How many ribs are there on one side? Manual therapy of internal organs - Naboychenko V.N.

It is not difficult to answer the question of how many ribs a person has, but it is difficult for an ordinary person who does not study anatomy or has graduated from school a long time ago. There is a legend that a woman was created by God from the rib of Adam, so it was previously believed that a man has fewer ribs than the fair sex. But this is a deep misconception, and scientists have long proven this fact. The first to refute such an assumption back in the Middle Ages was the outstanding anatomist Andreas Vesalius. This bold assumption served as a reason for the inquisitors to severely punish the scientist.

Rib cage

The number of ribs in a person is 12 pairs. Of this total number, 10 pairs close together to form a tight ring for the chest organs. The first 7 pairs of them are attached directly to the sternum, and the remaining three - to the cartilaginous part of the overlying rib. The last three pairs are not attached to anything, but end freely on the muscles. Based on this edge, they get their name: the first seven pairs are true, the next three pairs are false, and the last ones are oscillating.

Externally, the ribs are flat bones that are arched and form the chest - the lungs and heart are located in it. The chest consists of all 12 pairs of ribs, and this is the norm for every person. Sometimes there are eleven or thirteen pairs, which is undoubtedly not the norm, but this fact does not in any way affect the quality of a person’s life.

Rib anatomy

The thickness of the rib does not exceed five millimeters. By appearance it is a curved plate that consists of bone and cartilage parts. The bone part consists of spongy bone tissue and is divided into the head, neck, on which the tubercle and body are located. There is a groove at the bottom of the latter. The body is attached to the sternum using cartilage. The rib has two surfaces: internal (concave) and external (convex in shape). On inner surface, in the groove of the rib, there are vessels and nerves that feed the intercostal, abdominal muscles and organs of the chest and abdomen.

Joints of the ribs and the inner surface of the chest

The ribs are attached to the bones using various connections: joints - with the spinal column, and synarthrosis - with the sternum. The inside of the chest is lined with a special membrane called the pleura. The walls of the chest are lined by the parietal pleura, and the organs by the visceral pleura. With the help of a thin layer of lubricant, both sheets are able to slide freely over each other.

Function of the ribs and chest

The chest is an important anatomical structure and has many functions. She performs vital protection important organs from all kinds of injuries and external influences. The frame function of the ribs helps keep the organs in the correct anatomical position; due to this, the heart does not move to the sides and the lungs do not collapse. The ribs are also attachment points for many muscles, particularly the respiratory muscles, the largest of which is the diaphragm. The sternum is where the red bone marrow is located.

Injuries to the ribs and chest

Regardless of how many pairs of ribs a person has, fractures are the most common pathology. A fracture can damage internal organs located in the chest, as well as blood vessels and nerves. This injury mainly occurs in elderly and old age, this is associated with reduced elasticity as well as bone fragility. Even a minor injury can lead to a fracture at this age. The typical location for rib fractures is side surfaces chest due to the fact that this is where the maximum bending is observed. A typical clinical picture may be present immediately (fractures are accompanied by pain), but may develop later, when fragments touch internal organs and their function is disrupted. There is also an incomplete fracture of the rib, or the rib may break so that the fragments do not move. In addition to grass, a fracture can also be the result of a disease that affects the bone tissue of the rib and reduces its strength. It all depends on how many ribs a person has that are affected.

Other rib pathology

The ribs, like the rest of the bone tissue, can be affected by osteoporosis. With this disease, calcium is washed out of the bones and they become brittle. Oncology can often affect the ribs: the tumor can grow into the bones, as well as into neighboring organs. The consequence of its growth may be pathological fractures, the number and complexity of which depends on how many ribs a person has that are exposed to pathology. The rib may also be affected by tuberculosis or inflammation. Due to the fact that red is located in the rib and sternum Bone marrow, the development of pathology associated with it is possible. This pathology is myeloma, as well as leukemia.

Complications

An uncomplicated fracture of one rib is not life-threatening. But several broken ribs can lead to injury to internal organs, impair breathing and cause associated complications. Fragments can injure lung or pleural tissue. Due to this, pneumothorax (entry of air between the layers of the pleura), hemothorax (entry of blood into the pleural cavity), and also pneumohemothorax can develop. Subcutaneous emphysema may also develop, which is accompanied by the penetration of air into the subcutaneous fat.

Diagnosis and treatment

Single and multiple fractures are accompanied by pain, especially during inhalation, movement, coughing or talking. The pain syndrome goes away or decreases with the patient lying down or simply at rest. Fractures of the ribs are accompanied by shallow breathing, as well as a lag of the chest in the act of breathing on the affected side. During palpation, the patient characterizes the fracture zone as the place of greatest pain, and it is also possible to hear a characteristic crunching sound (crepitus).

The diagnosis of a “fracture”, as well as how many ribs a person has suffered, is not difficult to establish; it is enough to take a survey radiography of the chest. It is difficult to diagnose complications using a simple x-ray; an additional ultrasound examination of the pleural cavity, as well as puncture of the pleural space, will be required. Dysfunction external respiration cause anterior or lateral fractures. In the posterior region, injury causes pulmonary ventilation impairment less frequently. Rib fractures are not treated using the fixation method; only complicated, multiple injuries may require immobilization. This pathology requires treatment in a hospital, and in special cases, which are accompanied by injury to internal organs, as well as bleeding, surgical treatment may be required. If you fix the chest, you can get a serious infectious complication - congestive pneumonia, which is very difficult to treat and in many cases leads to fatal outcome. The same applies to the popular practice of tying the chest with sheets or towels. The period during which bone tissue fusion occurs is approximately one month (this is for an uncomplicated rib fracture). When treating multiple fractures, the treatment period is more than a long period, which depends on the general condition of the body, age, presence concomitant diseases, as well as the severity of complications that arose in connection with the injury.

The rib is a very simple bone anatomically, but it does a lot important functions and is part of such a skeletal formation as the chest. There are many pathologies in which a rib can be affected. The main thing is to diagnose them in a timely manner, because subsequently the function of vital organs may be impaired. In some situations, only immediate surgical treatment will help save the life of the victim; in other cases, the tactics of the chosen treatment depend on the pathology and the severity of its course.

The internal organs of the body are protected by the rib cage - a frame consisting of vertebrae, sternum and ribs. At normal development this frame is widened laterally and flattened in front. One of its components - the ribs - are flat bones shaped like an arc. They consist of a bone part, which is represented by long spongy bones. They are a tubercle, a head and a neck. The cartilaginous part of the ribs is their short anterior part.

In contact with

Classmates

The main functions of the sternum are protective (the chest protects internal organs and blood vessels from external damage) and frame (the ribs hold the internal organs - the heart and lungs - in a normal position).

Structure and structure of ribs

How many ribs do men and women have? Thanks to the biblical legend, according to which the first woman was created from Adam's rib, some believe that men have fewer of them than women. In fact, both female and male sexes have the same number - twelve pairs or twenty-four ribs.

Each rib consists of an outer and an inner side - a concave and convex surface, respectively, which are limited by rounded and sharp edges. There are twelve couples in total, which are divided into three groups:

• seven upper true pairs connected by cartilage to the sternum;
• the next three pairs are false, connected by syndesmosis;
• the last two pairs are oscillating ribs that are not connected to the sternum. Their cartilaginous components reach the muscles abdominal wall.

Now you know how many pairs of ribs end freely - the bottom two pairs.

At birth the chest is quite soft, with Over the years, the child experiences a slow ossification of all components chest frame. An adult and a developing teenager have a larger frame volume, due to which the posture takes shape.

Only the baby has a convex shape of the frame. As it matures, it becomes wide and flat, but a frame that is too wide or flat is considered a pathological deviation. Most often, deformation occurs due to diseases such as scoliosis and tuberculosis. IN early age The breast bones are horizontal; as they grow older, the ribs take on an almost vertical position.

Chest function

The thoracic frame performs many functions and is an important anatomical formation. In addition to protecting internal organs and keeping them in their normal position and, the ribs are the attachment points for many muscles, of which the largest is the diaphragm. The sternum also contains red bone marrow.

