Xiphoid process

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Xiphoid process
Xiphoid process frontal.png
Position of the xiphoid process (shown in red).
Posterior surface of sternum. (Xiphoid process labeled at bottom.)
Latin processus xiphoideus
Gray's p.121
MeSH A02.835.232.904.766.825
TA A02.3.03.007
FMA 7488
Anatomical terms of bone

The xiphoid process /ˈzfɔɪd/, or xiphisternum or metasternum, is a small cartilaginous process (extension) of the lower part of the sternum which is usually ossified in the adult human. It may also be referred to as the ensiform process. Both the Greek derived xiphoid and its Latin equivalent ensiform mean 'sword like'.


The xiphoid process is considered to be at the level of the 9th thoracic vertebra and the T6 dermatome.


In newborns and young (especially slender) infants, the tip of the xiphoid process may be both seen and felt as a lump just below the sternal notch. By age 15 to 29, the xiphoid usually fuses to the body of the sternum with a fibrous joint. Unlike the synovial articulation of major joints, this is non-movable. Ossification of the xiphoid process occurs around age 40.[1]


The xiphoid process can be naturally bifurcated, and sometimes perforated. These variances in morphology are inheritable, which can help group family members together when dealing with burial remains. These morphological differences pose no health risk, and are simply a difference in form.

In animals[edit]

In birds, the xiphoid process is a long structure, often following the direction of the carina.


Much the way the first seven ribs articulate with the sternum, the cartilage in the celiac plexus joins on the xiphoid process, reinforcing it, and indirectly attaches the costal cartilage to the sternum.

Clinical significances[edit]

Pressure on the xiphoid process should be avoided when administering chest compressions in CPR, as this can cause the xiphoid process to break off, resulting in punctures or lacerations of the diaphragm. Additionally, the liver may be punctured, resulting in lethal hemorrhaging.

Xiphoidalgia (Xiphodynia) is a syndrome distinguishable by pain and tenderness to the sternum. While some sources describe this disorder as rare, others suggest it is relatively common but overlooked by physicians.[2] Symptoms can include abdominal pain, chest pain, nausea and radiating pain to the back, neck, and shoulders. Lifting heavy objects or trauma to the chest may be the cause of this musculoskeletal disorder and pain may be heightened by bending or twisting. Anesthetic and steroid injections are commonly employed to treat this medical condition.[3]

After age 40, a person may become aware of their partially ossified xiphoid process and mistake it for an abnormality.[1]

Pericardiocentesis, the procedure whereby fluid is aspirated from the pericardium, often uses the xiphoid process as an anatomical landmark by which this procedure is carried out.[4]


The word derives from the Greek word xiphos for straight sword, the tip of which the process somewhat resembles.

In 1712 was the first known case of a xiphoid disorder.[2]


English xiphoid process is a translation of Latin processus xiphoides.[5][6] Besides this Latin coinage, other Latin expressions as os xyphoides [7] and cartilago xiphoides [5]/ xiphodes [8] can be found. These Latin expressions are ultimately derived from two Greek expressions that are attested in the writings of the Greek physician Galen.[9] Os xyphoides[7] can be considered as a translation of ξιφοειδές ὀστοῦν.[9] Classical Latin os and Ancient Greek ὀστοῦν both mean bone,[9][10] while ξιφοειδές means sword-shaped.[9] The latter adjective is derived from ξίφος, sword [9] and from εἶδος, form/shape.[9] Ξύφος is a variant of ξίφος,[8][9] thereby justifying the existence of the alternate xyphoides with a y instead of an i. Comparably, in anatomic English xyphoid [11] is also attested.

Besides these mixed expressions consisting of a Latin noun with Latinized Greek adjectives, fully Latin alternates like os ensiforme,[7] with ensiformis derived from classical Latin ensis ("sword"[10]) and os gladioli, with gladioli ("of a small sword"[10]) can be found.

Latin cartilago xiphoides/xiphodes is ultimately derived from Ancient Greek ξιφοειδής χόνδρος.[9] Latin cartilago as Ancient Greek χόνδρος means cartilage.[9][10] Anatomic Latin xiphodes is derived from Ancient Greek ξιφώδης.[8] In this case, full Latin expressions like cartilago ensiformis,[7][8] cartilago gladialis, with gladialis derived from gladius ("sword"[10]), cartilago mucronatus, with mucronatus ("pointed"[10]) derived from mucro ("sword’s point"[10]) and cartilago cultralis, with cultralis derived from culter ("knife"[10]) can also be found. The first three adjectives are also used in processus ensiformis,[7][12][13] processus gladialis [7] and processus mucronatus.[7] In anatomic English ensiform cartilage [11][14] and ensiform process [11][14] can be considered as translations of the aforementioned cartilago ensiformis and processus ensiformis, with sword-like cartilage[7] as full translation.

