Ribs

If you don''''t have a degree in anthropology, you might fall for it yourself.

At an historical museum a guide pointed out to Susan Larson--who has a Ph.D. in anthropology--that you can tell a female skeleton from a male one because it has an extra rib. But because Dr. Larson knows her bones--she''''s assistant professor of anatomy at the State University of New York at Stony Brook--she knew that it wasn''''t true.

"Men and women have the same number of ribs," says Dr. Larson. The idea that women have an extra one is a myth, one that most likely originated with the biblical story of God taking a rib from Adam to create Eve. So if the Creator gets blamed for rib robbery, it''''s a bad rap: The thievery never happened.

Your ribs--12 pairs of them--are flat, curved bones that branch off from your spinal column. Seven pairs curve around in front and attach to the sternum, or breastbone. The three lower pairs--referred to by doctors as "false ribs"--curve around front, curve upward and attach to the rib above. The last two pairs don''''t attach to anything--thus the name "floating ribs."

All together, the ribs form a cage that protects the heart, lungs and other organs. Thin sheets of muscle located between the ribs allow the cage to expand and relax as the lungs inflate and deflate during breathing.

If you fracture one of those protective bones, you''''ll know right away that something is wrong. "When you do break a rib, it is extremely painful," says Bruce Janiak, M.D., director of the Emergency Center at the Toledo Hospital in Ohio. Rib fractures usually result from a fall or a blow. If one area is painful to touch, a doctor will be able to confirm whether or not one or more ribs are broken, sometimes without an x-ray. "It is frequently unnecessary to x-ray for a broken rib. The physician should make the appropriate judgment," he says.

If you''''ve only broken one rib, there isn''''t much that the doctor can do to help you. Ice packs and anti-inflammatory medications will usually relieve the pain, says Dr. Janiak, and your doctor will advise you about rest and movement. But if your ribs have moved out of alignment--what''''s called a fragmented fracture--your doctor might have to perform surgery to wire the ribs in position.

Sometimes the rib cartilage--the rubbery tissue that connects the rib to the breastbone--can become inflamed, says Dr. Janiak. Because the cartilage contains nerves, inflammation can cause rib pain and tenderness.

Researchers aren''''t exactly sure what causes the inflammation, but it may be from a virus or physical stress to the ribs. If you can''''t tell whether it''''s rib pain or chest pain, talk to your doctor, who can prescribe medication to reduce inflammation, says Dr. Janiak.

Sometimes arm and shoulder pain is indirectly a rib problem. Some people are born with a pair of "extra" ribs just above the uppermost rib. The result is a condition known as thoracic outlet syndrome. Along with the arm and shoulder pain, it may cause pins-and-needles sensations in the fingers and weakness in your hand grip. Thoracic outlet syndrome can often be treated with exercises. In some rare cases a doctor might prescribe special devices that limit elevation of the arms, says Dr. Janiak. If necessary, surgery can be performed.

See also Nervous System, Skeletal System