subclavian artery course through what muscle

Where does the subclavian artery arise from?

What muscle runs between the subclavian artery and the subclavian vein?

Between which muscles is the subclavian artery and brachial plexus?

What divides the subclavian artery?

What are parts of subclavian artery?

What vessel arises from the subclavian artery and becomes the brachial artery?

What muscles does the brachial plexus innervate?

Where is the subclavian groove?

Which artery is the subclavian?

The subclavian becomes the axillary artery at the lateral border of the first rib .

Where does the subclavian artery travel?

From its origin, the subclavian artery travels laterally, passing between anterior and middle scalene muscles, with the anterior scalene ( scalenus anterior) on its anterior side and the middle scalene ( scalenus medius) on its posterior.

What is the left subclavian artery?

The left subclavian artery is the fifth branch of the aorta and the third branch from the arch of the aorta. The right subclavian artery arises from the brachiocephalic artery and its branches. (Right subclavian is at upper left, and left subclavian is at upper right.) In human anatomy, the subclavian arteries are paired major arteries ...

How many major arteries are there in the subclavian artery?

The subclavian arteries give off five major arteries each: the vertebral artery, the internal thoracic artery, the thyrocervical trunk, the costocervical trunk, and the dorsal scapular artery.

What muscle is behind the artery?

Behind the artery are the pleura and the scalenus medius muscle. Above the artery is the brachial plexus. Below the artery is the pleura. The subclavian vein lies below and anterior to the artery, separated from it by the scalenus anterior muscle.

Which artery forms the aortic arch on the left?

right 4th aortic arch. right dorsal aorta. right 7th intersegmental artery. Essentially, the 4th aortic arch and dorsal aorta form the aortic arch on the left, but since the right dorsal aorta regresses distal to the right 7th intersegmental artery, on the left they form the proximal portion of the subclavian artery.

Where is the third part of the subclavian artery located?

The third portion of the subclavian artery runs downward and lateralward from the lateral margin of the scalenus anterior muscle to the outer border of the first rib, where it becomes the axillary artery. This is the most superficial portion of the vessel, and is contained in the subclavian triangle.

What are the subclavian arteries?

As major branches within the aortic arterial supply line, the subclavian arteries provide vital flow for much of the head, neck, and upper extremities. The left subclavian artery arises directly from the aortic arch, but the right subclavian artery comes off the short brachiocephalic artery which gives off the right subclavian and right common carotid vessels. As the subclavian arteries extend laterally, they pass through the anterior and middle scalene muscles and convert into the axillary artery once they pass the tip of the first rib. Given the long path of the artery, it subdivides into three different parts labeled first, second, and third. The first part initiates as the root of the subclavian artery and ends at the medial edge of the scalene muscles, and this area can feed the circle of Willis, thyroid tissue and breast tissue. The second part starts at the medial edge of the scalenes and extends to the lateral edge of the scalenes; this area feeds the costocervical trunk. The third part initiates at the lateral scalene muscle running to the lateral tip of the first rib at which point the artery becomes the axillary artery and feeds the upper extremity. [7]

Where are the subclavian arteries located?

The subclavian arteries lie just below the clavicles, providing blood supply to the bilateral upper extremities with contributions to the head and neck. The right subclavian artery derives from the brachiocephalic trunk, while the left subclavian artery originates directly from the aortic arch. The subclavian arteries course laterally between the anterior and middle scalene muscles. The distal limit of the subclavian artery is the lateral border of the first rib, where it becomes the axillary artery.[1]  Additional branches of the subclavian arteries include the internal thoracic artery, vertebral artery, costocervical trunk, thyrocervical trunk, and the dorsal scapular artery.  During development, the left subclavian arises from the seventh intersegmental artery and the right subclavian develops in segments; proximally from the fourth aortic arch, medially from the dorsal aorta and distally from the seventh intersegmental artery.

What causes a diminished pulse in the proximal subclavian artery?

A similar cause of diminished pulses due to subclavian narrowing is an inflammatory condition called Takayasu arteritis. In this instance, inflammation causes pathological narrowing of the subclavian arteries which may be bilateral. Clinically one may find patients without a radial pulse and may auscultate bruits in the anterior lateral upper thorax.[5]  If intrinsic stenosis occurs unilaterally at the proximal subclavian artery, a distal pressure drop can lead to retrograde flow down the ipsilateral vertebral artery leading to the condition of subclavian steal syndrome. Due to this retrograde flow, there is diminished blood to the brain via the circle of Willis which can present as stroke, syncope or cognitive decline mimicking dementia. In most cases of subclavian pathology, treatment requires some level of surgical vascular repair if symptoms do not resolve with conservative treatment. [6]

What causes a subclavian artery to narrow?

