Ribs are 12 pairs of bones belonging to the human axial skeleton. The ribs form the bony walls of the chest, protecting its internal organs. Additionally, the ribs play an important role in the breathing process. Rib injuries are very painful and complications can be dangerous. Find out how the ribs are built, what the types of ribs are, the functions of the ribs and what diseases can affect the ribs.
Ribsare bones with a characteristic, semicircular shape, constituting the bone scaffolding of the chest. The back ends of the ribs are connected to the spine, more precisely, to the thoracic vertebrae. The number of thoracic vertebrae corresponds to the number of pairs of ribs (12), so each pair of ribs is connected to the corresponding vertebra. Successive pairs of ribs in the anatomy are marked with appropriate Roman numerals, from I to XII. The front ends of the ribs are connected to the sternum, although this rule does not apply to all ribs.
Ribs - construction
The following are distinguishedtypes of ribs :
- real ribs(Latincostae verae ) - ribs numbered I - VII, having a direct connection to the sternum
- pseudo-ribs(Latincostae spuriae ) - ribs numbered VIII - X, indirectly connected to the sternum by common cartilage
- free ribs(Latincostae librae ) - ribs numbered XI and XII, not having any connection with the sternum, have free endings in the abdominal wall
An interesting fact is thatthe number of ribs in a human may be individually variable . There are both missing and additional ribs, although these are relatively rare cases. Additional ribs may connect to the spine except for the typical location in the thoracic section - there are additional cervical and lumbar ribs. The excess cervical rib can cause the so-called cervical rib syndrome.
In the structure of each rib, we distinguish the head and neck (from the spine side) and the body (main part). The head and neck of the ribs have articular surfaces that connect to the corresponding parts of the vertebrae (cost-vertebral joints).
Real ribs (numbers I - VII) additionally formsternocostal joints . From the inside of each rib there is a so-called a furrow in which 3 structures are located: an artery, a veinand the intercostal nerve. They are collectively referred to as the neurovascular bundle.
The ribs are the skeleton to which the numerous muscles surrounding the chest attach. It is worth paying attention in particular tobreathing muscles , involved in the rhythmic breathing movements of the chest.
The main human respiratory muscle is the diaphragm, which has its attachments on the ribs VI - XII. There are also 2 layers of intercostal muscles between each pair of ribs.The intercostal musclesThe external muscles, together with the diaphragm, are involved in breathing in. The internal intercostal muscles work mainly when exhaling air intensively.
Ribs - functions
One of the most important functions of the ribs is to protect vital organs in the chest. The ribs form a bony cover for the heart, lungs, and large vessels (aorta, pulmonary arteries, and vena cava).
The lower ribsalso partially protect the abdominal organs, such as the liver and spleen. Thanks to the ribs, the above organs are less exposed to direct injuries. On the other hand, it should be remembered that any damage to the ribs may be complicated by damage to the adjacent internal organs.
Another important function of the ribs isbreathing . As you inhale, the ribs expand and rise, adding volume to your chest. The pressure inside the chest decreases, causing atmospheric air to be sucked in and you to inhale. As you exhale, the ribs move closer and lower, causing the pressure inside the chest to increase and the air to shift outwards.
Numerous muscles join the ribs, not only for the respiratory function. The ribs play an important role in the proper biomechanics of the entire upper body through connections with the dentate, pectoral muscles, subclavian muscle, latissimus dorsi muscle, and abdominal straight and oblique muscles.
Knowledge of the anatomy of the ribs is also important for physicians when performing a physical examination and thoracic surgery. Auscultation of the heart valves with a stethoscope takes place in specific intercostal spaces (for example - the tricuspid valve in the fourth intercostal space on the right).
The ribs also allow you to orient yourself in the anatomy of the chest when performing some life-saving procedures (for example - a chest puncture to decompress a tension pneumothorax is performed in the second intercostal space).
Ribs -diseases
The most common rib diseases are, of course, injuries resulting from falls, sports or traffic accidents. However, it is worth knowing that the ribs can also be affected by inflammatory diseases, cancer, and birth defects.
Rib injuries
Rib injuries in the form of bruises and fractures are relatively common. Since each rib has its own nerve, these types of injuries are very painful. The pain is further aggravated by the chest breathing movements.Broken ribsis usually treated conservatively - it is not possible to immobilize them because it would make breathing difficult. Reduced ventilation of a specific area of the lung, on the other hand, may contribute to the development of pneumonia, which is a complication of chest injuries.
Some rib fractures require more specialized treatment. This mainly applies to complicated injuries. One of the possible complications of a rib fracture is pneumothorax, which is a puncture of the pleura (the membrane surrounding the lungs). Pneumothorax may require chest drainage. The purpose of drainage is to remove the air filling the pleural cavity (this air compresses the lung, preventing its proper ventilation).
Multiple rib fracturescan cause the so-called flabby chest, i.e. loss of stability of the chest bone walls. Such a complication prevents proper breathing and requires advanced medical procedures. To prevent respiratory failure, endotracheal intubation and mechanical ventilation of the patient are necessary.
Costal cartilage inflammation (Tietz disease)
Costal cartilage inflammation, also known as Tietz's disease, is a condition that affects the connection of the ribs with the sternum. Inflammation of the costal cartilages is very painful and increases with every movement of the chest. Pain therapy is the mainstay of treatment of costal cartilage inflammation - pain must be controlled enough to allow the patient to breathe freely. However, no other interventions are necessary - costal cartilage inflammation is a mild disease and usually heals spontaneously.
Ribs - compression syndromes
Compression of some soft structures by the ribs may lead to the development of the so-calledupper chest opening syndrome . It is the name of a group of diseases, the essence of which is the compression of the subclavian vessels and the brachial plexus by bone structures.
The main symptom of the syndrome is pain and local blood circulation disorders. Defects may predispose to the syndromecongenital ribs, including an additional cervical rib (then the term "cervical rib syndrome" is used). If conservative treatment is unsuccessful, surgical removal of the rib causing symptoms may be necessary.
Congenital defects of ribs
Congenital rib defects can be generally divided into numerical and structural. Numerical defects concern the number of ribs other than 12 pairs - both additional and missing ribs may appear. In structural defects, the number of ribs is correct, but their structure is different. The most common examples of structural defects arefused ribs(synostosis) andbipartite ribs . Multiple defects of the ribs may cause significant deformation of the chest.
An example of such a disease isJeune's syndrome , also called clamping dysplasia of the thorax. Apart from the abnormal development of numerous ribs, the clinical picture is dominated by underdevelopment of the lungs and defects of other bones. Fortunately, such severe syndromes of birth defects are relatively rare.
Tumors of the ribs
Ribs, like other bones, can be a site for the development of neoplastic processes. Tumors can arise in both the bone and cartilaginous parts of the ribs. Some of them are benign and others are malignant. Examples of benign rib tumors are osteomas and chondomas.
Of the malignant neoplasms, the ribs may include osteosarcoma, chondrosarcoma and Ewing's sarcoma. It is also worth knowing that the ribs may contain neoplastic metastases from other organs (e.g. in the course of breast cancer and prostate cancer).
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