Dorsal scapular nerve
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|Dorsal scapular nerve|
|From||C5 of brachial plexus|
|Innervates||rhomboid minor, rhomboid major, levator scapulae|
|Latin||nervus dorsalis scapulae|
|Anatomical terms of neuroanatomy|
The dorsal scapular nerve is a branch of the brachial plexus. It supplies rhomboid major muscle, rhomboid minor muscle, and levator scapulae muscle. It causes the scapula to be moved medially towards the vertebral column. Dorsal scapular nerve syndrome can cause a winged scapula, with pain and limited motion.
The dorsal scapular nerve arises from the brachial plexus, usually from the plexus root (anterior/ventral ramus) of the cervical nerve C5. 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 one of two arteries: either the dorsal scapular artery (the only artery that branches off the third part of the subclavian artery, although its origin is highly variable in humans) or, when the dorsal scapular artery is absent, the deep branch of the transverse cervical artery. The latter is one of three arteries branching off the thyrocervical trunk, a branch of the first part of the subclavian artery, with the other two branches being the suprascapular artery, and the inferior thyroid artery.
The dorsal scapular nerve provides motor innervation to the rhomboid muscles, which pull the scapula medially towards the vertebral column, and levator scapulae muscle, which elevates the scapula. This helps to stabilise the scapula.
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.
Dorsal scapular nerve syndrome
Dorsal scapular nerve syndrome can be caused by nerve compression syndrome. A winged scapula is the most common symptom. 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.
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