Injuries and pathologies

Pain in the sternum can occur not only due to external injuries and damage. Unpleasant sensations appear when internal organs are damaged by various diseases, as well as when the functioning of nerves and blood vessels is disrupted.

Regardless of how many ribs a person has, they are all susceptible to external damage. A fracture entails serious damage to internal organs, nerves and blood vessels. Such injuries Elderly people are most susceptible who have increased bone fragility and decreased elasticity of soft tissues. Minor injury in people of this age can lead to fracture.

Most often, ribs break on the lateral surfaces of the chest frame, where the maximum bend is located. A person can find out about the damage immediately if he feels pain in the sternum or when breathing. But if the fracture is incomplete or there is no displacement of bone fragments, the injury can only be detected after an x-ray.

In addition to external damage, there are diseases that affect bone tissue in the body. Incomplete fractures and minor injuries occur due to the following diseases:

• leaching of calcium from bones;
• tuberculosis;
• chronic diseases and inflammation of bone tissue;
• blood diseases.

With osteoporosis, calcium is washed out of the bones and they become very fragile. Oncological diseases can lead to tumor growth into bone tissue. Tuberculosis and serious inflammation with colds cause pathology of bone tissue. Leukemia and multiple myeloma attack the bone marrow, causing tissue damage.

A fracture can lead to the following consequences:

• the development of subcutaneous diseases caused by damage to the lungs or the penetration of oxygen into the fiber;
• severe bleeding into soft tissues when the vessels between the ribs are damaged.

Multiple fractures are accompanied severe pain, which worsens with movement, breathing, talking and coughing. Injuries are detected by palpation of the bruised area, and a crunch of bone fragments appears and sharp pain. The doctor makes a diagnosis based on x-rays or tests of the pleural cavity. Breathing disorders are a consequence of lateral and anterior fractures.

Treatment of injuries

Minor injuries do not require fixation, but for complex or multiple fractures it is necessary. Wherein treatment must take place in a hospital under the strict supervision of a doctor. Only a doctor applies the fixation, since applying the splint yourself can further limit the ability to breathe. This leads to complications of treatment and the development of congestive diseases.

Minor injuries are cured within one month, the treatment period for multiple bruises and severe injuries depends on the severity of the complications that arise and the general condition of the body.

Ribs are simple bones in terms of anatomical structure, but they perform important functions to protect the body. The chest frame is often subject to damage and multiple pathologies. It is important to diagnose damage in a timely manner and be examined by your attending physician. IN difficult situations To save life and maintain normal functioning of the body, surgical intervention is necessary. In milder cases, treatment depends on the type of pathology and the conditions under which it occurs.

A person may encounter various injuries torso and spine. Some of them may be mild (bruises, abrasions), while others, on the contrary, may be severe (fractures of varying degrees of severity). The most common occurrence is rib fractures.

According to research, in medicine this type trauma accounts for 15% of known fracture cases. Its main danger is that in addition to damage to bones, vital organs that are nearby - the heart, lungs, and important blood vessels - can be damaged.

Features of the structure of the chest

The rib cage is a system that consists of 12 vertebrae. It is they who serve as a stable support for 12 pairs of rib bones. The anterior part of the ribs consists entirely of cartilaginous tissue, and it communicates with the sternum.

Rib bones are usually divided into several categories:

• primary. It includes rib pairs numbered 1 and 7;
• false. This includes pairs 8 and 10;
• fluctuating. This category includes the 11th and 12th pair.

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

Causes

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

Natural causes include the following:

• road traffic accidents. Often, fractures of the 10th, 11th, 12th ribs occur precisely in emergency situations on the road. These injuries usually occur when the driver hits the steering wheel with his chest during a collision. Pedestrians may also be injured; they may collide with a car or fall on the asphalt, which will provoke a strong blow specifically to the area where the lower rib pairs are located;
• a strong blow to the chest. In this case, not only a fracture of the 10th rib, but also other rib pairs may occur. The blow can occur either with a fist or with a various items;
• falling from a certain height. If a rib fracture is young man may occur when falling from high point, for example, from a tree, fence, roof, then an elderly person may experience a fracture of 10, 11, 12 ribs, even if he falls from a chair. Bone fragility in older people is caused by severe thinning of cartilage and bone tissue;
• various sports injuries;
• squeezing, which is similar to the working process of a press. These injuries are of an industrial type. In this case, not only damage to the rib pairs can occur, but also to other parts of the musculoskeletal system - the coccyx, pelvis, spine, and sometimes even the skull.

Pathological types of fractures usually do not result from emergency situations. They can occur when various problems health problems that can lead to bone fragility.

Pathological causes include:

• arthritis rheumatoid type;
• cancer metastases. The formation of metastases in the chest can occur due to the presence of malignant tumors in the breast, prostate gland, and kidneys. These pathological processes also 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 skeleton (spine, pelvis, arms, legs). Injuries and fractures often occur with even minor impacts;
• sometimes the sternum may be absent. This pathology may be congenital or acquired;
• the presence of genetic abnormalities in the structure of the skeleton. In these conditions, severe bone fragility is observed.

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 vary in severity. The nature of the signs depends on the location of the injury and the condition of the patient.

TO general symptoms can be attributed:

• painful sensations. Fractures of the 10th, 11th, 12th ribs are often accompanied by pain in the area of ​​injury. They are usually permanent in nature and can intensify with sudden movements, during deep breathing, or severe coughing;
• manifestation of swelling of soft tissues. The area with the fracture is often swollen and may also become red. A hematoma may develop under the skin;
• chest deformation;
• 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 when the layers of the pleura are damaged, which can provoke the penetration of air under the skin;
• presence of hemoptysis. This symptom is usually observed with damage to lung tissue and blood vessels.

Features of treatment

If you identify 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 or surgeon. It is best for the victim to call ambulance so that he could be taken to the hospital without any problems. Upon examination, the specialist will be able to determine the severity of the injury and its location. After this, he will prescribe adequate treatment.

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

• Pain relief therapy is performed using non-steroidal, anti-inflammatory drugs. If the patient is suspected of painful shock, then he may be given injections of corticosteroids and narcotic analgesics;
• an immobilization circular bandage, which is made of elastic materials, is applied to the fracture area;
• if necessary, a puncture of the pleural area is performed to remove air or blood;
• Oxygen therapy may be prescribed to relieve symptoms respiratory failure;
• if there are multiple fractures, surgery may be performed.

You must comply with everything necessary recommendations doctor during the rehabilitation period. Usually special physical exercise that need to be combined with breathing exercises. It is also recommended to follow special diet. All these measures will help you recover faster and get back to normal.

ENCYCLOPEDIA OF MEDICINE

ANATOMICAL ATLAS

Rib cage

The rib cage protects the vital organs located inside it and is also the attachment point for the muscles of the back, chest and shoulder girdle. Its relative lightness ensures free movement when breathing.

The rib cage is supported at the back by 12 thoracic vertebrae. It consists of 12 pairs of ribs, costal cartilages and the sternum, which is located in front.

Each rib of 12 pairs is connected posteriorly to the corresponding thoracic vertebra. The ribs then arc downwards towards the front surface of the body.

The 12 ribs are divided into two groups depending on the way they are attached to the front.

■ True (sternal) ribs

The first 7 pairs of ribs are attached directly to the sternum in front, each with the help of a separate costal cartilage.

■ False ribs

False ribs do not have a direct connection to the sternum. Pairs of ribs 8 to 10 (vertebral cartilaginous ribs) are attached to the sternum indirectly through the cartilage of the overlying rib. The 11th and 12th pairs of ribs are not connected to either bones or cartilage; these are called "oscillating" ribs. Their anterior end ends in the muscles of the lateral abdominal wall.

True ribs (1st-7th pairs)

They are attached directly to the sternum using the corresponding costal cartilages.

False ribs (8-12th pairs)

They do not have a direct connection to the sternum.

▲ The chest consists of the sternum, 12 pairs of ribs and the costal cartilages connected to them.

©Manubrium of the sternum

Is the site of attachment of the clavicle and first costal cartilage

O Body of the sternum

There are three transverse ridges on the front of the sternum. This indicates that. that the body of the sternum was formed by the fusion (in childhood) of four separate bones

©xiphoid process

The lowest of the three bones of the sternum. It can often be felt as a hard mass in the hollow of the abdomen.

