The Anatomy of the Transverse Cervical Artery

Artery in the neck is sometimes used in surgical reconstruction

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The transverse cervical artery (also called the transverse artery of the neck) is a small blood vessel located in your neck. This artery provides blood supply to your trapezius muscle, a large muscle in your back that helps raise your arms. You use your trapezius muscle for a variety of movements, including lifting heavy objects and lifting weights.

The transverse cervical artery can become damaged by a traumatic neck injury. In certain reconstructive surgical procedures involving the neck, this artery is surgically placed into the restructured tissue so that it can provide a healthy blood supply.

Arteries are examined with diagnostic tests

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Anatomy

You have two transverse cervical arteries, one on each side of your neck. These arteries are symmetrical and are structured alike, with symmetrical function.

The transverse cervical artery is one of three arteries that usually branch from the thyrocervical trunk, an artery that branches off of the subclavian artery and travels up into your neck.

As the transverse cervical artery travels underneath the omohyoid muscle in the neck, it extends further back in the neck near the anterior (front) portion of the trapezius muscle, where it divides into two smaller branches, the superficial cervical artery and the dorsal scapular artery.

Structure 

The transverse cervical artery is between 1.5 to 3 inches in length.

As mentioned above, it divides into two branches:

  • A superficial branch, which is the superficial cervical artery, travels upward after it branches from the transverse cervical artery.
  • A deep branch, which is the dorsal scapular artery, travels downward after it branches from the transverse cervical artery.

These branches are thinner than the transverse cervical artery, and their lengths are approximately the same as that of the transverse cervical artery.

Location

The left and right transverse cervical arteries are located on the sides of the neck, and they travel toward the back of the body.

These arteries lie deep in an area described as the interscalene triangle, a small region at the root of the neck. The anterior and middle scalene muscles border the sides of this triangular area, and the bottom is bordered by a rib.

There are a number of blood vessels and nerves near the transverse cervical artery, including the transverse cervical vein and the transverse cervical nerve, which are also small structures.

Anatomical Variations 

There are a number of anatomic variations when it comes to the structure of the transverse cervical artery. Generally, these variations are not considered clinically significant. They do not cause symptoms or problems, but they may be noticed during surgery or during diagnostic testing that visualizes the blood vessels.

Anatomic variations involving the transverse cervical artery can be important during surgical procedures, and they may be identified with diagnostic testing, such as angiography.

The most common variations include:

  • The dorsal scapular artery can branch directly from the subclavian artery, and studies suggest that the dorsal scapular artery arises more often from the subclavian artery than from the transverse cervical artery.
  • While the transverse cervical artery usually arises from the thyrocervical trunk, the most common variation is when the transverse cervical artery arises directly from the subclavian artery. In these cases, it may travel alongside the scalenus anterior muscle rather than the omohyoid muscle.
  • Sometimes the transverse cervical artery arises from another artery in the neck, such as the dorsal scapular artery, the inferior thyroid artery, the internal thoracic artery, or the costocervical trunk.
  • The anterior cervical artery can be completely absent, in which case the blood supply to the muscle is compensated for by another artery in a nearby location.

Variations are not rare, and they can be present on one or both transverse cervical arteries. When there are variations on both sides, the variations might not be identical in structure.

Function

Because it is an artery, the transverse cervical artery carries blood that is rich in oxygen and nutrients. The body uses oxygen and nutrients for energy. This artery is the main blood supply of the trapezius muscle, a large triangular-shaped muscle that is located in the upper and mid back.

The trapezius muscle is essential for stability of the upper portion of your back and trunk. This muscle controls the motion of the scapula, the large flat bone of the upper back. The trapezius muscle stabilizes and raises the shoulders, and also contributes movement to the head, neck, and back.

  • The superficial branch of the transverse cervical artery, the superficial cervical artery, supplies blood to the anterior portion of the trapezius muscle, which is the superficial (closer to the surface) muscular area of the back of the neck.
  • The deep branch, which is the dorsal scapular artery, supplies blood to the levator scapulae muscle, the rhomboid muscles, and part of the trapezius muscle, which are superficial muscles of the upper back.

Clinical Significance

As with all arteries in the body, the transverse cervical artery can be damaged by vascular disease. The transverse cervical artery can be damaged by injuries due to trauma to the neck, cancer metastasis, or radiation therapy injury.

The clinical consequences of an injury depend on the severity of the damage. Sometimes, severe traumatic injury of the transverse cervical artery may require surgical intervention.

Damage to this artery can cause bleeding, with resulting swelling of the neck, a hoarse voice, and/or difficulty breathing. 

An aneurysm or pseudoaneurysm can develop, typically due to a traumatic injury. This is a defective outpouching of the artery that could cause clinical effects, such as swelling, bleeding, and physical compression of nearby structures.

Use in Surgery

This artery can be involved in the surgical treatment of some cancers, such as when the tumor receives its blood supply from the transverse cervical artery.

In these types of situations, the artery can be closed off to prevent blood supply from reaching the cancer, a procedure that may help prevent the cancer from growing and surviving. Typically, the blood supply to important muscles would be provided by other arteries.  

Another important clinical feature of the transverse cervical artery is in its use in reconstructive head and neck surgery. This artery is often used as a source for vascularization (providing blood supply) to a flap in the neck. A flap is a portion of a person’s own tissue that is used in surgical repair.

These types of procedures may be needed in the neck due to extensive damage, such as due to cancer.

Diagnostic Tests

The transverse cervical artery can be examined by tests that help visualize the structure of blood vessels. Non-invasive angiography (looking at blood vessels) includes ultrasound, computerized tomography angiography (CTA), and magnetic resonance imaging angiography (MRA), and they are sometimes done with dye injected intravenously.

Invasive angiography tests use injected dye and a catheter to visualize the blood vessels. Sometimes a therapeutic procedure is done during an invasive angiography test.

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5 Sources
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