Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Head, Neck, and Thorax

Variations in the Branches of the Subclavian Artery

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed

There are three additional types of variations, 1) the vertebral, internal thoracic (internal mammary), costocervical, and the inferior thyroid arise from the first part of the subclavian, while the transverse cervical arises from the second part and the suprascapular from either the third part or from the axillary artery. 2) The inferior thyroid, suprascapular, and the transverse scapular arise from a common stem from the first part. 3) In the rarest form, the inferior thyroid and superficial cervical arteries arise from a common trunk from the first part of the subclavian, while the suprascapular artery arises from the internal thoracic (internal mammary).

The subclavian artery may give rise to the inferior thyroid (27 of 273 cases or 9.9%), ascending cervical, suprascapular, supreme intercostal, deep cervical, accessory root to the vertebral, thyroidea ima, accessory inferior thyroid, and radial and ulnar arteries (without the axillary artery intervening). It sometimes provides a stem that gives rise to the internal thoracic, inferior thyroid, suprascapular, superior esophageal, an accessory or lateral internal thoracic, a vessel to the brachial plexus, a pericardial branch, a bronchial, or a pleural cupula branch.

J.J. Long studied the formation of the thyroid axis (thyrocervical trunk) and in all, used 75 specimens. It was found that their were four primary modes in which the branches were distributed. The four variations follow: Variation 1.- This arrangement is the usual form of the trunk. The thyroid axis, arising from the first part of the subclavian artery, gave off three vessels- the inferior thyroid, transversalis colli (transverse cervical), and suprascapular arteries. This was found in 33 of the 75 specimens. Variation 2.- In this group the posterior (dorsal) scapular artery arose from the third part of the subclavian artery in addition to three thyroid axis branches, viz, inferior thyroid, suprascapular, and superficial cervical arteries. This arrangement was found in 22 of the 75 specimens studied. Variation 3.- The group includes cases in which an artery (transversalis colli) susequently divided into superficial cervical and posterior (dorsal) scapular arose from the third part of the subclavian, while the thyroid axis provided the inferior thyroid and suprascapular arteries. This was found in 21 of 75 specimens. Variation 4.- In these cases three arteries arose from the third portion of the subclavian, sometimes as a single trunk, dividing into three branches, or as two trunks, one of which then divided into two branches. The branches in either case took the distribution of the superficial cervical, posterior (dorsal) scapular and suprascapular arteries. The inferior thyroid artery in these cases was the only representative of the axis. This was found in 4 of 75 specimens.

It can be seen that the inferior thyroid arose from the axis with one exception. The posterior (dorsal) scapular, in 42 cases out of 75, arose fron the third part of the subclavian artery, in 22 instances as a separate trunk, in 20 being conjoined with the superficial cervical, forming the transverse cervical. The suprascapular artery was also found to be a very constant branch of the thyroid axis, there being only 4 exceptions, vide Group 4 variations. The vessels arising from the third part of the subclavian varied considerably in the exact point at which they arose, sometimes coming off close to its termination, at others quite near to its origin, and in a very few cases one of the branches actually arose from the second portion of the subclavian. These variations tended to be the same on both sides of the same subject.

See also aortic arch for additional references and discussion of subclavian artery variations.

Branches of

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References

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Additional references will be found with the section on the aortic arch.

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