The dorsal scapular nerve is a branch of the

brachial plexus The brachial plexus is a network of nerves (nerve plexus) formed by the anterior rami of the lower four Spinal nerve#Cervical nerves, cervical nerves and first Spinal nerve#Thoracic nerves, thoracic nerve (cervical spinal nerve 5, C5, Cervical spi ...

, usually derived from the ventral ramus of

cervical nerve A spinal nerve is a mixed nerve, which carries motor, sensory, and autonomic signals between the spinal cord and the body. In the human body there are 31 pairs of spinal nerves, one on each side of the vertebral column. These are grouped into t ...

C5. It provides motor innervation to the

rhomboid major muscle The rhomboid major is a skeletal muscle of the back that connects the scapula with the vertebrae of the spinal column. It originates from the spinous processes of the thoracic vertebrae T2–T5 and supraspinous ligament; it inserts onto the lower ...

rhomboid minor muscle In human anatomy, the rhomboid minor is a small skeletal muscle of the back that connects the scapula to the vertebrae of the spinal column. It arises from the nuchal ligament, the 7th cervical and 1st thoracic vertebrae and intervening sup ...

, and

levator scapulae muscle The levator scapulae is a slender skeletal muscle Skeletal muscle (commonly referred to as muscle) is one of the three types of vertebrate muscle tissue, the others being cardiac muscle and smooth muscle. They are part of the somatic nervous s ...

. 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 Stimulus (physiology), stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sense, sensory and emotional experience associated with, or res ...

and limited motion.

Structure

Origin

The dorsal scapular nerve arises from the

, usually from the plexus root ( anterior (ventral) ramus) of

C5.

Course and relations

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 ...

Function

The dorsal scapular nerve provides motor innervation to the two rhomboid muscles, and the

Clinical significance

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

scapula The scapula (: 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 either side ...

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, Local anesthetic nerve block (sometimes referred to as simply "nerve b ...

. This can cause

after some

surgeries Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery ...

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 chronic, direct pressure on a peripheral nerve. It is known colloquially as a ''trapped nerve'', though this may also refer to ...

. A

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

, and

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

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

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 Thoracic nerves