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Long thoracic nerve

September 01, 2023

The long thoracic nerve (also: external respiratory nerve of Bell, or posterior thoracic nerve) is a branch of the brachial plexus derived from cervical nerves C5-C7 that innervates the serratus anterior muscle.

Long thoracic nerve
Nerves of the left upper extremity. (Long thoracic labeled vertically at shoulder, to left of artery.)
The right brachial plexus with its short branches, viewed from in front. (Long thoracic labeled at center, third from top.)
Details
Frombrachial plexus (C5-C7)
Innervatesserratus anterior muscle
Identifiers
Latinnervus thoracicus longus
TA98A14.2.03.012
TA26410
FMA65275
Anatomical terms of neuroanatomy
[edit on Wikidata]

Structure Edit

Origin Edit

The long thoracic nerve arises from the anterior rami of cervical spinal nerves C5, C6, and C7.[1][2][3] The root from C7 may occasionally be absent.[4] The roots from C5 and C6 pierce through the scalenus medius, while the C7 root passes in front of the muscle.[citation needed]

Course and relations Edit

The long thoracic nerve descends through the cervicoaxillary canal. It is posterior to the brachial plexus,[3] and the axillary artery and vein.[4] This takes it deep to the clavicle.[2] It rests on the outer surface of the serratus anterior muscle. It extends along the side of the thorax to the lower border of the serratus anterior muscle, supplying fibres to each of the muscle's digitations.[5][6]

Function Edit

The long thoracic nerve innervates the serratus anterior muscle.[1] It supplies filaments to each of its digitations (finger-like projections).[5][6]

Clinical significance Edit

Due to its long, relatively superficial course, the long thoracic nerve is susceptible to injury, either through direct trauma or stretch.[7] Mechanisms of injury include:

Symptoms are often minimal – if symptomatic, a posterior shoulder or scapular burning type of pain may be reported. Some injuries, particularly lesions, can paralyse the serratus anterior muscle to produce a winged scapula.[3][12] This is most prominent when the arm is lifted forward or when the patient pushes the outstretched arm against a wall. However, even winging may not be evident until the trapezius stretches enough to reveal an injury several weeks later.[13]

