blow precisely to the area where the lower rib pairs are located;
hard blow to the chest. In this case, not only a fracture of the 10th rib, but also other rib pairs can occur. A blow can occur both with a fist and against various objects;
falling from a certain height. If a fracture of the ribs in a young person can occur when falling from a high point, for example, from a tree, a fence, a roof, then in an elderly person a fracture of 10, 11, 12 ribs can occur even when falling from a chair. The fragility of bones in the elderly is due to a strong thinning of cartilage and bone tissue;
various sports injuries;
squeezing, which is similar to the workflow of the press. These injuries are of industrial type. In this case, not only damage to the rib pairs can occur, but also other parts of the musculoskeletal system - the coccyx, pelvic part, spine, and sometimes even the skull.

Pathological types of fractures usually do not appear as a result of emergency situations. They can occur with various health problems that can lead to bone fragility.

Pathological causes include:

rheumatoid arthritis;
cancerous metastases. The formation of metastases in the chest can occur due to the presence of malignant tumors in the breast, prostate, kidneys. Also, these pathological processes include bone cancer;
osteoporosis. This disease causes bone fragility. For this reason, not only a fracture of the 11th rib can occur, but also other rib pairs, as well as different parts of the skeleton (spine, pelvic part, arms, legs). Injuries and fractures often occur with even minor impact;
sometimes the sternum may be missing. This pathology can be congenital or acquired;
the presence of genetic abnormalities in the structure of the skeleton. In these conditions, there is a strong fragility of the bones.

Symptoms

A fracture of the 11th rib on the left or right, as well as damage to other rib pairs, is accompanied by certain symptoms that may differ in severity. The nature of the symptoms depends on the location of the injury and the condition of the patient.

Common symptoms include:

painful sensations. A fracture of the 10th, 11th, 12th ribs is often accompanied by pain in the area of injury. They are usually permanent, and can be aggravated by sudden movements, during deep breathing, severe coughing;
manifestation of swelling of soft tissues. The area with the fracture is often swollen and may also be red. A hematoma may develop under the skin;
deformation of the chest;
subcutaneous emphysema. This symptom is observed with a closed fracture of the 10th, 11th, 12th ribs on the right or right. It can manifest itself with damage to the pleura, which can provoke the penetration of air under the skin;
the presence of hemoptysis. This symptom is usually observed with damage to the tissues of the lung and blood vessels.

Features of treatment

When identifying the main symptoms of a fracture of the 10th, 11th, 12th ribs on the left or right, you should immediately consult a doctor - a traumatologist, a surgeon. It is best for the victim to call an ambulance so that he can be taken to the hospital without any problems. On examination, the specialist will be able to determine the severity of the injury, its localization. After that, he will prescribe adequate treatment.

If a fracture of the 10th, 11th, 12th rib is established, then treatment in a hospital is carried out using the following procedures:

anesthesia therapy is performed, in which non-steroidal, anti-inflammatory drugs are used. If the patient has suspicions of pain shock, then he can be injected with corticosteroids, narcotic analgesics;
an immobilization circular bandage is applied to the fracture area, which is made of elastic materials;
if necessary, a puncture of the pleural region is made to remove air or blood;
oxygen therapy may be prescribed to eliminate symptoms of respiratory failure;
if there are multiple fractures, surgery may be performed.

Be sure to follow all the necessary recommendations of the doctor during the rehabilitation period. Usually, special physical exercises are prescribed, which must be combined with breathing exercises. It is also recommended to follow a special diet. All these measures will help you recover faster and bounce back.

The thorax is a very important key part of the human skeleton, which is a powerful conical rib-shaped annular frame with two holes at the top and bottom, attached in front to the sternum and behind to the vertebrae. It encloses the chest cavity on all sides, in which the vital organs of the respiratory and cardiac systems are located - the heart, lungs, trachea, bronchi, aorta, other large and small blood vessels, muscles. It is no wonder that the anatomy of the GC by nature provides for the creation of the necessary conditions for the normal functioning of all organs of the chest cavity. Let us consider in more detail the structure of the chest, and also answer the eternal question that has arisen since the time of the Old Testament: how many ribs does a person have.

How many ribs a person has - a question at the cost of life

Today, from the school bench, every child knows for sure that people have 12 pairs of ribs in their chest (occasionally - 13), that is, 24 or 26 pieces of ribs, and this figure does not depend on gender, that is, a man and a woman have the same number of ribs.

