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Journal of the Anatomical Society of India

Anomalous Origin Of Suprascapular Artery - A Case Report

Author(s): *Mishra, S; **Ajmani, M.L.

Vol. 52, No. 2 (2003-07 - 2003-12)

Department of Anatomy, *Maulana Azad Medical College, **AIIMS, New Delhi-INDIA


An anomalous origin of the suprascapular artery was observed in one of thirty cadavers dissected while an abnormal course was observed in three cadavers. The suprascapular artery was seen to emerge from the first part of axillary artery on the left side while on the right side it emerged from the thyrocervical trunk. After its origin from the first part of axillary artery it ascended up for 0.75 cm and passed transversely behind the clavicle and the brachial plexus. It reached the scapula at the suprascapular notch being accompanied by the suprascapular nerve. In three cases both the structures passed under the transverse scapular ligament and supplied the supraspinatus muscle. An arterial anastomosis was observed between suprascapular, circumflex scapular and the first part of subclavian artery.

Key words: Axillary artery, Subclavian artery, Thyrocervical trunk, Suprascapular ligament, anastomosis.


The suprascapular artery is usually a branch of the thyrocervical trunk of the subclavian artery. It passes transversely across the neck in front of the scalenus anterior muscle, the brachial plexus and the third part of the subclavian artery. On reaching the superior border of the scapula it passes above the transverse scapular ligament, while the nerve passes below the ligament as described in various anatomical texts (Williams et al 1995; Last 1990; Hollinshead, 1982). Numerous variations in the origin of the branches of the subclavian artery and the thyrocervical trunk have been reported on routine dissection (Bean 1905; Read and Trotter 1941; Daselor and Anson 1959; Saadeh 1979). On routine dissection a rare anomaly of the suprascapular artery was found to be interesting.

Material and Methods:

Thirty cadavers of adult age groups of both sexes (27 males and 3 females) were dissected. The pectoral region, axilla and the brachial plexus were dissected out carefully. The subclavian artery & its continuation the axillary artery were exposed. Each and every branch was traced from origin to termination. For proper orientation the axillary artery was divided into three parts by the pectoralis minor muscle.


The suprascapular artery arose from the first part of the axillary artery on the left side in one cadaver (Fig. 1). After ascending for 0.75cm, it passed behind the clavicle, deep to the subclavius muscle and ran transversely to the lateral side passing behind the lower trunk of the brachial plexus. At the superior border of the scapula the suprascapular nerve emerging from the upper trunk of brachial plexus accompanied the artery. Both the structures entered the supraspinatus fossa by passing below the transverse scapular ligament. This variation (i.e. suprascapular artery passing below the transeverse scapular ligament) was observed in three cadavers. Before entering it gave a branch to the supraspinatus fossa and passed to the infraspinatus fossa through the spinoglenoid notch. The artery gave an acromial branch to the shoulder and a sternal branch. The artery was seen to anastomose with the deep branch of the transverse cervical artery on the medial side and with the circumflex scapular artery on the lateral side on the dorsal aspect of the scapula. On the right side the suprascapular artery was emerging from the thyrocervical trunk.


In a large number of cases an abnormal origin of the suprascapular artery has been described (Table 1). The passage of both the nerve and artery below the transverse scapular ligament was observed in three cadavers and is reported also by various workers as a frequent anomaly (Williams et al, 1995; Daselor and Anson, 1959).

The suprascapular artery in the present study was observed to arise from the axillary artery on the left side while on the right side it was a branch of the thyrocervical trunk. Reports have shown the artery

Table I: Showing Different Origins of Suprascapular artery.

Sr. No. Author (Year) Percentage of cases with different types of origin
(3 rd Part)
1 Bean (1905) 22 10 Rare -
2 Reed & Trotter (1941) 28 5 Rare -
3 Daselor & Anson (1959) 13.15 - Rare 4.38 (common with Transverse cervical artery)
4 Saadeh (1979) - - - Rarely from Dorsal scapular
5 Hollinshead (1982) - - - 95% from Thyrocervical trunk
6 Present study (2003) - - 1.6 -

to arise from the third part of the subclavian artery directly in 22% (Bean, 1905) and in 28% (Reed and Trotter, 1941). The origin of the suprascapular artery from the internal thoracic artery has been observed in 10% cases by Bean, (1905) and in 5% cases by Reed and Trotter, (1941). Occasionally the artery has been observed to arise from the axillary artery

(Bean, 1905; Reed and Trotter, 1941; Daselor and Anson, 1959). Saadeh (1979) made an interesting observation on the branching pattern of the subclavian artery, where in a single case the suprascapular artery arose from the dorsal scapular artery. However in the present study the suprascapular artery arose from the first part of the axillary artery in one cadever on the left side. In a complete study of the branching of the thyrocervical trunk (Hollinshead, 1982) various origins of the suprascapular artery have been described. In the first type the inferior thyroid artery has a common stem of varying length for the suprascapular and transverse cervical arteries. In the second type both arteries arise directly from the thyrocervical trunk. In the third type the thyrocervical trunk bifurcates into the inferior thyroid artery with suprascapular artery or with the transverse cervical artery. In the current study suprascapular artery was seen to arise from the first part of the axillary artery in only one cadever on the left side. This is one of the uncommon anomalies as described by Reed and Trotter, (1941). This anomalous origin is of clinical importance as it has been observed that suprascapular neuropathy, is not always a result of the entrapment of the suprascapular nerve. An alternative postulate suggests that damage to the suprascapular artery or axillary artery can lead to microemboli in the vasa nervosum of the suprascapular nerve (Ringel et al, 1990). Secondary spasmodic torticollis may also result from vascular haemangioma of the cervical and scapular branches as reported by Duran and Chacon (2001). Suprascapular artery also has a major contribution of blood supply to the tendinous rotator cuff of the shoulder joint mainly the supraspinatus muscle (Detreme et al, 1996).

Hence understanding the origin and branching pattern of the suprascapular artery would help in the management of diseases of the cervical and shoulder region which could be due to vascular origin.


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Fig 1.

Missing Image

Dissection of left suprascapular artery and suprascapular nerve, showing the, upper trunk (UT), middle trunk (MT) and lower trunk (LT) of brachial plexus. Note the suprascapular nerve (SSN) emerging from the UT. The subclavian artery (SCA) is seen to continue as the axillary artery (AA) at the outer border of 1st rib. AA is giving rise to the suprascapular artery (SSA). Both SSA and SSN are seen to pass under the transverse scapular ligament (TSL). Note supraspinatus (SSM) and the pectoralis minor muscle (P. min).

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