Xiphoid Process

What is the xiphoid process?

The xiphoid process is the pointed, bottom section of your sternum (breastbone). Healthcare providers also call it the xiphisternum or just the xiphoid. Xiphoid process is pronounced “ZY-foyd PRA-sess.

Your sternum is a flat, T-shaped bone at the center and front of your chest. The xiphoid process sticks out from the bottom. A process is the medical name for a section of tissue that protrudes off a larger part inside your body.

Xiphoid process and CPR

The xiphoid process is commonly used as a reference point for where to give someone chest compressions if you’re performing CPR. If you’re performing CPR on an adult, you should put one of your hands over the other and place them in the middle of the person’s chest (right under their nipples). This is right above their xiphoid process.

Put your hands about the width of two fingers above the person’s xiphoid process. You should be able to estimate where that is by feeling their chest with your fingers. The breastbone ends where the person’s chest stops feeling hard through their skin.

What is the function of the xiphoid process?

As part of your sternum, the xiphoid process helps protect organs in your chest, including your:

• Heart.
• Lungs.
• Esophagus.
• Diaphragm.

The xiphoid process is also a connection point for ligaments in your chest and abdomen and some of your abdominal muscles. It holds these ligaments and muscles in place and keeps them anchored.

Where is the xiphoid process located?

The xiphoid process is the lowest part of your sternum (the distal end). It’s the pointed bottom of the sternum that’s in the center of your chest, where your ribcage connects to your sternum, right above your diaphragm.

It’s connected to the rest of your sternum by a symphysis. A symphysis is a wedge of cartilage that joins two bones together. Healthcare providers sometimes call symphyses (the plural form of symphysis) secondary joints.

The xiphoid process is around 1 to 2 inches (2 to 5 centimeters) in most adults.

What does the xiphoid process look like?

The xiphoid process is usually pointed, like the writing end of a pencil. But it’s possible that your xiphoid process has a different natural shape. Some people have xiphoid processes that are rounded or point more to one side instead of straight down.

Experts have found that the shape of your xiphoid process might be genetic and that members of biological families may share these features. Some studies have found that it’s possible to accurately know if two people are biologically related based only on chest X-ray images because families share a xiphoid process shape.

Is the xiphoid process a bone?

Whether or not your xiphoid process is a bone depends on how old you are. That’s because it changes as you age.

When babies are born, their xiphoid process is made entirely of cartilage. It hardens into bone (ossifies) throughout their lives. Typically, it fully ossifies when people are between 5 and 18 years old. But some adults as old as 60 might not have a fully ossified xiphoid process. This is a natural transition that takes longer in some people than others.

You’ll probably never know when your xiphoid process is or isn’t ossified unless you injure your sternum and need imaging tests. Having a less ossified xiphoid process doesn’t increase your risk of any injuries or health conditions.

What are the common conditions and disorders that affect the xiphoid process?

The most common injuries or health conditions that cause symptoms near your xiphoid process also affect your sternum, ribcage or tissue around them, including:

• Costochondritis.
• Pectus carinatum.
• Sternum fracture (broken sternum).
• Rib fractures (broken ribs).
• Muscle strains.

Some of these issues don’t actually affect your xiphoid process but can cause pain, swelling or tenderness in the area around it.

Xiphoid process syndrome is painful swelling in your xiphoid process. It’s rare, and pain in or around your xiphoid process is much more likely from one of the injuries or conditions listed above.

Visit a healthcare provider if you’re feeling chest pain. Go to the emergency room or call 911 (or your local emergency services number) if you think you’re having a heart attack.

What are common treatments for xiphoid process issues?

A healthcare provider will suggest treatments based on what’s causing the pain or other symptoms you’re experiencing. You might only need to rest, avoid intense physical activities and take over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs).

Do you need your xiphoid process?

The xiphoid process helps support muscles and ligaments in your chest and abdomen, but it’s possible to live without it. It’s what healthcare providers call a vestigial structure.

Vestigial structures are organs or other parts inside your body that have minor (or no) functions. They’re like leftovers from evolution that might’ve had more of a purpose in our past, but that you can live without now.

Can you remove your xiphoid process?

A surgeon might remove your xiphoid process if it’s damaged, injured or broken. It’s most common to need your xiphoid process removed if something breaks it and the broken piece(s) risks damaging the organs around it.