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Neurovasculature of the intercostal space

Learning objectives

After going through this study unit, you will be able to:

  1. Identify the arteries that supply the intercostal spaces, as well as their branches.
  2. Name the veins that drain the intercostal spaces and their tributaries.
  3. Describe the innervation of the intercostal spaces.

Watch video

Intercostal spaces are anatomical spaces which lie between adjacent ribs. They are occupied by three layers of intercostal muscles as well as neurovascular bundles of intercostal vessels and nerves. Each neurovascular bundle lies within the costal groove, along the inferior border of each rib and passes in the plane between the inner and innermost layers of muscles. From superior to inferior, they are arranged as vein, artery and then nerve. Smaller collateral branches of each nerve, artery and vein run along the superior border of the lower rib.

Find out more about the blood vessels and nerves of the intercostal space by watching the videos below. 

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Test your knowledge on the neurovasculature of the intercostal space by taking the following quiz.

You can also customize your own quiz with our custom quiz creator. On this link, you’ll find the preset for a quiz about all the structures of the thoracic wall.

Browse atlas

Explore the neurovasculature of the intercostal space, the intercostal muscles and the anatomic relations between the structures of the intercostal space in the galleries below. 

Summary

Key points about the neurovasculature of the intercostal space
Arteries Anterior intercostal arteries
Origin: Internal thoracic artery (upper six intercostal spaces), musculophrenic artery (lower intercostal spaces)
Branches: Collateral branch

Posterior intercostal arteries

Origin: Supreme intercostal artery (upper two), descending thoracic aorta (lower nine)
Branches: Dorsal branch, collateral branch, lateral cutaneous branch
Veins Anterior intercostal veins
Drain into: Internal thoracic vein

Posterior intercostal veins

Supreme intercostal vein (1st) drains into brachiocephalic vein
Right 2nd-3rd form right superior intercostal vein which drains into azygos vein
Left 2nd-3rd form left superior intercostal vein which drains into left brachiocephalic vein
Right 4th-11th drain into azygos vein
Left 4th-8th drain into accessory hemiazygos vein
Left 9th-11th drain into hemiazygos vein
Nerves Anterior rami of spinal nerves T1-T11 = Intercostal nerves
Branches: Collateral branch, lateral cutaneous branch, anterior cutaneous branch (muscular branches)

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