Costal cartilages

Pairs of ribs 1st to 10th are attached to the sternum using costal cartilages; form a costal arch

This place can be easily felt under the skin

Connects the head of the rib to its body

Rib structure

The inner surface of the rib body has a concave shape and a groove that protects the nerves and blood vessels, passing along each edge

And the 1st and 2nd ribs, ventral view. These ribs are different from "typical" ribs because they are flatter, shorter, and have a sharper angle to their body.

Connects to the corresponding thoracic vertebra(s).

Connects with the corresponding transverse process thoracic vertebra.

The ribs are slightly different from each other in structure. Ribs from 3rd to lde have a similar structure, which gives reason to call them typical. The ribs consist of the following parts:

■ Rib head

The head of the rib is connected to the corresponding thoracic vertebra, as well as to the overlying vertebra. For example, the 4th rib connects to the 3rd and 4th thoracic vertebrae.

■ Rib neck The small area between the head and body of the rib.

■ Tubercle

It is a raised formation located at the junction of the neck and body of the rib. On the tubercle there is a small articular surface for articulation with the transverse process of the thoracic vertebra.

■ Rib body

Is a continuation of the rib; has a flattened, curved shape, forming an angle of the rib and encircling the sternum.

RIBS WITH DIFFERENT STRUCTURE

■ 1st rib

The widest, shortest and flattest rib. It has only one articular surface on the head, which serves for articulation with the first thoracic vertebra. On the upper surface of the rib there is a protruding scalariform tubercle.

■ 2nd rib

The second rib is thinner than the first. Its body is more like that of a typical rib. In the middle of the body, on the lower surface, it has a second protruding tubercle to which muscles are attached.

■ 11th and 12th pairs of ribs (“oscillating” ribs)

They have only one articular surface on the head. They lack the place of articulation of the tubercle and the transverse process of the corresponding thoracic vertebra. At the ends of the rib bodies there are cartilages; they do not connect to other ribs.

Of the 12 pairs of ribs, only the 1st to 7th are fused with bone structures. The 8th, 9th and 10th pairs are attached to the sternum by cartilaginous tissue, and the 11th and 12th are not fused to it at all. Injury rates especially increase in elderly and senile people, when cartilage tissue they become more and more “ossified” (ossify) and become brittle. Among the general structure of fractures, rib fractures occur in percentage.

The danger of this type of injury lies in the close proximity of important internal organs - heart, lungs, blood vessels. In some cases, a person who has received a fracture does not even suspect that he has this injury. In other cases, serious conditions develop (organ injuries), which without treatment can result in complications.

What causes a rib fracture

The main causes can be classified into two groups: traumatic and pathological.

Traumatic ones occur as a result of the action of a direct damaging factor, and pathological ones occur against the background of the development of certain diseases.

Traumatic injuries are caused by:

• A blow to the chest with blunt objects, a fist. Violation of the bone structure of the rib in this case is often combined with a contusion of the chest, damage to the pleura, heart, and lungs.
• Accidents and disasters. In such a situation, the body is subjected to strong compression and collision. Injuries are most often multiple, combined, with bleeding and the development of shock.
• By falling.
• Sports injuries.
• Compression effects - when a person gets caught between two compressible surfaces.

Pathological rib fractures occur when:

• Some connective tissue diseases, in particular rheumatoid arthritis.
• Metastatic lesions of costal bone structures with primary foci oncological process and different organs. Penetration into bone structures cancer cells occurs lymphogenously and through the bloodstream.
• Tumors localized directly in bone tissue.
• The processes that cause osteoporosis are disturbances in the anatomical and morphological properties of osteoid cells, leading to their increased fragility and fragility. The mechanism of this ailment is based on calcium metabolism disorders, hormonal problems, heredity. Separately, senile osteoporosis can be distinguished.
• Abnormalities of the sternum structure – complete absence, or deformations due to congenital diseases, consequences of certain types of surgical intervention.
• Hereditary pathologies leading to excessive bone fragility. The consequence of these ailments is increased fragility of bones, including ribs.

Features of rib fractures in children

In childhood, bone tissue is more elastic and consists mainly of cartilaginous elements. This gives it elasticity. Therefore, bone fractures in children, in percentage terms, occur much less frequently than in adults. More often they take on the appearance of “green branches” - fractures.

If a rib fracture is detected in small patients, this means that it has been subjected to quite strong mechanical stress.

Mechanism and classification

When diagnosing, the doctor immediately determines a number of situations in order to subsequently apply the correct treatment tactics.

For this purpose, the fracture is classified:

1. According to the presence of damage to the skin: open (with visible tissue breaks, violations of the integrity of blood vessels, nerves). Closed (no external disturbances).
2. According to the intensity of the damage: complete (the bone tissue has completely separated), crack, subperiosteal (the “green branch” type, the damaged ends of the bone are fixed to each other by the periosteum).
3. By third-party localization: on one or both sides.

In addition, rib fractures can be multiple (several different ribs, or a fracture of one rib in two or more places - fenestrated) and single. The presence or absence of displacement is determined.

When a fracture occurs, the rib always “falls” into the chest.

This can only occur at the site of exposure:

• “double-ended failure” of the fracture site;
• “indentation” of a rib fragment when the bone cover is damaged in two or more places;
• combined, or multiple fragmentary fracture with “sinking”.

Complaints, manifestations and symptoms of rib fractures

The picture of this type of damage can be varied, depending on the location and severity of the patient’s condition. Let us note the most common clinical markers of this type of traumatic and pathological process.

A rib fracture is accompanied by:

• Painful sensations. The source of pain is at the site of injury, of a constant nature, with intensification when trying to make quick movements, with deep breathing (“the symptom of a broken breath”), with coughing tremors. During the examination, the specialist pays attention to the “lag” in the volume of respiratory movements (excursions) on the sore side.
• Swelling of soft tissues. The fracture area, and often the area around it, swells and turns red. A hematoma may develop under the skin. When the victim moves, a bone crunch (crepitus) can be detected.
• Deforming changes in the chest.
• Subcutaneous emphysema. This sign can be classified as a closed-type complication. It manifests itself when the layers of the pleura are damaged, which causes air to enter under the skin.
• Hemoptysis. This complaint is typical for damage to lung tissue and blood vessels.

With severe types of fractures, the following complications may occur:

1. Shock (painful, traumatic, hemorrhagic, pleuropulmonary) depending on the mechanism of pathology that led to it. It develops when there is extensive bleeding and air masses enter the area of ​​the pleural layers, causing compression of the lung tissue. Particularly rapid progression of this complication is observed in the cold.
2. Respiratory failure. The pain can be so intense that the patient cannot breathe normally, as a result of which he develops signs of oxygen starvation. In this case, there is a superficial and rapid breathing, fear of death, superficial pulse, cyanosis (cyanosis).
3. Pneumothorax. A condition characterized by the penetration of air from the lung tissue into the space between the inner and outer layers of the pleura. At the same time, the victim’s suffocation progresses.
4. Hemothorax. Irrigation of blood between the pleural layers (into the cavity). In this case, suffocation is accompanied by clinical blood loss (drop in blood pressure, arrhythmia).
5. Pneumonia. This complication can be classified as more distant. The immobile position of the patient, the lack of normal pulmonary ventilation, decreased immunity, the presence of foci of infection, all these factors contribute to the onset of pneumonia.

Healing of the fracture goes through a number of successive stages. At the beginning of the process, connective tissue cords (with blood cells and fibroblasts) grow from the site of the bone fracture, gradually completely covering the bone defect. Next, the forming callus is added with bone elements. Deposition in them inorganic substances, salts, forms ossification (ossifying callus). This formation is supplemented by osteoid elements and acquires the density and structure of normal bone.

The volume of the callus exceeds the size of a normal rib, but over time it returns to normal limits.

Diagnosis of rib fracture

When examining a patient (victim), you should examine and palpate the chest along the location of the ribs. In this case, the symptoms of the pain zone (“interrupted inspiration”), crepitus, and characteristic deformation of the chest will be determined. The doctor checks for specific Payr's syndrome (pain at the site of injury accompanied by tilting the body in the opposite direction). Axial pressure on different areas The chest gives off severe pain in the injured area.

