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Normal Growth of the Thorax

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The Growing Spine

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Abstract

The study of the normal thorax is important for a better understanding of the development and function of the child as well as of the many related critical internal structures, including the spine, spinal cord, heart, lungs, abdominal organs, and diaphragm. The thorax is a key component of the respiratory pump, which includes the rib cage, accessory muscles, diaphragm, abdominal muscles, and spine. Thoracic growth and spine growth are influenced by each other and are interdependent. The infant’s chest is an inverted funnel-shaped structure as well as circular in cross section compared with the adult. With increasing growth and maturity, the chest becomes more barrel shaped, with greater transverse width in the mid-thoracic spine. From osteological studies, there is symmetry and coupled growth between the upper and lower thoracic ribs. The mid-thoracic ribs grow linearly, mimicking the rapid growth of the distal femur, and create an increase in volume by the mathematical representation of a logarithmic spiral, similar to how other rigid biological structures increase their volume. The diaphragm is unique in mammals with several discrete but interrelated functions. The sternum has a different embryonic origin than the posterior aspects of the thorax, ribs and vertebrae, and it contributes greatly to the development and stability of the thorax.

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Abbreviations

BD:

Base diameter

CT:

Computerized tomography

EOS:

Early-onset scoliosis

MRI:

Magnetic resonance imaging

OCL:

Outer costal length

REM:

Rapid eye movement

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Author information

Authors and Affiliations

  1. Division of Orthopaedic Surgery, Children’s Mercy Hospital, Kansas City, MO, USA

    Richard M. Schwend

  2. Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA, USA

    Behrooz A. Akbarnia

  3. Retired Formerly from K2M Inc., Leesburg, VA, USA

    John A. Schmidt

  4. Pediatric Specialists of Virginia, Fairfax, FL, USA

    Laurel C. Blakemore

Authors
  1. Richard M. Schwend
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  2. Behrooz A. Akbarnia
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  3. John A. Schmidt
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  4. Laurel C. Blakemore
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Corresponding author

Correspondence to Richard M. Schwend .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA, USA

    Behrooz A. Akbarnia

  2. Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA

    George H. Thompson

  3. Department of Orthopedics and Traumatology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey

    Muharrem Yazici

  4. IWK Health Center, Dalhousie University, Halifax, NS, Canada

    Ron El-Hawary

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Schwend, R.M., Akbarnia, B.A., Schmidt, J.A., Blakemore, L.C. (2022). Normal Growth of the Thorax. In: Akbarnia, B.A., Thompson, G.H., Yazici, M., El-Hawary, R. (eds) The Growing Spine. Springer, Cham. https://doi.org/10.1007/978-3-030-84393-9_5

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  • DOI: https://doi.org/10.1007/978-3-030-84393-9_5

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