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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.
The murmur of chronic aortic regurgitation is typically described as early diastolic and decrescendo, which is best heard in the third left intercostal space and may radiate along the left sternal border. [22]
It may increase in intensity during inspiration and best heard over left second and third intercostal spaces. The murmur usually does not extend to S1. Early diastolic Left anterior descending artery stenosis This murmur, also known as Dock's murmur, is similar to that of aortic regurgitation and is heard at the left second or third intercostal ...
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.
There are eleven posterior intercostal veins on each side. Their patterns are variable, but they are commonly arranged as: The 1st posterior intercostal vein, supreme intercostal vein, drains into the brachiocephalic vein or the vertebral vein. The 2nd and 3rd (and often 4th) posterior intercostal veins drain into the superior intercostal vein.
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. [1] [2] The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and differ from the anterior rami of the other spinal nerves in that each pursues an independent course without plexus formation.
One may hear it at the left lower sternal border. A palpable S2 in the second left intercostal space correlates with pulmonary hypertension due to mitral stenosis. The cooing dove murmur is a cardiac murmur with a musical quality (high pitched). Associated with aortic valve regurgitation (or mitral regurgitation before rupture of chordae).
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.