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ANATOMY ▶ THORAX ▶ AREAS ▶ INTERCOSTAL SPACE

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INTERCOSTAL SPACE

The Intercostal space (ICS) is the space in between the two adjacent ribs . There are 11 intercostal spaces on each side, each
intercostal space is numbered for the rib superior to it. Every space consists of intercostal muscles and neurovascular bundle
of intercostal plane.
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In each space, the vein is the most superior structure and is thus highest in the costal groove. The nervovascular bundle is in
such a an order that vein is at the top, then the artery and then the nerve and they are generally not guarded by the groove. For
that reason, the nerve is the structure which is in most danger when objects perforate the upper part of an intercostal space.
Small collateral branches of the major intercostal nerves and vessels are often found above the inferior rib below.

Deep to the intercostal spaces and ribs , and separating such structures from the underlying pleura , is a layer of
loose connective tissue , knowned as endothoracic fascia , which consists of variable amounts of fat. Superficial to the spaces
are deep fascia , superfcial fascia, and skin. Muscles related to the upper limbs and back overlap the spaces.
 The blood supply and nerve supply of 3rd-6th intercostal spaces is restricted only upto the thorax as a result of which these
3rd-6th spaces are typical intercostal spaces.

INTERCOSTAL SPACES

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INTERACTIVE ANATOMICAL INTERFACE

BONES MUSCLES ORGANS NERVES ARTERIES VEINS

Front Back
 Highlight Highlight
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Scapula Twelfth Rib

Clavicle Manubrium
First Rib Sternum
Second Rib Sternoclavicular Ligament
Third Rib Interactiventervertebral Disc
Fourth Rib Thoracic Vertebra
Fifth Rib Linea Alba
Sixth Rib Coracoacromial Ligament
Seventh Rib Capsular Ligament
Eighth Rib Coracohumeral Ligament
Ninth Rib Intertransverse Ligament
 Tenth Rib Anterior Longitudinal Ligament
Eleventh Rib -

 
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INTERCOSTAL SPACE AND RELATIONSHIPS

ANTEROLATERAL VIEW

INTERCOSTAL SPACES: ANTEROLATERAL VIEW

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 INTERCOSTAL SPACE: RELATIONS

TRANSVERSE SECTION

 
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INTERCOSTAL SPACE: TRANSVERSE SECTION

CONTENTS OF A TYPICAL INTERCOSTAL SPACE

 Every space consists of these structures:

INTERCOSTAL MUSCLES

Intercostal spaces contains three intercostal muscles, viz. External intercostal, Internal intercostal and Innermost intercostal
(intercostalis intimus).

INTERCOSTAL NERVES

The 12 pairs of thoracic spinal nerves intervates the thoracic wall. When they leave, the intervertebral foramina they split into
anterior and posterior rami. The anterior primary rami of upper 11 thoracic spinal nerves (T1-T11) are named intercostal nerves
as they course via the intercostal spaces. The anterior primary ramus of the 12th thoracic spinal nerve runs in the
abdominal wall inferior to the 12th rib, therefore it is known as subcostal nerve .

Distinct features: The intercostal nerves are anterior primary rami of thoracic spinal nerves. They are segmental in character
unlike the anterior primary rami from other regions of spinal cord which create nerve plexuses viz. cervical, brachial, lumbar and
sacral.

Classification

The intercostal nerves are categorized into the following two groups: 1. Typical intercostal nerves (3rd, 4th, 5th, and 6th). 2.
Atypical intercostal nerves (1st, 2nd, 7th, 8th, 9th, 10th, and 11th). The typical intercostal nerves are those which remain
confined to their own intercostal spaces. The atypical spinal nerves extend beyond the thoracic wall and partly or entirely supply
the other regions.

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A Typical Intercostal Space

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Anatomy

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INTERCOSTAL ARTERIES

The thoracic wall has rich blood supply. It is provided by the posterior and anterior intercostal arteries . Each intercostal space
contains one posterior and two anterior intercostal arteries (upper and lower).

Posterior Intercostal Arteries

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There are 11 pairs of intercostal arteries, one in each space. They supply the greater part of the intercostal spaces.

Anterior Intercostal Arteries

There are two intercostal arteries in each intercostal space. They are present in the upper nine intercostal spaces only.

INTERCOSTAL VEINS

The number of intercostal vein corresponds to the number of intercostal arteries, i.e., each intercostal space contains two
anterior intercostal veins and one posterior intercostal vein. Their tributaries correspond to the branches of the arteries.
 INTERCOSTAL LYMPH VESSELS AND LYMPH NODES

Read about them here .

Plane of neurovascular bundle in the intercostal space: The neurovascular bundle being composed of intercostal nerve and
vessels is located between the internal intercostal and innermost intercostal muscles , i.e., between the intermediate and
deepest layers of muscles. They may be ordered in the following sequence from above downwards:

Intercostal Vein.
Intercostal Artery.
Intercostal Nerve.

(Mnemonic: VAN).

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 CONTENTS
 Interactive Anatomical Interface
  Intercostal Space and Relationships

Anterolateral View

Transverse Section
  Contents of a Typical Intercostal Space

Intercostal Muscles
 
Intercostal Nerves

Classification

Intercostal Arteries

Intercostal Veins
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
Intercostal Lymph vessels and Lymph nodes