Subclavian vessels

Internal carotid
artery
Subclavian artery
Course of artery
 first part of subclavian artery
• The first part of the subclavian artery passes superiorly and slightly laterally to lie
deep to the sternoclavicular joint. During this course its relations are:
• anteriorly, from deep to superficial:
– common carotid artery
– left phrenic nerve
– Internal juglar vein, Vertebral vein
– Cardic br of vagus n symp trunk, vagus nerve
– Thoracic duct, more sup. Rel. Sternohyoid, sternothyrid,
– ant jug vein, scm
– Posterior rel– supera pleural memb, cervical pleura,
– Apex of lung, rt recurrent laryngeal nr, ansa subclavia.

• The first part of the left subclavian artery gives off three branches, from proximal to
distal:
• vertebral artery; first to arise and passes from the superior margin of the vessel in a
superior direction
• thyrocervical trunk; again from the superior surface of the vessel. Passes superiorly.
• internal thoracic artery; arises from the inferior surface of the subclavian artery just
before the medial border of scalenus anterior. Passes inferiorly.
 second part of subclavian artery
• Ant: sca. Ant. Mus, n sternocleidomastoid
muscle In front of it are: right phrenic nerve,
subclavian vein, ant juglar vein.
• Sup: upper n middle trunk of brachial plexus,
• Posteroinf. : supera pleural memb, cervical
pleura, Apex of lung.
 third part of subclavian artery
• The third part of the subclavian artery is invested in prevertebral fascia
extending from the medial margin of scalenus anterior. The fascia passes
laterally in continuity with the axillary fascia.
• anterior: external jugular vein, supra scapular vessel, nr to subclavius,
prevertebral facia, subclavian vein, ant juglar vein, transverse cervical vein,
subclavius, scm, middle one third of clavicle.
– posteroinf : scal medius, lower trunk of brachial plexus, supera pleural
memb, cervical pleura, Apex of lung,
– Superior : upper n middle trunk of brachial plexus, inf belly of
omohyoid. Inf: 1st rib.
• This is the dorsal scapular artery that arises from its superior surface and
passes laterally, posteriorly and slightly superiorly through the lower roots
of the brachial plexus.
Branches of subclavian artery
 Vertebral art, internal thoracic

• Vertebral artery- Largest br, 4 parts, frst part in foramen transversarium o to 1st
cervical verebra. Run between scal. Ant n longus collis behind common carotid,
inferior thy ar, vertebral vein.
• Internal thoracic: arise frm inferior aspect opp origin of thyrocervical trunk, Enter
thorax by passing behind th first costal cartilage.
• Costocervical trunk
The Vertebral Arteries
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 Thyrocervical trunk
Divides into, 1. inferior thyroid artery 2.suprascapular artery 3. transverse cervical artery.

Vertebral
Deep cervical

Ascending
cervical

Transverse
cervical Inf. thyroid

Thyrocervical

Suprascapular

Thyrocervical
 Thyro cervical trunk
• Br of 1st part close to medial border of mus, btw pherinic, n vgus.
• Immediately divide into 3 br, inf. Thyroid, suprascaplar ar, transverse cervical ar.
1. Inf thy ar: with glnd
2. suprascaplar ar: run lateraly downward, cross scal. Ant Mus n pherinic nr, lie
behind scm n internal juglar vein. Then crosses trunks of brachial plexus come in
posterior triangle then reach sup. Border f scapula, n anast. Around scapula
3. transverse cervical ar: run lat abbv the abv ar, Then crosses trunks of brachial
plexus come in post triangle to reach ant border f trapezius where it divid into
sup, n deep br, sup accompany accessory spinal nr, n deep take part in anast aroun
scapul, sommetime two br arise seprately sup from thy cer trunk, deep from third
part,
4. Dorsal scapular: 3rd part br
 Costocervical trunk
Splits into,1. superior intercostal artery
2. deep cervical artery
.
 Costocervical trunk

• Arise from post surface of 2nd part of subclavian art. on rt side n 1st part of
subclavian art. on left side
• Arches backwards over cervical pleura n divided into descending sup. intercostal
and ascending deep cervical art.,
• at neck of the first rib superior intercostal art divide into first and second posterior
inercostal artery.
 Clinical anat.

1. 3rd part of art can be effectively comprssed against 1st rib after depressing
shoulder, pressure is applied downward, backward, n medially in angle bt scm n
clavical.
2. Cervical rib_ diminish radial pulse.
3. Aneurysm may form in 3rd part, its pressure on brachial plexus causes pain,
weakness, numbness in upp.limb.
Subclavian vein
common carotid a.
• The left a. begins at aortic arch.
• The right a. arises from
brachiocephalic trunk.
• The course of the a.
Post. to the sternoclavicular joint
Running upwards in the carotid
sheath
Divided into the internal and
external carotid aa., at the level
of the superior border the
thyroid cartilage
 Internal Carotid artery
• It is one of the terminal branches of the common
carotid artery

• It supplies the brain, the eye, the forehead, and the

part of nose

• It begins at the level of the upper border of the

thyroid cartilage

• Ascends in the neck to the base of the skull

 Internal Carotid artery

• It enters the cranial cavity through the carotid

canal in the petrous part of the temporal bone

• It lies embedded in the carotid sheath with

the internal jugular vein and vagus nerve

• It gives off no branches in the neck

 Relations
• Anteriorly: lie the skin, the fascia, anterior border of
sternocleidomastoid and the hypoglossal nerve,
anteomedial external carotid artery. the stylohyoid and
the stylopharyngeus muscles, parotid gland.
• Posteriorly: superior cervical ganglion,Carotid sheath,
the glossopharyngeal nerve, the pharyngeal branch of
vagus nerve.
• Medially: The pharyngeal wall , pharynx, and the
superior laryngeal nerve
• Laterally: The internal jugular vein.
 Head and neck
• Common carotids :

• External carotid:
supplies head external
to brain and orbit

• Internal carotid-Supply
orbits and most of cerebrum

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Internal carotid artery
Enters skull through carotid
canal
Gives off:
Ophthalmic artery
Then divides into anterior
and middle cerebral
arteries.
together they
supply 80% of
cerebrum
Thank you