Scapular arteries !

The scapular arteries feed the rotator cuff and back muscles and link up around the shoulder blade, a backup route if the main artery is blocked.

Official name: Suprascapular, subscapular and circumflex scapular arteries

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What it is

Arteries around the shoulder blade.

What it does

Feed the rotator cuff and back muscles and form a network around the scapula.

Key facts

Origin: Suprascapular (thyrocervical trunk), subscapular (axillary artery), dorsal scapular (subclavian)
Branches: Circumflex scapular, thoracodorsal
Supplies: Rotator cuff and scapular muscles; the scapular anastomosis bypasses an axillary block

Relations

Course: Suprascapular artery: from the thyrocervical trunk across the root of the neck behind the clavicle, over the ligament into the supraspinous fossa, then round the spinoglenoid notch into the infraspinous fossa
Behind: Circumflex scapular artery: from the subscapular artery through the triangular space into the infraspinous fossa, under the infraspinatus
Medial: Dorsal scapular artery: passes back through the brachial plexus (usually between the upper and middle trunks), then runs along the medial border of the scapula, deep to the rhomboids and levator scapulae, with the dorsal scapular nerve
Below: Thoracodorsal artery: down the lateral border with the thoracodorsal nerve to the latissimus dorsi

How to find it

Not palpable. In dissection the suprascapular artery is found above the ligament at the scapular notch, the circumflex scapular artery in the triangular space and the thoracodorsal artery on the deep surface of latissimus dorsi.

On imaging

Seen on CT or catheter angiography as the suprascapular, dorsal scapular and circumflex scapular arteries meeting around the scapula. When the artery between the subclavian and the third part of the axillary is blocked, this network enlarges to bypass it. In aortic coarctation it also feeds the intercostal arteries, whose enlargement notches the ribs on the chest radiograph.

Clinical notes

In coarctation of the aorta these vessels enlarge as part of the collateral circulation, and pulsation may be felt around the scapula
The thoracodorsal pedicle feeds the latissimus dorsi flap used in breast and limb reconstruction and is preserved during axillary lymph node dissection
The circumflex scapular artery is the pedicle of the scapular and parascapular flaps
Release of the suprascapular nerve at the notch or the spinoglenoid notch is done with the artery close by

Anatomical variants

The dorsal scapular artery may arise from the transverse cervical artery (thyrocervical trunk) instead of the subclavian; the suprascapular artery may come straight from the subclavian artery

Memory aid

At the suprascapular notch: "the Army goes over the bridge, the Navy goes under" (artery over the ligament, nerve under it).

Test yourself

Think of the answer, then tap the question to see it.

Which arteries does the scapular anastomosis link, and why does it matter?

The subclavian (suprascapular, dorsal scapular) with the third part of the axillary (subscapular, circumflex scapular); it bypasses a block between them.

How does the suprascapular artery pass the superior transverse scapular ligament?

Over the ligament, while the suprascapular nerve passes under it through the notch.

Through which space does the circumflex scapular artery leave the axilla?

The triangular space: teres minor above, teres major below, long head of triceps laterally.

Why may pulsation be felt around the scapula in coarctation of the aorta?

The scapular arteries enlarge as part of the collateral circulation.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2): arteria suprascapularis TA2 4599
Official Spanish (DeCS): Arterias supraescapular, subescapular, circunfleja de la escápula y toracodorsal
English (TA2): Suprascapular, subscapular and circumflex scapular arteries

Sources: Terminologia Anatomica (TA2); Anatomy, Thorax, Thyrocervical Arteries; Anatomy, Shoulder and Upper Limb, Arm Quadrangular Space; Tratado de anatomía humana (9.ª ed.), tomo II, Libro IV Angiología, arterias subclavia, axilar, humeral, radial y cubital, arcos palmares y vías anastomóticas del miembro superior.

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Representative model, for educational purposes only.

Scapular arteries highlighted on the Durgical 3D model