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# Manubrium

The manubrium is the top part of the breastbone (sternum); the collarbones join it, making it the inner anchor of the shoulder girdle.

Official name: Manubrium of the sternum

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## What it is

The top part of the breastbone, where the collarbone meets it.

## What it does

Forms the inner end of the shoulder girdle (the sternoclavicular joint).

## Key points

- The sternal angle (manubriosternal joint) lies at the 2nd costal cartilage and the T4–T5 plane: the aortic arch begins and ends and the trachea divides at this level
- The sternoclavicular joint is the only bony joint linking the [upper limb](https://durgical.com/en/anatomy/region/upper-limb/) to the trunk; a saddle-type synovial joint divided by the SC disc
- Posterior sternoclavicular dislocation can push the medial [clavicle](https://durgical.com/en/anatomy/clavicle/) against the great vessels, trachea and oesophagus behind it

## Key facts

**Joints with**
Clavicles (SC joints), 1st costal cartilages, part of the 2nd, body of the sternum

**Landmarks**
Jugular notch, clavicular notches, sternal angle (T4–T5 level, 2nd rib)

## Relations

**Above**
Jugular notch, with the [trachea](https://durgical.com/en/anatomy/trachea/) above and behind it

**Lateral**
Clavicular notches with the [SC capsule](https://durgical.com/en/anatomy/sternoclavicular-joint-capsule/), [SC ligaments](https://durgical.com/en/anatomy/sternoclavicular-ligaments/) and [SC disc](https://durgical.com/en/anatomy/sternoclavicular-joint-disc/); first [costal cartilage](https://durgical.com/en/anatomy/costal-cartilage/) just below

**Behind**
[Sternohyoid](https://durgical.com/en/anatomy/sternohyoid-muscle/) and [sternothyroid](https://durgical.com/en/anatomy/sternothyroid-muscle/); behind them the left [brachiocephalic vein](https://durgical.com/en/anatomy/brachiocephalic-vein/), then the [aortic arch](https://durgical.com/en/anatomy/aortic-arch/) with its branches and the thymic remnant

**In front**
Sternal head of the [sternocleidomastoid](https://durgical.com/en/anatomy/sternocleidomastoid-muscle/) and the origin of the [pectoralis major](https://durgical.com/en/anatomy/pectoralis-major-muscle/)

**Below**
Body of the [sternum](https://durgical.com/en/anatomy/sternum/) at the manubriosternal joint, with half of the 2nd costal cartilage

## How to find it

The jugular notch is felt at the base of the neck between the clavicular heads; sliding down a few centimetres, the transverse ridge of the sternal angle is felt, with the 2nd costal cartilage beside it, the starting point for counting [ribs](https://durgical.com/en/anatomy/ribs/).

## On imaging

Sternoclavicular joints are hard to see on plain films (a view with the beam tilted about 40° toward the head helps); CT is the standard for sternoclavicular dislocation and manubrial fractures.

## Clinical notes

- Septic arthritis of the sternoclavicular joint is classically seen in people who inject drugs, people with diabetes and people with central lines
- A median sternotomy splits the manubrium and body to reach the heart and mediastinum

## Development

Ossifies from one or more centres in late fetal life; the manubriosternal joint is usually a fibrocartilaginous joint and may stay unfused into old age.

## Related conditions

- [Goitre](https://durgical.com/en/conditions/goitre/)

## Test yourself

Think of the answer, then tap the question to see it.

## What lies at the level of the sternal angle (manubriosternal joint)?

The 2nd costal cartilage and the T4–T5 plane, where the aortic arch begins and ends and the trachea divides.

## Which is the only bony joint linking the upper limb to the trunk?

The sternoclavicular joint between the clavicle and the manubrium, a saddle-type synovial joint divided by the SC disc.

## Which vein crosses behind the manubrium?

The left brachiocephalic vein, behind sternohyoid and sternothyroid, with the aortic arch and its branches beyond.

## Which imaging study is the standard for sternoclavicular dislocation and manubrial fractures?

CT, because these joints are hard to see on plain films.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
manubrium sterni TA2 1130

**Official Spanish (DeCS)**
Manubrio del esternón

**English (TA2)**
Manubrium of the sternum

## Related

- [Interclavicular ligament](https://durgical.com/en/anatomy/interclavicular-ligament/)
- [Pectoralis major](https://durgical.com/en/anatomy/pectoralis-major-muscle/)
- [SC capsule](https://durgical.com/en/anatomy/sternoclavicular-joint-capsule/)
- [SC disc](https://durgical.com/en/anatomy/sternoclavicular-joint-disc/)
- [SC ligaments](https://durgical.com/en/anatomy/sternoclavicular-ligaments/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Thorax, Sternum](https://www.ncbi.nlm.nih.gov/books/NBK541141/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/manubrium-of-sternum/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/manubrium-of-sternum/