The sternal notch, also known formally as the jugular notch or suprasternal notch, is a readily visible and palpable dip located at the very base of the front of the neck. This small depression represents a significant landmark in human anatomy. It acts as a primary surface reference point for both physical examination and numerous medical procedures. The notch provides an easy-to-find marker that allows practitioners to estimate the location of deeper, less accessible structures within the chest cavity.
Precise Anatomical Location
The sternal notch is an indentation situated on the superior, or uppermost, border of the manubrium, which is the top part of the sternum (breastbone). This bony dip is positioned exactly at the center of the manubrium’s upper edge. The notch is flanked on either side by the clavicular notches, where the collarbones (clavicles) meet the breastbone. This means the sternal notch sits precisely between the medial ends of the left and right clavicles. The anatomical names, jugular notch and suprasternal notch, are often used interchangeably.
Practical Guide to Palpation
Locating the sternal notch requires only a light touch. Start by placing one or two fingers gently at the front of your neck, just below the Adam’s apple or voice box area. Slowly slide your fingers downward, following the midline toward your chest. The first distinct, hard, bony depression encountered at the intersection of the neck and chest is the sternal notch. This depression is the uppermost edge of the breastbone and is easily distinguishable because it lies between the firm, rounded heads of the two collarbones.
Essential Medical and Clinical Significance
The sternal notch serves as a fundamental surface landmark for assessment and intervention in clinical medicine. It is frequently used as a reference point when assessing the pressure in the jugular veins, known as Jugular Venous Pressure (JVP). This measurement helps clinicians evaluate the fluid status and function of the right side of the heart.
In advanced medical settings, the notch guides procedures like the placement of central venous catheters (CVCs) into the subclavian vein. The needle is sometimes directed toward the sternal notch during a lateral approach to ensure proper placement in the vein beneath the clavicle.
The notch also helps physicians estimate the location of the tracheal bifurcation, or carina, where the windpipe splits into the two main bronchial tubes. While the carina is slightly deeper and lower, the sternal notch is the initial point from which this structure can be estimated. Palpating the notch can also reveal an abnormal pulse, which may suggest an issue with the aorta, such as an aneurysm or tortuous vessel.
Structures Immediately Behind the Notch
Directly posterior to the sternal notch and the manubrium is a region containing several major structures protected by the breastbone. The trachea (windpipe) passes downward just behind this bony structure, with its upper portion extending slightly above the notch in most adults. The great blood vessels of the upper chest also lie deep to this area, including the brachiocephalic veins and the superior vena cava. Though the bulk of the aortic arch is lower, its proximity means issues with this major artery can sometimes be detected by examining the notch.