Student of DPT at University of Sialkot, Sialkot.

1. PRESENTED BY:
MAHEEN DILAWAR
ROLL NO: 041
4TH SEMESTER
COSTAL
CARTILAGE AND
RIBS

2. WHAT IS COSTAL
CARTILAGE?
 The costal cartilage are segments of cartilage that
connect the sternum to the ribs and help to extend the
ribs into a forward motion.
 This cartilage also contributes to elasticity within the
walls of thorax, allowing the chest to expand during
respiration.

3. STRUCTURE OF COSTAL
CARTILAGE
Each costal cartilage presents two surfaces, two borders,
and two extremities. They are as follows:
1) Surfaces:
a)The anterior surface is convex, and looks forward
and upward
b)The posterior surface is concave, and directed
backward and downward

4. CONTINUED….
2) Borders:
a) The superior border is concave
b) The inferior border is convex
3) Extremities:
a)The lateral end of each cartilage is continuous with
the osseous tissue of the rib to which it belongs
b)The medial end of the first is continuous with the
sternum. The medial ends of the six succeeding ones
are rounded and are received into shallow
concavities on the lateral margins of the sternum.

5. INTERCOSTAL MUSCLES
 Inter costal muscles are several muscles that runs
between the ribs and move the chest wall.
 The inter costal muscles are mainly involved in
breathing.
 These muscles help expand and shrink the size of the
chest cavity to facilitate breathing.

6. FUNCTIONS OF COSTAL
CARTILAGE
1) Costal Cartilage forms a semi-movable joint
between the true ribs and the sternum. The joint
formed by the costal cartilage permits flexibility in
the rib cage while keeping the ribs firmly connected
to the sternum.
2) The flexibility of the costal cartilage allows the
ribcage to expand along with the lungs during deep
inhalation.

7. CONTINUED….
3) Costal cartilage also allows the thoracic region to
bend laterally, anteriorly, and posteriorly.
4) The costal cartilage may act as a shock absorber to
prevent blows to the anterior portion of the chest
from resulting in rib fractures.

8. INJURIES AND DISORDERS
OF COSTAL CARTILAGE
1) Costochondritis: Costochondritis, also known
as chest wall pain, costosternal syndrome,
or costosternal chondrodynia is an acute and often
temporary inflammation of the costal cartilage, the
structure that connects each rib to the sternum at
the costosternal joint.
2) Rib Separation: After a direct impact, the costal
cartilage can become separated from the end of the
rib that it is normally attached to. This painful
condition is known as a rib separation.

9. WHAT ARE RIBS?
 Ribs are the long curved bones which form the rib
cage part of axial skeleton.
 Ribs are set of twelve bones which form the
protective cage of the thorax.
 Humans have 24 ribs, in 12 pairs. All of which are
attached at the back to the thoracic vertebrae and are
numbered from 1-12 according to the vertebrae they
attach to.
 They articulate with the vertebral column posteriorly
and terminates anteriorly as cartilage known as costal
cartilage.

10. STRUCTURE OF RIBS
The structure of a rib include the head, neck, body (or
shaft), angle, and tubercle.
1) Head Of The Rib: The head of the rib lies next
to a vertebra. The ribs connect to the vertebrae with
two costovertebral joints, one on the head and one
on the neck. The head of the rib has a superior and
an inferior articulating region, separated by a crest.
These articulate with the superior and inferior costal
facets on the connecting vertebrae.

11. CONTINUED….
2) Neck Of The Rib: The neck of the rib is a
flattened part that extends laterally from the head.
The neck is about 3 cm long. Its anterior surface is
flat and smooth, whilst its posterior is perforated by
numerous foramina and its surface rough, to give
attachment to the ligament of the neck. Its upper
border presents a rough crest (crista colli costae) for
the attachment of the anterior costotransverse
ligament; its lower border is rounded.

12. CONTINUED….
3) Body Or Shaft Of The Ribs: The body, or
shaft of the rib is flat and curved. The internal
surface of the shaft has a groove for the
neurovascular supply of the thorax, protecting the
vessels and nerves from damage.
4) Angle Of Ribs: The angle of the ribs forms the
most posterior portion of the thoracic cage. The
costal groove in the inferior margin of
each rib carries blood vessels and a nerve.
Anteriorly, each rib ends in a costal cartilage.
True ribs (1–7) attach directly to the sternum via
their costal cartilage.

13. CONTINUED….
5) Tubercle Of Rib: A tubercle of rib on the
posterior surface of the neck of the rib, has two
facets one articulating and one non-articulating. The
articular facet, is small and oval and is the lower
and more medial of the two, and connects to the
transverse costal facet on the thoracic vertebra of the
same rib number. The transverse costal facet is on
the end of the transverse process of the lower of the
two vertebrae to which the head is connected. The
non-articular portion is a rough elevation and
affords attachment to the ligament of the tubercle.
The tubercle is much more prominent in the upper
ribs than in the lower ribs.

15. ATTACHMENT OF RIBS
 The first ribs is attached to thoracic vertebra 1(T1).
At the front of the body most of the ribs are joined by
costal cartilages to the sternum.
 The last two 11 and 12 ribs are known as floating
ribs. They attached to the vertebrae only, and not to
the sternum or cartilage coming of the sternum.
 The rib cage is separated from the lower abdomen by
the thoracic diaphragm which control breathing.

