A.

Levins
Anatomy P.1
Beauman
27 March, 2018
The Anatomy of a Broken/Fractured 5th Rib
The fracturing of a 5th ribs is most common out of all of the ribs (out of the 2 sets of 12)
in fracturing due to the fact that they are the most exposed ribs (The Fifth). Fracturing in the ribs
are caused most often by a direct impact such as a hard punch to the ribs (often seen in child
abuse), a car crash (when a hard and fast impact causes shock), and falls (when the ribs hit a hard
surface). They can also be caused by repetitive trauma from situations like sports (a common one
is seen in golf when one pushes in and twists their core) (Broken Ribs). When trauma does
occur, the ribs usually crack, but sometimes they can break into separate pieces, but when that
does happen it is far more dangerous than just a crack. A crack in the rib is only a break into the
bone, but pieces have not broken off. When trauma is hard, fast, and sudden, the broken rib can
act like a shatter, where jagged bone pieces can break off. Those jagged pieces of bone can
lacerate internal organs, puncture a lung,and tear the blood vessels and the aorta (Shaw).
Muscles that attach to the fifth rib are the ​serratus anterior, serratus posterior superior,
pectoralis minor, iliocostalis cervicis, iliocostalis thoracis, internal intercostal, and external
intercostal. Also, just like every rib starting at the second one, the fifth rib has an internal
attachment to the pleura (The Fifth). All of these can be torn if the fifth rib has debris from
trauma, and some can even be torn from harsh movement and a crack in the bone. The pleura is
especially susceptible to trauma from that of the rib. A lesion in the fifth rib would be essentially
the same as one in the fourth rib, except that the fifth rib would cause a different type of damage
to surrounding structures due to its position (each rib is near certain organs and structures,
making a break in each one unique to a certain extent). A lesion in the right fifth rib could
possibly cause “bronchial, pleural, and lung disorders” because it covers and is near the right
lung. (The Fifth). However, a lesion in the left fifth rib would produce nervous, mechanical, and
circulatory problems because it covers the left lung, is near the heart, and is near the liver
(Human). Most commonly seen in broken ribs is damage done when pulmonary contusions
accompany the injury. ​Also, complications that can make a person more at risk for a broken rib
include; osteoporosis (a disease in which one’s bone density is low, causing them to be more
susceptible to breaks and fractures), contact sports in which a person receives trauma
continuously or harshly, advanced age, and cancerous lesions that weaken bones (Broken Ribs).
Broken ribs cannot be ‘fixed,’ but rather aided in the natural healing process; small
hairline fractures can heal of their own, but breaks sometimes have to be aided with the insertion
of metal plates to hold the pieces together. Also with more major breaks, patients may be put on
oxygen support if a ​pneumothorax is involved (Serfin). When a rib does break, its natural healing
process begins within the first few hours after the injury occurs, as a blood clot forms around the
break. Phagocytes then clean the bone and destroy any bacteria or foreign materials that may
have gotten on the inside of the bone. Then, chondroblasts form a collagen callus around the
fracture, allowing a hard callus to form from osteoblast cells (this stage usually occurs around 2
weeks after the initial break, and ends around the 6th-12th week according to the extent of the
break). The last stage is when osteoclasts break down any extra bone that may be sticking out
