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Supraclavicular fossa

The supraclavicular fossa is a depression located superior to the clavicle and lateral to the sternocleidomastoid muscle, forming an important anatomical landmark in the posterior triangle of the neck. It overlies critical neurovascular structures including the subclavian artery and vein, brachial plexus trunks, and supraclavicular lymph nodes.

This fossa is clinically significant as a palpation site for lymphadenopathy, a window for vascular access or nerve blocks, and a key region in thoracic outlet and metastatic disease assessment. Its contour varies with body habitus, respiration, and shoulder position.

Synonyms

  • Supraclavicular triangle

  • Lesser supraclavicular fossa

  • Omoclavicular fossa

Location and Boundaries

  • Position: Depression above the clavicle, at the root of the neck, lateral to the clavicular head of the sternocleidomastoid.

  • Boundaries:

    • Superior: Inferior belly of omohyoid muscle

    • Inferior: Superior surface of the clavicle

    • Medial: Lateral border of the sternocleidomastoid muscle

    • Lateral: Trapezius muscle

    • Floor: Formed by the first rib, scalene muscles, and fascia covering the subclavian vessels and brachial plexus trunks

    • Roof: Investing layer of deep cervical fascia covered by skin and platysma

Relations

  • Anteriorly: Skin, superficial fascia, and platysma muscle

  • Posteriorly: Scalenus anterior and medius muscles, first rib, subclavian artery and vein

  • Medially: Sternocleidomastoid and lower portion of internal jugular vein

  • Laterally: Trapezius and omohyoid muscles

  • Inferiorly: Continuity with the thoracic outlet

  • Superiorly: Overlies lower deep cervical lymph nodes and the supraclavicular part of the brachial plexus

Contents

  • Neurovascular structures:

    • Subclavian artery (3rd part) and subclavian vein

    • Suprascapular and transverse cervical arteries (branches of thyrocervical trunk)

    • Brachial plexus trunks (upper, middle, lower)

    • Supraclavicular nerves (cutaneous branches of cervical plexus)

  • Lymph nodes:

    • Supraclavicular lymph nodes, including Virchow’s node on the left side — sentinel node for thoracic or abdominal malignancies

  • Fascia and fat: Loose areolar tissue connecting to lower neck and upper mediastinum

Clinical Significance

  • Lymphadenopathy: Enlargement of supraclavicular nodes often indicates thoracic or abdominal malignancy (e.g., Virchow’s node in gastric cancer).

  • Thoracic outlet syndrome: Compression of subclavian vessels or brachial plexus within the fossa causes pain, paresthesia, or ischemic symptoms.

  • Venous access: Subclavian and supraclavicular approaches are used for central line placement.

  • Infection or metastasis: May involve supraclavicular nodes or fat plane obliteration on imaging.

  • Brachial plexus injury: Trauma or stretch injuries often manifest with swelling or hematoma within the fossa.

MRI image

Supraclavicular fossa shoulder axial cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

CT image

Supraclavicular fossa ct axial