The intercostal space (ICS) is the anatomic space between two

ribs The rib cage, as an enclosure that comprises the ribs, vertebral column and sternum in the thorax of most vertebrates, protects vital organs such as the heart, lungs and great vessels. The sternum, together known as the thoracic cage, is a semi- ...

(Lat. costa). Since there are 12 ribs on each side, there are 11 intercostal spaces, each numbered for the rib superior to it.

Structures in intercostal space

* several kinds of intercostal muscle *

intercostal arteries The intercostal arteries are a group of arteries that supply the area between the ribs ("costae"), called the intercostal space. The highest intercostal artery (supreme intercostal artery or superior intercostal artery) is an artery in the hu ...

and

intercostal veins The intercostal veins are a group of veins which drain the area between the ribs ("costae"), called the intercostal space. They can be divided as follows: * Anterior intercostal veins * Posterior intercostal veins ** Posterior intercost vein t ...

* intercostal lymph nodes *

intercostal nerves The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and di ...

Order of components

Muscles

There are 3 muscular layers in each intercostal space, consisting of the

external intercostal muscle The external intercostal muscles, or external intercostals (Intercostales externi) are eleven in number on both sides. Structure The muscles extend from the tubercles of the ribs behind, to the cartilages of the ribs in front, where they end ...

, the

internal intercostal muscle The internal intercostal muscles (intercostales interni) are a group of skeletal muscles located between the ribs. They are eleven in number on either side. They commence anteriorly at the sternum, in the intercostal spaces between the cartilage ...

, and the thinner

innermost intercostal muscle The innermost intercostal muscle is a layer of intercostal muscles. It may also be called the intima of the internal intercostal muscles. It is the deepest muscular layer of the thorax, with muscle fibres running vertically (in parallel with the ...

. These muscles help to move the ribs during

breathing Breathing (or ventilation) is the process of moving air into and from the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxygen. All aerobic creatures need oxygen for cellu ...

Neurovascular bundles

Neurovascular bundles are located between the internal intercostal muscle and the innermost intercostal muscle. The

neurovascular bundle A neurovascular bundle is a structure that binds nerves and veins (and in some cases arteries and lymphatics) with connective tissue so that they travel in tandem through the body. Structure There are two types of neurovascular bundles: superficia ...

has a strict order of

vein Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated ...

artery An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pu ...

nerve A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the ...

(VAN), from top to bottom. This neurovascular bundle runs high in the intercostal space, and the smaller collateral neurovascular bundle runs just superior to the lower rib of the space (in the order NAV from superior to inferior). Invasive procedures such as thoracentesis are performed with oblique entry of the instrument, directly above the upper margin of the relevant rib, to avoid damaging the neurovascular bundles.

Nerves

In reference to the muscles of the

thoracic wall The thoracic wall or chest wall is the boundary of the thoracic cavity. Structure The bony skeletal part of the thoracic wall is the rib cage, and the rest is made up of muscle, skin, and fasciae. The chest wall has 10 layers, namely (from sup ...

, the intercostal nerves and vessels run just behind the internal intercostal muscles: therefore, they are generally covered on the inside by the parietal

pleura The pulmonary pleurae (''sing.'' pleura) are the two opposing layers of serous membrane overlying the lungs and the inside of the surrounding chest walls. The inner pleura, called the visceral pleura, covers the surface of each lung and dips b ...

, except when they are covered by the innermost intercostal muscles, innermost intercostal membrane, subcostal muscles or the transversus thoracis muscle.

References

External links

* - "Structural organization within an intercostal space." * - "Thoracic Wall: The Anterior Thoracic Wall" Thorax (human anatomy) {{anatomy-stub