Anatomy · Heart and Thorax Anatomy

Within the costal groove, what is the arrangement of the intercostal neurovascular bundle from superior to inferior?

  • A Artery, vein, nerve
  • B Nerve, artery, vein
  • C Vein, artery, nerve
  • D Artery, nerve, vein
Correct answer: C. Vein, artery, nerve

Explanation

The classic mnemonic VAN runs from above downward in the costal groove: intercostal vein, then artery, then nerve, all sheltered in the groove between the internal and innermost intercostal muscles. This is why thoracocentesis needles are passed over the lower border of a rib, keeping the needle away from the bundle. Below the rib, only the collateral branch of the artery and nerve runs along the upper border of the rib below.

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

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