1. Thorax

2. Lateral cutaneous branch
Aorta
Posterior intercostal artery
Anterior intercostal branch
Internal thoracic artery

9. Nerves
Eleven pairs of intercostal nerves course between adjacent ribs, and the subcostal nerves course below each 12th rib. These nerves are the continuation of the ventral primary rami of thoracic segments of the spinal cord. The intercostal nerves travel just inferior to the inferior margin of the rib, in the costal groove.

10. Each intercostal nerve contains somatic sensory and motor axons as well as sympathetic axons that innervate sweat glands, arrector pili muscles , and vascular smooth muscle. Each intercostal nerve innervates deep structures, such as the intercostal muscles, the lateral rim of the diaphragm, and the parietal pleura, and has cutaneous branches innervating the skin and superficial fasciae..

11. The first intercostal nerve contribute mostly to the Brachial plexus & what remains is a small branch, the 2nd & some times the 3rd give lateral cutaneous branch called intercostobrachial nerve which anastomose with the medial cutaneous nerve of the arm. Intercostal nerves 7 to 12 continue inferomedially to innervate the abdominal wall

13. Intercostal Nerve Block
Costal angle (mostly)
Posterior axillary line
Anterior axillary line
Fracture site
Parasternal line

14. Intercostal Nerve Block

21. D I a p h r a g m

23. Sternal origin
Central tendon
Costal origin
Lumbar origin

24. Sternocostal triangle
Lumbocostal triangle

25. 3 Hiatus Vena cava foramen: inferior vena cava ( vertebrae VIII & IX)
Esophageal hiatus: esophagus, vagus nerve (vertebrae X )
Aortic hiatus: aorta, thoracic duct, azygos vein, hemiazygos vein (vertebrae XII )

26. aorta
esophagus
Inferior vena cava

27. Vena caval foramen
Esophagus hiatus
thoracic aorta

28. Esophageal Hiatus Hernia

29. Diaphragmatic Hernia

30. Blood Vessels Superior Surface: superior phrenic arteries
Pericardiophrenic artery
Musculophrenic artery
superior phrenic arteries
Inferior Surface:
Inferior phrenic arteries
Veins
Correspond to the arteries
Internal thoracic artery
Thoracic Aorta
Abdominal aorta
Superior & inferior vena cava

31. Lymphatic Drainage & Innervation
Parasternal & posterior mediastinal lymph nodes
Phrenic lymph nodes
Phrenic nerves
Cervical plexus ( C3-C5 )