The suprascapular notch (or ''scapular notch'') is a notch in the superior border of 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 eith ...
, just medial to the base of the
coracoid process
The coracoid process (from Greek κόραξ, raven) is a small hook-like structure on the lateral edge of the superior anterior portion of the scapula (hence: coracoid, or "like a raven's beak"). Pointing laterally forward, it, together with the ...
. It forms the entrance site into the
suprascapular canal.
Structure
This notch is converted into a
by the
suprascapular ligament, and serves for the passage of the
suprascapular nerve
The suprascapular nerve is a nerve that branches from the upper trunk of the brachial plexus. It is responsible for the innervation of two of the muscles that originate from the scapula, namely the supraspinatus and infraspinatus muscles.
Structur ...
; sometimes the
ligament is
ossified
Ossification (also called osteogenesis or bone mineralization) in bone remodeling is the process of laying down new bone material by cells named osteoblasts. It is synonymous with bone tissue formation. There are two processes resulting in t ...
. The suprascapular vessels varies in number as well as in their course as they run at the suprascapular notch site. The
suprascapular artery
The suprascapular artery is a branch of the thyrocervical trunk on the neck.
Structure
At first, it passes downward and laterally across the scalenus anterior and phrenic nerve, being covered by the sternocleidomastoid muscle; it then crosses ...
pass above the
suprascapular ligament in most cases. The
suprascapular vein
The suprascapular vein is a vein running above the scapula. It drains into the external jugular vein. It drains the posterior region around the scapula.
Structure
The suprascapular vein runs above the scapula. It runs above the anterior corac ...
been found to pass above the
suprascapular ligament as well as passing through the suprascapular notch.
Types
Two main classification systems exists with others being modified approaches of the same principle.
Typing based on subjective observation of the suprascapular notch shape. Introduced by and modified by .
There are six basic types of scapular notch:
* Type I: Notch is absent. The superior border forms a wide depression from the medial angle to the coracoid process.
* Type II: Notch is a blunted V-shape occupying the middle third of the superior border.
* Type III: Notch is U-shaped with nearly parallel margins.
* Type IV: Notch is V-shaped and very small. A shallow groove is frequently formed for the suprascapular nerve adjacent to the notch.
* Type V: Notch is minimal and U-shaped with a partially ossified ligament.
* Type VI: Notch is a
as the ligament is completely ossified.
Typing based on parametric measurements of depth to upper width ratio of the suprascapular notch introduced by and modified by .
There are five basic types of scapular notch:
* Type I: Depth larger than upper width.
* Type II: Depth equal to upper width.
* Type III: Depth is smaller than upper width.
* Type IV: Notch is a
.
* Type V: Discrete notch.
The second method of suprascapular notch typing yields more practical approach in clinical diagnosis of the
suprascapular nerve entrapment.
Clinical Relevance
As the suprascapular nerve passes through the suprascapular notch, it is a common site of entrapment for the nerve.
Suprascapular notch
stenosis is a narrowing of the notch internal space that can potentially compress the suprascapular nerve leading to
suprascapular nerve entrapment. predicted the morphological pattern of the suprascapular notch
stenosis revealing higher incidence in the discrete notch (Type V according to the parametric measurements typing system). Two main suprascapular
stenosis pattern:
* Vertical stenosis. Treated surgically by cutting the
suprascapular ligament (ligamentectomy).
* Horizontal stenosis. Treated surgically by trimming the notch borders (
osteoplasty Osteoplasty is the branch of surgery concerned with bone repair or bone grafting. It is the surgical alteration or reshaping of bone. It may be used to relieve pain associated with metastatic bone disease. Percutaneous osteoplasty involves the use ...
).
The suprascapular nerve predictably passes through the suprascapular notch, so it is a good place for a local
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, ...
of the entire nerve.
Additional images
File:Suprascapular notch of left scapula - animation01.gif, Left scapula. Suprascapular notch shown in red.
File:Suprascapular notch - animation02.gif, Animation. Suprascapular notch shown in red.
File:Gray203.png, Left 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 eith ...
. Dorsal surface
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
. (Sup. notch visible at top center.)
File:Anterior surface of scapula.jpg, Costal surface of left scapula. Suprascapular notch labeled at top center.
See also
*
Great scapular notch
The great scapular notch (or ''spinoglenoid notch'') is a notch which serves to connect the supraspinous fossa and infraspinous fossa. It lies immediately medial to the attachment of the acromion to the lateral angle of the scapular spine.
The ...
*
Suprascapular canal
References
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Shoulder
Scapula