See also Edit

References Edit

  1. ^ a b Rakocevic, G. (January 1, 2014), "Thoracic Nerve, Long", in Aminoff, Michael J.; Daroff, Robert B. (eds.), Encyclopedia of the Neurological Sciences (Second Edition), Oxford: Academic Press, pp. 448–450, doi:10.1016/b978-0-12-385157-4.00699-0, ISBN 978-0-12-385158-1, retrieved October 25, 2020
  2. ^ a b Tubbs, R. Shane; Goodrich, Dylan; Watanabe, Koichi; Loukas, Marios (January 1, 2015), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 43 - Anatomic Landmarks for Selected Nerves of the Head, Neck, and Upper and Lower Limbs", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 575–588, doi:10.1016/b978-0-12-410390-0.00045-7, ISBN 978-0-12-410390-0, retrieved October 25, 2020
  3. ^ a b c d Ryan, Monique M.; Jones, H. Royden (January 1, 2015), Darras, Basil T.; Jones, H. Royden; Ryan, Monique M.; De Vivo, Darryl C. (eds.), "Chapter 14 – Mononeuropathies", Neuromuscular Disorders of Infancy, Childhood, and Adolescence (Second Edition), San Diego: Academic Press, pp. 243–273, doi:10.1016/b978-0-12-417044-5.00014-7, ISBN 978-0-12-417044-5, retrieved October 25, 2020
  4. ^ a b Tomberlin, John (January 1, 2009), Wilk, Kevin E.; Reinold, Michael M.; Andrews, James R. (eds.), "CHAPTER 53 - Neurodynamic Techniques for the Athlete's Shoulder", The Athlete's Shoulder (Second Edition), Philadelphia: Churchill Livingstone, pp. 707–717, doi:10.1016/b978-044306701-3.50056-6, ISBN 978-0-443-06701-3, retrieved October 25, 2020
  5. ^ a b Fischer, J. (2012). Anatomy of the Axilla. Fischer's Mastery of Surgery, 2 Volume Set. Retrieved September 20, 2015 from http://www.r2library.com/Resource/Title/1608317404/ch0046s1193
  6. ^ a b Bertelli, Jayme Augusto (2005). "Long Thoracic Nerve: Anatomy and Functional Assessment". The Journal of Bone and Joint Surgery. American Volume. 87 (5): 993–8. doi:10.2106/JBJS.D.02383. ISSN 0021-9355. PMID 15866961.
  7. ^ Ostrowska, Monika; de Carvalho, Mamede (January 1, 2015), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 34 - Injuries of the Nerves of the Thorax", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 525–543, doi:10.1016/b978-0-12-802653-3.00083-x, ISBN 978-0-12-802653-3, retrieved October 25, 2020
  8. ^ a b "An Isolated Long Thoracic Nerve Injury in a Navy Airman". Military Medicine. 2004.
  9. ^ Belmonte, Roser; Monleon, Sandra; Bofill, Neus; Alvarado, Martha Ligia; Espadaler, Josep; Royo, Inmaculada (2015). "Long thoracic nerve injury in breast cancer patients treated with axillary lymph node dissection". Supportive Care in Cancer. 23 (1): 169–175. doi:10.1007/s00520-014-2338-5. ISSN 1433-7339. PMID 25035064. S2CID 25547808.
  10. ^ Berthold, Justin B.; Burg, Timothy M.; Nussbaum, Ryan Paul (February 1, 2017). "Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging". Journal of Osteopathic Medicine. 117 (2): 133–137. doi:10.7556/jaoa.2017.025. ISSN 2702-3648. PMID 28134956. S2CID 25777654.
  11. ^ Monteiro dos Santos, Ricardo Barreto; dos Santos, Saulo Monteiro; Carneiro Leal, Flávio José Câmara; Lins, Otávio Gomes; Magalhães, Carmem; Mertens Fittipaldi, Ricardo Bruno (April 17, 2015). "Parsonage–Turner syndrome". Revista Brasileira de Ortopedia. 50 (3): 336–341. doi:10.1016/j.rboe.2015.04.002. ISSN 2255-4971. PMC 4519651. PMID 26229940.
  12. ^ Le Nail, L. R.; Bacle, G.; Marteau, E.; Corcia, P.; Favard, L.; Laulan, J. (June 2014). "Isolated paralysis of the serratus anterior muscle: surgical release of the distal segment of the long thoracic nerve in 52 patients". Orthopaedics & Traumatology, Surgery & Research. 100 (4 Suppl): S243–248. doi:10.1016/j.otsr.2014.03.004. ISSN 1877-0568. PMID 24703793.
  13. ^ Preston, David C.; Shapiro, Barbara E. (January 1, 2013), Preston, David C.; Shapiro, Barbara E. (eds.), "31 - Proximal Neuropathies of the Shoulder and Arm", Electromyography and Neuromuscular Disorders (Third Edition), London: W.B. Saunders, pp. 487–500, doi:10.1016/b978-1-4557-2672-1.00031-3, ISBN 978-1-4557-2672-1, retrieved October 25, 2020

Additional images Edit

  •  

    The right brachial plexus (infraclavicular portion) in the axillary fossa; viewed from below and in front.