Inspection and palpation are complemented by:

• Radiography. Most informative diagnostic method, allowing you to determine all the details of the fracture.
• CT scan. This examination allows you to clarify doubtful and complicated variants of traumatic injury.
• MRI. Diagnostics using these methods is recommended when X-ray methods are not possible (or are contraindicated).
• Ultrasound. Ultrasound diagnostics will allow monitoring the healing process.
• Other methods (clinical blood test, angiography).

How to provide first aid

In any condition, if there is a suspicion of a possible rib fracture, you should see a doctor (traumatologist, surgeon).

If the condition worsens - pain increases, the area of ​​edema increases, and difficulty breathing develops, then you should resort to calling an ambulance and transporting the patient to the hospital. To do this, the victim is seated with support on a soft pillow, blanket, clothing, and given the painkiller available on hand. If necessary, apply a compressive bandage and cold to the fracture site.

If there is an open wound on the damaged area, then to prevent the development of external (valvular) pneumothorax, the skin around the wound should be treated with a disinfectant. Then, clean paper, plastic film, or any clean airtight material is placed on it, which must be sealed, preventing air from entering the chest cavity. This will avoid a very life-threatening complication - a collapsed lung.

Treatment of rib fracture

In uncomplicated cases, it is enough to observe a rest regime and create the most gentle conditions for the independent restoration of bone integrity. Complete healing occurs after 3 or 4 weeks after the injury. In elderly and weakened patients, the recovery process can take up to 4 or 5 weeks.

In the hospital, victims are provided with:

• Adequate analgesic therapy with non-steroidal anti-inflammatory drugs, blockades. If a developing pain shock is suspected, corticosteroids and narcotic analgesics are given;
• Application of an immobilization circular bandage using elastic materials;
• Puncture of the pleural cavity with a special needle to drain excess air (for pneumothorax) and blood (for hemothorax);
• Oxygen therapy to eliminate symptoms of respiratory failure.
• Surgical restoration of bone formations in case of multiple fractures that may not heal on their own.

To speed up healing and reduce pain the victim (patient) needs to sleep in a reclining position, or on the floor sitting position, depending on how much easier it is for him, on the volume and location of the injury.

Pathological fractures imply the need to treat the underlying disease.

Rehabilitation and preventive measures

You should not expose your body to physical activity until 1-2 months of the post-traumatic period have passed. Recovery should begin with low-intensity exercises, gradually increasing their strength and amplitude.

Physical exercises should be combined with breathing exercises.

The prognosis for this type of injury is positive.

Lotin Alexander, doctor, medical columnist

Fractured ribs: symptoms, treatment, at home, chest

Among all chest injuries known in medicine, rib fractures are the most common in practice. Among all fractures, the frequency of such injury is 10-15%. The most important aspect This type of fracture is highly likely to damage internal organs. In some cases, this development of events can lead to death, so the importance of the issue of rib fracture is very high.

A rib fracture is a violation of the integrity of the bony or cartilaginous part of a rib or group of ribs. Damage to one or two ribs in most cases does not require immobilization and hospitalization. If a large number of ribs are damaged, and it is complicated by damage to the chest organs, it is necessary to carry out treatment under the supervision of a doctor in a hospital.

Anatomy of the chest

The rib cage includes 12 thoracic vertebrae, to which 12 pairs of ribs are attached using joints. In front, the cartilaginous parts of the ribs are adjacent to the sternum.

All edges are divided into three groups: true - include 1-7 pairs, false - represented by 8-10 pairs and oscillating pairs. The true ribs are attached to the sternum with the help of their own cartilaginous parts. False ribs lack their own direct connection to the sternum. The cartilaginous endings fuse with the cartilages of the ribs, which are located above. The oscillating ribs do not articulate with anything at all with their cartilaginous parts.

All ribs have bone and cartilage parts. The anatomical structure of the rib includes the tubercle, body, neck and head. On the inner surface of the thigh there is a groove in which the neurovascular bundle is located. In the case of a rib fracture, very often, this bundle is damaged, which leads to disruption of the trophism of the intercostal muscles and bleeding.

Etiology of the disease

In most cases, the cause of rib fractures is compression of the chest, a blow to it, or a fall with the chest onto a hard protruding object. Also, such damage can develop against the background of other diseases in the body: osteomyelitis, osteoporosis, tumors. In such cases, the fracture is called pathological.

Classification of rib fractures

Based on the presence of damage to the integrity of the skin

Open fracture – there is damage to the skin

Closed fracture - no skin damage

By degree of damage

Subperiosteal fracture - only the bone tissue is damaged

Complete fracture is the most common type. The rib is damaged throughout its entire thickness

Bilateral fracture - the ribs are damaged on both sides. May be accompanied by respiratory problems

Fenestrated fracture - the ribs are damaged in several places, but on one side of the chest

By number of fractures

Multiple – fracture of several ribs

Single – fracture of one rib

According to the presence of displacement of fragments

Mechanism of injury

Most often, a rib breaks in the area of ​​greatest bending, namely along the axillary line on the lateral surface of the chest. The most common fractures are ribs 5-8, the most rare are fractures 9-12 ribs. This is due to the fact that these pairs of ribs have the greatest mobility, especially in the distal part.

When the ribs are fractured in the posterior part of the arch, the symptoms appear blurred. This feature is associated with the slight mobility of bone fragments during breathing in this particular part. Rib fractures in the anterior and lateral parts of the costal arch have very pronounced symptoms and are the most difficult to tolerate. It is worth considering the three most common, depending on the mechanism of injury, fracture.

Indentation of a rib fragment

If a large area of ​​the chest is subjected to strong pressure, a fragment of a rib or ribs may be pressed into the chest. During this process, blood vessels, pleura, lungs, and nerves are injured. Fractures of this type are called fenestrated. When a large area involving several ribs is injured, a large mobile area may appear located in the chest wall. This area is called the rib valve.

Most often appears when falling on the chest. During a fracture, a fragment appears that moves during motor movements. Damage to nerves, intercostal vessels, lungs, and pleura is quite often observed.

Fracture of a limited area of ​​the rib arch

Appears when injured by a heavy angular object. Damage occurs at the site of direct traumatic impact. The fracture rushes inward. First, damage occurs to the inside of the rib, and then to the outside.

Symptoms of a rib fracture:

Pain – appears in the area of ​​the fracture, intensifies with inhalation and exhalation, movements, and coughing. To reduce pain, rest is necessary; you can take a sitting position.

Shallow breathing, as well as lag in breathing on the damaged side of the chest.

Swelling of tissues located in the area of ​​injury.

The appearance of a hematoma at the fracture site - develops with a traumatic fracture that appears as a result of direct mechanical impact.

The crunching or sound of rubbing bones at the time of injury is typical for multiple fractures of one rib without displacement of parts of the damaged bone or for fractures resulting in the appearance of a large number of fragments.

With complicated and multiple fractures, the following signs may appear:

Hemoptysis - when coughing, blood is released from the respiratory tract. This indicates the presence of lung damage.

Subcutaneous emphysema - if there is damage to the lung, air gradually begins to penetrate under the skin.

Pneumothorax is the penetration of air into the pleural cavity. Without timely treatment, the process can develop into a tension pneumothorax, which increases the risk of cardiac arrest.

Hemothorax is penetration of blood into the pleural cavity. Compression of the lung appears, difficulty breathing, shortness of breath. As it progresses, it turns into respiratory failure.

Respiratory failure is a process in which shallow breathing is observed, the pulse quickens, and the skin becomes blue and pale. During breathing, the asymmetry of the chest and the retraction of individual areas are visually determined.

Pleuropulmonary shock – develops with pneumothorax and the presence large area wounds. This leads to a large amount of air entering the pleura. The rate of development of shock increases if the air is cold. It manifests itself as respiratory failure, with cold extremities and a painful cough.

Pneumonia. Appears frequently pneumonia in case of damage to the lung tissue, inability to perform normal motor movements, low physical activity.

Stages of healing of a rib fracture

The first stage is connective tissue callus. At the point of injury, blood begins to accumulate, and with its flow, cells that produce connective tissue(fibroblasts).