Although symptoms are usually benign, in some cases they may cause esophageal narrowing due to a vascular ring compressing the esophagus or voice changes from pressure placed on the recurrent laryngeal nerve .[3] Another pathology is due to the arteries path between the scalenes and around the tip of the first rib. If muscular hypertrophy or bony displacement occurs then stenosis may occur leading to thoracic outlet syndrome, which manifests as numbness and tingling down the affected upper extremity along with diminished pulses on the ipsilateral side. One can test for this syndrome in the clinic by stretching the scalene muscles to assess for diminished radial pulses; this test is the Addison maneuver. [8]

What are the congenital anomalies of the subclavian arteries?

The most common congenital anomaly is an aberrant subclavian artery which is usually a benign condition but can be symptomatic in twenty percent of cases.[3]  Within the musculoskeletal system, a condition known as thoracic outlet syndrome involves stenosis of the middle or distal ends of the arteries and can cause impeded flow to the distal tributaries. This lack of flow can manifest and weakened pulses and lead to hosts of neurological and ischemic changes in the upper extremities.[4]  If affected primarily within the arteries themselves pathologies such as Takayasu arteritis may manifest leading to inflammatory changes within the major branches of the aortic arch, including the subclavian arteries, and can clinically be seen with bilateral bruits heard in the upper lateral anterior thorax accompanied by ischemic changes to either the head and neck or the upper extremities.[5]  Another primary issue seen with the subclavian arteries is the aptly named subclavian steal syndrome which involves primary stenosis of an artery leading to retrograde flow down the opposite subclavian artery from the vertebral arteries (arising from the subclavian arteries) leading to a "steal" of blood flow from the circle of Willis, which supplies blood to the brain.[6]  Although rare, some other issues include subclavian arterial aneurysms or congenital stenosis of either artery due to redundant tissue or an aberrant variation in the anatomical location of bones and nerves.

What is the name of the artery that comes off a location different than typically found?

The most common variant includes the aberrant subclavi an, which means the artery root comes off a location different than typically found. Majority of these cases are benign, but in some cases, the variant may cause symptomology. If the right subclavian roots directly from the aortic arch (the most common aberrant) as the last branch of the arch it travels posteriorly, and it may wrap around the esophagus leading to a vascular ring which may induce dysphagia (dysphagia lusoria). Less likely, this variation's path may also put pressure on the recurrent nerve and lead to hoarseness or vocal cord paralysis (dubbed Ortner syndrome). [3]

Which nerves travel along the subclavian arteries?

Multiple aspects of the nervous system travel alongside or near the subclavian arteries. They include the sympathetic trunk, the vagus nerve, parts of the brachial plexus, the phrenic nerve and the right recurrent laryngeal nerve .[2]  Alongside these neuronal pathways, the arteries are also linked closely to venous pathways such as the internal jugular veins and vertebral veins.   These vessels make an interconnected highway that helps fuel the cellular processes used by the neck and upper extremity muscle groups, the brain and thyroid gland.

Which muscle passes through the subclavian vein?

The brachial plexus, suprascapular artery, subclavian artery and subclavian vein pass deep to the subclavius muscle.

What is the subclavius muscle?

The subclavius muscle is a short, triangular muscle of the thoracic wall that lies underneath the clavicle. It originates from the first rib and courses laterally to insert on the undersurface of the middle third of the clavicle. The main function of the subclavius is to stabilize the clavicle during movements of the shoulder girdle.

Why is the subclavius important?

Additionally, the subclavius is important to prevent injury of the adjacent subclavian blood vessels and the superior trunk of the brachial plexus in case of a fractured clavicle. Learning the attachments, innervation and function of over 650 muscles of the human body can be a daunting task, especially from large scary textbooks.

Which nerve innervates the subclavian nerve?

The subclavius is innervated by the subclavian nerve (C5-6), a small branch that arises from the superior trunk of brachial plexus.

Where does the subclavius originate?

