A 39-year-old woman complains of an inability to reach the top of her head to brush her hair. History reveals that she had undergone a bilateral mastectomy procedure 2 months earlier. Physical examination demonstrates winging of both of her scapulae. Which nerves were most likely damaged during surgery?
The long thoracic nerve innervates the serratus anterior, which is responsible for elevation and abduction of the scapula beyond the horizontal level while maintaining its position against the thoracic wall. Along with the thoracodorsal nerve, the long thoracic nerve runs superficially along the thoracic wall and is commonly subject to injury during mastectomy procedures. The axillary nerve, the spinal accessory nerve, and the thoracodorsal nerve supply the deltoid muscle, trapezius muscle, and latissimus dorsi muscles, respectively. The dorsal scapular nerve is responsible for innervation of the rhomboids and levator scapulae. Aside from the long thoracic and thoracodorsal nerves, the remaining nerves do not course along the lateral thoracic wall.
Axillary
Spinal accessory
Long thoracic
Dorsal scapular
Upper Extremity