Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Head, Neck, and Thorax
Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed
When the thyrocervical trunk is absent, the inferior thyroid is absent or arises from another source, usually as a branch from the first part of the subclavian. The other branches may form a combined "cervico-scapular" trunk (10%), giving rise to the transverse cervical and suprascapular arteries. A "thyrovertebral trunk" has also been reported.
The internal thoracic (internal mammary) may also arise from the thyrocervical trunk (9%).
A lateral internal thoracic artery may arise from the thyrocervical trunk. This artery is found in the thorax at about mid-axillary line.
In a study of the transverse cervical artery , Phillips also reported ten forms or groups of thyrocervical trunks.
Group I:This group has the usual three branches from the thyrocervical trunk (inferior thyroid, transverse cervical and suprascapular) originating from the first part of the subclavian artery, just proximal to the medial border of the anterior scalene muscle. The transverse cervical artery is superior to the suprascapular artery and both vessels cross the anterior scalene anteriorly. This pattern occured in 43% of 150 thyrocervical trunks studied (68/150). Three secondary variants were noted. Subgroup Ia: The pattern of branching is similar, but the transverse cervical artery is coursing posterior to the anterior scalene, the suprascapular coursing anterior. This variant occurred in 9/150 or 6%. In subgroup Ib: the basic pattern is the same but the suprascapular artery courses posterior to the anterior scalene, the transverse cervical artery anterior. It occurred in 6/150 or 4%. Subgroup Ic: The basic pattern is unchanged but the transverse cervical and suprascapular course posterior to the anterior scalene. Occurred in 2/150 or 1.3%.
Group II:The superficial cervical artery arises from the thyrocervical trunk and replaces the superficial branch of the transverse cervical artery, the descending branch being replaced by the dorsal scapular artery, which arises from the third part of the subclavian artery. Frequency 29/150 or 19%.
Group III:No thyrocervical trunk is formed. The inferior thyroid artery arises from the posterior surface of the subclavian, just proximal to the medial border of the anterior scalene. The transverse cervical artery arises from the second portion of the subclavian artery and the suprascapular artery arises from the third portion of the subclavian. Frequency 11/150 or 7%.
Group IV:No typical thyrocervical trunk. The transverse cervical artery arises from the third portion of the subclavian artery. Freqency 9/150 or 6%.
Group V: No typical thyrocervical trunk. The inferior thyroid and transverse cervical arteries arise separately from the first portion of the subclavian artery. The suprascapular artery arising from the third portion of the subclavian. Frequency 8/150 or 5%.
Group VI:The thyrocervical trunk, with typical trifucation, arises from the posterior surface of the second portion of the subclavian artery. Frequency 2/150 or 1.3%.
Group VII: The thyrocervical trunk is bifurcated. The transverse cervical artery arises as a branch of the proximal inferior thyroid and passes behind the scalenus anterior muscle. Frequency 2/150 or 1.3%.
Group VIII:The transverse cervical artery arises from the proximal internal thoracic artery and courses posterior to the subclavian artery and anterior scalene muscle. Frequency 2/150 or 1.3%.
Group IX:The transverse cervical artery arises from the proximal internal thoracic artery and courses posterior to the subclavian inferiorly, paralleling the clavicle. The suprascapular is absent. Frequency 1/150.
Group X: The suprascapular and transverse scapular arteries are absent. A branch arising from the third portion of the subclavian is bifucating into a lateral branch, and distributes as would a typical suprascapular, and a medial branch that joins the midportion of the inferior thyroid. Frequency 1/150.
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