The subclavius muscle originates by a strong tendon from the sternal end of the 1st rib, near its articulation with the costal cartilage. The tendon spreads superolaterally into a muscle belly that inserts into the lower surface of the middle third of the body of clavicle (groove for subclavius muscle).

How many muscles are there in the human body?

Learning the attachments, innervation and function of over 650 muscles of the human body can be a daunting task, especially from large scary textbooks. Make your life easier with our high-yield condensed muscle reference charts !

Which muscle is the left subclavian artery?

Paths of the Left & Right Subclavian Arteries. From their respective sites of origin, each subclavian artery progresses towards the anterior scalene muscle, which is a muscle belonging to the group of scalene muscles found on either side of the neck. Each artery then moves through the gap between the anterior and medial scalene muscles.

What is the subclavian artery?

The subclavian arteries (the right subclavian artery and the left subclavian artery) are a pair of major arteries that supply blood to the head, neck, chest, shoulders, and upper extremities. Subclavian means ‘under the clavicle,’, describing where these vessels are found. The subclavian arteries are sometimes associated ...

What causes a subclavian artery to enlarge?

Weaknesses in the subclavian artery can cause the vessel to enlarge, which is called an aneurysm. Common causes of an aneurism include trauma, thoracic outlet obstruction (compression of the blood vessels around the upper thorax), and arteriosclerosis. Atherosclerosis describes the buildup of fatty plaque in the arteries. The risk factors for the development of atherosclerosis are hypertension, obesity, diabetes, and smoking.

What is the thyrocervical trunk?

The thyrocervical trunk arises between the origin of the subclavian arteries and the anterior scalene muscles (the first portion of the vessel). The thyrocervical trunk supplies blood to the thyroid, muscles of the upper back, shoulders, and neck. The costocervical trunk is a smaller branch of the subclavian artery that supplies the muscles ...

Why are subclavian arteries so rare?

Injury to the subclavian arteries is relatively rare, owing to their protection by the clavicles, surrounding muscle, and connective tissue. The subclavian arteries are damaged in less than 5% of trauma cases. If they are damaged by injury, the trauma is usually caused by a penetrative injury, such as gunshot wounds or knife injuries.

What is the ICD-10 code for aberrant subclavian artery?

However, symptoms can appear over time, and in later life, it can cause problems swallowing and chest pains. The ICD-10 code for aberrant subclavian artery is Q278.

Where is the second part of the scalene muscle?

The second part is found behind the anterior scalene muscle . The third and final part (before the subclavian artery becomes the axillary artery) is located between the lateral border of the anterior scalene muscle and the outer part of the first rib.

Where does the subclavian artery exit?

The subclavian artery exits the thorax via the superior thoracic aperture between the anterior and middle scalene muscles before passing between the first rib and clavicle. At the lateral border of the first rib it continues as the axillary artery.

What is the origin of the right subclavian artery?

Right and left subclavian arteries classically have different origins: right subclavian artery (RSA) is one of the terminal branches of the brachiocephalic artery. left subclavian artery (LSA) arises as the third branch of the aortic arch after the left common carotid artery.

Why do subclavian vessels arise?

The subclavian vessels may arise from aberrant locations if there is failure of the normal embryological aortic arch development.

Which artery causes breathing difficulties?

The most common variant is the aberrant right subclavian artery which results in a vessel that arises distal to the left subclavian artery and courses posteriorly between the trachea and esophagus where it may cause compression resulting in breathing difficulties or dysphagia.

Which arteries supply blood to the posterior cerebrum, cerebellum, posterior neck, upper limbs,

Subclavian artery. The subclavian arteries are asymmetric paired arteries that supply blood to the posterior cerebrum, cerebellum, posterior neck, upper limbs and the superior and anterior chest wall.

How many parts does a scalenus vessel have?

The vessel can be split into three parts (first, second, third) depending on the position of the vessel in relation to scalenus anterior: first part: from its origin to the medial border of scalenus anterior. second part: posterior to scalenus anterior.

Where does the subclavian artery go?

The subclavian artery leaves the thorax through the superior thoracic aperture between the anterior and middle scalene muscles before passing between the first and second ribs and the clavicle. It continues as the axillary artery at the lateral boundary of the first rib.

What is the right subclavian artery?