  •  

    Brachial plexus

  •  

    Brachial plexus with courses of spinal nerves shown

External links Edit

  • Long thoracic nerve at the Duke University Health System's Orthopedics program
  • synd/2384 at Who Named It?
  • Anatomy figure: 05:03-07 at Human Anatomy Online, SUNY Downstate Medical Center - "The major subdivisions and terminal nerves of the brachial plexus."
  • Long Thoracic Nerve - BlueLink Anatomy - University of Michigan Medical School

September 01, 2023
long, thoracic, nerve, long, thoracic, nerve, also, external, respiratory, nerve, bell, posterior, thoracic, nerve, branch, brachial, plexus, derived, from, cervical, nerves, that, innervates, serratus, anterior, muscle, nerves, left, upper, extremity, long, t. The long thoracic nerve also external respiratory nerve of Bell or posterior thoracic nerve is a branch of the brachial plexus derived from cervical nerves C5 C7 that innervates the serratus anterior muscle Long thoracic nerveNerves of the left upper extremity Long thoracic labeled vertically at shoulder to left of artery The right brachial plexus with its short branches viewed from in front Long thoracic labeled at center third from top DetailsFrombrachial plexus C5 C7 Innervatesserratus anterior muscleIdentifiersLatinnervus thoracicus longusTA98A14 2 03 012TA26410FMA65275Anatomical terms of neuroanatomy edit on Wikidata Contents 1 Structure 1 1 Origin 1 2 Course and relations 2 Function 3 Clinical significance 4 See also 5 References 6 Additional images 7 External linksStructure EditOrigin Edit The long thoracic nerve arises from the anterior rami of cervical spinal nerves C5 C6 and C7 1 2 3 The root from C7 may occasionally be absent 4 The roots from C5 and C6 pierce through the scalenus medius while the C7 root passes in front of the muscle citation needed Course and relations Edit The long thoracic nerve descends through the cervicoaxillary canal It is posterior to the brachial plexus 3 and the axillary artery and vein 4 This takes it deep to the clavicle 2 It rests on the outer surface of the serratus anterior muscle It extends along the side of the thorax to the lower border of the serratus anterior muscle supplying fibres to each of the muscle s digitations 5 6 Function EditThe long thoracic nerve innervates the serratus anterior muscle 1 It supplies filaments to each of its digitations finger like projections 5 6 Clinical significance EditDue to its long relatively superficial course the long thoracic nerve is susceptible to injury either through direct trauma or stretch 7 Mechanisms of injury include nerve lesions 3 various sports injuries typically occurring from a blow to the ribs underneath an outstretched arm surgery for shoulder and thorax 8 Treating breast cancer with removal of axillary lymph nodes 9 carrying weight such as heavy bags over the shoulder for a prolonged time 10 Parsonage Turner Syndrome an autoimmune disease 11 trauma or infection 8 Symptoms are often minimal if symptomatic a posterior shoulder or scapular burning type of pain may be reported Some injuries particularly lesions can paralyse the serratus anterior muscle to produce a winged scapula 3 12 This is most prominent when the arm is lifted forward or when the patient pushes the outstretched arm against a wall However even winging may not be evident until the trapezius stretches enough to reveal an injury several weeks later 13 See also EditBackpack palsyReferences Edit a b Rakocevic G January 1 2014 Thoracic Nerve Long in Aminoff Michael J Daroff Robert B eds Encyclopedia of the Neurological Sciences Second Edition Oxford Academic Press pp 448 450 doi 10 1016 b978 0 12 385157 4 00699 0 ISBN 978 0 12 385158 1 retrieved October 25 2020 a b Tubbs R Shane Goodrich Dylan Watanabe Koichi Loukas Marios January 1 2015 Tubbs R Shane Rizk Elias Shoja Mohammadali M Loukas Marios eds Chapter 43 Anatomic Landmarks for Selected