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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 intercostal arteries are a group of arteries passing within an intercostal space (the space between two adjacent ribs). There are 9 anterior and 11 posterior intercostal arteries on each side of the body. The anterior intercostal arteries are branches of the internal thoracic artery and its terminal branch – the musculophrenic artery.
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).
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
Another location is through the 5th or 6th intercostal space at the left sternal border at the cardiac notch of the left lung, and is also called as parasternal approach. [10] The needle is inserted at an angle of 90 degrees to the chest. [10] Some evidence suggests that this poses lower risk of vascular damage in adults. [10]
Identification of the second rib and thus the second intercostal space inferiorly is useful when auscultating heart sounds. The optimal location for auscultation of the aortic valve is generally the right second intercostal space, whereas the optimal location for auscultation of the pulmonic valve is generally the left second intercostal space.
The internal surface, smooth, and concave, is directed downward and a little inward: on its posterior part there is a short costal groove between the ridge of the internal surface of the rib and the inferior border. It protects the intercostal space containing the intercostal veins, intercostal arteries, and intercostal nerves. [6] [4]
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.