The supraclavicular nerves (descending branches) arise from the third and fourth cervical nerves. They emerge beneath the posterior border of the sternocleidomastoideus (sternocleidomastoid muscle), and descend in the posterior triangle of the neck beneath the platysma muscle and the

deep cervical fascia The deep cervical fascia (or fascia colli in older texts) lies under cover of the platysma, and invests the muscles of the neck; it also forms sheaths for the carotid vessels, and for the structures situated in front of the vertebral column. Its a ...

. Together, they innervate skin over the shoulder. The supraclavicular nerve can be blocked during shoulder surgery.

Branches

The supraclavicular nerves arise from C3 and C4 spinal nerve roots. Near the

clavicle The clavicle, or collarbone, is a slender, S-shaped long bone approximately 6 inches (15 cm) long that serves as a strut between the shoulder blade and the sternum (breastbone). There are two clavicles, one on the left and one on the rig ...

, the supraclavicular nerves perforate the fascia and the platysma muscle to become cutaneous. They are arranged, according to their position, into three groups—anterior, middle, and posterior.

Medial supraclavicular nerve

The medial supraclavicular nerves or ''anterior supraclavicular nerves'' (nn. supraclaviculares anteriores; suprasternal nerves) cross obliquely over the external jugular vein and the clavicular and sternal heads of the sternocleidomastoideus, and supply the skin as far as the middle line. They furnish one or two filaments to the sternoclavicular joint.

Intermedial supraclavicular nerve

The intermedial supraclavicular nerve ''middle supraclavicular nerves'' (nn. supraclaviculares medii; supraclavicular nerves) cross the

, and supply the skin over the

pectoralis major The pectoralis major () is a thick, fan-shaped or triangular convergent muscle, situated at the chest of the human body. It makes up the bulk of the chest muscles and lies under the breast. Beneath the pectoralis major is the pectoralis minor, a ...

and deltoideus, communicating with the cutaneous branches of the

upper intercostal nerves The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and diff ...

Lateral supraclavicular nerve

The lateral supraclavicular nerve or ''posterior supraclavicular nerves''(nn. supraclaviculares posteriores; supra-acromial nerves) pass obliquely across the outer surface of the

trapezius The trapezius is a large paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It moves the scapula and supports the ...

and the

acromion In human anatomy, the acromion (from Greek: ''akros'', "highest", ''ōmos'', "shoulder", plural: acromia) is a bony process on the scapula (shoulder blade). Together with the coracoid process it extends laterally over the shoulder joint. The acro ...

, and supply the skin of the upper and posterior parts of the shoulder.

Function

The supraclavicular nerves together innervate the

skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...

over the shoulder.

Clinical significance

A supraclavicular nerve block is useful when performing

surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

on the shoulder, anaesthetising a large area of skin. The supraclavicular nerves are vulnerable during surgery on the

, and must be identified early on in surgeries to reduce the risk of nerve injury and

neuroma A neuroma (; plural: neuromata or neuromas) is a growth or tumor of nerve tissue. Neuromas tend to be benign (i.e. not cancerous); many nerve tumors, including those that are commonly malignant, are nowadays referred to by other terms. Neuroma ...

Additional images

File:Gray784.png, Dermatome distribution of the trigeminal nerve File:Gray811and813.PNG, Cutaneous nerves of right upper extremity. File:Gray812and814.PNG, Diagram of segmental distribution of the cutaneous nerves of the right upper extremity. File:Gray1210.png, Side of neck, showing chief surface markings.

References

External links

* {{Authority control Nerves of the head and neck