Xiphoid Process

Have you ever felt the small extension located at the end of your sternum? It is the Xiphoid Process. Read this article to know about the development, functions and certain disorders of this extension.

Xiphoid Process Definition

It is a pointed cartilaginous extension attached to the breastbone or sternum. It is the lowest and smallest part of the sternum. The Xiphoid Process, also known as the xiphisternum or metasternum, is initially a cartilage which becomes ossified (hard and bony) in adults.

The name “Xiphoid” is derived from the Greek words “xiphos” meaning “straight sword” and “eidos” meaning “like”. The sword-like appearance of the extension earned it the name.

Xiphoid Process Anatomy

The small Xiphoid extends from the place where the lowest ribs are attached to the breastbone or sternum. The extension is marked by a small hole. It also has a sharp tip resembling that of a sword.

The part of the sternum located just above the Xiphoid Process is known as the manubrium. The Xiphisternal joint is the immobile point between the two sternum portions.

Xiphoid Process Bifurcation

This process is sometimes naturally bifurcated and can also be perforated sometimes. These morphological variations are not harmful for the health. They only make the Xiphoid Process look different.

Xiphoid Process Development

This cartilaginous extension can be seen and felt in infants. At this stage, the Xiphoid Process is a lump located below the sternal notch. It becomes ossified and gets fused to the sternum as the individual grows up. The cartilage becomes hard and bony anytime between an individual’s 15 and 29 years of age. This pattern of a cartilage becoming ossified with age is quite common in human body. Many other human bones such as the growth plates of the limb bones are also initially cartilages that are later replaced by bones.

Xiphoid Process Function

It works as the attachment for many important muscles like the abdominal diaphragm, which is a sheet-like muscle necessary for breathing. The rectus abdominus and the transversus thoracis muscles are also attached to the Xiphoid.

Xiphoid Process and CPR

Care should be taken not to put any pressure on the Xiphoid Process during cardiopulmonary resuscitation (CPR). It is an unsupported structure and can break off under pressure. A broken Xiphoid can damage various internal organs and cause serious pain and inflammation in the chest. There are many CPR hand positions that are unsafe for women as the hand extends past the sternum base in these positions. These hand positions increase the risk of breaking the Xiphoid Process.

The structure is often used as a landmark in CPR because it is easy to locate this extension and it can help to remember the location of the heart-apex.

Xiphoid Process Pain

Sometimes, this structure can also bend to form a lump that sticks out from an area around the chest. This lump generally does not cause any problem for the individual in the initial stage. However, it can be very uncomfortable when the individual tries to lift weight or eats a heavy meal. This condition should be treated at the early stage otherwise it can cause serious problems. One can experience severe pain and inflammation in the swollen Xiphoid Process.

Sometimes, this extension may break off completely due to some accident or trauma. It can cause various health problems such as chest pain, breathing difficulties and nausea. However, a protruding or broken Xiphoid Process does not generally cause death of the victim.

Causes of Lump in Xiphoid Process

There are numerous reasons that can make the Xiphoid Process protrude outwards. People who lose weight can feel the extension sticking outwards. The excess weight might put enough pressure on the Xiphoid Process to bend it. Sometimes it may feel like the extension has enlarged but generally, it causes pain just by protruding outwards. A serious chest trauma or an accident can also damage this small bone.

Xiphoid Process Cancer

A protruding Xiphoid Process is often mistaken for a tumor, hernia or even cancer. However, the lump near the end of the sternum is generally harmless although care should be taken so that the extension does not break off completely.

Xiphoid Process Pain Treatment

One should immediately consult a doctor if experiencing pain in the lower parts of the sternum. Usually, various tests and examinations like the x ray are done on the patient to understand the situation properly. The treatment is done based on the x ray report. Doctors generally recommend hot or cold treatment for this condition. There are also various medicines that help to lessen the pain. Patients are also advised to use elastic rib belts to avoid further dislocation of the Process.

Xiphoid Process Syndrome

Activities like bending, lifting heavy objects and eating heavy meals can trigger acute pain in the structure. Certain medical conditions and diseases as well as various drugs can also cause this pain. This condition is often known as the Xiphoidalgia or Xiphoid Syndrome. It is characterized by the following symptoms:

  • Tenderness in the chest
  • Feeling of discomfort in the chest
  • Tenderness in the shoulders
  • Tenderness in the back
  • Pain and discomfort in the back
  • Epigastric discomfort
  • Epigastric tenderness
  • Severe pain in the chest
  • Shoulder pain
  • Nausea

This medical condition is generally treated by using anesthetics and steroid injections.

Xiphoid Process Removal

According to some people, the Xiphoid Process does not have any serious functions. However, it works as an anchor for several important muscles. It can cause serious pain and health problems in case it breaks off the sternum.

It is possible to remove the Xiphoid Process by surgery. The removal process is known as Xiphoidectomy. This surgical procedure is really complex and should be performed only by experts. There are also other simpler surgeries for removing the extension. One should consult a Cardio-thoracic surgeon to decide upon the most suitable surgery for an individual. Xiphoidectomy should only be considered after all other treatments for relieving the Xiphoid pain have failed.

Xiphoid Process Pictures

Here are some images of this cartilaginous extension of the sternum. Note the sword-tip like appearance of the process.

Picture 1 – Xiphoid Process

Picture 2 – Xiphoid Process Image



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