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The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. [1] [2] The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and differ from the anterior rami of the other spinal nerves in that each pursues an independent course without plexus formation.
The normal apex beat can be palpated in the precordium left 5th intercostal space, half-inch medial to the left midclavicular line and 3–4 inches left of left border of sternum. In children the apex beat occurs in the fourth rib interspace medial to the nipple.
In reference to the muscles of the thoracic wall, the intercostal nerves and vessels run posterior to 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, innermost intercostal membrane, subcostal muscles or the transversus thoracis muscle.
The white ramus communicans (pl.: rami communicantes) from Latin ramus (branch) and communicans (communicating) is the preganglionic sympathetic outflow nerve tract from the spinal cord. Each of the thoracic, and the first and second lumbar nerves contribute a white ramus communicans to the adjoining sympathetic ganglion , unlike the gray rami ...
The grey rami communicantes exist at every level of the spinal cord and are responsible for carrying postganglionic nerve fibres from the paravertebral ganglia to their destination, and for carrying those preganglionic nerve fibres which enter the paravertebral ganglia but do not synapse. [citation needed] [1]
Afferent nerve cell bodies bring information from the body to the brain and spinal cord, while efferent nerve cell bodies bring information from the brain and spinal cord to the rest of the body. The cell bodies create long sympathetic chains that are on either side of the spinal cord. They also form para- or pre-vertebral ganglia of gross anatomy.
These pierce the intercostales externi and the obliquus externus abdominis, in the same line as the lateral cutaneous branches of the upper thoracic nerves, and divide into anterior and posterior branches, which are distributed to the skin of the abdomen and back; the anterior branches supply the digitations of the obliquus externus abdominis ...
As it crosses the neck of the first rib it lies medial to the anterior division of the first thoracic nerve, and lateral to the first thoracic ganglion of the sympathetic trunk. In the first intercostal space, it gives off a branch which is distributed in a manner similar to the distribution of the aortic intercostals.