Intercostal Spaces

Question 1

What are the contents of the intercostal spaces?

Answer 1

-intercostal muscles
-intercostal veins, arteries, and nerves (VAN)

Question 2

How do the intercostal veins, arteries, and nerves (VAN) travel in the intercostal spaces?

Answer 2

Travel together just inferior to each rib *there is a little groove in the bottom of the rib that gives these structures room to pass through/wrap around

*Travel DEEP to internal intercostal muscle

Question 3

Where do the collateral branches of the intercostal vessels/nerves travel in the intercostal space?

Answer 3

just superior to each rib (there is a little groove here too that allows them to travel through and wrap around)

Question 4

What vessel supplies the anterior intercostal artery?

Answer 4

Internal thoracic artery

Question 5

How does the anterior intercostal artery travel?

Answer 5

front to back (wrapping around)

Question 6

What vessel supplies the posterior intercostal artery?

Answer 6

Thoracic aorta

Question 7

How does the posterior intercostal artery travel?

Answer 7

back to front (wrapping around)

Question 8

What do anterior intercostal and posterior intercostal arteries form?

Answer 8

Anastomosis (connection), really act as a single conduit that allows blood to allow blood flow to make its way in between the ribs
*important that the ribs have adequate blood flow, so its good that there are two pathways to supply this area

Question 9

What kind of spinal nerves exit the intervertebral foramen (IVF) to continue into the intercostal spaces?

Answer 9

Thoracic spinal nerves (branches of these nerves enter the intercostal spaces)

Question 10

How many thoracic spinal nerves exit the IVF (intervertebral foramen)?

Answer 10

12

Question 11

What as known as an intercostal nerve?

Answer 11

A branch of the spinal nerve that continues along the intercostal space

Question 12

Which virus can remain dormant in the root of the single segmental spinal nerves?

Answer 12

Herpes Zoster (Shingles)

Question 13

What happens when Herpes zoster becomes active in the root of the single segmental spinal nerves?

Answer 13

Virus will spill out of intercostal nerve endings and cause a painful, red, vesicular rash in its dermatome/region
(rash will really follow the pathway of the intercostal space depending on which space has a nerve that is affected)

Question 14

Does shingles only occur in the thoracic region?

Answer 14

No, it is not limited to the thoracic region

BUT it is very common here

Question 15

What is a thoracentesis?

Answer 15

Insertion of a needle into the intercostal space to remove fluid from the pleural cavity

Question 16

What should you use as a landmark for a thoracentesis?

Answer 16

The inferior rib (superior margin) of that intercostal space
*use this as landmark to avoid hitting/damaging intercostal nerves/vessels

(NOT the inferior part of the top rib of that space, the superior part of the BOTTOM rib)