Question #85
Winging of the scapula can occur following surgery to the axilla. Which of the following nerves may be damaged to cause this?
The long thoracic nerve innervates serratus anterior. It runs on the exterior surface of serratus anterior before innervating it and so is at risk of damage during surgery in the axilla. Since serratus anterior acts to hold the scapula against the thoracic wall, the resultant paralysis of serratus anterior will cause the scapula to stand away from the posterior thoracic wall, ‘ winging of the scapula’.
Thoracodorsal nerve innervates latissimus dorsi. This nerve is also at risk during surgery in the axilla. Paralysis of latissimus dorsi will result in a weakness in extension and adduction of the arm.
There is no internal thoracic or infraspinous nerve.
Lower subscapular nerve innervates subscapularis and teres major, upper subscapular nerve just innervates subscapularis.
Dorsal scapular nerve innervates the rhomboids and occasionally levator scapulae.