The interspace is formed by two superimposed muscles, the outer and inner intercostal muscle ( external intercostal muscles and internus ), and by outer and inner Brustwandfaszie ( fascia thoracic externa or fascia endothoracica closed). In the lower chest area there is also the muscle subcostalis and in the anterior chest area the muscle transversus thoracis . The corresponding intercostal blood vessels and nerves ( vena , arteria and nervus intercostalis , in animals: nervus intercostalis dorsalis) run in the order vein - artery - nerve (VAN) directly below, behind each rib in animals . Medical interventions, such as a pleural puncture , are therefore carried out on the upper edge (front edge) of the respective rib. The blood supply to the intercostal spaces takes place via the anterior and posterior intercostal arteries, and in the first two intercostal spaces also via the upper thoracic artery .
The division of the thorax into intercostal spaces plays a role in the topography for numerous diagnostic and therapeutic procedures. The organs within the thorax are topographically and anatomically defined primarily in their relationship to the ribs and intercostal spaces. Important diagnostic procedures are auscultation (listening to the sound signals generated in the body) of the heart (see also heart tones , heart noises ), lung percussion as well as heart , pericardium and pleural puncture .
Clinically significant intercostal spaces
The hereditary point in the 3rd ICR parasternal (next to the sternum ) on the left is the central auscultation point: Here you can best hear all heart murmurs and get an initial overview of the heart's activity. In certain intercostal spaces, abnormal heart murmurs can be assigned to the individual heart valves ( puncta maxima ).
In humans, the puncta maxima lie over the following intercostal spaces:
- 2. ICR parasternal right: aortic valve
- 2. ICR parasternal left: pulmonary valve
- 4. ICR parasternal right: tricuspid valve
- 5. ICR on the left above the apex of the heart: mitral valve
In animals these puncta maxima are as follows:
- 3. ICR parasternal left, shoulder joint level: pulmonary valve
- 4. ICR parasternal left, shoulder joint level: aortic valve
- 5. ICR parasternal left, near the star: mitral valve
- 4. ICR parasternal right, near the star: tricuspid valve
- Anton Waldeyer: Human anatomy . 17th edition. Gruyter, 2003, ISBN 978-3-11-016561-6 , pp. 802 ff .
- Titus von Lanz , Werner Wachsmuth : back . In: Practical Anatomy: Practical Anatomy. 1st edition. Springer, Berlin 2003, ISBN 978-3-540-40572-6 , pp. 75 .
- Dagmar Reiche: Roche Lexicon Medicine . 5th edition. Urban & Fischer Verlag / Elsevier GmbH, 2003, ISBN 978-3-437-15150-7 ( Gesundheit.de ).
- Hermann S. Füeßl, Martin Middeke: Anamnesis and clinical examination . Hippocrates, 1998, ISBN 978-3-7773-1055-8 , pp. 181 .