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Anatomy · Heart & blood vessels

Subclavian artery

Artery beneath the collarbone

Root of the neck · upper limb supply

The main artery of the upper limb, passing over the first rib and beneath the clavicle. The right subclavian arises from the brachiocephalic trunk and the left directly from the aortic arch. It becomes the axillary artery at the outer border of the first rib and gives off the vertebral artery, the internal thoracic artery and the thyrocervical and costocervical trunks.

How to spot them

  • ▸Arches over the cupula of the pleura and lies in a groove on the top of the first rib
  • ▸Passes between scalenus anterior and scalenus medius; the subclavian vein lies in front of scalenus anterior
  • ▸First part gives the vertebral artery, internal thoracic artery and thyrocervical trunk
  • ▸Becomes the axillary artery at the lateral border of the first rib

What to know

Arises from the brachiocephalic trunk on the right, but directly from the aortic arch on the left

Subclavian artery — the right is shorter.

Named for its position below the collarbone, it arches over the first rib and grooves its upper surface

Subclavian artery — the groove for the subclavian artery.

Passes behind scalenus anterior, with the vein in front and the brachial plexus alongside

Subclavian artery — the second part lies behind scalenus anterior.

Gives off the vertebral artery, which ascends through the transverse foramina of the cervical vertebrae

Subclavian artery — first part branch.

Its branch to the front of the chest runs behind the costal cartilages and is used as a bypass graft for the heart

Subclavian artery — the internal thoracic (mammary) artery.

Blockage near its origin can make blood flow backwards down the vertebral artery, causing arm exercise to produce dizziness

Subclavian artery — subclavian steal syndrome.

At the outer border of the first rib it changes its name to the axillary artery

Subclavian artery.

It was divided and joined to the pulmonary artery in the 1944 operation that first relieved a cyanotic congenital defect in a child

Subclavian artery — Blalock–Taussig shunt.

Key ideas

  • Three parts relative to scalenus anterior: first (medial), second (behind), third (lateral).
  • Thoracic outlet: the artery, vein and brachial plexus all pass over the first rib, and can be compressed by a cervical rib.

Quick-fire facts

  • •Right subclavian: from the brachiocephalic trunk behind the right sternoclavicular joint. Left: directly from the arch of the aorta.
  • •Divided into three parts by scalenus anterior; the second part lies behind it.
  • •Branches: vertebral artery, internal thoracic artery, thyrocervical trunk (first part); costocervical trunk (second part); dorsal scapular (third part, sometimes).
  • •It becomes the axillary artery at the lateral border of the first rib.
  • •Subclavian steal syndrome is retrograde flow in the vertebral artery due to proximal subclavian stenosis.
  • •The Blalock–Taussig shunt, devised by Alfred Blalock, Helen Taussig and Vivien Thomas, first used in 1944 to treat blue babies.
  • •An aberrant right subclavian artery (arteria lusoria) arising from the descending aorta is found in roughly 1% of people.
  • •The vertebral arteries unite to form the basilar artery, which feeds the posterior circulation of the brain.

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Sources