The second stage is osteoid callus. In the connective tissue callus, deposits of mineral salts and inorganic substances accumulate and osteoid is formed.

The third stage – the strength of the callus increases due to the deposition of hydroxyapatites in the osteoid. At first, the callus remains loose and exceeds the diameter of the rib in size, but over time it reaches normal size.

Inspection and data collection. When you feel (palpate) the area of ​​injury, you can detect a deformation similar to a step and feel the crepitus of bone fragments.

Symptom of interrupted inspiration - a deep breath is interrupted due to pain.

A symptom of axial load - when the chest itself is compressed in different planes, pain appears not in the area of ​​​​pressure, but at the site of the fracture.

Payra's symptom - when tilting to the healthy side, pain is felt in the area of ​​the fracture itself.

X-ray examination is the most accurate and most common diagnostic method.

First aid for a broken rib

Self-medication for such an injury is strictly contraindicated, and the use of compresses, herbs, and ointments can only lead to aggravation of the situation. If the victim is in in serious condition, he has shortness of breath, weakness, there is an open fracture, you must immediately call an ambulance. You can also help him sit up if sitting makes him feel better. If there is a suspicion of a closed rib fracture, you can apply ice, take painkillers, apply a tight bandage to the chest, but then be sure to contact a traumatology department.

The main treatment method for an uncomplicated rib fracture is immobilization and anesthesia.

In a hospital setting, an alcohol-procaine blockade is performed.

Procaine and 1 ml are injected into the fracture projection ethyl alcohol 70%.

The chest is secured with an elastic bandage.

In the presence of respiratory failure, oxygen inhalation is used.

In case of extensive hemothorax and pneumothorax, a puncture of the pleural cavity is performed, thereby diverting blood or air.

If hemothorax is present with a small amount of blood, the puncture is not performed; the blood is absorbed by the body on its own.

Treatment time for a rib fracture is on average 3-4 weeks.

Clinical case

Patient N. was admitted to the traumatology department with complaints of difficulty breathing, chest pain on the right, and weakness. From the anamnesis: During icy conditions, he slipped and fell, hitting his chest on a large stone.

On examination: On the right side of the skin along the axillary line in the area of ​​5-8 ribs there is bruising and swelling of soft tissues small size. The skin is pale. Palpation revealed crepitus and pain in the area of ​​6-7 ribs. The pulse is 88 beats per minute, breathing is shallow, shortness of breath - up to 20 respiratory movements per minute. The examination revealed a fracture of the 6th and 7th ribs on the right and a right-sided hemothorax.

Treatment: Immobilization of the chest, pain relief, infusion therapy, puncture of the pleural cavity (withdrawal of 80 ml of blood), oxygen inhalation.

Human ribs: numbering, structure, diagram

How many ribs does a person have and what is their structure? Diseases associated with them and their treatment:

There is a legend that a woman was created by God from the rib of Adam, so it was previously believed that a man has fewer ribs than the fair sex. But this is a deep misconception, and scientists have long proven this fact.

The first to refute such an assumption back in the Middle Ages was the outstanding anatomist Andreas Vesalius. This bold assumption served as a reason for the inquisitors to severely punish the scientist.

Rib cage

The number of ribs in a person is 12 pairs. Of this total number, 10 pairs close together to form a tight ring for the chest organs.

The first 7 pairs of them are attached directly to the sternum, and the remaining three - to the cartilaginous part of the overlying rib. The last three pairs are not attached to anything, but end freely on the muscles.

The chest consists of all 12 pairs of ribs, and this is the norm for every person.

Sometimes there are eleven or thirteen pairs, which is undoubtedly not the norm, but this fact does not in any way affect the quality of a person’s life.

Rib anatomy

The thickness of the rib does not exceed five millimeters. In appearance, it is a curved plate that consists of bone and cartilage parts. The bone part consists of spongy bone tissue and is divided into the head, neck, on which the tubercle and body are located.

There is a groove at the bottom of the latter. The body is attached to the sternum using cartilage. The rib has two surfaces: internal (concave) and external (convex in shape).

Joints of the ribs and the inner surface of the chest

The inside of the chest is lined with a special membrane called the pleura. The walls of the chest are lined by the parietal pleura, and the organs are lined by the visceral pleura.

With the help of a thin layer of lubricant, both sheets are able to slide freely over each other.

The chest is an important anatomical structure and has many functions. It protects vital organs from all kinds of injuries and external influences.

The ribs are also attachment points for many muscles, particularly the respiratory muscles, the largest of which is the diaphragm. The sternum is where the red bone marrow is located.

Injuries to the ribs and chest

Regardless of how many pairs of ribs a person has, fractures are the most common pathology. A fracture can damage internal organs located in the chest, as well as blood vessels and nerves.

This injury mainly occurs in elderly and senile people; this is associated with reduced elasticity, as well as fragility of bones. Even a minor injury can lead to a fracture at this age.

The typical location for rib fractures is the lateral surfaces of the chest due to the fact that this is where the maximum bending is observed.

A typical clinical picture may be present immediately (fractures are accompanied by pain), but may develop later, when fragments touch internal organs and their function is disrupted.

There is also an incomplete fracture of the rib, or the rib may break so that the fragments do not move. In addition to grass, a fracture can also be the result of a disease that affects the bone tissue of the rib and reduces its strength. It all depends on how many ribs a person has that are affected.

Other rib pathology

The ribs, like the rest of the bone tissue, can be affected by osteoporosis. With this disease, calcium is washed out of the bones and they become brittle.

Oncology can often affect the ribs: the tumor can grow into the bones, as well as into neighboring organs.

The consequence of its growth can be pathological fractures, the number and complexity of which depends on how many ribs a person has exposed to pathology.

The rib may also be affected by tuberculosis or inflammation. Due to the fact that red bone marrow is located in the rib and sternum, pathology associated with it can also develop. This pathology is myeloma, as well as leukemia.

Complications

An uncomplicated fracture of one rib is not life-threatening. But several broken ribs can lead to injury to internal organs, impair breathing and cause related complications. Fragments can injure lung or pleural tissue.

Due to this, pneumothorax (entry of air between the layers of the pleura), hemothorax (entry of blood into the pleural cavity), and also pneumohemothorax can develop.

Subcutaneous emphysema may also develop, which is accompanied by the penetration of air into the subcutaneous fat.

Diagnosis and treatment

Single and multiple fractures are accompanied by pain, especially during inhalation, movement, coughing or talking. The pain syndrome goes away or decreases with the patient lying down or simply at rest.

Fractures of the ribs are accompanied by shallow breathing, as well as a lag of the chest in the act of breathing on the affected side.

During palpation, the patient characterizes the fracture zone as the place of greatest pain, and it is also possible to hear a characteristic crunching sound (crepitus).

It is difficult to diagnose complications using a simple x-ray; an additional ultrasound examination of the pleural cavity, as well as puncture of the pleural space, will be required. Impaired respiratory function causes anterior or lateral fractures.

In the posterior region, injury causes pulmonary ventilation impairment less frequently. Rib fractures are not treated using the fixation method; only complicated, multiple injuries may require immobilization.

This pathology requires treatment in a hospital, and in special cases, which are accompanied by injury to internal organs, as well as bleeding, surgical treatment may be required.

If you fix the chest, you can get a serious infectious complication - congestive pneumonia, which is very difficult to treat and in many cases leads to death.

When treating multiple fractures, the treatment period is longer, which depends on the general condition of the body, age, the presence of concomitant diseases, as well as the severity of complications that arose due to the injury.

The rib is an anatomically very simple bone, but it performs many important functions and is part of such a skeletal formation as the rib cage. There are many pathologies in which a rib can be affected. The main thing is to diagnose them in a timely manner, because subsequently the function of vital organs may be impaired. In some situations, only immediate surgical treatment will help save the life of the victim; in other cases, the tactics of the chosen treatment depend on the pathology and the severity of its course.

Ribs - structure, main functions, causes of fractures and treatment

Ribs are arched paired flat bones that, connecting the spine and sternum, form the rib cage. The thickness of the rib rarely exceeds 5 millimeters.

Structure of ribs

The ribs are curved narrow plates consisting of:

• Bones (long spongy bones with a head, neck and tubercle) - in their longest (posterior) part;
• Cartilage - in the shorter (anterior) part.

