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1. First part - ascends b/w LONGUS COLLI + SCALENUS ANTERIOR, behind CCA + vertebral vein. The inferior thyroid artery + thoracic duct crosses anteriorly on the left; inferior thyroid artery + right lymphatic duct on the right. Posterior to the artery are: C7 transverse process, inferior cervical sympathetic ganglion, ventral rami of C7 + C8 nerve roots.

2. Second part - ascends vertically through C6-C2 transverse foramina, accompanied by a large branch from the inferior cervical sympathetic ganglion and a plexus of veins which unite in the lower neck to form the vertebral vein.

3. Third part - begins at the medial side of the RECTUS CAPITIS LATERALIS, curves backwards behind the C1 lateral mass, where C1 ventral ramus lies on its medial side. It runs on the groove on the posterior arch of the atlas to enter the vertebral canal below the posterior atlanto-occipital membrane. Here it is covered by SEMISPINALIS CAPITIS and lies in the suboccipital triangle.

4. Fourth part - pierces the dura and lies anterior to CN XII. It runs to the medulla, unites with its counterpart to form the basilar artery at the lower border of the pons.


1. Mcminn. (2003). Last's Anatomy. Elsevier Australia. ISBN:0729537528. Read it at Google Books - Find it at Amazon
2. Netter, F. H. (2019). Atlas of human anatomy. Philadelphia, PA: Elsevier.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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