From the superior angle of the clavicle it runs with an artery along the medial margin of the scapula and underneath the rhomboid muscles. Your healthcare professional will educate you on on the expected timeline for recovery in addition to limitations on activity. 7.25), both of which originate from the brachial plexus in the axilla. If this sounds like you, then you may have a problem with a nerve known as the Dorsal Scapular Nerve (DSN). TRAPEZIUS MUSCLE: It is innervated by the spinal accessory nerve. Surgical intervention may be utilized in some cases. Spell. Conservative treatment goals are to decrease muscle spasms, increase muscle control, and provide back and shoulder pain relief. This is a common site of the nerve entrapment or compression. Flashcards. Neck and shoulder stretching is important part of therapy. Muscles and tendons develop scar tissue or fascial adhesions between the fibers, which further prevents their normal sliding motions and contractile movements. Axillary nerve. This is a common site of the nerve entrapment or compression. Medial rotation of the arm Additional notes:-• The posterior scapular region also contains part of one additional muscle, the long head of the triceps brachii, which passes between the scapula and the proximal end of the forearm. Chest xray: non displaced right clavicle fx. suprascapular nerve. Upper limb anatomy: Scapular Region and Scapulohumeral Group Scapula and Humeral relationship, anatomy, and musculature. They may notice a soreness developing in their rotator cuff, bicep tendon, or shoulder external rotators and assume the pain is an aggravation of a previous shoulder injury. It is found just proximal to the upper trunk of the brachial plexus. PLAY. This is a previously under-diagnosed cause of neck, mid-back and shoulder pain and dysfunction. Back and shoulder muscles stabilize and control the scapulae. However, this nerve may also receive some contributions from C4 to T1. Clinically, dorsal scapular nerve injuries and compression produce a mild form of scapular wing in a resting position. Write. Active rehabilitation procedures will improve spinal joint dysfunction and decrease muscle and neuromuscular dysfunction. The prevalence was similar across anatomical regions for single scapular fracture and was higher with multiple fractures. Pain management physicians may be utilized in severe cases for pain relief and management. The two major nerves of the posterior scapular region are the suprascapular and axillary nerves (see Fig. Eventually the compensation mechanisms become overwhelmed and shoulder sprains and strains develop. Continuing to challenge and overwork the shoulder predisposes other shoulder muscles and tendons to injury, and care should be avoided to prevent a compensation injury to any of the other muscles, tendons, ligaments, or joint capsule. Dorsal scapular nerve syndrome may play a role in many shoulder injuries and is often misdiagnosed or underdiagnosed in clinical settings. scapular region is often associated with a cervical nerve root block. [4], Dorsal scapular nerve syndrome can be caused by nerve entrapment. 6. Weakness and fatigue of the rhomboid and levator scapulae muscles can produce mild winging of the scapula and a lack of shoulder stabilization. Patients affected by the nerve compression find it difficult to bring their scapula together. Region: Scapular region. Jaundice, with pain about liver and right scapula. 2015/2016 An MRI provides information on the soft tissue of the cervical spine, discs, and neck muscles. The dorsal scapular nerve arises from the brachial plexus, usually from the plexus root (anterior/ventral ramus) of the cervical nerve C5. Throwing athletes may notice the early shoulder fatigue and assume the repetitive microtrauma has lead to shoulder glenoid articular damage, arthritis, cartilage damage, costoclavicular syndrome, suprascapular nerve syndrome, axillary nerve damage, or spinal accessory nerve damage. As the joints lose normal ranges of motion and movements, they begin sending pain signals to the brain which produces mild chronic pain symptoms and further increases scalene, trapezius, and levator muscle spasms. Lower lip of spine of scapula. Dorsal surface of lateral margin of scapula below teres minor. [1][2][3] Once the nerve leaves C5 it commonly pierces the middle scalene muscle, and continues deep to levator scapulae and the rhomboids (minor superior to major). The dorsal scapular nerve may share a common trunk with the long thoracic nerve. the scapular region is almost entirely by branches of the brachial plexus (see Chapter 16): • the dorsal scapular nerve (levator and rhomboid muscles) is from the anterior ramus of C5; • the suprascapular nerve (supraspinatus and infraspinatus muscles) is from the superior trunk; • the four other nerves to this region (the superior and inferior Terms in this set (19) cranial pectoral nerves. The suprascapular nerve is a nerve that branches from the upper trunk of the brachial plexus. These muscles are innervated by the dorsal scapular nerve, which travels from the lower cervical spine down the posterior thoracic region where nerve branches control the rhomboid and levator muscles. innervate the superficial pectoral muscle . Seventy-six percent of the dorsal scapular nerve originates from the C5 ventral ramus, which travels behind a major portion of the brachial plexus where it pierces the medial scalene muscles. Abstract. During active rehabilitation in the office, many patients feel increased stiffness and soreness in their neck, upper back, and shoulder. Outer margin of acromion. However, this nerve entrapment responds very well to conservative treatment that restores normal scapular motion and movement, in addition to relieving the nerve compression. University College Dublin. Suprascapular nerve. This cycle of pain, spasm, posture changes, and dysfunction slowly progresses over months leading to the syndrome’s development. Without direct injury or trauma, many of these injuries or conditions could produce shoulder and radiating pain. A small and subtle shift in glenohumeral angles can produce significant strain and damage to these muscles and tendons, producing shoulder pain, tendinopathy, sprains, strains, or possibly tendon rupture. Alternative and conservative treatments address the offending muscles or soft tissue adhesions that are compressing the nerve and producing nerve damage. It provides motor innervation to the rhomboid muscles, which pull the scapula towards the spine and levator scapulae muscle, which elevates the scapula. The circumflex scapular artery is visible in the triangular space (2) Compression of the dorsal scapular nerves leads to scapular instability and back pain. Of the 426 injuries with detailed information on nerve injury, 208 (49%) involved the radial nerve, 113 (26.5%) the ulnar nerve, 65 (15%) the median nerve, 36 (8.5%) the axillary nerve and four (1%) the musculocutaneous nerve. Teres Major. 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