The body of the rib has an internal (concave) and external (convex) surface, limited by rounded and sharp edges. The vessels and nerves are located in a groove running along the inner surface of the lower edge.

Humans have twelve ribs on each side, which are connected to the bodies of the thoracic vertebrae by their posterior ends. The ribs are divided into three groups according to the method of fastening:

• The seven upper ribs (true ribs) connect directly to the sternum at their anterior ends;
• The next three, false ribs, are connected by their cartilage to the cartilage of the previous rib;
• The two lower ribs (oscillating ribs) lie freely at their anterior ends.

The ribs are connected to the sternum and vertebrae using all types of connections:

• Synarthrosis (syndesmosis and synchondrosis);
• Symphyses;
• Diarthrosis.

The chest is lined from the inside with a connective tissue membrane, immediately under which there is a pleura consisting of two smooth layers. A thin layer of lubricant allows you to slide freely between the sheets when breathing.

Edge function

The main functions of the ribs include:

• Protective function. The ribs, forming the chest, cover the heart, lungs and large vessels from injury and external influences;
• Frame function. The rib cage, which helps hold the organs in the chest cavity in the desired position, prevents the heart from moving to the sides and collapsing of the lungs.

Fractured ribs

There are three main groups of reasons why ribs hurt:

• Damage to internal organs located directly in the chest;
• Damage to blood vessels and nerves;
• Violation of the chest wall frame.

A rib fracture is one of the most common injuries to the chest and is generally more common in older people due to age-related changes elasticity of the bone structures of the chest.

The most common causes of rib fractures are injuries resulting from:

• Falls;
• Direct blow to the ribs;
• Chest compression.

Ribs break more often on the lateral surfaces of the chest (in places of greatest bending), which causes pain in this area. In many cases, the ribs do not hurt immediately after the injury, but somewhat later, when bone fragments begin to rub during breathing (especially when inhaling) and movement.

Partial disruption of the integrity of the rib without displacement of bone fragments, which occurs due to injury or a pathological process in the body, is called an incomplete fracture.

An incomplete fracture can occur either due to injury or due to damage to the inert part of the rib by a pathological process leading to a decrease in the strength of bone tissue, for example:

• For osteoporosis (conditions in which calcium salts are washed out of bone tissue);
• With the development of tumors in the chest area;
• With tuberculosis of the ribs;
• At chronic inflammation rib bone tissue;
• For blood diseases (myeloma).

Uncomplicated fractures of one or more ribs usually do not pose a threat to human health and life. The main danger with this injury is:

• Damage to internal organs;
• Breathing disorders;
• Development of associated complications.

A more serious risk is multiple rib fractures, which are associated with an increased risk of pleuropulmonary shock and life-threatening complications (eg, pneumothorax and hemothorax). In addition, with multiple fractures, displacement of fragments is often observed, which pose a threat to the pleura, lungs and intercostal vessels due to their sharp ends.

A fracture can also lead to:

• To the development of subcutaneous emphysema caused by the penetration of air into subcutaneous tissue in case of lung damage;
• TO heavy bleeding into soft tissues or the pleural cavity when intercostal vessels are damaged.

With multiple fractures, the ribs hurt greatly, and the pain intensifies with movements, breathing, coughing, talking and decreases with rest and in a sitting position. Also, with multiple rib fractures, shallow breathing and sagging of the chest on the affected side are observed.

A broken rib is revealed by palpation as the most painful place, as well as by a peculiar crunching of bone fragments (bone crepitus).

The diagnosis can usually be confirmed by chest x-ray, and in cases of suspected pneumothorax and hemothorax, ultrasound of the pleural cavity, fluoroscopic examination and pleural puncture should be additionally performed.

More often, breathing problems are accompanied by anterior and lateral rib fractures, which, as a rule, are more difficult to tolerate. Damage to the posterior parts of the ribs causes disturbances in pulmonary ventilation less frequently.

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 breathing restriction, which in turn contributes to the development stagnation, 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.

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Anatomy and structure of the chest

The anatomy and structure of the chest forms a strong frame for reliable protection of internal vital organs, such as the heart and lungs.

The physiological structure of the human chest includes several types of bones. These are costal arches that are attached at the back to the spinal column, and at the front to the sternum.

This is one of the most important parts of the human skeleton.

This structure of the chest provides a certain mobility for the ribs.

Between them are located muscles, nerve endings and other important parts of the anatomical skeleton, which provide not only support and motor function.

Due to the coordinated work of the intercostal muscles, a person has the ability to fully inhale and exhale.

Look at the structure of the human chest in the photo, which illustrates all the most important structural parts:

Features of the structure of the human skeleton and bones of the chest

Anatomical and topographical information gives an idea of ​​the structural features of the chest, which is a unique articulation of bones.

According to the anatomical atlas, according to its bone structure, the human chest is a part of the body, the bone base of which is the thoracic vertebrae, ribs and sternum.

The structure of the chest skeleton is such that it consists of the thoracic spine and 12 pairs of ribs, the sternum and costal cartilages.

Only the first 7 pairs of ribs reach the sternum; The VIII, IX and X ribs with their cartilages connect to the overlying rib and form a costal arch; The XI and XII ribs end freely.

The connection of the manubrium with the body of the sternum usually occurs at a certain angle, open posteriorly (angle of Louis - angulus sterni seu Ludovici).

This angle in the form of a roller is well defined on the sternum upon palpation (at the place of attachment of the cartilage of the second rib to the sternum), and in asthenic patients it is even visible. The bony wall of the chest, devoid of soft tissues, especially muscles, is a truncated cone, with a wide base facing the abdominal cavity, and a tapering apex towards the neck.

Look at the structure of the chest in the photo, which illustrates the ribs and their attachment to the sternum and spine:

Sternum and ribs in the structure of the chest

Due to the special structure of the chest, the manubrium of the sternum articulates with the sternal ends of the clavicles and connects (without forming a joint) with the cartilages of the 1st and 2nd ribs. The body of the sternum has semilunar notches for III and. IV rib. The chest has 2 openings: upper and lower.

The superior inlet (apertura thoracis superior) is formed by the 1st thoracic vertebra, 1st rib and the upper edge of the manubrium of the sternum.

Due to the fact that the upper edge of the manubrium of the sternum together with the jugular notch (incisura jugularis sterni) is located approximately at the level of the lower surface of the body of the second thoracic vertebra, the virtual plane laid through the entrance to the chest descends in the anterior direction.

Since the apex of the pleura and part upper lobes the lungs extend beyond the anterior border of the entrance to the chest, we can say that the chest cavity, in fact, extends to the neck.

Below, at the outlet of the chest, the position is opposite: the border of the outlet of the chest is indicated by a line running from the xiphoid process in both directions along the costal arches.

The exit from the chest is covered by the diaphragmatic muscle, part of which starts from the lower ribs.

The two arches of the diaphragm with their apices face the pharyngeal cavity, thus, the abdominal organs are already located in the subdiaphragmatic (still protected by the Ribs) space.

The ribs in the structure of the chest are connected to the vertebrae at their posterior ends; from here they go outward, fixing in the region of the costal tubercle to the transverse processes, and then sharply curl anteriorly and downward, forming obtuse costal angles (angulus costae). In front (in the cartilaginous part) the ribs rise obliquely upward.

Muscles in the structure of the chest

On the inside, the ribs and intercostal muscles are lined with intrathoracic fascia (fascia endothoracica), to which the parietal pleura is closely adjacent.

In addition to the intercostal muscles, the chest in its structure is covered with the following main muscle layers: pectoralis major and minor, vastus, serratus and trapezius muscles.

The intertwining teeth of the serratus anterior and external oblique muscles form a zigzag line on the lower-lateral surface of the chest wall - the Zherdi line - a relief serrated contour of the beginning of the serratus anterior muscle on the lateral surface of the chest.

At the lower end of the median sulcus, in the region of the substernal angle (angulus infrasternalis), there is an epigastric fossa (fossa epigastrica seu scrobiculus cordis).

The depression or angle is divided by the xiphoid process, palpable in the depths, into the right and left costoxiphoid angles (angulus costoxiphoideus), which are laterally limited by the joint formed by the cartilage of the 7th rib and the sternum.

