Upper limb: scapular anastomosis: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Upper limb: scapular anastomosis

Sample item

A stab wound requires ligation of the axillary artery just proximal to the origin of the subscapular artery, yet the hand stays warm and viable. Which collateral channel mainly restores flow to the arm?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Suprascapular and dorsal scapular arteries joining the circumflex scapular branch of the subscapular artery

The scapular anastomosis links the suprascapular and dorsal scapular branches of the subclavian system with the circumflex scapular branch of the subscapular artery. Blood passes backward down the subscapular artery to refill the axillary artery distal to the ligature. This is why the ligation proximal to the subscapular artery is tolerated.

Option by option

  • A. Internal thoracic artery with the posterior intercostal arteries

    This route is the collateral pathway of aortic coarctation, not of axillary artery ligation.

  • B. Profunda brachii artery with the radial recurrent artery

    These vessels bypass an obstruction at the elbow level of the brachial artery, not in the axilla.

  • C. Suprascapular and dorsal scapular arteries joining the circumflex scapular branch of the subscapular artery (correct)

    Correct. This anastomosis bridges the subclavian and the axillary arteries around the scapula.

  • D. Anterior and posterior circumflex humeral arteries

    The circumflex humeral arteries both arise distal to the ligature and do not bypass it.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, Suprascapular and dorsal scapular arteries joining the circumflex scapular branch of the subscapular artery. The scapular anastomosis links the suprascapular and dorsal scapular branches of the subclavian system with the circumflex scapular branch of the subscapular artery.

Why is "Internal thoracic artery with the posterior intercostal arteries" not the answer?

This route is the collateral pathway of aortic coarctation, not of axillary artery ligation.

Why is "Profunda brachii artery with the radial recurrent artery" not the answer?

These vessels bypass an obstruction at the elbow level of the brachial artery, not in the axilla.

Why is "Anterior and posterior circumflex humeral arteries" not the answer?

The circumflex humeral arteries both arise distal to the ligature and do not bypass it.

What concept does this question test?

It tests Upper limb: scapular anastomosis in Anatomy. Blood passes backward down the subscapular artery to refill the axillary artery distal to the ligature. This is why the ligation proximal to the subscapular artery is tolerated.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Upper limb: scapular anastomosis?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.