But it was not always so.

Thanks to biblical legends and church prohibitions that existed in antiquity regarding such a branch of medicine as pathology, it was believed for a long time that a man has one pair of ribs more than a woman. And from this extra pair, the Creator, they say, created Eve.

Despite the threat of being burned at the stake for heresy, some courageous Aesculapius of antiquity, in order to learn how to heal correctly, which is impossible without an anatomical atlas, performed an autopsy at their own peril and risk. The more autopsies were performed, the more doctors of those years became convinced that the number of ribs in men and women, as well as their anatomical structure, are exactly the same, although the female skeleton is more fragile, and the woman’s chest is less voluminous.

To get an answer to such a childish question that seems ridiculous today, many ancient doctors paid with their lives ...

Anatomical structure of the chest

So, what do we know today about the chest:

It consists in most cases of 12 pairs of ribs, symmetrically located on both sides of the skeleton (seven pairs on each side).
In some individuals, an additional, extra 13th pair of ribs is found, which, in memory of the biblical tradition, was called "Adam's" ribs. Any person (both man and woman) can also have this extra one pair, that is, "Adam's" ribs are not some kind of male privilege or a sign of some kind of chosenness.
Each rib of an adult consists of bone flat arcuate plates about 5 mm thick, ending in front with cartilage, and behind the neck and head, covered with cartilage, which enters the costovertebral joint.
In addition to the costovertebral joint, each rib is also attached to the vertebra with the help of a costotransverse joint connecting the costal tubercle with the transverse process of the vertebra.
In the anterior region, seven pairs of ribs, with the help of cartilages, form an elastic connection with the sternum, which consists of a handle, body, and xiphoid process. These seven pairs are called true ribs.
The first pair of ribs is attached to the manubrium of the sternum by means of synchondrosis (an elastic cartilaginous connection), and the next six pairs by means of flat costosternal joints (symphyses).
The next five (in rare cases, six) pairs are not attached to the sternum, so they are called free. Each of the costal pairs, starting from the 8th, forms a soft connective tissue syndesmosis (fusion) with the pair located above. The last (12th or 13th) pair is attached only to the muscles.
A child's rib differs from an adult's in that it consists almost entirely of cartilage, so the child's chest is very fragile and vulnerable.
With age, the process of ossification of the rib is completed, and cartilage is preserved only at the ends of the ribs connected to the sternum.
Each rib is covered with thin hard hyaline cartilage, and inside it contains spongy bone tissue.
The sternum consists of the outer periosteum, under which is the red bone marrow.

Functions of the chest

The chest performs three important functions:

The organs and respiratory muscles of the chest cavity are attached to it, which is why the organs are protected from the threat of displacement during body movements, and the chest itself takes part in breathing (support and respiratory functions).
Due to the frame structure, the chest from all sides protects the organs located in it from blows, injuries, penetrating damage (protective function).

Of course, the chest cannot provide 100% protection either to the organs or even to itself, therefore a wide variety of pathologies are possible in it.

Pathology of the chest

rib fracture

One of the most common pathologies -. A person risks getting this injury, mainly when falling from a great height or due to an accident.

A rib fracture is a very dangerous injury, as it can damage the pleura or even the lung itself. In this case, part of the air leaves the lung, and it decreases in volume, the patient has symptoms of respiratory failure. Such damage to the lung by a fragment of the rib is called pneumothorax.

Another complication of a rib fracture is also possible - hemothorax (accumulation of blood in the pleural cavity).

Rib fracture in osteoporosis and metastases

The ribs become especially vulnerable with a formidable age-related disease, which, however, can be not only in the elderly, but also in people with endocrine disorders or as a result of taking certain medications (for example, corticosteroids, cytostatics), leading to bone resorption.

The rib loses its density, which is clearly visible on the section under the microscope: the distance between the bone cells increases, the bone structure becomes porous. On x-rays, the bones and ribs of a patient with osteoporosis become translucent, that is, the pattern of the rib is, as it were, shaded, and its boundaries are erased.

Women are especially at risk for osteoporotic rib fractures. Very often, it is the ribs that are the first to respond to oncological diseases, especially breast or lung cancer. In women, bone metastases are precisely of the osteolytic type, that is, leading to a rarefaction of density and dissolution of the bone. X-ray shows areas of shading at the sites of metastases.

Rib fractures in osteoporosis or metastases are possible with the slightest effort (sudden movement, strong cough, turning to the other side).