from the hard callus until the rib is returned to its original shape. Though it may feel healed to
the patient, the healing and remodeling of a broken rib can take up to 3-9 years (Dr. Biology). To
help prevent broken ribs, one can wear protective equipment while playing contact sports,
remove items from walking spaces to prevent from tripping, and ingesting about 600 milligrams
of vitamin D and 1,200 milligrams of calcium from supplements (Broken Ribs). Calcium is
needed to build bones and give them strength, clot blood and send nerve impulses, and prevent
osteoporosis, and vitamin D aids (Cornell Health).
Kevin Durant, a Golden State Warrior basketball player, participated in a game on March
11th this year in Minnesota in which he recalled getting hit in the ribs by another player. On the
14th, during another game, he complained of pain where he was hit, and an MRI on the 16th
showed that he had been suffering an incomplete fracture in one of his ribs. Durant said that he
“felt something stretch and pull.” Durant claimed that all he needed was recovery, no procedure,
so he is still currently out of any NBA games. Because Durant’s fracture was only a small
fracture, he will not need a metal plate (Press). Mark Cavendish, a British sprint biker, also
suffered a rib injury in 2011 during the Tirreno-Adriatico when he crashed his bike. He was
going 55 mph when he hit the pavement, and he suffered multiple soft tissue abrasions on his
hands, legs, arms, face, hips, and elsewhere. When Cavendish went in for an x-ray, doctors
found that he had fractured his right seventh rib, and that it was stable with no lose pieces.
Cavendish said that he had to stay off of the bike for quite a few weeks, as he was suffering
extreme abdominal pain, but he did mention that he would not need any kind of procedure
(AFP).
Glossary
● Serratus anterior: muscle that starts on the surface of the 1st-8th ribs, and inserts at the
anterior scapula.
● Serratus posterior superior: thin muscles that sit at the upper and back part of the thorax
and the lower spine which covers the lower ribs.
● Pectoralis minor: thin, triangular muscle that sits in the upper chest along the 3rd-5th ribs.
● Iliocostalis cervicis: muscle that is the deep, fleshy portion of the serratus anterior.
● Iliocostalis thoracis: a spinal muscle that inserts at the 4th-6th ribs.
● Internal intercostal: a group of skeletal muscles that are located between ribs and connect
to the anterior side of the sternum. There are 11 on each side of the ribcage, and they aid
in respiration.
● External intercostal: muscles that are located in the lower border of the ribs with an
insertion above and below. They aid in respiration, and there are 11 on each side of the
rib cage.
● Pleura: a pair of serous membranes that line the thorax and envelope the lungs.
● Bronchial disorder: when the bronchi, tubes of the lungs, are disrupted by respiratory
issues, whether it be inflammation from mucus, or lung damage.
● Pleural disorder: when fluid builds up between the lungs and the membrane that
surrounds the lungs (pleura).
● Pulmonary Contusion: when a lung is bruised from chest trauma, and the result is damage
to capillaries, which causes blood to build up in the lung tissue.
● Pneumothorax: a collapsed lung.
● Phagocytes: protists in the human body that can engulf and absorb bacteria, small cells,
and other particles so to clean an area.
● Chondroblasts: perichondrial cells that form chondrocytes, a cells that secretes cartilage
matrix, in the growing cartilage matrix.
● Osteoblast cells: cells that secrete minerals and proteins that aid in bone formation.
 KD out with broken rib

