Intercostal Arteries, Anterior View

Description

Running segmentally along the thoracic wall, the posterior intercostal arteries arise from the descending thoracic aorta and course laterally within each intercostal space, then turn anteriorly toward the sternum where they anastomose with anterior intercostal branches from the internal thoracic artery. From an anterior perspective, the paired internal thoracic arteries descend on either side of the sternum, giving off anterior intercostal arteries that pass laterally between adjacent ribs and costal cartilages. Superficially, the ribs, sternum, and costal margins frame the vascular pattern, while the heart silhouette and central great vessels provide midline orientation. Intercostal veins often accompany these arteries as part of the intercostal neurovascular bundle. Anterior mapping of the intercostal arteries matters when you need to think about where the neurovascular bundle sits relative to the ribs. It lies in the costal groove on the inferior border of each rib (classically VAN from superior to inferior), a detail that drives safe technique for chest tube placement and thoracentesis by favoring the superior aspect of the rib below. For cardiothoracic and breast procedures, the internal thoracic artery is the landmark and conduit, and its anterior intercostal branches explain both collateral flow and bleeding points during parasternal dissection. Use this artwork for teaching thoracic wall circulation in gross anatomy, for surgical atlases covering intercostal space access and internal thoracic artery harvest, and for clinical slide decks on traumatic hemothorax, rib fracture bleeding, or intercostal artery injury during thoracic drainage. Anatomical accuracy verified by SciePro's Medical Advisory Board.