The Right Subclavian Artery: The right subclavian artery (RSA) is one of the brachiocephalic artery’s terminal branches.

What are the two arteries that supply blood to the thorax?

The subclavian arteries are two large arteries in the thorax that supply blood to the thorax, as well as the head, neck, shoulder, and arms. It may have two roots, depending on which side of the body it is on: the aortic arch on the left or the brachiocephalic trunk on the right.

What is the accessory inferior thyroid artery?

It is known as the accessory inferior thyroid artery if the inferior thyroid artery emerges from it rather than the natural origin of the thyrocervical trunk.

What is the smartest way to remember the branches of the subclavian artery?

Mnemonic is the important and smartest way to remember the branches of the subclavian artery;

Where does the transverse cervical artery travel?

The artery is then known as the dorsal scapular artery. It travels through the brachial plexus in this scenario, normally between the upper and middle trunks.

Which artery is the axillary artery?

The subclavian artery eventually becomes the axillary artery, the arterial supply to the upper limb regardless of which side of the body it is on. It splits into several branches along its route, one from each of its three regions: thoracic, muscular, and cervical. There are a total of eight branches.

What is the subclavian artery?

At the outer edge of the first rib, the subclavian artery becomes the axillary artery (see Fig. 7-5 ). The vessel runs behind the pectoralis major and minor muscles and lateral to the axillary vein. Its major branches include the superior thoracic, thoracoacromial, lateral thoracic, subscapular, and anterior and posterior humeral circumflex arteries. These branches supply muscles of the shoulder girdle, humerus, scapula, and chest wall.

Where does the subclavian artery transition to?

The subclavian artery transitions to the axillary artery at the lateral border of the first rib ( Fig. AI2.11B ). The axillary artery then transitions to the brachial artery at the lower border of the teres major muscle. The anterior and posterior circumflex arteries form an anastomosing circle around the surgical neck of the humerus.

What arteries supply the palmar arch?

The arterial anatomy of the hand is extremely variable, and deviations from the classic pattern described here are common. 5,6 The ulnar artery supplies the superficial palmar arch, and the radial artery supplies the deep palmar arch ( Figs. 7-9 and 7-10 ). The arches often are in continuity with the opposing forearm artery through small branches at the wrist. The superficial arch is dominant and usually lies distal to the deep arch. The princeps pollicis and radialis indicis arteries arise from the radial artery and supply the thumb and index finger, respectively. The superficial palmar arch gives off three or four common palmar digital arteries, and the deep arch gives off the palmar metacarpal arteries. At the bases of the proximal phalanges, adjacent metacarpal vessels from each arch join and then immediately divide into proper digital arteries, which supply apposing surfaces of the fingers. A so-called incomplete arch, defined by a lack of continuity of the radial artery with the superficial arch and lack of supply of the thumb and medial index finger by the ulnar artery, is found in about 20% of the population in autopsy studies. 5 This pattern is found more frequently in angiographic series. 7

What happens if you damage the subclavian artery?

Damage to the subclavian artery itself can result in arterial pathology ranging from a small stenosis to aneurysm formation or complete occlusion. Each of these occurrences then can have its own sequelae secondary to embolization or thrombosis or the extremely rare rupture of a subclavian aneurysm.

Which artery divides into the radial and ulnar arteries?

At about the level of the radial head, the brachial artery divides into the radial and ulnar arteries ( Fig. 7-8 ). The radial recurrent artery and the posterior and anterior ulnar recurrent arteries arise immediately beyond the origins of their respective arteries to form anastomoses with branches of the brachial and deep brachial artery (see Fig. 7-7 ). The radial artery descends on the radial side of the forearm. The ulnar artery, which is larger than the radial artery in most cases, gives off the common interosseous artery and then descends on the ulnar side of the forearm. The interosseous artery divides into anterior and posterior branches that run on either side of the interosseous membrane. In less than 10% of cases, the anterior interosseous or median artery persists and contributes to the palmar arch of the hand. 5

Which artery divides the thyrocervical trunk into inferior thyroid, suprascapular, and

The thyrocervical trunk takes off beyond the vertebral artery origin and immediately divides into the inferior thyroid, suprascapular, and superficial cervical arteries.

Where is the brachial artery?

