The innermost intercostals are the deepest intercostal layer, separated from the internal intercostals by the intercostal neurovascular bundle. They are poorly defined and may be absent in some intercostal spaces.
| Origin | Inner surface of one rib |
|---|---|
| Insertion | Inner surface of a non-adjacent rib — typically spanning 2-3 intercostal spaces |
| Nerve Supply | Intercostal nerves |
| Blood Supply | Posterior intercostal arteries |
| Actions | Assist expiration; Stabilise the inner thoracic wall |
|---|
The intercostal neurovascular bundle runs in the plane between the internal and innermost intercostals — this is the anatomical reference for safe intercostal access. The innermost intercostals are the layer most at risk of damage during rib retraction in open thoracotomy.
Not individually palpable.
The plane between internal and innermost intercostals containing the intercostal nerve, artery and vein — the key anatomical reference for intercostal block injection and thoracic access.
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