Rib arthrosis

Costal arthrosis usually occurs against the background. It manifests itself in aching pains, crunching in the chest during movements, subluxations of the ribs, attacks of severe intercostal neuralgia. To explain all these phenomena is simple:

Degenerative processes in the cartilage disrupt the congruence of the costovertebral joints and lead to flattening of the costal pits on the surface of the vertebrae.
The rib begins to come out of the joints, that is, subluxation occurs.
In the process of movement, spontaneous repositioning of the rib may occur, accompanied by a click.
Sometimes the rib jams in an incorrectly displaced position, and it begins to pinch the vertebral nerve passing in the intercostal spaces, which is manifested by bouts of severe pain during movement and breathing - intercostal neuralgia.

Due to the large length of the vertebral nerves that innervate many areas of the thoracic region, shoulder girdle, upper limbs, epigastric region, intercostal neuralgia can spread to a wide variety of areas: shoulder-scapular, sternum, diaphragmatic, etc. ) or false signs of gastritis, pancreatitis and other gastrointestinal diseases.

Costal arthrosis and intercostal neuralgia must be differentiated from thoracic osteochondrosis or hernia - quite rare pathologies for the thoracic region.

Costal synostosis

Sometimes splitting of the costal ends, mainly the first two upper pairs of ribs, can occur, due to which the gap between them narrows, and they can even grow together, forming a synostosis. A defect in the rib may look like a cavity in the lung on an x-ray. It is possible to distinguish synostosis from a cavity defect by its displacement during breathing and its absence in the picture in the lateral projection.

The disease can cause pinching of the nerves and severe attacks of intercostal neuralgia.

Inflammation of the cartilage of the ribs (costal chondritis)

This rare pathology (its other name is Tietze's syndrome) affects in most cases the 4th - 6th pairs of ribs. Tietze's syndrome is more common in adolescents, but can also be the cause of unexplained pseudoanginal chest pain in adults that resembles symptoms of heart disease. The causes of the pathology are not fully understood. The following can presumably lead to chondritis of the ribs:

frequent physical activity;
chest trauma;
SARS, accompanied by a strong cough;
injection drug addiction and substance abuse;
infection after chest surgery.

After elimination of harmful factors, costal chondritis usually disappears.

Diagnosis of pathologies of the chest

Fundamental diagnostics: external examination, instrumental, and, if necessary, laboratory examination.

During an external examination, the doctor pays attention to the following symptoms:

pain on palpation at the point of attachment of the ribs to the sternum and vertebrae;
increased pain when inhaling;
protrusion of the rib outward, or, conversely, the formation of a dent or sinking in the chest;
free movement of the rib;
the presence of hematomas, wounds and other signs of severe bruising.

The following types of instrumental examinations are carried out:

Radiography.
Densitometry (for osteoporosis)
Scintigraphy, CT or MRI (for metastases, detailed diagnostics for spondylarthrosis, complex comminuted rib fractures).
Electroneuromyography (with intercostal neuralgia).
Laboratory blood tests (general, biochemical, endocrinological, bacteriological, etc.) are performed for osteoporosis, osteogenesis disorders, oncological diseases, chondritis of the ribs.

Treatment of chest pathologies

In case of a rib fracture, outpatient treatment is carried out mainly, with the exception of complicated or multiple fractures. Plaster immobilization of the thoracic region in case of rib fractures is not done due to the need for constant ventilation of the lungs and the threat of developing pneumonia and pulmonary edema. A tight bandage is simply applied to the area of broken ribs. Analgesic therapy (novocaine or vagosympathetic blockade), physiotherapy exercises are prescribed. With pneumothorax or hemothorax, a puncture is performed with pumping out air or blood from the pleural cavity. Treatment of fractures takes on average about a month. With complex multiple fractures in the hospital, rigid fixation is performed.
With osteoporotic or metastatic fractures, complex therapy of osteoporosis is added: part of it is the intake of either hormonal drugs or bisphosphonates.
Treatment of costal arthrosis is similar to the treatment of spondyloarthrosis: taking chondroprotectors, manual therapy; exercise therapy.
Attacks of intercostal neuralgia are stopped by anti-inflammatory standard drugs (diclofenac, Nise, nimesil, etc.).
Synostosis of the rib, causing bouts of radiculopathy and intercostal neuralgia, is removed surgically.
Costal chondritis is treated, depending on its cause: sometimes, for example, after surgery, antibiotics are needed, but in other cases, NSAIDs, combined use of steroid hormones and anesthetics are used predominantly. physiotherapy methods

)12 pairs, - narrow, curved bone plates of various lengths, symmetrically located on the sides of the thoracic spine.

