The Anatomy and Physiology of Subclavian Artery

The subclavian arteries are asymmetric paired arteries that supply blood to the posterior
cerebral circulation, cerebellum, posterior neck, upper limbs and the superior and anterior chest
wall. Right and left subclavian arteries classically have different origins, right subclavian artery
(RSA) is one of the terminal branches of the brachiocephalic artery which arise from the surface
of the aortic arch and left subclavian artery (LSA) arises as the third branch of the aortic arch
after the left common carotid artery. Three major branches arise before a subclavian artery leaves
the thoracic cavity: (1) the thyrocervical trunk, which provides blood to muscles and other
tissues of the neck, shoulder, and upper back; (2) an internal thoracic artery, supplying the
pericardium and anterior wall of the chest; and (3) a vertebral artery, which provides blood to the
brain and spinal cord.1,2
After leaving the thoracic cavity and passing over the outer border of the first rib, the
subclavian artery becomes the axillary artery, which supplies blood to the muscles of the pectoral
region and axilla. The axillary artery crosses the axilla to enter the arm, where it gives rise to the
humeral circumflex arteries, which supply structures near the head of the humerus. Distally the
axillary artery becomes the brachial artery, which supplies blood to the upper limb.1,2
The brachial artery first gives rise to the deep brachial artery, which supplies deep
structures along the posterior surface of the arm. It then supplies blood to the ulnar collateral
arteries, which, together with the ulnar recurrent arteries, supply the area around the elbow. At
the cubital fossa, the brachial artery divides into the radial artery, which follows the radius, and
the ulnar artery, which follows the ulna to the wrist. These arteries supply blood to the forearm.
The pathology related to the subclavian artery named subclavian steal syndrome which an
occlusion in the subclavian artery that cause stealing blood from posterior circulation or known
as the reversal blood flow of vertebral artery and associated with cerebral ischemic symptom. 1,2
Reference :
1. Martini FH, Tallitsch RB, Timmons MJ. Human Anatomy 7th ed. USA: Pearson Benjamin
Cummings; 2012.
2. Snell, RS. Clinical Anatomy by Regions 9 th ed. Philadelphia: Lippincott Williams &
Wilkins; 2012.