Forms like processus xiphoideus [15][16] and cartilago xiphoidea [17] both exhibit the alternate ending –eus/-ea/-eum instead of –es. Those variants with the adjective xiphoideus/xiphoidea would be faulty renderings[18][19] of Ancient Greek ξιφοειδής in Latin. Greek compounds ending on -ειδής, when imported into Latin as loanword, ended on -ides.[19][20] In the 17th-century the non-classical Latin form on -ideus/-idea/ideum for Greek -ειδής/-ειδές became into use, mostly by French anatomist Jean Riolan the Younger.[21] No Greek loanwords (originally on -ειδής/-ειδές) ending on -ideus/-idea/-ideum exist in classical Latin,[10][20] thereby making the form on -ideus/-idea/-ideum non-Latinate in character.[20]

Additional images[edit]


  1. ^ a b Moore, Keith L. Moore Clinically Oriented Anatomy (7 ed.). LWW. p. 84. ISBN 9781451119459. 
  2. ^ a b Xiphodynia: A diagnostic conundrum
  3. ^ major causes of musculoskeletal chest pain[dead link]
  4. ^ Sam, Amir H.; James T.H. Teo (September 2010). Rapid Medicine. Wiley-Blackwell. ISBN 1-4051-8323-3. 
  5. ^ a b Siebenhaar, F.J. (1850). Terminologisches Wörterbuch der medicinischen Wissenschaften. (Zweite Auflage). Leipzig: Arnoldische Buchhandlung.
  6. ^ Triepel, H. (1910). Die anatomischen Namen. Ihre Ableitung und Aussprache. Mit einem Anhang: Biographische Notizen.(Dritte Auflage). Wiesbaden: Verlag J.F. Bergmann.
  7. ^ a b c d e f g h Schreger, C.H.Th.(1805). Synonymia anatomica. Synonymik der anatomischen Nomenclatur. Fürth: im Bureau für Literatur.
  8. ^ a b c d Kraus, L.A. (1844). Kritisch-etymologisches medicinisches Lexikon (Dritte Auflage). Göttingen: Verlag der Deuerlich- und Dieterichschen Buchhandlung.
  9. ^ a b c d e f g h i Liddell, H.G. & Scott, R. (1940). A Greek-English Lexicon. revised and augmented throughout by Sir Henry Stuart Jones. with the assistance of. Roderick McKenzie. Oxford: Clarendon Press.
  10. ^ a b c d e f g h i Lewis, C.T. & Short, C. (1879). A Latin dictionary founded on Andrews' edition of Freund's Latin dictionary. Oxford: Clarendon Press.
  11. ^ a b c Anderson, D.M. (2000). Dorland’s illustrated medical dictionary (29th edition). Philadelphia/London/Toronto/Montreal/Sydney/Tokyo: W.B. Saunders Company.
  12. ^ Kopsch, F. (1941). Die Nomina anatomica des Jahres 1895 (B.N.A.) nach der Buchstabenreihe geordnet und gegenübergestellt den Nomina anatomica des Jahres 1935 (I.N.A.) (3. Auflage). Leipzig: Georg Thieme Verlag.
  13. ^ Donáth, T. & Crawford, G.C.N. (1969). Anatomical dictionary with nomenclature and explanatory notes. Oxford/London/Edinburgh/New York/Toronto/Syney/Paris/Braunschweig: Pergamon Press.
  14. ^ a b Dorland, W.A.N. & Miller, E.C.L. (1948). The American illustrated medical dictionary. (21st edition). Philadelphia/London: W.B. Saunders Company.
  15. ^ His, W. (1895). Die anatomische Nomenclatur. Nomina Anatomica. Der von der Anatomischen Gesellschaft auf ihrer IX. Versammlung in Basel angenommenen Namen. Leipzig: Verlag Veit & Comp.
  16. ^ Federative Committee on Anatomical Terminology (FCAT) (1998). Terminologia Anatomica. Stuttgart: Thieme
  17. ^ Foster, F.D. (1891-1893). An illustrated medical dictionary. Being a dictionary of the technical terms used by writers on medicine and the collateral sciences, in the Latin, English, French, and German languages. New York: D. Appleton and Company.
  18. ^ Triepel, H. (1908). Memorial on the anatomical nomenclature of the anatomical society. In A. Rose (Ed.), Medical Greek. Collection of papers on medical onomatology and a grammatical guide to learn modern Greek (pp. 176-193). New York: Peri Hellados publication office.
  19. ^ a b Triepel, H. (1927). Die anatomischen Namen. Ihre Ableitung und Aussprache. Anhang: Biographische Notizen.(Elfte Auflage). München: Verlag J.F. Bergmann.
  20. ^ a b c Kossmann, R. (1903). Allgemeine Gynaecologie. Berlin: Verlag von August Hirschwald.
  21. ^ Hyrtl, J. (1880). Onomatologia Anatomica. Geschichte und Kritik der anatomischen Sprache der Gegenwart. Wien: Wilhelm Braumüller. K.K. Hof- und Unversitätsbuchhändler.

External links[edit]

This article uses anatomical terminology; for an overview, see anatomical terminology.