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The intercostal space (ICS) is the anatomic space between two ribs (Lat. costa). Since there are 12 ribs on each side, there are 11 intercostal spaces, each numbered for the rib superior to it. Since there are 12 ribs on each side, there are 11 intercostal spaces, each numbered for the rib superior to it.
A left-sided S3 is best heard in the left lateral decubitus position and at the apex of the heart, which is normally located in the 5th left intercostal space at the midclavicular line. A right-sided S3 is best heard at the lower left sternal border.
The normal apex beat can be palpated in the precordium left 5th intercostal space, half-inch medial to the left midclavicular line and 3–4 inches left of left border of sternum. In children the apex beat occurs in the fourth rib interspace medial to the nipple.
The apex beat is found approximately in the fifth left intercostal space in the mid-clavicular line. It can be impalpable for a variety of reasons including obesity, emphysema, effusion and rarely dextrocardia. The apex beat is assessed for size, amplitude, location, impulse and duration.
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 that drain into the Supreme intercostal vein - 1st intercostal space
The left aortic intercostals run backward on the sides of the vertebrae and are covered by the left lung and pleura; the upper two vessels are crossed by the left superior intercostal vein, the lower vessels by the hemiazygos vein. The sympathetic trunk (opposite the heads of the ribs) and splanchnic nerves pass anterior to the arteries.
First an incision is made along the fourth or fifth intercostal space (between the ribs), intercostal muscles and the parietal pleura are divided, and then the ribs are retracted to provide visualization. [6] When the incision covers both the right and left hemithoraxes it is referred to as a "clamshell" thoracotomy.
The lateral pad should be placed along the left midaxillary line at the level of the left 5th intercostal space. [12] [13] The left nipple can be used as a reference for the level of the left 4th intercostal space. From here, the midaxillary 5th intercostal space is identified by moving inferiorly one intercostal space and laterally towards the ...