Subclavian artery

Subclavian artery (a. subclavia) is a large pair vessel supplying blood occipital brain, the cerebellum, the cervical part of spinal cord, muscles, and organs (part of) the neck, shoulders and upper limb.
Right subclavian artery leaves from the shoulder-the head of the trunk (truncus brachiocephalicus), the left - directly from the aortic arch (arcus aortae). The left subclavian artery longer the right to 2-2 .5 cm throughout the building. there are three parts: the first is the place of occurrence of an artery to the inner edge of the front scalenus (m. scalenus ant.), second - limited outside mileschicago period (spatium interscalenum) and third - from the outside edge of the front scalenus until the middle clavicle., where P. A. goes in the armpit (a. axillaris).

topography subclavian artery
Fig. 1. Topography right subclavian artery: 1 - a. vertebralis; 2 - truncus tliyreocervicalis (deleted); 3 - m. scalenus ant. (clipped); 4 - a. subclavia dext.; .5 - m. scalenus post, (deleted); 6 - a. transversa colli (deleted); 7 - truncus costocervicalis.

The first part of the subclavian artery is located on the dome of the pleura and covered the front coustem internal jugular vein (v. jugularis interna) and right subclavian vein (v. subclavia) or the initial part of the shoulder-head of Vienna and thoracic duct (left) To the front surface of the building, adjacent inside the vagus nerve (n. vagus) and outside of the chest-bruny nerve (n. phrenicus). Behind artery is lower cervical sympathetic ganglion, which, combined with the first breast, forms a star node; medially from P. A. is located common carotid artery (a. carotis communis). Right P. A. hinge covers the recurrent laryngeal nerve (n. laryngeus recurrens) - a branch of the vagus nerve. From the first part of the building. depart the following branches (Fig. 1): vertebral artery (a. vertebralis), internal thoracic artery (a. thoracica interna), sito-cervical trunk (truncus thyreocervicalis).
The second part of the subclavian artery is located directly on the first edge between anterior and middle flight muscles. In this part from the building. depart rib-cervical trunk (truncus costocervicalis), disintegrating on top intercostal artery (a. intercostalis suprema) and deep arteries in the neck (a. cervicalis profunda)and lateral artery neck (a. transversa colli).
The third part of the building. is relatively superficial and most accessible for surgical interventions. Anterior to the artery is located subclavian Vienna (v. subclavia). The beams of the brachial plexus adjacent to it from the top, front and back.
Damage subclavian artery in peacetime relatively rare, gunshot wounds during the great Patriotic war was 1.8% of all injuries vessels of the body. When wounded P. A. simultaneous damage of Vienna, stellate site, brachial plexus, pleura and easy, thoracic lymphatic duct. Symptoms injured P. A.: disorders of blood circulation of the upper limb, the external bleeding (41,7%), pulsating hematoma. While wounding pleura and easily observed hemothorax, thoracic duct - chylothorax, when brachial plexus injury - full or partial paralysis of the upper limb. Traumatic aneurysms occur relatively infrequently.

Fig. 2. The cuts in operations on subclavian artery: 1 - after; 2 - Lexer; 3 - Agutinu; 4 - the Reich; 5 - classical; 6 - the type of incision Dobrovolsky.

Temporary stop bleeding from the building. is the maximum institution hands behind his back and down or finger pressure, final - artery ligation or the imposition of vascular suture. After ligation P. A. 20.5% of cases observed gangrene (C. I. Pods). Operations on the building. produce about aneurysms (see Aneurysm), with some congenital heart defects (TOF) to create an anastomosis between the large and the small circle of blood circulation, obliterative Takayasu, traumatic arteriovenous fistulas. The main accesses to the subclavian artery - see Fig. 2. Extended access with resection of the clavicle is especially important in patients with aneurysms. Cm. also the Blood vessels.