From cephalad to caudad, what is the correct order of structures in the intercostal space?

From cephalad to caudad, what is the correct order of structures in the intercostal space?

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

Answer: (C)

The structures lie in the costal groove along the inferior border of the rib, and from head (cephalad) to toe (caudad) you encounter them in the order Vein, Artery, Nerve. This VAN arrangement (superior to inferior) is why the nerve sits deepest and the vein is the most superior within the groove. Clinically, this helps explain why intercostal procedures aim to avoid the bundle by approaching just above the rib’s inferior border.

The structures lie in the costal groove along the inferior border of the rib, and from head (cephalad) to toe (caudad) you encounter them in the order Vein, Artery, Nerve. This VAN arrangement (superior to inferior) is why the nerve sits deepest and the vein is the most superior within the groove. Clinically, this helps explain why intercostal procedures aim to avoid the bundle by approaching just above the rib’s inferior border.