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Clavicle

The clavicle, or collarbone, is a slender, S-shaped long bone approximat ely 6 inches (15 cm)
long[1] t hat serves as a st rut bet ween t he shoulder blade and t he st ernum (breast bone). There
are t wo clavicles, one on t he left and one on t he right . The clavicle is t he only long bone in t he
body t hat lies horizont ally. Toget her wit h t he shoulder blade, it makes up t he shoulder girdle. It is
a t ouchable bone, and in people who have less fat in t his region, t he locat ion of t he bone is
clearly visible, as it creat es a bulge in t he skin. It receives it s name from t he Lat in clavicula
("lit t le key"), because t he bone rot at es along it s axis like a key when t he shoulder is abduct ed.
The clavicle is t he most commonly fract ured bone. It can easily be fract ured by impact s t o t he
shoulder from t he force of falling on out st ret ched arms or by a direct hit .[2]
 Clavicle (collarbone)

Collarbone (shown in red)

Human collarbone

Details

Identifiers

Latin Clavicula

MeSH D002968 (https://meshb.nlm.nih.gov/record/ui?ui

=D002968)

TA98 A02.4.02.001 (http://www.unifr.ch/ifaa/Public/Ent

ryPage/TA98%20Tree/Entity%20TA98%20EN/02.
4.02.001%20Entity%20TA98%20EN.htm)

TA2 1168 (https://ta2viewer.openanatomy.org/?id=11

68)

FMA 13321 (https://bioportal.bioontology.org/ontolog

 ies/FMA/?p=classes&conceptid=http%3A%2F%2F
purl.org%2Fsig%2Font%2Ffma%2Ffma13321)

Anatomical terms of bone

Structure

The collarbone is a t hin doubly curved long bone t hat connect s t he arm t o t he t runk of t he body.
Locat ed direct ly above t he first rib, it act s as a st rut t o keep t he scapula in place so t hat t he
arm can hang freely. At it s rounded medial end (st ernal end), it art iculat es wit h t he manubrium of
t he st ernum (breast bone) at t he st ernoclavicular joint . At it s flat t ened lat eral end (acromial end),
it art iculat es wit h t he acromion, a process of t he scapula (shoulder blade), at t he
acromioclavicular joint .

Right clavicle—from below, and from above

Left clavicle—from above, and from below

The rounded medial region (st ernal region) of t he shaft has a long curve lat erally and ant eriorly
along t wo-t hirds of t he ent ire shaft . The flat t ened lat eral region (acromial region) of t he shaft
has an even larger post erior curve t o art iculat e wit h t he acromion of t he scapula. The medial
region is t he longest clavicular region as it t akes up t wo-t hirds of t he ent ire shaft . The lat eral
region is bot h t he widest clavicular region and t hinnest clavicular region. The lat eral end has a
rough inferior surface t hat bears a ridge, t he t rapezoid line, and a slight rounded project ion, t he
conoid t ubercle (above t he coracoid process). These surface feat ures are at t achment sit es for
muscles and ligament s of t he shoulder.

It can be divided int o t hree part s: medial end, lat eral end, and shaft .

Medial end E…

The medial end is also known as t he st ernal end. It is quadrangular and art iculat es wit h t he
clavicular not ch of t he manubrium of t he st ernum t o form t he st ernoclavicular joint . The art icular
surface ext ends t o t he inferior aspect for art iculat ion wit h t he first cost al cart ilage.

Lateral end E…

The lat eral end is also known as t he acromial end. It is flat from above downward. It bears a
facet t hat art iculat es wit h t he shoulder t o form t he acromioclavicular joint . The area surrounding
t he joint gives an at t achment t o t he joint capsule. The ant erior border is concave forward and
t he post erior border is convex backward.