● The Associated Press

● ​Mar 16, 2018

OAKLAND — Kevin Durant will miss at least two weeks with a fractured
rib on his right side, joining fellow All-Stars Stephen Curry and Klay
Thompson on the injury list for the defending champion Golden State
Warriors.

An MRI exam Friday for the NBA Finals MVP revealed the incomplete fracture, and the
Warriors said Durant would be re-evaluated in two weeks. Durant said he got hit in the ribs at
Minnesota last Sunday and initially thought it was just a bruise, but he was sore the next couple
of days. He played Wednesday night against the Lakers and felt it again when he hustled to close
out on the wing and “felt something stretch and pull.”

“It was a little sore the next couple of days but not something I was worried about,” Durant said.

He worked out Thursday and it took him longer to loosen up. By Friday morning, he experienced
significant discomfort. It’s an injury Durant has never had previously.

“Hopefully it gets better in the next week or so and see what happens,” said Durant, who missed
time down the stretch last season with a left knee injury before a dazzling postseason to capture
his first career title. “Just recovery, no procedure and see how it feels. It’s a different type of pain
than I’ve felt before so I didn’t really know what it was and I’m just glad I got it looked at.”

Curry missed his fourth straight game Friday after re-injuring his troublesome right ankle. He
will be re-evaluated Tuesday, while Thompson has a fractured right thumb and will be examined
again next Thursday.
Cavendish suffers broken rib, out of Tirreno-Adriatico 

AFP | Mar 8, 2018, 15:57 IST 

2 
Mark Cavendish. (AFP Photo) 
ROME: British sprint star ​Mark Cavendish​ suffered a broken rib in a heavy crash during 
the ​Tirreno-Adriatico​ opening stage, his South African team said on Thursday. 

Although the 2011 world champion was prepared to race on, he is out of the week-long 
Italian stage race after finishing Wednesday's opening team time-trial outside the time 
limit, having suffered multiple injuries in his crash. 

He crossed the line with a bloodied face and was taken straight to hospital. 

"He came down pretty hard at around 55km/h and he sustained multiple abrasions and 
soft tissue injuries to his knees, hips, hands and some swelling on his face as well," sad 
Dimension Data doctor ​Jarrad van Zuydam​. 

"He had a lot of rib pain, (for) which we went to x-ray, and found that he has a fracture of 
the seventh rib on the right side. 

"The fracture's nice and stable and should heal well. 

"The plan was to let him start stage two but unfortunately it was ruled he finished 
outside the time limit and so won't be allowed to take the start." 

Cavendish's crash came just two weeks after he suffered a concussion in another fall at 
the ​Abu Dhabi Tour​. 

This was his first race back since then. 

"It's frustrating to have crashed, particularly in light of the concussion that I sustained in 
Abu Dhabi, but I'm just pleased that there's no major damage done," added the 
32-year-old, a silver medallist on the track at the ​Rio Olympics​ in 2016. 
 Works Cited
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India​, Sports, 8 Mar. 2018, timesofindia.indiatimes.com/sports/more-
sports/cycling/cavendish-suffers-broken-rib-out-of-tirreno-adriatico/articleshow/6321728
2.cms.
“Broken Ribs.” ​Mayo Clinic,​ Mayo Foundation for Medical Education and Research, 7 Mar.
2018, ​www.mayoclinic.org/diseases-
conditions/broken-ribs/symptoms-causes/syc-20350763.
Cornell Health. “Calcium, Vitamin D, and Bone Health.” ​Kazilek,​
askabiologist.asu.edu/bone-healing.
Dr. Biology. "Bone Healing". ASU - Ask A Biologist. 01 Feb 2011. ASU - Ask A Biologist,
Web. 29 Mar 2018. ​https://askabiologist.asu.edu/bone-healing
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2015, anatomyhuman123.com/human-body-ribs-liver
-diagram/human-body-ribs-liver-diagram-image-lute/.
Press. “KD out with Broken Rib.” ​San Mateo Daily Journal​, The Daily Journal, 17 Mar. 2018,
www.smdailyjournal.com/sports/kd-out-with-broken-rib/
article_0965541e-298e-11e8-bc22-5386058ddbb3.html​.
Serfin, Jennifer A., and W. Alan Guo. “Rib Fractures - The American Association for the
Surgery of Trauma.” ​AAST,​ The American Association for the Surgery of Trauma,
www.aast.org/rib-fractures​.
Shaw, Jesse. “Pain of Fractured Ribs Makes It Dangerous.” ​All-Pro Orthopedics & Sports
Medicine​, All-Pro Orthopedics & Sport Medicine, 28 Feb. 2018,
allproorthopedics.com/blog/pain-of-fractured-ribs-makes-it-dangerous/.
“The Fifth (Rib That Is).” ​Classical Osteopathy in Ontario​, Classical Osteopathy in Ontario, 15
Nov. 2011, classicalosteopathyontario.wordpress.com/2011/11/15/the-fifth-rib-that-is/.