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Intercostal space
- 2. • True ribs : 1-7 • False ribs : 8-12 • Atypical ribs : 1,2 • Typical ribs : 3-9 • Floating ribs : 11,12 DANIEL’S ANATOMY DANIEL’S ANATOMY
- 19. • Origin : Lower border of the rib above. • Insertion : Outer lip of upper border of the below rib. • Action : Inspiration. DANIEL’S ANATOMY DANIEL’S ANATOMY
- 20. • Origin : Floor of the costal groove of rib above. • Insertion : Inner lip of upper border of below rib. • Action : Inspiration DANIEL’S ANATOMY DANIEL’S ANATOMY
- 21. • Origin : Middle 2/4th of the ridge above the costal groove. • Insertion : Inner lip of upper border of below rib. • Action : Expiration DANIEL’S ANATOMY DANIEL’S ANATOMY
- 22. • Origin : • Lower 1/3rd of posterior surface of Body of Sternum, • Posterior surface of Xiphoid, • Posterior surface of lower 3 or 4 ribs. • Insertion : Costal cartilages of 2nd to 6th ribs. DANIEL’S ANATOMY DANIEL’S ANATOMY
- 23. • Origin: Inner surface of rib near angle. • Insertion : Inner surface of 2-3 ribs below DANIEL’S ANATOMY DANIEL’S ANATOMY
- 27. • VEIN • ARTERY • NERVE DANIEL’S ANATOMY DANIEL’S ANATOMY
- 29. • Formation : Important channel connecting the Superior & Inferior venacavae. • Azygous : Union of Lumbar azygous,Right Ascending Lumbar,Right subcostal veins. • Passes through Aortic opening (T12) & at 4th thorasic vertebra level it arches over right lung & opens into SVC. • Tributaries : • Right superior Intercostal vein : Formed by joining of 2,3,4 posterior Intercostal veins. • 5-11 Posterior Intercostal veins drains into Azygous. • At 8th Thorasic vertebraelevel Hemi azygous & Acessary Hemiazygous veins also drains into Azygous vein. • First Right Posterior Intercostal vein directly drains into Right Brachiocephalic vein. DANIEL’S ANATOMY DANIEL’S ANATOMY
- 30. • Mirror image of Lower part of Azygous vein. • Formation : Union of Lumbar azygous,Left Ascending Lumbar,Left subcostal veins. • Pierces left crus of Diaphragm. • Turns & passes over to right side, overlapped by Aorta & drains into azygous vein. • Tributaries : • Lumbar azygous vein. • Left Ascending Lumbar vein. • Left Subcostal vein. • 9-11 Left Posterior Intercostal veins. DANIEL’S ANATOMY DANIEL’S ANATOMY
- 31. • Mirror image of Upper part of Azygous vein. • Tributaries : • 5-8 Left Posterior Intercostal veins. • Left 2,3,4 Posterior Intercostal veins joins together to form Left superior Intercostal vein & drains into Left Brachiocephalic vein. • First Left Posterior Intercostal vein drains into Left Brachiocephalic vein. DANIEL’S ANATOMY DANIEL’S ANATOMY
- 34. • 11 Posterior Intercostal arteries are present. • 1,2 – Arises from Superior Intercostal artery – branch of Costocervical trunk. • 3-11 – Arises from Descending thorasic aorta. • Runs in coatal groove and ends at Costochondral junction. • Branches : • Muscular arteries. • Main Branch anatomosis with Anterior branch of Anterior Intercostal artery. • Lateral cutaneous arteries (as nerve) from Collateral branch. • Collateral branch (Arises at angle) anastomosis with Posterior branch of Anterior Intercostal artery. • Dorsal branch : Skin of back. • Right bronchial artery : Branch of right 3rd posterior Intercostal artery.DANIEL’S ANATOMY DANIEL’S ANATOMY
- 37. • Arises from 1st part of Subclavian artery. • Course : Runs downwards medially behind the sternum. • Termination : At 6th Intercostal space. • Terminates as Superior Epigastric & Musculophrenic arteries. • Branches : • 2-Anterior Intercostal arteries in 1-9 spaces. • Superior Epigastric artery : Enters Rectus sheath & anastomses with Inferior Epigastric artery. • Musculophrenic artery :supplies from 7,8,9 and gives of 2 – Anterior Intercostal arteries. • At 3rd Intercostal space level 2-Venae comitantes and forms Internal Thorasic vein and ends in Brachiocephalic vein. DANIEL’S ANATOMY DANIEL’S ANATOMY
- 38. • Mediastinal branches : Thymus. • Pericardiophrenic arteries : Pleura & Pericardium. • Perforating arteries : Female Breast – 2,3,4 spaces. DANIEL’S ANATOMY DANIEL’S ANATOMY
- 41. • Intercostal nerves are Anterior primary ramii of T1 t0 T-11 thorasic spinal nerves and T-12 runs forwards in the abdominal wall as Subcostal nerve. • Runs between Internal Intercostal & Inner Intercostal Muscle , i.e runs in the Costal groove. • 1-6 Nerves Purely supplies to corresponding Intercostal spaces Hence called as TYPICAL INTERCOSTAL NERVES. • 7,8,9 Nerves leaves the anterior end of corresponding space and enters Anterior Abdominal wall. • 10,11,12 – Directly enters the Anterior abdominal wall. DANIEL’S ANATOMY DANIEL’S ANATOMY
- 42. • Branches : • Muscular branches : Intercostal muscles. • Collateral branch : Runs Inferior to Main branch. • Anterior cutaneous branch : Supplies to Skin near midline & divides into Medial and lateral branches. • Lateral cutaneous branch :Supplies to skin on lateral side of chest & divides into Anterior and posterior branches. • Pleural sensory branches : Parietal pleura. • Peritoneal sensory branches : Parietal peritoneum (7-11 Spaces). • Rami communicanes : Connects Intercostal nerve to sympathetic ganglion. DANIEL’S ANATOMY DANIEL’S ANATOMY
- 44. DANIEL’S ANATOMY DANIEL’S ANATOMY DANIEL’S ANATOMY