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 eithe ...

, 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

foramen In anatomy and osteology, a foramen (;Entry "foramen"
in

by the

suprascapular ligament The superior transverse ligament (transverse or suprascapular ligament) converts the suprascapular notch into a foramen or opening. It is a thin and flat fascicle Fascicle or ''fasciculus'' may refer to: Anatomy and histology * Muscle fascicle ...

, 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 cross ...

pass above the

in most cases. The suprascapular vein been found to pass above the

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

foramen In anatomy and osteology, a foramen (;Entry "foramen"
in

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

foramen In anatomy and osteology, a foramen (;Entry "foramen"
in

. * 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 A stenosis (from Ancient Greek στενός, "narrow") is an abnormal narrowing in a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture). ''Stricture' ...

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

revealing higher incidence in the discrete notch (Type V according to the parametric measurements typing system). Two main suprascapular

pattern: * Vertical stenosis. Treated surgically by cutting the

(ligamentectomy). * Horizontal stenosis. Treated surgically by trimming the notch borders ( osteoplasty). 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

. Dorsal surface. (Sup. notch visible at top center.) File:Anterior surface of scapula.jpg, Costal surface of left scapula. Suprascapular notch labeled at top center.

References

* * * * * {{Authority control Shoulder Scapula

Structure

Types

Clinical Relevance

Additional images

See also

References