Costal cartilage, also known as rib cartilage, are bars of hyaline cartilage that serve to prolong the forward and contribute to the elasticity of the walls of the thorax. Costal cartilage is only found at the anterior ends of the ribs, providing medial extension.
Like the ribs, the costal cartilages vary in their length, Length, and direction. They increase in length from the first to the seventh, then gradually decrease to the twelfth.
Their breadth, as well as that of the intervals between them, diminishes from the first to the last. They are broad at their attachments to the ribs, and taper toward their sternal extremities, excepting the first two, which are of the same breadth throughout, and the sixth, seventh, and eighth, which are enlarged where their margins are in contact.
They also vary in direction: the first descends a little to the sternum, the second is horizontal, the third ascends slightly, while the others are angular, following the course of the ribs for a short distance, and then ascending to the sternum or preceding cartilage.
The posterior surface is concave, and directed backward and downward; that of the first gives attachment to the sternothyroideus, those of the third to the sixth inclusive to the transversus thoracis muscle, and the six or seven inferior ones to the transversus abdominis muscle and the diaphragm.
The inferior borders of the sixth, seventh, eighth, and ninth cartilages present heel-like projections at the points of greatest convexity. These projections carry smooth oblong facets which articulate with facets on slight projections from the upper borders of the seventh, eighth, ninth, and tenth cartilages, respectively.
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.
The medial ends of the eighth, ninth, and tenth costal cartilages are pointed, and are connected each with the cartilage immediately above.
Those of the eleventh and twelfth are pointed and free.
In costochondritis and Tietze syndrome, inflammation of the costal cartilage occurs. This is a common cause of chest pain.
Major trauma may lead to fracture of the costal cartilage. Such injuries often go unnoticed during X-ray, but can be diagnosed with CT scan. Surgery is typically used to fix the costal cartilage back onto either the rib or sternum.
Costal cartilage may be harvested for reparative use elsewhere in the body. Whilst this is typically conducted using a general anaesthetic, IV sedation can also be used. The procedure presents a minor risk of pleural tear.
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