The dorsal scapular nerve is a branch of the

brachial plexus The brachial plexus is a network () of nerves formed by the anterior rami of the lower four cervical nerves and first thoracic nerve ( C5, C6, C7, C8, and T1). This plexus extends from the spinal cord, through the cervicoaxillary canal in th ...

. It supplies

rhomboid major muscle The rhomboid major is a skeletal muscle on the back that connects the scapula with the vertebrae of the spinal column. In human anatomy, it acts together with the rhomboid minor to keep the scapula pressed against thoracic wall and to retract the ...

, rhomboid minor muscle, and

levator scapulae muscle The levator scapulae is a slender skeletal muscle situated at the back and side of the neck. As the Latin name suggests, its main function is to lift the scapula. Anatomy Attachments The muscle descends diagonally from its origin to its inserti ...

. It causes the scapula to be moved medially towards the

vertebral column The vertebral column, also known as the backbone or spine, is part of the axial skeleton. The vertebral column is the defining characteristic of a vertebrate in which the notochord (a flexible rod of uniform composition) found in all chordata, ...

. Dorsal scapular nerve syndrome can cause a

winged scapula A winged scapula (scapula alata) is a skeletal medical condition in which the shoulder blade protrudes from a person's back in an abnormal position. In rare conditions it has the potential to lead to limited functional activity in the upper ex ...

, with

pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...

and limited motion.

Structure

The dorsal scapular nerve arises from the

, 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

and the rhomboids (minor superior to major). The nerve is accompanied by

dorsal scapular artery The transverse cervical artery (transverse artery of neck or transversa colli artery) is an artery in the neck and a branch of the thyrocervical trunk, running at a higher level than the suprascapular artery. Structure It passes transversely b ...

Function

The dorsal scapular nerve provides motor innervation to the

rhomboid muscle The rhomboid muscles (), often simply called the rhomboids, are rhombus-shaped muscles associated with the scapula. There are two rhomboid muscles on each side of the upper back: * Rhomboid major muscle * Rhomboid minor muscle The large rhom ...

s. These pull the

scapula The scapula (plural scapulae or scapulas), also known as the shoulder blade, is the bone that connects the humerus (upper arm bone) with the clavicle (collar bone). Like their connected bones, the scapulae are paired, with each scapula on eithe ...

medially towards the

. It also provides motor innervation to

. This elevates the scapula. This helps to stabilise the scapula.

Clinical Significance

Injury to the dorsal scapular nerve is usually apparent on inspection when the

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. The dorsal scapular nerve is typically not anaesthetised during a supraclavicular

nerve block Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. Local anesthetic nerve block (sometimes referred to as simply "nerve block") is a short-term block, ...

. This can cause

after some surgeries.

Dorsal scapular nerve syndrome

Dorsal scapular nerve syndrome can be caused by

nerve compression syndrome Nerve compression syndrome, or compression neuropathy, or nerve entrapment syndrome, is a medical condition caused by direct pressure on a nerve. It is known colloquially as a ''trapped nerve'', though this may also refer to nerve root compress ...

. A

is the most common symptom. Shoulder pain may occur. It causes weakness in

rhomboid minor muscle In human anatomy, the rhomboid minor is a small skeletal muscle on the back that connects the scapula with the vertebrae of the spinal column. Located inferior to levator scapulae and superior to rhomboid major, it acts together with the latte ...

, and

. The range of motion of the shoulder may be limited. Treatment is usually

conservative Conservatism is a cultural, social, and political philosophy that seeks to promote and to preserve traditional institutions, practices, and values. The central tenets of conservatism may vary in relation to the culture and civilization i ...

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

External links

* {{Authority control Nerves of the upper limb