Shaft E…

The shaft is divided int o t wo main regions, t he medial region, and t he lat eral region. The medial
region is also known as t he st ernal region, it is t he longest clavicular region as it t akes up t wo-
t hirds of t he ent ire shaft . The lat eral region is also known as t he acromial region, it is bot h t he
widest clavicular region and t hinnest clavicular region.

3D model of the clavicle

Lat eral region of t he shaft
E…
The lat eral region of t he shaft has t wo borders and t wo surfaces.

t he ant erior border is concave forward and gives origin t o t he delt oid muscle.

t he post erior border is convex and gives at t achment t o t he t rapezius muscle.

t he inferior surface has a ridge called t he t rapezoid line and a t ubercle; t he conoid t ubercle for
at t achment wit h t he t rapezoid and t he conoid ligament , part of t he coracoclavicular ligament
t hat serves t o connect t he collarbone wit h t he coracoid process of t he scapula.

Development E…

The collarbone is t he first bone t o begin t he process of ossificat ion (laying down of minerals
ont o a preformed mat rix) during development of t he embryo, during t he fift h and sixt h weeks of
gest at ion. However, it is one of t he last bones t o finish ossificat ion at about 21–25 years of age.
It s lat eral end is formed by int ramembranous ossificat ion while medially it is formed by
endochondral ossificat ion. It consist s of a mass of cancellous bone surrounded by a compact
bone shell. The cancellous bone forms via t wo ossificat ion cent res, one medial and one lat eral,
which fuse lat er on. The compact forms as t he layer of fascia covering t he bone st imulat e t he
ossificat ion of adjacent t issue. The result ing compact bone is known as a periost eal collar.

Even t hough it is classified as a long bone, t he collarbone has no medullary cavit y (marrow cavit y)
like ot her long bones, t hough t his is not always t rue. It is made up of spongy cancellous bone
wit h a shell of compact bone.[3] It is a dermal bone derived from element s originally at t ached t o
t he skull.

Variation E…
The shape of t he clavicle varies more t han most ot her long bones. It is occasionally pierced by a
branch of t he supraclavicular nerve. In males t he clavicle is usually longer and larger t han in
females. A st udy measuring 748 males and 252 females saw a difference in collarbone lengt h
bet ween age groups 18–20 and 21–25 of about 6 and 5 mm (0.24 and 0.20 in) for males and
females respect ively.[4]

The left clavicle is usually longer and weaker t han t he right clavicle.[3][5]

The collarbones are somet imes part ly or complet ely absent in cleidocranial dysost osis.
The levat or claviculae muscle, present in 2–3% of people, originat es on t he t ransverse
processes of t he upper cervical vert ebrae and is insert ed in t he lat eral half of t he clavicle.

Functions

The collarbone serves several funct ions:[3]

It serves as a rigid support from which t he scapula and free limb suspended; an arrangement
t hat keeps t he upper limb away from t he t horax so t hat t he arm has maximum range of
movement . Act ing as a flexible, crane-like st rut , it allows t he scapula t o move freely on t he
t horacic wall.

Covering t he cervicoaxillary canal, it prot ect s t he neurovascular bundle t hat supplies t he upper
limb.

Transmit s physical impact s from t he upper limb t o t he axial skelet on.

Muscle E…
Muscles and ligament s t hat at t ach t o t he collarbone include:
 At t achment on
Muscle/Ligament Ot her at t achment
collarbone

Superior surface and delt oid t ubercle, ant eriorly

Delt oid muscle
ant erior border on t he lat eral t hird

post eriorly on t he lat eral

Superior surface Trapezius muscle
t hird

Inferior surface Subclavius muscle subclavian groove

Conoid ligament (t he medial part of t he

Inferior surface conoid t ubercle
coracoclavicular ligament )

Trapezoid ligament (t he lat eral part of t he

Inferior surface t rapezoid line
coracoclavicular ligament )

medial t hird (rounded

Ant erior border Pect oralis major muscle
border)