The brachial artery passes down the medial aspect of the upper arm to the cubital fossa below which it divides into the radial and ulnar arteries; the point of division sometimes lies higher in the upper arm. Apart from muscular branches, the main branches of the brachial artery are the profunda brachii artery, which is given off in the upper arm and passes behind the humerus; the superior and inferior ulnar collateral arteries arise from the lower part of the brachial artery. It divides into the ulnar and radial arteries in the antecubital fossa.

What is the first part of the subclavian artery?

First part – origin of the subclavian artery to the medial border of the anterior scalene. Second part – posterior to the anterior scalene. Third part – lateral border of anterior scalene to the lateral border of the first rib.

Where does the arterial supply to the upper limb begin?

The arterial supply to the upper limb begins as the subclavian artery. On the right, the subclavian artery arises from the brachiocephalic trunk. On the left, it branches directly from the arch of aorta.

What is the condition of the brachial plexus?

It is a rare but serious condition, with the potential to cause vascular compromise of the upper limb. The dilated portion of the axillary artery can compress the brachial plexus, producing neurological symptoms such as paraesthesia and muscle weakness.

What is the deep palmar arch?

Deep palmar arch – located deep to the flexor tendons of the hand. It contributes to the blood supply to the digits and to the wrist joint. By TeachMeSeries Ltd (2021) Fig 6 – Arterial supply to the hand, via the superficial and deep palmar arches.

Which artery forms the radial and ulnar arteries?

The radial and ulnar arteries are formed by the bifurcation of the brachial artery within the cubital fossa:

Which artery is the brachial artery?

As it moves through the cubital fossa, underneath the bicipital aponeurosis, the brachial artery terminates by bifurcating into the radial and ulnar arteries.

Which artery is the main supply of blood for the arm?

The brachial artery is a continuation of the axillary artery past the lower border of the teres major. It is the main supply of blood for the arm.

Which artery gives rise to the right subclavian artery?

The brachiocephalic trunk (brachiocephalic artery) gives rise to the right subclavian artery and the right common carotid artery. Each subclavian artery arches over the respective lung, rising as high as the base of the neck slightly superior to the clavicle. It then passes posterior to the clavicle, downward over the first rib, ...

How to treat occlusive lesions of the proximal subclavian artery?

There are several methods of treating symptomatic occlusive lesions of the proximal subclavian artery. An endovascular approach is attempted before proceeding to open subclavian artery revascularization as it is a less invasive procedure 28). Surgical revascularization is attempted either via transposition of subclavian to carotid artery, carotid – subclavian bypass using a synthetic graft or by subclavian – axillary bypass if the carotid is not feasible 29).

What causes stenosis of the right subclavian artery?

The most common cause of subclavian artery stenosis is atherosclerosis but other causes include congenital abnormalities such as arteria lusoria (aberrant subclavian artery) or right sided aortic arch that can cause compression of the right subclavian artery leading to congenital subclavian steal syndrome 27).

What is the thyrocervical trunk?

Transverse cervical artery. The middle branch of the thyrocervical trunk is the transverse cervical artery. This branch passes laterally, across the anterior surface of the anterior scalene muscle and the phrenic nerve, and enters and crosses the base of the posterior triangle of the neck. It continues to the deep surface of the trapezius muscle, where it divides into superficial and deep branches : 1 The superficial branch continues on the deep surface of the trapezius muscle. 2 The deep branch continues on the deep surface of the rhomboid muscles near the medial border of the scapula.

What is the name of the artery that runs through the thoracic wall?

In the shoulder, it gives off several small branches to the thoracic wall and viscera. As the subclavian artery continues past the first rib, it is named the axillary artery. It continues through the axillary region, gives off small thoracic branches and ends, again in name only, at the neck of the humerus.

Which artery supplies the head, neck, shoulder, and upper limbs?

Subclavian arter y. Three large arteries arise from the aortic arch to collectively supply the head, neck, shoulder, and upper limbs: the brachiocephalic trunk, the left common carotid artery, and the left subclavian arter y. The brachiocephalic trunk (brachiocephalic artery) gives rise to the right subclavian artery and the right common carotid ...

Where is the superior ulnar collateral artery?

The superior ulnar collateral artery arises about midway along the brachial artery and descends in the medial side of the arm. It empties into the ulnar artery slightly distal to the elbow. Just distal to the elbow, the brachial artery forks into the radial and ulnar arteries.

Overview

Structure

Function

Clinical significance

Additional images

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