The supraclavicular nerve is a cutaneous (sensory) nerve of the

cervical plexus The cervical plexus is a nerve plexus of the anterior rami of the first (i.e. upper-most) four cervical spinal nerves C1-C4. The cervical plexus provides motor innervation to some muscles of the neck, and the diaphragm; it provides sensory inne ...

that arises from the third and fourth cervical (spinal) nerves. It emerges from beneath the posterior border of the

sternocleidomastoid muscle The sternocleidomastoid muscle is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and Anatomical terms of motion#Flexion and extension, flexion of the neck. ...

, then split into multiple branches. Together, these innervate the skin over the shoulder. The supraclavicular nerve can be blocked during shoulder surgery.

Anatomy

Origin

The supraclavicular nerve is a branch of the

that arises from cervical (spinal) nerves C3-C4 with the predominant contribution from C4.

Course

It emerges at the posterior border of the

alongside the other three cutaneous branches of the cervical plexus, then promptly divides into several branches. The nerves descend in the posterior triangle of the neck beneath the

platysma muscle The platysma muscle or platysma is a superficial muscle of the human neck that overlaps the sternocleidomastoid. It covers the anterior surface of the neck superficially. When it contracts, it produces a slight wrinkling of the neck, and a "bowst ...

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 ...

. Near the

clavicle The clavicle, collarbone, or keybone is a slender, S-shaped long bone approximately long that serves as a strut between the scapula, shoulder blade and the sternum (breastbone). There are two clavicles, one on each side of the body. The clavic ...

, the supraclavicular nerves perforate the fascia and the

to become cutaneous. They are arranged, according to their position, into three groups—anterior, middle, and posterior.

Medial supraclavicular nerves

The medial supraclavicular nerves or ''anterior supraclavicular nerves'' (nn. supraclaviculares anteriores; suprasternal nerves) cross obliquely over the

external jugular vein The external jugular vein is a paired jugular vein which receives the greater part of the blood from the exterior of the cranium and the deep parts of the face, being formed by the junction of the posterior division of the retromandibular vein wi ...

and the clavicular and sternal heads of the

sternocleidomastoideus The sternocleidomastoid muscle is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The sternocleidomastoid is innervated by the acces ...

, and supply the skin as far as the middle line. They furnish one or two filaments to the sternoclavicular joint.

Intermedial supraclavicular nerves

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

, and supply the skin over the pectoralis major and

deltoideus The deltoid muscle is the muscle forming the rounded contour of the human shoulder. It is also known as the 'common shoulder muscle', particularly in other animals such as the domestic cat. Anatomically, the deltoid muscle is made up of three d ...

, communicating with the cutaneous branches of the upper intercostal nerves.

Lateral supraclavicular nerves

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 human spine, spine and laterally to the spine of the scapula. It moves the scapula and ...

and the

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

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

shoulder The human shoulder is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder m ...

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 animal coverings, such as the arthropod exoskeleton, have different ...

over the

Clinical significance

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 ...

is useful when performing

surgery 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 s ...

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 Nerve injury is an injury to a nerve. There is no single classification system that can describe all the many variations of nerve injuries. In 1941, Herbert Seddon introduced a classification of nerve injuries based on three main types of nerve ...

and neuroma.

Additional images

File:Gray784.png, Dermatome distribution of the trigeminal nerve File:Gray811and813.PNG, Cutaneous nerves of right upper extremity. File:Gray812and814.svg, 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