St ernocleidomast oid muscle (clavicular superiorly, on t he medial

Post erior border
head) t hird

Post erior border St ernohyoid muscle inferiorly, on t he medial t hird

Post erior border Trapezius muscle lat eral t hird

Clinical significance

Acromioclavicular dislocat ion ("AC Separat ion")

Degenerat ion of t he clavicle

Ost eolysis

St ernoclavicular dislocat ions

A vert ical line drawn from t he mid-clavicle called t he mid-clavicular line is used as a reference in
describing cardiac apex beat during medical examinat ion. It is also useful for evaluat ing an
enlarged liver, and for locat ing t he gallbladder which is bet ween t he mid-clavicular line and t he
t ranspyloric plane.

Collarbone fracture E…
Clavicle fract ures (colloquially, a broken collarbone) occur as a result of injury or t rauma. The
most common t ype of fract ures occur when a person falls horizont ally on t he shoulder or wit h an
out st ret ched hand. A direct hit t o t he collarbone will also cause a break. In most cases, t he
direct hit occurs from t he lat eral side t owards t he medial side of t he bone. The most common
sit e of fract ure is t he junct ion bet ween t he t wo curvat ures of t he bone, which is t he weakest
point .[6] This result s in t he st ernocleidomast oid muscle lift ing t he medial aspect superiorly, which
can result in perforat ion of t he overlying skin.

Other animals

The clavicle first appears as part of t he skelet on in primit ive bony fish, where it is associat ed
wit h t he pect oral fin; t hey also have a bone called t he cleit hrum. In such fish, t he paired clavicles
run behind and below t he gills on each side, and are joined by a solid symphysis on t he fish's
underside. They are, however, absent in cart ilaginous fish and in t he vast majorit y of living bony
fish, including all of t he t eleost s.[7]

The earliest t et rapods ret ained t his arrangement , wit h t he addit ion of a diamond-shaped
int erclavicle bet ween t he base of t he clavicles, alt hough t his is not found in living amphibians.
The cleit hrum disappeared early in t he evolut ion of rept iles, and is not found in any living
amniot es, but t he int erclavicle is present in most modern rept iles, and also in monot remes. In
modern forms, however, t here are a number of variat ions from t he primit ive pat t ern. For example,
crocodilians and salamanders lack clavicles alt oget her (alt hough crocodilians do ret ain t he
int erclavicle), while in t urt les, t hey form part of t he armoured plast ron.[7]

The int erclavicle is absent in marsupials and placent al mammals. In many mammals, t he clavicles
are also reduced, or even absent , t o allow t he scapula great er freedom of mot ion, which may be
useful in fast -running animals.[7]

Though a number of fossil hominin (humans and chimpanzees) clavicles have been found, most of
t hese are mere segment s offering limit ed informat ion on t he form and funct ion of t he pect oral
girdle. One except ion is t he clavicle of AL 333x6/9 at t ribut ed t o Australopithecus afarensis
which has a well-preserved st ernal end. One int erpret at ion of t his specimen, based on t he
orient at ion of it s lat eral end and t he posit ion of t he delt oid at t achment area, suggest s t hat t his
clavicle is dist inct from t hose found in ext ant apes (including humans), and t hus t hat t he shape
of t he human shoulder dat es back t o less t han
3 t o 4 (ht t p://t ools.wmflabs.org/t imescale/?Ma=3%E2%80%934) million years ago. However,
analyses of t he clavicle in ext ant primat es suggest t hat t he low posit ion of t he scapula in
humans is reflect ed most ly in t he curvat ure of t he medial port ion of t he clavicle rat her t han t he
lat eral port ion. This part of t he bone is similar in A. afarensis and it is t hus possible t hat t his
species had a high shoulder posit ion similar t o t hat in modern humans.[8]

In dinosaurs E…

In dinosaurs t he main bones of t he pect oral girdle were t he scapula (shoulder blade) and t he
coracoid, bot h of which direct ly art iculat ed wit h t he clavicle. The clavicle was present in
saurischian dinosaurs but largely absent in ornit hischian dinosaurs. The place on t he scapula
where it art iculat ed wit h t he humerus (upper bone of t he forelimb) is t he called t he glenoid. The
clavicles fused in some t heropod dinosaurs t o form a furcula, which is t he equivalent t o a
wishbone.[9]

In birds, t he clavicles and int erclavicle have fused t o form a single Y-shaped bone, t he furcula or
"wishbone" which evolved from t he clavicles found in coelurosaurian t heropods.

