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Intercostal space
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Intercostal spaces, viewed from the left.
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Sternocostal and interchondral articulations. Anterior view.
Latin spatium intercostale
Gray's subject #28 123

The intercostal space (ICS) is the 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.

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Importance of intercostal space

Because the chest is protected by the rib cage, the intercostal spaces are important access points in medicine, for example:

Structures in intercostal space

Order of components

Comprehensive insight in the anatomy of the intercostal spaces is mandatory for everyone who practices medicine. One particular concept is that the neurovascular bundle has a strict order: V-A-N, or vein-artery-nerve, from top to bottom (as illustrated). This neurovascular bundle runs high in the intercostal space: therefore, the intercostal space should be penetrated as low as possible by invasive procedures.

In reference to the muscles of the thoracic wall, the intercostal nerves and vessels run just behind the internal intercostal muscles: therefore, they are generally covered on the inside by the parietal pleura, except when they are covered by the innermost intercostal muscles, subcostal muscles or the transversus thoracis muscle.

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