Subclavian Vein

Describe the anatomy relevant to central venous access (including femoral, internal jugular, external jugular, subclavian and peripheral veins)

The subclavian vein:

• Is a continuation of the axillary vein as it crosses the upper surface of the first rib
• Travels posterior to the clavicle, separated from the subclavian artery by the anterior scalene
• Joins with the internal jugular vein to form the brachiocephalic vein

Borders

• Anteriorly by the clavicle, subclavius muscle, and pectoralis major
• Posteriorly by anterior scalene muscle and subclavian artery
• Inferiorly by first rib and lung apex
• Superiorly by skin, subcutaneous tissue, and platysma
• Medially by the brachiocephalic vein
• Laterally by the axillary vein

Surface Anatomy

The needle is placed in the deltopectoral groove, inferior and lateral to the middle third of the clavicle. The needle is inserted at a shallow angle, passing under the middle third of the clavicle aiming at the sternal notch.

References

1. McMinn, RMH. Last's Anatomy: Regional and Applied. 9th Ed. Elsevier. 2003.