The xiphoid process is the inferior tip of the sternum, the smallest and most variable segment of the sternum. It begins as cartilage, ossifies progressively in adulthood, and fuses to the sternal body variably — sometimes by the fourth decade, occasionally remaining cartilaginous well into old age. Its shape is highly variable (pointed, bifid, curved, perforated) and it may not be palpable in obese individuals.
The xiphoid process can be palpated and is occasionally painful from xiphoidalgia — tenderness of the xiphoid process from trauma, pressure, or referred pain from gastrointestinal pathology. Xiphoid fractures from CPR chest compressions occur during resuscitation but do not affect CPR efficacy. The xiphoid is a landmark for the subxiphoid pericardiocentesis approach and for upper abdominal laparotomy incision planning.
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