16. TYPES OF RIBS
There are three types of ribs. They are as follows:
1) Seven ribs which connect directly to the sternum (1-
7)
2)Three ribs which connect to the costal cartilages of the
rib above (8-10)
3)Two "floating" ribs which connect only at the back
(11&12)

17. TRUE RIBS (1-7)
 The first seven ribs are connected behind with
the vertebral column, and in front, through the
intervention of the costal cartilages, with the
sternum they are called true ribs or vertebro-
sternal ribs.

18. FALSE RIBS (8-12)
 A rib is said to be false if it does not attach to the
sternum (the breastbone). The upper three false
ribs connect to the costal cartilages of the ribs just
above them. The last two false ribs usually have no
ventral attachment to anchor them in front and so are
called floating, fluctuating, or vertebral ribs.

19. FLOATING RIBS
 The last two pairs of ribs are floating ribs because
they are not attached to the sternum. The floating ribs
are less stable and risk breaking because they have
only one attachment dorsally to the vertebrae and
have very thin bone tissue locked in muscle as they
extend laterally.

21. TYPICAL RIBS
The typical ribs consist of neck, head and body.
a) Head: The head is wedge shaped, and has two
articular facets separated by a wedge of bone. One
facet articulates with the numerically corresponding
vertebrae, and the other articulates with the
vertebrae above.
b) Neck: The neck contains no bony prominences, but
simply connects the head with the body. Where the
neck meets the body there is a roughed tubercle,
with a facet for articulation with the transverse
process of the corresponding vertebrae.

22. CONTINUED….
c) Body Or Shaft: The body, or shaft of the rib is
flat and curved. The internal surface of the shaft has
a groove for the neurovascular supply of the thorax,
protecting the vessels and nerves from damage.

23. ATYPICAL RIBS
Ribs 1, 2, 10 11 and 12 can be described as atypical.
They have features that are not common to all the ribs.
a) Rib 1: It is shorter and wider than the other ribs. It
only has one facet on its head for articulation with
its corresponding vertebrae (there isn’t a thoracic
vertebrae above it). The superior surface is marked
by two grooves, which make way for the subclavian
vessels.

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b) Rib 2: It is thinner and longer than rib 1, and has
two articular facets on the head as normal. It has a
roughened area on its upper surface, where
the serratus anterior muscle attaches.
c) Rib 10: It only has one facet for articulation with
its numerically corresponding vertebrae.
d) Ribs 11 and 12: They have no neck, and only
contain one facet, which is for articulation with their
corresponding vertebrae.

25. FUNCTIONS OF RIBS
1) They serve to protect lungs, heart, and other internal
organs of the thorax.
2) The ribs provide support.
3) The ribs encloses and protects the heart and lungs. It
forms a protective cage around the heart and the
lungs, protecting them from physical damage from
outside.
4) It provides a strong frame work muscles of the
shoulder girdle, chest, upper abdomen, and back can
attach.

26. FUNCTIONS OF RIBS IN
RESPIRATORY
SYSTEM
1) The ribs help in the expansion and contraction of the
thoracic cavity (though that is primarily the function
of the diaphragm).
2) When the diaphragm expands or contracts, the
thoracic (chest) cavity expands or contracts,
alternately pulling in air (inhalation) or expelling it
(exhalation).

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3) The ribs, which are flexible, along with the
intercostal muscles, help in this process. Since
expansion of the lungs is greater in the lower lobes,
the floating ribs enable that process.

28. CAUSES OF RIB PAIN
The causes of rib pain are as follows:
1) Broken ribs
2) Injuries to the chest
3) Rib fractures
4) Diseases that affect the bones, such as osteoporosis
5) Inflammation of the lining of the lungs
6) Muscle spasms.
7) Swollen rib cartilage

29. INJURIES, FRACTURES AND
DISORDERS OF RIBS
1) TIETZE SYNDROME: Tietze syndrome is a
rare, inflammatory disorder characterized by chest
pain and swelling of the cartilage of one or more of
the upper ribs (costochondral junction), specifically
where the ribs attach to the breastbone (sternum).
Onset of pain may be gradual or sudden and may
spread to affect the arms and/or shoulders.

30. CONTINUED….
2) Broken Ribs: A broken rib is a common injury
that occurs when one of the bones in your rib cage
breaks or cracks. The most common cause is chest
trauma, such as from a fall, motor vehicle accident
or impact during contact sports. Broken ribs are
most commonly caused by direct impacts such as
those from motor vehicle accidents, falls, child
abuse or contact sports.

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3) Flail Chest: Flail chest is a life-threatening
medical condition that occurs when a segment of
the rib cage breaks due to trauma and becomes
detached from the rest of the chest wall. Two of
the symptoms of flail chest are chest
pain and shortness of breath. It occurs when multiple
adjacent ribs are broken in multiple places,
separating a segment, so a part of the chest wall
moves independently.

32. SYMPTOMS
 Pain in rib area and very sore to touch.
 Normal activity causes rib area to feel uncomfortable
and sore.
 Swelling and bruising over fractured site.
 Rib pain with heavy breathing or coughing.