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The hypoechoic space between the parietal pleura and the lateral costotransverse ligament and internal intercostal membrane laterally represents the apex of the TPVS or the medial limit of the posterior intercostal space. (Courtesy of Dr Jean-Louis Horn.) Source: Chapter 149. Thoracic Paravertebral Blocks, The Anesthesia Guide Citation: Atchabahian A, Gupta R. The Anesthesia Guide; 2013 Available at: http://mhmedical.com/ Accessed: May 13, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved