SUBSCAPULAR ARTERY

CONTENTS
 INTRODUCTION
 ORIGIN
 BRANCHES
 SUPPLY
 ANATOMICAL VARIANTS
 FUNCTION
 ABNORMALITIES

INTRODUCTION
The axillary artery has a distal part. The largest branch of this part is known as the
subscapular artery (SA) which proceeds inferiorly on the wall of the posterior axillary.
It follows the subscapularis muscle exactly on the lateral margin. Two terminal branches
are the end part of the subscapular artery (SA). These two terminals are the circumflex
scapular and thoracodorsal arteries. The main function of these two terminal branches is
to generate the anastomoses in the scapula region.

ORIGIN
In addition to serving as the largest branch, the subscapular artery is also the most
variable part of the axillary artery. This branch usually arises from the third part of the
axillary artery at the inferior border of the subscapularis muscle. Two clinical studies
reported that the mean distance of the subscapular artery origin from the axillary artery
was 7.3 cm and 6.69 cm, respectively.

BRANCHES
The subscapular artery (SA) consists of two large terminal branches including the
thoracodorsal artery and circumflex scapular artery. The function of these two branches is
as follows:
a. The thoracodorsal artery proceeds anteroposteriorly along the scapula on its lateral
border. On the way, this artery provides an increase to small branches that supply
the two parts including adjacent skin and latissimus dorsi muscle.
b. The larger part of the two terminal branches is known as the circumflex scapular
artery. This branch proceeds posteriorly, encloses the lateral edge of the scapula,
and arises on the posterior surface of the scapula. The circumflex scapular artery
supplies the subscapularis muscles and teres major. This branch also gives
collateral branches that take part in the formation of the anastomoses on the
scapular artery.

SUPPLY
The subscapular artery is part of the axillary artery which has a large diameter and has
two terminal branches. Due to these characteristics, the subscapular artery is
responsible for supplying many of the muscles in the shoulder area. The muscles
supplied by the subscapular artery are as follows:
a. Supraspinatus muscle: This type of muscle is relatively small in size and upper
back muscle that extends from the superior supraspinous fossa of the scapula
to the greater tubercle of the humerus.
 b. Infraspinatus muscle: This muscle is relatively thick in size and structure as a
triangular muscle. This muscle occupies the infraspinatus fossa in the main
part This muscle is categorized as a rotator cuff muscle. It has the main
function to stabilize the shoulder joint and externally rotate the humerus.
c. Deltoid muscle: this muscle forms the rounded contour of the human shoulder.
d. Latissimus dorsi muscle: this type of muscle is known as climbing muscle
along your arms are still above your head, you can lift your torso, together
with the help of the pectoralis major muscles.
e. Serratus anterior muscle: this muscle is a fan-shaped muscle on the lateral wall
of the thorax. Its main part is located deep under the scapula and pectoral
muscles. It is easy to feel between the pectoralis major and latissimus dorsi
muscles.
f. Subscapularis muscle: this muscle is well defined as a large triangular muscle
originating from the subscapular fossa. It is part of the four rotator cuff
muscles, the other three being the supraspinatus, infraspinatus, and teres minor
muscles.
g. The long head of triceps brachii muscle: this muscle is a large muscle on the
back of the upper limb of vertebrates. The medial head is mostly covered by
the long and lateral head, and only visible distal to the humerus.

ANATOMICAL VARIANTS
The subscapular artery is part of the axillary artery which is quite stable from an anatomical
point of view, with more than 80% showing its basic anatomy. Anatomical variations of the
subscapular artery that may occur include:
a. It arises from the second part of the axillary artery (about 15% of possibility)
 b. It is absent in just about 3% of circumflex scapular arteries and thoracodorsal artery
which arise separately from the axillary artery.
c. The lateral thoracic arteries, which possibly arise from the subscapular arteries
d. The posterior humeral circumflex artery originates from the subscapular artery or the
thoracodorsal artery.
e. From the perspective of its origin, the subscapular artery could arise from the second
or third part of the axillary artery. It is also could rise from the common trunk with a
posterior circumflex humeral artery from an axillary artery, a common trunk with a
lateral thoracic artery from the axillary artery, or a common trunk with a transverse
cervical artery from the thyrocervical trunk of the subclavian artery.
Because the axillary artery including the subscapular artery has the highest rate of rupture
rate and damage after the popliteal artery, knowing its variations is important and essential
for anatomists, surgeons, and radiologists to decide the best clinical interventions for patients
with an uncommon anatomical variant of the subscapular artery.

FUNCTION
The subscapular artery has the main function as a provider of blood supply to the shoulders,
thoracic wall muscles, skin, and upper extremities. The muscles supplied by the subscapular
artery have been mentioned above.

ABNORMALITIES
Some anatomical and physiological abnormalities case reports of the subscapular artery are as
follows:
 Branching and bifurcation of the subscapular artery are found in a case study of 60
years old Greek male corpse. There are deep brachial arteries and superficial arteries
in the 2nd section of the right-sided axillary artery. After generating the anterior
humeral circumflex artery, the deep brachial artery is divided into branches and
proceeds distally along the subscapular artery and the posterior humeral circumflex
artery.
 A ruptured aneurysm disease is found on the left side of the subscapular artery of 74
years old woman with a medical history of type 1 neurofibromatosis. This ruptured
aneurysm disease is clinically manifested with a sudden left chest mass and is later
well diagnosed. This abnormality is caused by chronic occlusion of the left side
subclavian artery. This circumstance is diagnosed with angiography before
embolization. In conclusion, the collateral artery aneurysms in the presence of chronic
occlusion of the major muscular arteries could develop in patients with a medical
record of neurofibromatosis type 1.