During surgery to remove a cervical rib, which vessel is at greatest risk of injury?

• A. Brachiocephalic artery
• B. Right common carotid artery
• C. Right internal carotid artery
• D. Right subclavian artery

Answer: (D)

The vessel that is at greatest risk of injury during surgery to remove a cervical rib is the right subclavian artery. The anatomical location of the cervical rib can create a close relationship with the subclavian artery as it arises from the brachiocephalic trunk and courses laterally towards the upper limb. When a cervical rib is present, it can either compress or be directly adjacent to this artery, increasing the likelihood of damage during surgical manipulation.

Surgeons operating in this area need to be particularly cautious about the surrounding structures. The right subclavian artery is positioned right under where the cervical rib would be present, making it vulnerable to accidental laceration or transection during surgical dissection.

In contrast, the other arteries mentioned are situated either more anteriorly or deeper within the neck and are not as closely associated with the cervical rib during this type of surgical intervention. Thus, while they could also potentially be impacted during extensive procedures, they do not have the same level of risk as the right subclavian artery when specifically addressing a cervical rib.