dorsal scapular nerve
{{Use American English|date = January 2019}}
{{Use mdy dates|date = January 2019}}
{{Short description|Branch of the brachial plexus that supplies rhomboid muscles and levator scapulae}}
{{Not to be confused with|Thoracodorsal nerve}}
{{Infobox nerve
| Name = Dorsal scapular nerve
| Latin = nervus dorsalis scapulae
| Image = Gray808.png
| Caption = The right brachial plexus with its short branches, viewed from in front. (Dorsalis scapulae labeled at left, second from top.)
| Image2 =
| Caption2 =
| Innervates = Rhomboid minor, rhomboid major, levator scapulae
| BranchFrom = C5 of brachial plexus
| BranchTo =
}}
The dorsal scapular nerve is a branch of the brachial plexus, usually derived from the ventral ramus of cervical nerve C5. It provides motor innervation to the rhomboid major muscle, rhomboid minor muscle, and levator scapulae muscle.
Dorsal scapular nerve syndrome can cause a winged scapula, with pain and limited motion.
Structure
= Origin =
The dorsal scapular nerve arises from the brachial plexus, usually from the plexus root (anterior (ventral) ramus) of cervical nerve C5.{{Citation|last1=Tubbs|first1=R. Shane|title=Chapter 43 - Anatomic Landmarks for Selected Nerves of the Head, Neck, and Upper and Lower Limbs|date=2015-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780124103900000457|work=Nerves and Nerve Injuries|pages=575–588|editor-last=Tubbs|editor-first=R. Shane|place=San Diego|publisher=Academic Press|language=en|doi=10.1016/b978-0-12-410390-0.00045-7|isbn=978-0-12-410390-0|access-date=2020-11-02|last2=Goodrich|first2=Dylan|last3=Watanabe|first3=Koichi|last4=Loukas|first4=Marios|editor2-last=Rizk|editor2-first=Elias|editor3-last=Shoja|editor3-first=Mohammadali M.|editor4-last=Loukas|editor4-first=Marios|url-access=subscription}}{{Citation|last1=Felten|first1=David L.|title=Peripheral Nervous System|date=2016|url=https://linkinghub.elsevier.com/retrieve/pii/B9780323265119000096|work=Netter's Atlas of Neuroscience|pages=153–231|publisher=Elsevier|language=en|doi=10.1016/b978-0-323-26511-9.00009-6|isbn=978-0-323-26511-9|access-date=2020-11-02|last2=O'Banion|first2=M. Kerry|last3=Maida|first3=Mary Summo|url-access=subscription}}{{Citation|last=Ma|first=Yun-tao|title=CHAPTER 8 - Neuroanatomy of Acu-Reflex Points|date=2011-01-01|url=http://www.sciencedirect.com/science/article/pii/B9781437709278000087|work=Acupuncture for Sports and Trauma Rehabilitation|pages=88–131|editor-last=Ma|editor-first=Yun-tao|place=Saint Louis|publisher=Churchill Livingstone|language=en|doi=10.1016/b978-1-4377-0927-8.00008-7|isbn=978-1-4377-0927-8|access-date=2020-11-02|url-access=subscription}}
= Course and relations =
Once the nerve leaves C5 it commonly pierces the middle scalene muscle. It continues deep to levator scapulae muscle and the rhomboids (minor superior to major).
The nerve is accompanied by dorsal scapular artery.{{Cite journal |last1=Chang |first1=Ke-Vin |last2=Lin |first2=Chih-Peng |last3=Lin |first3=Chia-Shiang |last4=Wu |first4=Wei-Ting |last5=Karmakar |first5=Manoj K |last6=Özçakar |first6=Levent |date=2017-01-04 |title=Sonographic tracking of trunk nerves: essential for ultrasound-guided pain management and research |journal=Journal of Pain Research |volume=10 |pages=79–88 |doi=10.2147/JPR.S123828 |issn=1178-7090 |pmc=5222601 |pmid=28115867 |doi-access=free }}
Function
The dorsal scapular nerve provides motor innervation to the two rhomboid muscles, and the levator scapulae muscle.
Clinical significance
Injury to the dorsal scapular nerve is usually apparent on inspection when the scapula on the injured side is located farther from the midline than the uninjured scapula. The patient would be unable to pull their shoulder back, as when standing at attention. Isolated dorsal scapular nerve injury is uncommon, but case reports usually involve injury to the scalene muscles.{{cite book|last1=Akuthota|first1=Venu|last2=Herring|first2=Stanley A.|date=28 May 2009|title=Nerve and Vascular Injuries in Sports Medicine|url=https://books.google.com/books?id=MfG0632WzhYC|publisher=Springer Science & Business Media|isbn=9780387766003|via=Google Books}}
The dorsal scapular nerve is typically not anaesthetised during a supraclavicular nerve block.{{Cite book|last1=Williams|first1=Brain A.|chapter-url=https://www.sciencedirect.com/science/article/pii/B9780323041843500170|title=Raj's Practical Management of Pain|last2=Neumann|first2=Krystof J.|last3=Goel|first3=Shiv K.|last4=Wu|first4=Christopher L.|publisher=Mosby|year=2008|isbn=978-0-323-04184-3|edition=4th|pages=299–334|language=en|chapter=14 - Postoperative Pain and Other Acute Pain Syndromes|doi=10.1016/B978-032304184-3.50017-0}} This can cause pain after some surgeries.
= Dorsal scapular nerve syndrome =
Dorsal scapular nerve syndrome can be caused by nerve compression syndrome. A winged scapula is the most common symptom.{{Cite book|last=Rea|first=Paul|chapter-url=https://www.sciencedirect.com/science/article/pii/B9780128030622000024|title=Essential Clinically Applied Anatomy of the Peripheral Nervous System in the Limbs|date=2015-01-01|publisher=Academic Press|isbn=978-0-12-803062-2|pages=41–100|language=en|chapter=Chapter 2 - Upper Limb Nerve Supply|doi=10.1016/B978-0-12-803062-2.00002-4}} Shoulder pain may occur. It causes weakness in rhomboid major muscle, rhomboid minor muscle, and levator scapulae muscle. The range of motion of the shoulder may be limited. Treatment is usually conservative.
See also
Additional images
File:Brachial plexus.svg|Brachial plexus
File:Brachial_plexus_color.svg|Brachial plexus with courses of spinal nerves shown
File:Thyrocervical_trunk.png|Deep Branch of Transverse Cervical running with Dorsal Scapular
References
{{Reflist}}
External links
- {{DukeOrtho|Dorsal_scapular_nerve}}
{{Brachial plexus}}
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