Right subclavian vein

At a glance

English

Right subclavian vein

Latin (TA2)

Vena subclavia dextra

System

Vein

Region

Trunk

Side

Single, on the midline

About the right subclavian vein

The right subclavian vein drains the right upper limb. It begins at the lateral margin of the first rib, carrying on from the axillary vein, and ends behind the medial end of the clavicle, close to the sternoclavicular joint, where it unites with the right internal jugular vein. The junction is the right venous angle, and the vessel produced is the short right brachiocephalic vein. The subclavian vein is broad, typically one to two centimetres in diameter.

On its course it crosses the upper surface of the first rib, passing in front of scalenus anterior. The subclavian artery runs behind that muscle, between it and scalenus medius, so the muscle's attachment to the rib keeps the two vessels apart. The clavicle and subclavius lie in front of the vein. Its wall is held by the surrounding fascia, keeping the lumen open, and it normally has a valve shortly before its termination.

It receives the external jugular vein and sometimes the anterior jugular vein. At the right venous angle, a small right lymphatic duct, or several separate lymph trunks, empties lymph from the right side of the head, neck and thorax and from the right upper limb. The much larger thoracic duct ends on the left side instead, so fat-rich chyle from the gut does not normally pass through the right vein.

This vein is often chosen for central venous lines and pacemaker leads, because it is large, central and lies fairly close to the skin under the clavicle, giving a short straight path to the superior vena cava. Even so, the right internal jugular vein is frequently preferred, as the subclavian route carries a greater risk of pneumothorax, bleeding into the chest and accidental puncture of the artery. Compression or clotting of the vein at the thoracic outlet, typically with strenuous overhead arm activity, produces a swollen, aching, discoloured arm and must be treated without delay.

Course and drainage

Begins at

Continues the axillary vein at the lateral border of the first rib.

Drains into

Joins the right internal jugular vein behind the medial end of the clavicle, at the right venous angle, to form the right brachiocephalic vein.

Drains

Drains the right upper limb and, through the external jugular vein, parts of the scalp and neck; the right lymphatic duct opens at its junction.