Following surgical removal of a firm nodular cancerous swelling in the right breast and exploration of the right axilla, patient was found to have a winged right scapula. This occurred due to injury to which of the following nerve?
Long thoracic nerve is a pure motor nerve which arise from branches of the C5, C6 and C7 nerve roots. It supplies serratus anterior muscle and damage to this muscle cause winging of scapula. Serratus anterior is the primary upward rotator of of the scapula during abduction of the arm and it stabilizes the shoulder during scapular protraction. It arises from the first through ninth ribs and it inses onto the costo medial border border of the scapula.It upper fibers inses onto the superior angle of the scapula and stabilize the scapula during the initial stages of abduction.Middle fibers inses onto the veebral border of the scapula.Lower fibers inses onto the inferior angle of scapula.Ref: Conservative Management of Spos Injuries edited by Thomas E. Hyde page 356.
Subscapular muscle
Coracoid process of scapula
Long thoracic nerve
Circumflex scapular aery