172 



APPLIED ANATOMY. 



sternum. If the sternum projects markedly it constitutes what is known as pigeon 

 breast, the chest in such a condition being longer from before backward than from side 

 to side. In this disease also there may be a depression on each side of the sternum, 



Clavicular articulation 

 Manubrium 



Angulus sterni or 

 angle of Ludwig 



Body or gladiolus 



*^:. 



Xiphosternal articulation 



Xiphoid or ensiform 

 cartilage 



FIG. 192. The bony thorax. 



the back is rounded owing to the bending of the vertebral column, and the points of 

 junction of the ribs and cartilages are enlarged, this latter constituting what is known 



as beading of the ribs. These beads are 

 felt as rounded enlargements at the sternal 

 extremities of the ribs and form a line 

 parallel to the sternum above and sloping 

 outward below. This line of beads has 

 been called the ' ' rachitic rosary. ' ' From 

 the level of the ensiform cartilage a groove 

 passes out toward the sides ; this has 

 been called " Harrison' s groove" (see 

 Fig. 193). Sometimes the lower end of 

 the sternum is pressed inward, forming a 

 deep funnel-shaped depression constituting 

 the deformity known as "funnel chest " 

 or the "Trichtefbrust" of the Germans. 

 This condition of the chest, with the 

 exception of the beading, is also produced 

 in children by obstruction to the breathing 

 from enlargement of the tonsils, from the 

 presence of adenoid growths in the pharynx, 

 and from hypertrophy of the turbinate 

 bones, all of which interfere particularly 

 with nasal respiration. 



Diseases of the lungs and pleurae alter 

 the shape of the chest. In emphysema and 

 when distended by plural effusions, the 

 thorax becomes more rounded in shape, 

 forming what is called the ' ' barrel-shaped 



chest. ' ' In phthisis the wasting of the tissues and contraction of the lungs causes the 

 chest to collapse. The ribs slope more sharply downward and the chest becomes 



FIG. 193. Child showing Harrison's groove opposite 

 the ensiform cartilage. 



