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Each posterior intercostal artery travels along the bottom of the rib alongside its corresponding posterior intercostal vein and intercostal nerve; the vein is superior to the artery, and the nerve is inferior to it. The mnemonic "VAN" is commonly used to recall their order from superior to inferior.
Passing backward, it splits into the deep cervical artery and the supreme intercostal artery (highest intercostal artery), which descends behind the pleura in front of the necks of the first and second ribs, and anastomoses with the first aortic intercostal (3rd posterior intercostal artery).
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The left superior intercostal vein drains the 2nd and 3rd posterior intercostal veins on the left side of the body. It usually drains into the left brachiocephalic vein . [ 1 ] [ 2 ] It may also communicate with the accessory hemiazygos vein .
The neurovascular bundle has a strict order of vein-artery-nerve (VAN), from top to bottom. [2] 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).
The superior intercostal vein then drains into the Azygous vein. Posterior intercost veins that drain directly into the Azygous vein - in spaces 5–11. Subcostal vein —below bottom (12th) rib and also drains into the Azygous vein.
The superior thoracic artery (highest thoracic artery) is a small artery [1] located near the armpit. [2] It usually originates from (the first division of) the axillary artery, but can instead originate from the thoracoacromial artery (itself a branch of the second division of the axillary artery).
The perforating branches of the internal thoracic artery pierce through the internal intercostal muscles of the superior six intercostal spaces. These small arteries run with the anterior cutaneous branches of the intercostal nerves. The perforating arteries constitute part of the blood supply to the pectoralis major and the overlying tissue ...