Xii: Anatomy of the subclavian artery

  • From: Axillary v (lateral border 1st rib)
  • To: Brachiocephalic v (forms IJV)

Course

  • Travels posterior to clavicle
  • Posteriorly, ant. scalene separates it from subclav a.
  • Travels over sup. border of 1st rib & joins IJV
  • Anterior – subclavius m., clavicle
  • Posterior – ant. scalene, subclavian a.
  • Inferior – lung apex, pleura
  • Superior – skin, platysma, aponeurosis
  • Medial – brachiocephalic trunk, vagal trunks, thoracic duct
  • Lateral – brachial plexus

Lymphatics

R) lymphatic duct drains lymph into the junction of R) internal jugular and R) subclavian

Thoracic duct drains into L) subclavian near junction of L) internal jugular

Surface Anatomy

NB: subclavian v stays patent in hypovolaemia due to connective tissue around it

  • Landmarks: SCM, clavicle, suprasternal notch
  • Insert needle ~2cm inferior to clavicle, aim towards suprasternal notch & go under clavicle