View source for Dorsal scapular nerve

{{Use American English|date = January 2019}}
{{Use mdy dates|date = January 2019}}
{{Short description|Branch of the brachial plexus that supplies rhomboid muscles and levator scapulae}}
{{Not to be confused with|Thoracodorsal nerve}}
{{Infobox nerve
| Name        = Dorsal scapular nerve
| Latin       = nervus dorsalis scapulae
| Image       = Gray808.png
| Caption     = The right [[brachial plexus]] with its short branches, viewed from in front. (Dorsalis scapulae labeled at left, second from top.)
| Image2      =
| Caption2    =
| Innervates  = [[rhomboid minor muscle|Rhomboid minor]], [[rhomboid major muscle|rhomboid major]], [[levator scapulae muscle|levator scapulae]]
| BranchFrom  = C5 of [[brachial plexus]]
| BranchTo    =
}}

The '''dorsal scapular nerve''' is a branch of the [[brachial plexus]], usually derived from the ventral ramus of [[cervical nerve]] C5. It provides motor innervation to the [[rhomboid major muscle]], [[rhomboid minor muscle]], and [[levator scapulae muscle]].

Dorsal scapular nerve syndrome can cause a [[winged scapula]], with [[Shoulder problem|pain]] and limited motion.

== Structure ==

=== Origin ===
The dorsal scapular nerve arises from the [[brachial plexus]], usually from the plexus root ([[Ventral ramus|anterior (ventral) ramus]]) of [[cervical nerve]] C5.<ref name=":0">{{Citation|last1=Tubbs|first1=R. Shane|title=Chapter 43 - Anatomic Landmarks for Selected Nerves of the Head, Neck, and Upper and Lower Limbs|date=2015-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780124103900000457|work=Nerves and Nerve Injuries|pages=575–588|editor-last=Tubbs|editor-first=R. Shane|place=San Diego|publisher=Academic Press|language=en|doi=10.1016/b978-0-12-410390-0.00045-7|isbn=978-0-12-410390-0|access-date=2020-11-02|last2=Goodrich|first2=Dylan|last3=Watanabe|first3=Koichi|last4=Loukas|first4=Marios|editor2-last=Rizk|editor2-first=Elias|editor3-last=Shoja|editor3-first=Mohammadali M.|editor4-last=Loukas|editor4-first=Marios|url-access=subscription}}</ref><ref name=":1">{{Citation|last1=Felten|first1=David L.|title=Peripheral Nervous System|date=2016|url=https://linkinghub.elsevier.com/retrieve/pii/B9780323265119000096|work=Netter's Atlas of Neuroscience|pages=153–231|publisher=Elsevier|language=en|doi=10.1016/b978-0-323-26511-9.00009-6|isbn=978-0-323-26511-9|access-date=2020-11-02|last2=O'Banion|first2=M. Kerry|last3=Maida|first3=Mary Summo|url-access=subscription}}</ref><ref name=":2">{{Citation|last=Ma|first=Yun-tao|title=CHAPTER 8 - Neuroanatomy of Acu-Reflex Points|date=2011-01-01|url=http://www.sciencedirect.com/science/article/pii/B9781437709278000087|work=Acupuncture for Sports and Trauma Rehabilitation|pages=88–131|editor-last=Ma|editor-first=Yun-tao|place=Saint Louis|publisher=Churchill Livingstone|language=en|doi=10.1016/b978-1-4377-0927-8.00008-7|isbn=978-1-4377-0927-8|access-date=2020-11-02|url-access=subscription}}</ref>

=== Course and relations ===
Once the nerve leaves C5 it commonly pierces the [[Scalene muscles|middle scalene muscle]].<ref name=":0" /> It continues deep to [[levator scapulae muscle]] and the rhomboids (minor superior to major).<ref name=":0" />

The nerve is accompanied by [[dorsal scapular artery]].<ref>{{Cite journal |last1=Chang |first1=Ke-Vin |last2=Lin |first2=Chih-Peng |last3=Lin |first3=Chia-Shiang |last4=Wu |first4=Wei-Ting |last5=Karmakar |first5=Manoj K |last6=Özçakar |first6=Levent |date=2017-01-04 |title=Sonographic tracking of trunk nerves: essential for ultrasound-guided pain management and research |journal=Journal of Pain Research |volume=10 |pages=79–88 |doi=10.2147/JPR.S123828 |issn=1178-7090 |pmc=5222601 |pmid=28115867 |doi-access=free }}</ref>

== Function ==
The dorsal scapular nerve provides motor innervation to the two [[rhomboid muscle]]s,<ref name=":1" /><ref name=":2" /> and the [[levator scapulae muscle]].<ref name=":1" /><ref name=":2" />

== Clinical significance ==
Injury to the dorsal scapular nerve is usually apparent on inspection when the [[scapula]] 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.<ref>{{cite book|last1=Akuthota|first1=Venu|last2=Herring|first2=Stanley A.|date=28 May 2009|title=Nerve and Vascular Injuries in Sports Medicine|url=https://books.google.com/books?id=MfG0632WzhYC|publisher=Springer Science & Business Media|isbn=9780387766003|via=Google Books}}</ref>

The dorsal scapular nerve is typically not [[Anesthesia|anaesthetised]] during a supraclavicular [[nerve block]].<ref name=":4">{{Cite book|last1=Williams|first1=Brain A.|chapter-url=https://www.sciencedirect.com/science/article/pii/B9780323041843500170|title=Raj's Practical Management of Pain|last2=Neumann|first2=Krystof J.|last3=Goel|first3=Shiv K.|last4=Wu|first4=Christopher L.|publisher=[[Mosby (publisher)|Mosby]]|year=2008|isbn=978-0-323-04184-3|edition=4th|pages=299–334|language=en|chapter=14 - Postoperative Pain and Other Acute Pain Syndromes|doi=10.1016/B978-032304184-3.50017-0}}</ref> This can cause [[pain]] after some [[Surgery|surgeries]].<ref name=":4" />

=== Dorsal scapular nerve syndrome ===
'''Dorsal scapular nerve syndrome''' can be caused by [[nerve compression syndrome]]. A [[winged scapula]] is the most common symptom.<ref name=":3">{{Cite book|last=Rea|first=Paul|chapter-url=https://www.sciencedirect.com/science/article/pii/B9780128030622000024|title=Essential Clinically Applied Anatomy of the Peripheral Nervous System in the Limbs|date=2015-01-01|publisher=[[Academic Press]]|isbn=978-0-12-803062-2|pages=41–100|language=en|chapter=Chapter 2 - Upper Limb Nerve Supply|doi=10.1016/B978-0-12-803062-2.00002-4}}</ref> [[Shoulder problem|Shoulder pain]] may occur.<ref name=":3" /> It causes weakness in [[rhomboid major muscle]], [[rhomboid minor muscle]], and [[levator scapulae muscle]].<ref name=":3" /> The range of motion of the shoulder may be limited.<ref name=":3" /> Treatment is usually [[Conservative management|conservative]].<ref name=":3" />

== See also ==
* [[Dorsal scapular artery]]

== Additional images ==
<gallery>
 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
</gallery>

== References ==
{{Reflist}}

== External links ==
* {{DukeOrtho|Dorsal_scapular_nerve}}

{{Brachial plexus}}
{{Authority control}}

[[Category:Nerves of the upper limb]]
[[Category:Thoracic nerves]]