Atlas of Human Anatomy in Cross Section: Appendix: Topography of the Thorax and Abdomen
Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew,
M.D., and Paul C. Reimann, B.S.
Peer Review Status: Externally Peer Reviewed
Eycleshymer and Schoemaker reported variations in the vertebral level of the suprasternal notch ranging from the upper third of the second thoracic vertebra to a level between the third thoracic disk and the upper third of the fourth thoracic vertebra. The average position is at the level of the upper third of the third thoracic vertebra. Poiner and Charpy and Cunningham place the notch at the level of the lower part of the second thoracic vertebra. Treves and Morris place it at the level of the second thoracic disk and Sobotta and Piersol at the level of the second disk at the end of expiration. Mehnert states that the upper border of the sternum is usually at the level of the second thoracic vertebra or the disk below, but it may lie at the level of the upper portion of the third thoracic vertebra. Finally, Langer and Toldt state that the upper border of the sternum is opposite the spinous process of the second thoracic vertebra.
Manubriosternal Junction (Sternal Angle)
The levels of the manubriosternal junction range from the third thoracic disk to the lower third of the sixth thoracic vertebra, according to Eycleshymer and Schoemaker. The average position is at the level of the middle third of the fifth thoracic vertebra. Morris places the sternal angle at the level of the fourth thoracic vertebra, Piersol places it opposite the fifth, and Cunningham puts it at the spinous process of the third thoracic vertebra.
Eycleshymer and Schoemaker reported the range of variation in the level of the xiphosternal Junction to be from the seventh thoracic disk to the middle of the eleventh thoracic vertebra. The average position is between the ninth thoracic disk and the upper third of the tenth thoracic vertebra. Treves places the xiphosternal junction opposite the middle of the ninth thoracic vertebra. Morris and Plersol place it at the I part of the ninth, and Cunningham indicates that It is opposite the ninth disk and the sp process of the eighth.
Apex of the Xiphoid Process
Eycleshymer and Schoemaker reported the range of variation in the position of the apex of the xiphoid process to be from the ninth thoracic disk to the upper third of the first lumbar vertebra, with the average being at the level of the eleventh thoracic disk.
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