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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).
Deep neurovascular bundles, which often include arteries, have a more complicated structure than superficial neurovascular bundles. Since arteries have high intraluminal blood pressure relative to capillaries and veins, these bundles have smooth muscle and connective tissue structures outside the endothelium. This structure allows arteries to ...
They originate on ribs 1–11 and have their insertion on ribs 2–12. The external intercostals are responsible for the elevation of the ribs and bending them more open, thus expanding the transverse dimensions of the thoracic cavity. The muscle fibers are directed downwards, forwards and medially in the anterior part.
The spaces between the ribs are known as intercostal spaces; they contain the instrinsic intercostal muscles and the neurovascular bundles containing intercostal nerves, arteries and veins. [4] The superficial surface of the rib cage is covered by the thoracolumbar fascia , which provides external attachments for the neck , back , pectoral and ...
In cases where the first rib (or a fibrous band extending from the first rib) is compressing a vein, artery, or the nerve bundle, part of the first rib and any compressive fibrous tissue, can be removed in a first rib resection and thoracic outlet decompression surgical procedure; scalene muscles may also need to be removed (scalenectomy).
The upper five or six anterior intercostal arteries are branches of the internal thoracic artery (anterior intercostal branches of internal thoracic artery).The internal thoracic artery then divides into its two terminal branches, one of which - the musculophrenic artery - proceeds to issue anterior intercostal arteries to the remaining 6th, 7th, and 9th intercostal spaces; these diminish in ...
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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.