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Subclavian artery: Regional approach and mnemonic

The subclavian arteries are a pair of large arteries in the thorax that supply blood to the thorax itself, head, neck, shoulder and arms. Depending on the side of the body, it can have two origins: the aortic arch on the left and the brachiocephalic trunk on the right.

The subclavian artery becomes the axillary artery in the end, the arterial supply to the upper limb, regardless of which side of the body it is. During its course, it gives off several branches from each of its three respective regions: thoracic, muscular, and cervical regions. In total, there are eight branches.

This article will shed some light onto one of the important arteries found in your body, together with its course, branches, and a mnemonic to help you remember them more easily.

Key facts about the subclavian artery
Origin Aortic arch (left side of the body), brachiocephalic trunk (right side of the body)
Continuation Axillary artery
Thoracic region branches Vertebral artery
Internal thoracic artery: superior epigastric, pericardiacophrenic, musculophrenic arteries
Thyrocervical trunk: inferior thyroid artery, ascending cervical, transverse cervical, suprascapular arteries
Muscular region branches Costocervical trunk: supreme intercostal, deep cervical arteries
Cervical region branches Deep branch of the transverse cervical artery
Mnemonic ' Very Tired Individuals Sip Strong Coffee Served Daily'
  1. Course of the subclavian artery
  2. Subclavian artery branches
    1. The thoracic region
    2. The muscular region
    3. The cervical region
  3. Subclavian artery branches: Mnemonic
  4. Summary
  5. Sources
+ Show all

Course of the subclavian artery

On the left side of the body the subclavian comes directly from the aortic arch whereas on the right side it arises from the brachiocephalic trunk. Both course above the cervical pleura towards the anterior scalene muscle and through the posterior scalene gap (between the anterior and medial scalene muscles). It enters the axilla between the first rib and the clavicle and becomes the axillary artery.

Notice that the right subclavian artery originates from the brachiocephalic trunk, while the left one originates from the aortic arch.

Subclavian artery branches

The thoracic region

During its course it gives off numerous branches. In the thoracic region, the following branches arise medial to the scalenus anterior muscle:

Vertebral artery

The first artery is the vertebral artery which ascends until it reaches the vertebral column at the transverse foramen of the sixth or seventh cervical vertebra.

Vertebral artery

Internal thoracic artery

Second is the internal thoracic artery which runs in the opposite direction to the vertebral artery behind the sternum and costal cage. It branches off into three smaller arteries:

Thyrocervical trunk

The third artery is the thyrocervical trunk which gives off four branches as it ascends:

  • The inferior thyroid artery ascends, makes a loop behind the common carotid artery and courses towards the backside of the thyroid crossing the recurrent laryngeal nerve. It branches off arteries to the larynx (inferior laryngeal artery), infrahyoid muscles and prevertebral muscles and many more smaller ones to the surrounding structures.
  • The ascending cervical artery is next and ascends along the phrenic nerve at the level of the fourth cervical vertebra.
  • The transverse cervical artery divides into a superficial and deep branch.
  • The superficial branch runs superficially in the lateral cervical region and then under the trapezius muscle (together with the accessory nerve). The deep branch branches off into two smaller arteries, one of which follows the dorsal scapular nerve along the medial border of the scapula. The suprascapular artery courses above the scapula in front of the anterior scalene muscle and behind the clavicle. It anastomoses with the scapular circumflex and thoracoacromial arteries (via the acromial branches).

The muscular region

The costocervical trunk arises behind the anterior scalene muscle and divides into two main branches:

  • The supreme intercostal artery is the highest of all intercostal arteries and supplies the upper two intercostal spaces, the deep neck and back muscles, the skin of the back and the vertebral canal.
  • As the trunk descends it gives rise to the deep cervical artery between the first rib and the seventh cervical vertebra which supplies the deep neck musculature.

The cervical region

Very often the deep branch of the transverse cervical artery arises directly from the subclavian artery lateral to the anterior scalene muscle. It is then referred to as the dorsal scapular artery. In this case it passes through the brachial plexus, usually between the upper and middle trunks.

Why not solidfy what you've learned with some flashcards? We've written an article on how you can make your own!

Subclavian artery branches: Mnemonic

One smart and fun way to remember the correct order and names of the most important branches of the subclavian artery is to learn the mnemonic 'Very Tired Individuals Sip Strong Coffee Served Daily'. It covers the following structures:

  • Vertebral artery
  • Thyrocervical trunk
  1. Inferior thyroid artery
  2. Superior cervical artery
  3. Suprascapular artery
  • Costocervical trunk
  1. Supreme intercostal artery
  2. Deep cervical artery

Test your knowledge on the subclavian and other arteries of the head seen on the lateral view by taking the quiz below!

Subclavian artery: Regional approach and mnemonic: want to learn more about it?

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