Puncture of the deepest point of the pericardium is carried out by inserting a needle to a depth of approximately 1.5-2 cm precisely in the angulus costoxiphoideus - at Larrey's point.

The chest wall is supplied with blood through the internal mammary artery, the anterior and posterior intercostal arteries, and the axillary artery.

The chest wall is innervated by segmental spinal nerves(nervi intercostalis) and branches brachial plexus. The trapezius muscle in the structure of the chest is innervated by the accessory nerve of Willis - nervus Willisii.

Function of the ribs and chest

The chest consists of all 12 pairs of ribs, and this is the norm for every person. Connections of the ribs with the sternum and art. sternolavularis receive nutrition from a. thoracica interna.

The articulations of the 1st, 11th and 12th ribs do not have lig. intraarticulare. X-ray image of the sternum and ribs.

The human chest is a frame consisting of vertebrae, sternum and ribs connected by ligaments and joints.

It is not difficult to answer the question of how many ribs a person has, but it is difficult for an ordinary person who does not study anatomy or has graduated from school a long time ago.

Based on this edge, they get their name: the first seven pairs are true, the next three pairs are false, and the last ones are oscillating.

Externally, the ribs are flat bones that are arched and form the chest - the lungs and heart are located in it.

The thickness of the rib does not exceed five millimeters. In appearance, it is a curved plate that consists of bone and cartilage parts. The body is attached to the sternum using cartilage.

The rib has two surfaces: internal (concave) and external (convex in shape).

On the inner surface, in the rib groove, there are vessels and nerves that supply the intercostal, abdominal muscles and organs of the chest and abdomen.

The ribs are attached to the bones using various connections: joints - with the spinal column, and synarthrosis - with the sternum.

The chest is an important anatomical structure and has many functions.

The frame function of the ribs helps keep the organs in the correct anatomical position; due to this, the heart does not move to the sides and the lungs do not collapse.

Regardless of how many pairs of ribs a person has, fractures are the most common pathology.

There is also an incomplete fracture of the rib, or the rib may break so that the fragments do not move.

In addition to grass, a fracture can also be the result of a disease that affects the bone tissue of the rib and reduces its strength.

Oncology can often affect the ribs: the tumor can grow into the bones, as well as into neighboring organs. The consequence of its growth can be pathological fractures, the number and complexity of which depends on how many ribs a person has exposed to pathology.

Due to the fact that red bone marrow is located in the rib and sternum, pathology associated with it can also develop. This pathology is myeloma, as well as leukemia.

An uncomplicated fracture of one rib is not life-threatening.

But several broken ribs can lead to injury to internal organs, impair breathing and cause related complications.

The diagnosis of a “fracture”, as well as how many ribs a person has suffered, is not difficult to establish; it is enough to take a survey X-ray of the chest.

In the posterior region, injury causes pulmonary ventilation impairment less frequently.

Rib fractures are not treated using the fixation method; only complicated, multiple injuries may require immobilization.

Anatomy of the human chest

The same applies to the popular practice of tying the chest with sheets or towels. The period during which bone tissue fusion occurs is approximately one month (this is for an uncomplicated rib fracture).

The rib is an anatomically very simple bone, but it performs many important functions and is part of such a skeletal formation as the rib cage. There are many pathologies in which a rib can be affected.

The main thing is to diagnose them in a timely manner, because subsequently the function of vital organs may be impaired.

There are 12 ribs on each side. All of them are connected with the bodies of the thoracic vertebrae by their posterior ends. The anterior ends of the 7 upper ribs connect directly to the sternum.

These are true ribs, costae verae.

The next three ribs (VIII, IX and X), which join with their cartilages not to the sternum, but to the cartilage of the previous rib, are called false ribs, costae spuriae.

On each bony rib, the posterior and anterior ends are distinguished, and between them the body of the rib, corpus costae.

The posterior end has a thickening, the head of the rib, caput costae, with an articular surface divided by a ridge, through which the rib articulates with the vertebral bodies. In the 1st, 11th and 12th ribs, the articular surface is not divided by a ridge.

At the junction of the neck with the body of the rib there is a tubercle of the rib, tuberculum costae, with an articular surface for articulation with the articular surface of the transverse process of the corresponding vertebra.

The ribs, like the rest of the bone tissue, can be affected by osteoporosis. The rib may also be affected by tuberculosis or inflammation. There is no tubercle on the XI and XII ribs, since these ribs do not articulate with the transverse processes of the last thoracic vertebrae.

Ribs of the chest

Ribs, costae, 12 pairs, are narrow, curved bone plates of varying lengths, symmetrically located on the sides of the thoracic spinal column.

In each rib, there is a longer bony part of the rib, os costale, a short cartilaginous part - the costal cartilage, cartilago costalis, and two ends - the anterior one, facing the sternum, and the posterior one, facing the spinal column.

The bone part, in turn, includes three clearly distinguishable sections: the head, neck and body. The head of the rib, caput costae, is located at its vertebral end. It has an articular surface of the rib head, fades articularis capitis costae.

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

At the border with the body at the 10 upper pairs of ribs on the neck there is a small tubercle of the rib, tuberculum costae, on which there is an articular surface of the tubercle of the rib, fades articularis tuberculi costae, articulating with the transverse costal fossa of the corresponding vertebra.

Between the posterior surface of the rib neck and the anterior surface of the transverse process of the corresponding vertebra, a costotransverse foramen, foramen costotransversarium, is formed.

Thoracic segment. The relationship of the ribs to the vertebra (IV) and sternum.

Body of the rib, cogrus costae, represented by spongy bone, has different lengths: from the first pair of ribs to the VII (less often VIII) the length of the body gradually increases; at the next ribs, the body is successively shortened, extending from the tubercle to the sternal end of the rib; it is the longest section of the bony part of the rib. At some distance from the tubercle, the body of the rib, bending strongly, forms the angle of the rib, angulus costae. At the 1st rib it coincides with the tubercle of the anterior scalene muscle (tuberculum m. scaleni anterioris), in front of which there is a groove of the subclavian vein (sulcus v. subclaviae), and behind it there is a groove subclavian artery(sulcus a. subclaviae), and on the remaining ribs the distance between these formations increases (up to the XI rib); the body of the XII edge does not form an angle. The body of the rib is flattened throughout. This allows us to distinguish between two surfaces: 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 rib groove, sulcus costae, 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.

The costal cartilages, cartilagines costales (there are also 12 pairs of them), are a continuation of the bony parts of the ribs. From the 1st to the 2nd ribs they gradually lengthen and connect directly to the sternum. The upper 7 pairs of ribs are the true ribs, costae verae, the lower ones

False ribs (5 pairs) - costae spuriae, ribs XI and XII - oscillating ribs, costae fluitantes.

Some features have two first and two last pairs of edges.

The first rib, costa prima (I), is shorter but wider than the others, has almost horizontally located upper and lower surfaces (instead of the outer and inner ones of the other ribs).

On the upper surface of the rib, in the anterior section, there is a tubercle of the anterior scalene muscle, tuberculum t. scaleni anterioris (place of attachment of this muscle).

Outside and posterior to the tubercle lies a shallow groove of the subclavian artery, sulcus a. subclaviae (trace of the artery of the same name running here, a.

subclavia), posterior to which there is a small roughness (place of attachment of the middle scalenus muscle, m. scalenus medius). Anterior and medially from the tubercle there is a faint groove of the subclavian vein, sulcus v. subclaviae. The articular surface of the head of the first rib is not divided by a ridge; the neck is long and thin; The costal angle coincides with the tubercle of the rib.

The second rib, costa secunda (II), has a roughness on the outer surface - the tuberosity of the serratus anterior muscle, tuberositas and serrati anterioris (the place of attachment of the tooth of the said muscle).

The eleventh and twelfth ribs, costa XI et costa XII, have articular surfaces of the head that are not separated by a ridge. On the XI rib, the angle, neck, tubercle and costal groove are weakly expressed, and on the XII they are absent.

Twelfth rib, costa XII, right, from the inside.

