Regarding VCC.
The stepper motor drivers have two voltages. VMOT (the motor voltage) and VCC/VDD (the logic side, what it's called depends how it's labelled on the board).
The VMOT is fed directly from the 5A input on the RAMPS. This also feeds the VIN on the Arduino (via diode D1).
On the Arduino is a regulator that can provide enough power for the Arduino and other pieces. The VCC (usually 5V) from the Arduino powers all the logic side of the stepper controllers. These do not require a large amount of current.
There are a few ways to hook it up. If you want the Arduino always on you can remove Diode D1 and connect the 5Vstb to the VCC pin, and then connect the standby wire PS-ON.
The +5V pin is only to power servo motors. This is because a servo can draw a fair bit more current, so it's been given it's own input (so you don't have to run it off the Arduino).