In the costal groove of a typical rib, the intercostal neurovascular bundle is arranged from above downward in which order, and from which point does the collateral branch arise?

• A Nerve, artery, vein; collateral arises near the vertebral column
• B Vein, artery, nerve; collateral arises at the midaxillary line ✓
• C Vein, artery, nerve; collateral arises near the angle of the rib
• D Artery, vein, nerve; collateral arises at the sternum

Explanation

Within the costal groove the order from above downward is vein, artery, nerve, remembered by the mnemonic VAN. Each posterior intercostal artery gives off a collateral branch that runs along the upper border of the rib below, arising at approximately the midaxillary line, which is why needles are kept close to the upper border of a rib beyond that point. Option A reverses the order, and the collateral branch does not originate near the vertebral column or the sternum.

Reference: Gray's Anatomy for Students, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.