While some sources describe this disorder as rare, others suggest it is relatively common but overlooked by physicians. Xiphoidalgia (Xiphodynia) is a syndrome distinguishable by pain and tenderness to the sternum. Additionally, the liver may be punctured, resulting in deadly internal bleeding. Pressure on the xiphoid process should be avoided when administering chest compressions in cardiopulmonary resuscitation (CPR), as this can cause the xiphoid process to break and detach, resulting in punctures or lacerations of the diaphragm. It also anchors the rectus abdominis muscles ("abs"). The xiphoid process is involved in the attachment of many muscles, including the abdominal diaphragm, a muscle necessary for normal breathing. Much the way the first seven ribs articulate with the sternum, the cartilage in the celiac plexus joins on the xiphoid process, reinforcing it, and indirectly attaches the costal cartilage to the sternum. In birds, the xiphoid process is a long structure, often following the direction of the keel. These morphological differences pose no health risk, and are simply a difference in form. These variances in morphology are inheritable, which can help group family members together when dealing with burial remains. The xiphoid process can be naturally bifurcated or sometimes perforated (xiphoidal foramen). Ossification of the xiphoid process occurs around age 40. Unlike the synovial articulation of major joints, this is non-movable. Between 15 and 29 years of age, the xiphoid process usually fuses to the body of the sternum with a fibrous joint. In newborns and young (especially small) infants, the tip of the xiphoid process may be both seen and felt as a lump just below the sternal notch. The xiphoid process is considered to be at the level of the 9th thoracic vertebra and the T7 dermatome. Both the Greek-derived xiphoid and its Latin equivalent ensiform mean "swordlike" or "sword-shaped". The xiphoid process ( / ˈ z ɪ f ɔɪ d/), ensiform process, xiphisternum or metasternum, is a small cartilaginous process (extension) of the inferior (lower) part of the sternum, which is usually ossified in the adult human.
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