Additional media

Position of collarbone (shown in red). Animation.

Shape of collarbone (left). Animation.

3D image
Pectoral girdle—front

Diagram of the human shoulder joint, front view

Diagram of the human shoulder joint, back view

Muscles of the neck. Anterior view.

 Clavicle

Clavicle Anatomy

See also

Clavicle fract ure

References

1. The Shoulder Complex. In: Prentice WE. eds. Principles of Athletic Training: A Guide to Evidence-Based
Clinical Practice, 17e. McGraw-Hill; Accessed October 30, 2020. https://accessphysiotherapy-
mhmedical-com.libaccess.lib.mcmaster.ca/content.aspx?bookid=2992&sectionid=250962289
 2. "Busy Bones" (https://askabiologist.asu.edu/how-bone-breaks) . 2011-05-13. Retrieved 2016-12-02.

3. Moore, Keith L.; Dalley, Arthur F. (1999). Clinically Oriented Anatomy (https://archive.org/details/clinica
llyorient00moor) (4th ed.). Lippincott Williams & Wilkins. ISBN 978-0-683-06141-3.

4. "medind.nic.in" (http://medind.nic.in/jae/t02/i2/jaet02i2p199.pdf) (PDF). Archived (https://web.archi

ve.org/web/20140327031355/http://medind.nic.in/jae/t02/i2/jaet02i2p199.pdf) (PDF) from the
original on 2014-03-27. Retrieved 2012-02-13.

5. A. Bernat, T. Huysmans, F. Van Glabbeek, J. Sijbers, J. Gielen, and A. Van Tongel (2014). "The anatomy
of the clavicle: A Three-dimensional Cadaveric Study". Clinical Anatomy. 27 (5): 712–723.
doi:10.1002/ca.22288 (https://doi.org/10.1002%2Fca.22288) . PMID 24142486 (https://pubmed.ncb
i.nlm.nih.gov/24142486) . S2CID 23982787 (https://api.semanticscholar.org/CorpusID:23982787) .

. "Clavicle Fracture: Symptoms, Diagnosis & Treatment" (https://www.shoulder-pain-explained.com/clav

icle-fracture.html) .

7. Romer, Alfred Sherwood; Parsons, Thomas S. (1977). The Vertebrate Body. Philadelphia, PA: Holt-
Saunders International. pp. 184–186. ISBN 978-0-03-910284-5.

. Larson, Susan G. (2009). "Evolution of the Hominin Shoulder: Early Homo". In Grine, Frederick E.;
Fleagle, John G.; Leakey, Richard E. (eds.). The First Humans - Origin and Early Evolution of the Genus
Homo. Vertebrate Paleobiology and Paleoanthropology. Springer. p. 66. doi:10.1007/978-1-4020-9980-
9 (https://doi.org/10.1007%2F978-1-4020-9980-9) . ISBN 978-1-4020-9979-3.

9. Martin, A.J. (2006). Introduction to the Study of Dinosaurs. Second Edition. Oxford, Blackwell
Publishing. pg. 299-300. ISBN 1-4051-3413-5.

External links

Clavicle (ht t ps://sit es.google.com/a/umich.edu/bluelink/curricula/first -year-medical-curriculu

m/sequence-1-Foundat ions/session-1-basic-body-plan-pat t erns/bluelink) - BlueLink
Anat omy - Universit y of Michigan Medical School

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