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Sternalis
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The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

 

The Sternalis is a muscle of the chest.

Anatomical Attachments: The sternalis is poorly defined and abnormal in appearance. It may not be detected in a high preponderance of individuals. Many authors consider it to be nothing more than a detached part of the pectoralis major. Its origin has been described as attaching superiorly from an invagination of the SCM, inferiorly to the rectus abdominis, posteriorly to the costochondral junction and laterally to the pectoralis major. Other studies state that it attaches to the costochondral junctions on ribs 3 and 4 and invaginates into the pectoralis major. While seldom occurring, some authors state that the 2 separate sternalis muscles can invaginate into one another, thus appearing as one single muscle covering the anterior surface of the sternum. Therefore, we can say that this muscle is highly variable in appearance and in it’s presence within a population. It may appear unilaterally, bilaterally or occasionally, as a consolidated muscle that covers the anterior surface of the sternum and usually has at least one of its attachments arising from the fascia of the SCM, pectoralis major or rectus abdominis with the costochondral junctions of ribs 3 through 7 as its attachment. While variable in length, it can cover the length of the sternum. Just as there is no distinctive anatomical attachments, nerve innervation appears to differ among the leading sources of anatomical description. The most agreed upon description of nerve innervation is regarded as C8-T1 or the anterior division of the thoracic spine.

Travell and Simons Trigger Point Pain Referral:  

 

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Trigger Point Signs and Symptoms: Severe deep substernal pain, tenderness over the sternum.

Trigger Point Activating and Perpetuating Factors: Ischemic heart disease, mechanical overload (weight lifting such as butterflies or bench pressing), and direct trauma.

Differential Diagnosis: Costochondritis, Fractured sternum, Bruised sternum, Slipping Rib Syndrome (Tietze’s syndrome), Angina Pectoris, Myocardial infarction, Aortic aneurysm, Post Thoracic surgery adhesions, Gastroesophageal reflux, Gastroenteritis, Esophagitis, Peptic ulcer, Hiatal Hernia, Pleurisy, (Segmental, Subluxation, Somatic dysfunction) C7 C8 T1 T2 T3 T4 or T5 radiculopathy, Sprain/Strain of the Pectoral muscles, Polymyalgia rheumatica, Fibromyalgia, Eosinophilic fasciitis, Tetanus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

 

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