Brachiocephalic trunk

Branch · 1st arch branch Right SCJ

First and largest arch branch, arising to the right of the midline behind the manubrium and ascending to divide behind the right sternoclavicular joint into the right common carotid and right subclavian arteries. There is no left-sided equivalent.

Traced from the start

  1. Arch of the aorta
  2. Brachiocephalic trunk

Detail

Level
Arch to the right sternoclavicular joint
Branches
Right common carotid, right subclavian (occasionally a thyroid ima artery)
Relations
Left brachiocephalic vein crosses in front of it; trachea behind and to its left

When it goes wrong

Low tracheostomy, or erosion by a long-term tracheostomy tube cuff

Tracheo-innominate fistula: torrential bleeding from the tracheostomy as the trunk crosses the trachea in the suprasternal region

Thyroid ima artery variant (up to about 10%)

Unexpected bleeding in front of the trachea during tracheostomy or thyroidectomy

Practise this structure

1 question in the bank tagged Arterial Supply.