Ribs

Anatomy Bones Bones of the torso Rib cage and chest bones

Ribs, costae, (Fig. 36, 37, 38, 39) 12 pairs, are narrow, curved bone plates of varying lengths, symmetrically located on the sides of the thoracic spinal column.

In each rib, there is a longer bony part of the rib, os costale, a short cartilaginous part - costal cartilage, cartilago costalis, and two ends - the anterior one, facing the sternum, and the posterior one, facing the spinal column.

Bone part of the rib Costal cartilages Features of the first and last pairs of ribs

The bony part of the rib has a head, neck and body. The head of the rib, caput costae, is located at its vertebral end. It has an articular surface of the rib head, facies articularis capitis costae.

This surface on the II-X ribs is divided by the horizontally running ridge of the rib head, crista capitis costae, into an upper, smaller, and lower, larger part, each of which respectively articulates with the costal fossae of two adjacent vertebrae.

rice. 36. Ribs, costae, right; view from above. A - 1st rib; B - II rib.

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

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

Between the posterior surface of the rib neck and the anterior surface of the transverse process of the corresponding vertebra, a costotransverse foramen, foramen costotransversarium, is formed (see Fig. 44).

rice. 37. Eighth (VIII) rib, costa VIII) right. (Inner surface.)

The body of the rib, 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, bending strongly, forms the angle of the rib, angulus costae. At the first ribs (see Fig.

36) 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 edge does not form an angle. The body of the rib is flattened throughout.

This allows us to distinguish between two surfaces: 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 rib groove, sulcus costae (see Fig. 37), 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.

rice. 38. Twelfth (XII) rib, costa XII) right. (Outside surface.)

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

The costal cartilages, cartilagines costales, (there are also 12 pairs of them), are a continuation of the bony parts of the ribs. From the 1st to the 2nd ribs they gradually lengthen and connect directly to the sternum.

The upper 7 pairs of ribs are true ribs, costae verae, the lower 5 pairs of ribs are false ribs, costae spuriae, and the XI and XII ribs are fluctuating ribs, costae fluitantes.

The cartilages of the VIII, IX and X ribs do not directly approach 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.

rice. 39. Twelfth (XII) rib, costa XII) right. (Inner surface.)

Some features have two first and two last pairs of edges. The first rib, costa prima (I) (see Fig. 36, A), is shorter, but wider than the others, has almost horizontally located upper and lower surfaces (instead of the outer and inner ones of the 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 running here, a.

subclavia, behind which there is a slight roughness (the place of attachment of the middle scalenus muscle, m. scalenus medius. Anterior and inward from the tubercle there is a weakly defined groove of the subclavian vein, sulcus v. subclaviae.

The articular surface of the head of the first rib is not divided by a ridge; the neck is long and thin; The costal angle coincides with the tubercle of the rib.

rice. 44. Thoracic segment. The relationship of the ribs to the vertebra (IV) and sternum.

The second rib, costa secunda (II)) (see Fig. 36, B), has a roughness on the outer surface - the tuberosity of the serratus anterior muscle, tuberositas m. serrati anterioris, (place of attachment of the tooth of the specified muscle).

The eleventh and twelfth ribs, costa II et costa XII (see Fig. 39), 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 rib they are absent.

How many ribs and their pairs are there in a person's chest?

“How many ribs and how many pairs of ribs are there in a person’s chest?” - this is not an idle question. Since ancient times, this issue has been shrouded in mystery.

The basis was the biblical legend about God’s creation of the first male human, Adam, and the woman, Eve, destined for him as his wife.

According to this legend, Eve was created from Adam's rib, and for this reason, she had one more rib than Adam. According to the Bible, all the descendants of Adam and Eve had the same number of ribs, i.e. Adam's male descendants should have one less.

Despite the strong pressure of church dogma on the people, in those ancient times there were experienced healers who practiced surgery and autopsies of the dead.

The records of some of those healers have survived to this day, in which they refute the biblical legend about the different number of ribs in men and women.

But the power of the church was so strong, and the punishment for deviating from its truths was so severe, that few people dared to openly oppose the church and expose themselves to the punishment of the Inquisition.

This continued until the 16th century, when in 1543 Andreas Vesal, a surgeon and anatomist, a physician at the court of Charles V and then Philip II, who came from a family of hereditary doctors, published his work entitled “De corpore humani fabrica” (“ On the structure of the human body”). In this work, he presented the results of his research and gave a description of the internal organs of a person and the structure of the human body, moreover, the description of each organ was supplemented with a color drawing.

This work created an “explosion” in both the scientific and church worlds. In fact, Vezal openly opposed church dogmas and loudly declared how many ribs a person actually has and, in particular, how many there are in men and how many in women.

He argued that people, regardless of their gender, have the same number of ribs, there are 24 in total and they make up 12 pairs.

Of course, with his statement, Vesal incurred the wrath of the church and fell into disgrace.

Only thanks to the intervention of the king, Vesal miraculously managed to avoid the fate of the heretic, and he was not burned at the stake.

From this time the countdown begins in the study and development of modern anatomy.

And the church, in order not to “give up” its position on the issue of Eve’s origin, gives the following explanation: Eve was created by God from Adam’s rib, so he has one less rib than Eve. However, this anatomical feature was not passed on to Adam’s descendants, i.e. all subsequent generations of men and women had the same number of ribs.

What are ribs and their number

Ribs are flat bones that contain red bone marrow. They are arched in shape and consist of two parts:

• posterior bones - spongy tissue, articulate with the vertebrae;
• the anterior bones are cartilaginous tissue, connected to the sternum.

So, how many ribs does a person have? There are only 24 ribs in the human skeleton, which form 12 pairs.

The ribs are counted from top to bottom. They arc around the human body and form the chest (at the back with the spine and at the front with breastbone or sternum).

Their length gradually increases from 1st to 7th, and shortens from 8th to 12th.

The rib has two surfaces: internal (concave) and external (convex).

On the inner surface there is a groove in which nerves and vessels are located that feed the muscles (intercostal and abdominal), as well as internal organs located inside the chest and abdomen.

Rib cage

The rib cage is important in human anatomy and performs several functions, in particular:

• protective function - protects from damage the soft tissues and internal organs of a person located in the chest cavity - the heart, trachea, bronchi, lungs and esophagus.
• frame function - keeps the organs of the chest cavity in the correct anatomical position, due to this the heart does not move and the lungs do not sag.
• fastening function respiratory muscles, in particular, the largest of which is the aperture.

The ribs are divided into two groups, depending on their connection to the sternum and to each other.

• Group I – “true”. Group I consists of seven upper pairs, which, together with the spine and sternum, form a dense ring. The anterior cartilaginous ends of the ribs are connected to the sternum.
• Group II – “false”, from 8th to 12th, which do not reach the sternum. “False” ones are divided into two subgroups according to the way they are connected to each other:
• The 8th, 9th and 10th are connected to each other by cartilaginous ends (the underlying ones with the overlying ones). They form the costal arches.
• The 11th and 12th extend from the spine, do not close at the sternum and are in no way connected with the overlying ones. Their anterior ends are located freely in the lateral sections of the abdominal wall and are called “wandering” or “oscillating”.

Adam's rib syndrome

Every rule may have exceptions. This also applies to the number of ribs a person has.

Despite the fact that having 12 pairs is considered the norm for people, there are people who have more (13 pairs) or fewer (11 pairs).

This phenomenon in the structure of the chest does not depend on the gender of the person and is called “Adam’s rib syndrome.”

The presence of an additional 13th pair is a congenital feature of the body, its pathology. Excess bones weigh down the chest and can put pressure on internal organs, thereby causing them to malfunction.

In order to eliminate negative consequences Because of the inconvenience caused by extra bones, doctors recommend that people with this pathology undergo surgery to remove them.

The absence of the 12th pair, as a rule, is caused by people’s desire to achieve, from their point of view, a more perfect figure. These are mainly women who decide to undergo such operations in order to get more thin waist and narrow the chest.

There is nothing new in such women’s desires, since back in the 18th century, when the so-called “wasp” waist came into fashion, women were so pulled into corsets that they could not breathe normally.

These days, among film and show business actresses, such operations are quite in demand, there are many examples of this.

will help you better understand the structure of the chest and learn the classification and structure of the ribs.