Nerves of the Head Neck and Upper and Lower Limbs Nerves and Nerve Injuries San Diego Academic Press pp 575 588 doi 10 1016 b978 0 12 410390 0 00045 7 ISBN 978 0 12 410390 0 retrieved October 25 2020 a b c d Ryan Monique M Jones H Royden January 1 2015 Darras Basil T Jones H Royden Ryan Monique M De Vivo Darryl C eds Chapter 14 Mononeuropathies Neuromuscular Disorders of Infancy Childhood and Adolescence Second Edition San Diego Academic Press pp 243 273 doi 10 1016 b978 0 12 417044 5 00014 7 ISBN 978 0 12 417044 5 retrieved October 25 2020 a b Tomberlin John January 1 2009 Wilk Kevin E Reinold Michael M Andrews James R eds CHAPTER 53 Neurodynamic Techniques for the Athlete s Shoulder The Athlete s Shoulder Second Edition Philadelphia Churchill Livingstone pp 707 717 doi 10 1016 b978 044306701 3 50056 6 ISBN 978 0 443 06701 3 retrieved October 25 2020 a b Fischer J 2012 Anatomy of the Axilla Fischer s Mastery of Surgery 2 Volume Set Retrieved September 20 2015 from http www r2library com Resource Title 1608317404 ch0046s1193 a b Bertelli Jayme Augusto 2005 Long Thoracic Nerve Anatomy and Functional Assessment The Journal of Bone and Joint Surgery American Volume 87 5 993 8 doi 10 2106 JBJS D 02383 ISSN 0021 9355 PMID 15866961 Ostrowska Monika de Carvalho Mamede January 1 2015 Tubbs R Shane Rizk Elias Shoja Mohammadali M Loukas Marios eds Chapter 34 Injuries of the Nerves of the Thorax Nerves and Nerve Injuries San Diego Academic Press pp 525 543 doi 10 1016 b978 0 12 802653 3 00083 x ISBN 978 0 12 802653 3 retrieved October 25 2020 a b An Isolated Long Thoracic Nerve Injury in a Navy Airman Military Medicine 2004 Belmonte Roser Monleon Sandra Bofill Neus Alvarado Martha Ligia Espadaler Josep Royo Inmaculada 2015 Long thoracic nerve injury in breast cancer patients treated with axillary lymph node dissection Supportive Care in Cancer 23 1 169 175 doi 10 1007 s00520 014 2338 5 ISSN 1433 7339 PMID 25035064 S2CID 25547808 Berthold Justin B Burg Timothy M Nussbaum Ryan Paul February 1 2017 Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging Journal of Osteopathic Medicine 117 2 133 137 doi 10 7556 jaoa 2017 025 ISSN 2702 3648 PMID 28134956 S2CID 25777654 Monteiro dos Santos Ricardo Barreto dos Santos Saulo Monteiro Carneiro Leal Flavio Jose Camara Lins Otavio Gomes Magalhaes Carmem Mertens Fittipaldi Ricardo Bruno April 17 2015 Parsonage Turner syndrome Revista Brasileira de Ortopedia 50 3 336 341 doi 10 1016 j rboe 2015 04 002 ISSN 2255 4971 PMC 4519651 PMID 26229940 Le Nail L R Bacle G Marteau E Corcia P Favard L Laulan J June 2014 Isolated paralysis of the serratus anterior muscle surgical release of the distal segment of the long thoracic nerve in 52 patients Orthopaedics amp Traumatology Surgery amp Research 100 4 Suppl S243 248 doi 10 1016 j otsr 2014 03 004 ISSN 1877 0568 PMID 24703793 Preston David C Shapiro Barbara E January 1 2013 Preston David C Shapiro Barbara E eds 31 Proximal Neuropathies of the Shoulder and Arm Electromyography and Neuromuscular Disorders Third Edition London W B Saunders pp 487 500 doi 10 1016 b978 1 4557 2672 1 00031 3 ISBN 978 1 4557 2672 1 retrieved October 25 2020Additional images Edit nbsp The right brachial plexus infraclavicular portion in the axillary fossa viewed from below and in front nbsp Brachial plexus nbsp Brachial plexus with courses of spinal nerves shownExternal links EditLong thoracic nerve at the Duke University Health System s Orthopedics program synd 2384 at Who Named It Anatomy figure 05 03 07 at Human Anatomy Online SUNY Downstate Medical Center The major subdivisions and terminal nerves of the brachial plexus Long Thoracic Nerve BlueLink Anatomy University of Michigan Medical School Retrieved from https en wikipedia org w index php title Long thoracic nerve amp oldid 1172469489, wikipedia, wiki, book, books, library,

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