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The subclavian nerve may issue a branch called the accessory phrenic nerve [3] [2] which innervates the diaphragm. [3] The accessory phrenic nerve may rather branch from the C4 or C6 segments or ansa cervicalis. [4] This nerve usually joins with the phrenic nerve before innervating the diaphragm, ventral to the subclavian vein. [5]
The upper (superior) trunk is part of the brachial plexus. It is formed by joining of the ventral rami of the fifth (C5) and sixth (C6) cervical nerves. The upper trunk divides into an anterior and posterior division. The branches of the upper trunk from proximal to distal are: subclavian nerve (C5-C6) suprascapular nerve (C5-C6)
The subclavius is a small triangular muscle, placed between the clavicle and the first rib. [1] Along with the pectoralis major and pectoralis minor muscles , the subclavius muscle makes up the anterior axioappendicular muscles , also known as anterior wall of the axilla .
The coracoid process of the scapula is not subcutaneous; It is covered by the anterior border of the deltoid. However, the tip of the coracoid process can be felt on deep palpation on the lateral aspect of the clavipectoral triangle. The coracoid process is used as a bony landmark when performing a brachial plexus block.
The internal thoracic artery arises from the anterior surface of the subclavian artery near its origin. [2] [3] It has a width of between 1-2 mm. [4] It travels downward on the inside of the rib cage, approximately 1 cm from the sides of the sternum, [3] and thus medial to the nipple. It is accompanied by the internal thoracic vein.
The subclavian vein lies behind the clavicle, and is not usually seen in this space; but in some cases it rises as high as the artery, and has even been seen to pass with that vessel behind the Scalenus anterior. The brachial plexus of nerves lies above the artery, and in close contact
Immediately anteroposteriorly the clavicle an areolar space exists between the investing layer and the sheath of the subclavian vessels, and in this space are found the lower part of the external jugular vein, the descending clavicular nerves, the transverse scapular and transverse cervical vessels, and the inferior belly of the omohyoid muscle.
The scalene muscles have an important relationship to other structures in the neck. The brachial plexus and subclavian artery pass between the anterior and middle scalenes. [4] The subclavian vein and phrenic nerve pass anteriorly to the anterior scalene as the muscle crosses over the first rib. The phrenic nerve is oriented vertically as it ...