Supraclavicular Nerves
The nerves that course laterally and just superficial to the clavicle are the supraclavicular nerves, which are purely sensory branches of the cervical plexus (C3-C4 nerve roots).
Anatomical Course and Distribution
The supraclavicular nerves emerge as a single trunk in approximately 95% of cases, wrapping around the posterior border of the sternocleidomastoid muscle before entering the posterior cervical triangle 1. They then branch into three divisions:
- Medial supraclavicular nerves - innervate skin over the sternoclavicular joint and upper chest
- Intermediate supraclavicular nerves - innervate skin over the mid-clavicular region
- Lateral supraclavicular nerves - innervate skin over the shoulder and acromioclavicular joint
These nerves provide sensation to the skin over and below the clavicle, crossing the bone in a predictable superficial pattern 1. Importantly, all clavicular specimens receive contributions from supraclavicular nerves along their entire length, specifically innervating the cephalad (superior) and ventral (anterior) aspects of the clavicular bone 2.
Clinical Significance
Surgical Considerations
The superficial location of these nerves makes them vulnerable to iatrogenic injury during:
- Clavicle fracture repair and plate osteosynthesis
- Neck dissections
- Central venous catheter placement
- Any surgical approach to the supraclavicular region
The supraclavicular nerves are the sole innervation to the sternoclavicular joint and contribute (along with the lateral pectoral nerve) to acromioclavicular joint innervation 2.
Deeper Structures
While the supraclavicular nerves are the most superficial nerves in this region, clinicians should be aware that deeper neurovascular structures run beneath the clavicle, including the subclavian vessels and brachial plexus, which course at varying distances from the sternal end of the clavicle 3.