The Tenth Rib

Marion Clark describes the tenth rib as a peculiar rib due to the fact that it only has one articulating facet with the body of the tenth thoracic vertebrae. The tenth rib is also a false rib as it articulates with the common costal cartilage and not the sternum. The tenth rib is quite mobile.

The nerves associated with the tenth rib are: the anterior and posterior divisions of the tenth thoracic nerve, the tenth intercostal nerve, the sympathetic chain ganglia, the tenth thoracic sympathetic ganglion, the recurrent meningeal nerve, and the lesser splanchic nerve.

The circulatory structures associated with the tenth rib are: the intercostal artery and vein, the mediastinal artery and vein, the azygos and hemiazygos vein, the bronchomediastinal lymphatic duct, and the thoracic lymphatic duct. As with the eighth and ninth ribs I will suggest that the connection of the tenth rib with the diaphragm also has the ability to effect the descending aorta, the inferior vena cava, the phrenic arteries and veins, as well as the superior mesenteric artery (this one is more a nervous connection).

The muscles that attach to the tenth rib are: serratus posterior inferior, diaphragm, transverse abdominis, internal oblique, external oblique, iliocostalis thoracis, iliocostalis lumborum, internal intercostal, and external intercostal.

The commonly associated conditions with a lesion of the tenth rib are: Bright’s disease (now classified as acute or chronic nephritis), intestinal indigestion, any ovarian condition, and abdominal pain near the umbilicus.

Again, due to the muscular attachments and possible movements it may be more advantageous to deal with a long diagonal torsion before treating the rib directly. It also seems to make sense to deal with any malposition of the tenth thoracic vertebrae as the tenth rib is attached to it (back to the principles of treating from the centre out).

As a side note, the picture to the left shows the common flow of nerve, artery, and vein in relation to the ribs so it should be more clear how a rib lesion can impact these structures. Also, the picture shows the large amount of nerve tissue associated with the abdominal viscera (especially the intestines). This lends fairly well to my general belief that the human body is built with two primary concerns: 1. Don’t starve (look at all of the nerve tissue dedicated to ensuring the function of the intestines) and 2. Don’t fall over (I will talk about that at other times).


3 thoughts on “The Tenth Rib

  1. Don’t forget to take out your sidebending lesions to free those lower ribs up and encourage diaphragm function, better respiration, balanced thoracic and abdominal pressure gradients for fluid flow!

    • Now we are talking! That is why the principles state that a person is an fully integrated unit of mind body and spirit as well as the reasoning behind treating the whole body! Osteopathic problem solving at it’s best!

  2. Pingback: The Tenth Thoracic Vertebra | Classical Osteopathy in Ontario

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