Dorsal scapular nerve explained

Dorsal scapular nerve
Latin:nervus dorsalis scapulae
Innervates:Rhomboid minor, rhomboid major, levator scapulae
Branchfrom:C5 of brachial plexus

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.

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.[1]

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.[2]

The dorsal scapular nerve is typically not anaesthetised during a supraclavicular nerve block.[3] 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.[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

Notes and References

  1. Chang . Ke-Vin . Lin . Chih-Peng . Lin . Chia-Shiang . Wu . Wei-Ting . Karmakar . Manoj K . Özçakar . Levent . 2017-01-04 . Sonographic tracking of trunk nerves: essential for ultrasound-guided pain management and research . Journal of Pain Research . 10 . 79–88 . 10.2147/JPR.S123828 . 1178-7090 . 5222601 . 28115867 . free .
  2. Book: Akuthota. Venu. Herring. Stanley A.. 28 May 2009. Nerve and Vascular Injuries in Sports Medicine. Springer Science & Business Media. 9780387766003. Google Books.
  3. Book: Williams. Brain A.. https://www.sciencedirect.com/science/article/pii/B9780323041843500170. Raj's Practical Management of Pain. Neumann. Krystof J.. Goel. Shiv K.. Wu. Christopher L.. Mosby. 2008. 978-0-323-04184-3. 4th. 299–334. en. 14 - Postoperative Pain and Other Acute Pain Syndromes. 10.1016/B978-032304184-3.50017-0.
  4. Book: Rea, Paul. https://www.sciencedirect.com/science/article/pii/B9780128030622000024. Essential Clinically Applied Anatomy of the Peripheral Nervous System in the Limbs. 2015-01-01. Academic Press. 2015. 978-0-12-803062-2. 41–100. en. Chapter 2 - Upper Limb Nerve Supply. 10.1016/B978-0-12-803062-2.00002-4.