Long thoracic nerve
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218208274
2008-06-09T17:19:31Z
KC Panchal
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provided Wiktionary linking for digitation
{{Infobox Nerve |
Name = {{PAGENAME}} |
Latin = nervus thoracicus longus |
GraySubject = 210 |
GrayPage = 933 |
Image = Nerves of the left upper extremity.gif |
Caption = Nerves of the left upper extremity. (Long thoracic labeled vertically at shoulder, to left of artery.) |
Image2 = Gray808.png |
Caption2 = The right [[brachial plexus]] with its short branches, viewed from in front. (Long thoracic labeled at center, third from top.) |
Innervates = [[serratus anterior muscle]] |
BranchFrom = [[brachial plexus]] (C5-C7) |
BranchTo = |
MeshName = |
MeshNumber = |
DorlandsPre = n_05 |
DorlandsSuf = 12566912 |
}}
The '''long thoracic nerve''' ('''external respiratory nerve of Bell'''; '''posterior thoracic nerve''') supplies the [[Serratus anterior]]. This nerve characteristically arises by three roots from the fifth, sixth, and seventh [[cervical nerves]] (C5-C7) but the root from C7 may be absent. The roots from C5 and C6 pierce the [[Scalenus medius]], while the C7 root passes in front of the muscle.
The nerve descends behind the [[brachial plexus]] and the axillary vessels, resting on the outer surface of the [[Serratus anterior]]. It extends along the side of the thorax to the lower border of that [[muscle]], supplying filaments to each of its [[Wiktionary: Digitate| digitations]] (finger-like projections).
== Damage ==
Due to its long, relatively superficial course, it is susceptible to injury either through direct trauma or stretch. Injury has been reported in almost all [[sports]], typically occurring from a blow to the ribs underneath an outstretched arm. Surgically the long thoracic nerve can also be damaged during surgery for [[breast cancer]], specifically [[mastectomy|radical mastectomies]] that involve removal of [[axillary lymph nodes]].
Injuries to the nerve can result from carrying heavy bags over the shoulder for a prolonged time. There are also reports of isolated damage to this nerve as a variant of [[Parsonage Turner Syndrome]], an [[autoimmune]] disease.
Symptoms are often minimal – if symptomatic, a posterior shoulder or scapular burning type of pain may be reported.
A lesion of the nerve paralyses the [[serratus anterior]] to produce [[scapula winging]], which 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 prior.
==Additional images==
<gallery>
Image:Gray809.png|The right brachial plexus (infraclavicular portion) in the axillary fossa; viewed from below and in front.
Image:Brachial plexus.svg|Brachial plexus
</gallery>
==External links==
* {{DukeOrtho|long_thoracic_nerve}}
* {{WhoNamedIt|synd|2384}}
* {{eMedicineDictionary|long+thoracic+nerve}}
* {{SUNYAnatomyFigs|05|03|07}} - "The major subdivisions and terminal nerves of the [[brachial plexus]]."
{{neuroscience-stub}}
{{Brachial plexus}}
[[Category:Peripheral nervous system]]
[[Category:Back anatomy]]
[[de:Nervus thoracicus longus]]
[[fr:Nerf thoracique long]]
[[id:Nervus thoracicus longus]]
[[pl:Nerw piersiowy długi]]
[[sv:Nervus thoracicus longus]]