Each rib has a longer bony part of the rib, os costale, short cartilaginous - costal cartilage, cartilago сostalis, and two ends - the anterior, facing the sternum, and the posterior, facing the spinal column.

Bony part of the rib

The bony part of the rib has a head, neck and body. rib head, caput costae, located at its vertebral end. It has an articular surface of the head of the rib, facies articularis capitis costae. This surface on the II-X ribs is divided by a horizontally running crest of the rib head, Crista capitis costae, into the upper, smaller, and lower, larger, parts, each of which, respectively, articulates with the costal fossae of two adjacent vertebrae.

rice. 36. Ribs, costae, right; view from above. A - I rib; B - II rib.

rib neck, collum costae, - the most narrowed and rounded part of the rib, bears the crest of the neck of the rib on the upper edge, crista colli costae, (ribs I and XII do not have this ridge).

On the border with the body, 10 upper pairs of ribs on the neck have a small tubercle of the rib, tuberculum costae, on which the articular surface of the tubercle of the rib is located, facies articularis tuberculi costae, articulating with the transverse costal fossa of the corresponding vertebra.

Between the posterior surface of the neck of the rib and the anterior surface of the transverse process of the corresponding vertebra, a costal-transverse opening is formed, foramen costotransversarium (see Fig.).

rib body, corpus costae, extending from the tubercle to the sternal end of the rib, is the longest section of the bony part of the rib. At some distance from the tubercle, the body of the rib, strongly curving, forms the angle of the rib, angulus costae. At the I rib (see Fig.), it coincides with the tubercle, and on the remaining ribs the distance between these formations increases (up to the XI rib); the body of the XII rib does not form an angle. Throughout the body of the rib is flattened. This makes it possible to distinguish two surfaces in it: the inner, concave, and the outer, convex, and two edges: the upper, rounded, and the lower, sharp. On the inner surface along the lower edge there is a groove of the rib, Sulcus costae(see fig.), where the intercostal artery, vein and nerve lie. The edges of the ribs describe a spiral, so the rib is twisted around its long axis.

At the anterior sternal end of the bone part of the rib there is a fossa with a slight roughness; the costal cartilage is attached to it.

Costal cartilages

costal cartilage, cartilagines costales, (there are also 12 pairs of them), are a continuation of the bone parts of the ribs. From I to II ribs, they gradually lengthen and connect directly to the sternum. The top 7 pairs of ribs are true ribs, costae verae, the lower 5 pairs of edges are false edges, costae spuriae, and XI and XII ribs are oscillating ribs, costae fluitantes. Cartilages VIII, IX and X of the ribs do not fit directly to the sternum, but each of them joins the cartilage of the overlying rib. The cartilages of the XI and XII ribs (sometimes X) do not reach the sternum and, with their cartilaginous ends, lie freely in the muscles of the abdominal wall.

Features of the first and last pairs of ribs

Some features have two first and two last pairs of edges. first rib, costa prima(I) (see fig. , A), shorter but wider than the rest, has almost horizontal upper and lower surfaces (instead of the outer and inner at other ribs). On the upper surface of the rib, in the anterior section, there is a tubercle of the anterior scalene muscle, tuberculum m. Scaleni anterioris. Outside and behind the tubercle lies a shallow groove of the subclavian artery, sulcus a. subclaviae, (trace of the artery of the same name lying here, a. subclavia, posterior to which there is a slight roughness (the place of attachment of the middle scalene muscle, m. scalenus medius. Anteriorly and medially from the tubercle there is a weakly expressed groove of the subclavian vein, Sulcus v. subclaviae. The articular surface of the head of the 1st rib is not divided by a ridge; the neck is long and thin; the costal angle coincides with the tubercle of the rib.

second rib, costa secunda(II)) (see Fig. , B), has roughness on the outer surface - tuberosity of the serratus anterior muscle, tuberositas m. serrati anterioris, (place of attachment of the tooth of the indicated muscle).

Eleventh and twelfth ribs costa II and costa XII(see fig.), have articular surfaces of the head not separated by a ridge. On the XI rib, the angle, neck, tubercle and costal groove are weakly expressed, and on the III they are absent.