Transcript I. Anterior intercostal veins

‫بسم هللا الرمحن الرحيم‬
I. Anterior intercostal veins:
- They correspond to the anterior intercostal
arteries.
- They drain into the venae comitantes of the
musculophrenic and internal thoracic
arteries.
II. Posterior Intercostal Veins
Right side:
- 1st post. intercostal
vein right
innominate vein.
- 2nd + 3rd post.
intercostal veins unite
to form the right
superior intercostal vein
 azygos vein.
-4th - 11th post.
intercostal veins 
azygos vein.
-Subcostal veinAzygos
vein
II. Posterior Intercostal Veins
Left side:
- 1stpost. intercostal vein
left innominate vein.
- 2nd + 3rd post. intercostal
veins unite to form the
superior intercostal vein 
left innominate vein.
- 4th – 8th post. intercostal
veins superior
hemiazygos.
- 9th – 11th post. intercostal
vein inferior
hemiazygos vein.
- Subcostal vein inferior
hemiazygos vein.
Intercostal Nerves
- There are 11 intercostal nerves in the upper 11
intercostal spaces and a subcostal nerve below the last
rib (on each side).
- Each intercostal nerve arises from the ventral ramus
of the corresponding thoracic nerve.
- They are classified into:
I. Typical Intercostal Nerves
II. Atypical Intercostal Nerves: which are the
first intercostal nerve, second intercostal nerve and
lower five intercostal nerves .
I. Typical Intercostal Nerves
I. Typical Intercostal Nerves
Branches
1. Communicating branch to the sympathetic trunk.
2. Collateral branch which runs over the upper border of
the rib below.
3. Anterior cutaneous branch .
4. Lateral cutaneous branch which divides into anterior
and posterior branches.
5. Muscular branches to the intercostal muscles.
6. Sensory branches to the pleura.
II. Atypical Intercostal Nerves
1. First intercostal nerve
- It has a small lat. Cut. Branch to the axilla and ends as a
small anterior cutaneous branch.
2. Second intercostal nerve
- Its lateral cutaneous branch is called the intercostobrachial nerve which supplies the base of the axilla and
upper part of the medial side of arm and does not divide
into anterior and posterior branches.
3. Lower five intercostal nerves
- They reach the anterior abdominal wall at the anterior ends
of the spaces and supply its structures in addition to the
diaphragm.
Arrangement of intercostal nerve and
vessels in the costal groove
 In the posterior end of the
space  the nerve is above
the vessels.
 Then, it crosses behind
the vessels to continue
below them (VAN).
 In the posterior part , the
vessels& nerve are midway
between the two ribs.
 In the lateral& anterior
parts  In the costal
groove
Applied anatomy:
1. Stab wounds in the posterior part of the
intercostal spaces lead to injury of the posterior
intercostal nerve and vessels because they run
midway between the ribs.
-But in the lateral part of the intercostal spaces,
they do not injury of the posterior intercostal
nerve and vessels because these structures are
protected by the costal groove.
Applied anatomy:
2. Needles introduced into the intercostal
spaces (to remove collection in the pleura)
Site: They are done in the lateral part of the chest
wall.
Cause: To avoid injury of the posterio intercostal
nerve and vessels.
(It is also better to be introduced near the rib
below).
Thank You
Prof.: Dr. Wafaa Abdel-Rahman