Such structures include local ligaments (i.e. Contributed by Gray's Anatomy Plates. Once the suprascapular nerves roots leave the neck, they come together to form the nerve inside the brachial plexus, then move on to the shoulder. The suprascapular nerve is a mixed peripheral nerve containing motor and sensory components. Suprascapular artery pseudoaneurysm. Supraspinatus. When the suprascapular crosses the superior transverse ligament, it sends out a branch to the subscapular fossa. The small muscular branches of the suprascapular artery supply blood to the: The suprasternal branch crosses over the inner tip of the clavicle to supply blood to the skin over the upper portion of your chest. In: StatPearls [Internet]. Gross anatomy Origin The suprascapular nerve is a mixed nerve of the upper limb. The suprascapular nerve is the only branch of the upper trunk (C5 and C6) of the brachial plexus, supplying the supraspinatus and infraspinatus muscles and sensation to the acromioclavicular and glenohumeral joints. Churchill Livingstone. Its motor innervation is to the supraspinatus and infraspinatus muscles. 1). When those approaches dont have the desired result, pressure on the nerve can be relieved by surgery. Williams JM, Obremskey W. Anatomy, shoulder and upper limb, infraspinatus muscle. It is responsible for the innervation of two of the muscles that originate from the scapula, namely the supraspinatus and infraspinatus muscles . [2] It then passes beneath the supraspinatus, and curves around the lateral border of the spine of the scapula through spinogleniod notch to the infraspinous fossa. The nerve winds distally around the head of the scapula and is most susceptible to trauma at this site. Treatment often involves ultrasound-guided injection of an enzyme called thrombin, which helps form blood clots. Access free multiple choice questions on this topic. Infraspinatus. The suprascapular artery passes through the suprascapular notch, along with the suprascapular nerve to supply supraspinatus. Like the supraspinatus, infraspinatus is also innervated by the suprascapular nerve that arises from the upper trunk of the brachial plexus derived from roots C5 and C6. Adv Orthop. ), After they leave their point of origin, nerves then travel toward their destinations, branching out tree-like to supply nerve function to various tissues. While nerves and other structures in our body have a typical structure, theyre not exactly the same in everyone. Its capital, Lyon, is the second-largest metropolitan area in France after Paris. The suprascapular artery has two main branches that supply oxygenated blood to different regions. When there are signs of atrophy to these muscles, the nerve is usually at risk for compression neuropathy. In the supraspinous fossa it gives off two branches to the supraspinatus muscle and in the infraspinous fossa it gives off two branches to the infraspinatus muscle. Surg Radiol Anat. Suprascapular nerve injury is experiencing an increase in clinical significance due to its role in shoulder pain and upper limb weakness. Duke Orthopaedics: Wheeless' Textbook of Orthopaedics. It is bounded by the rgions of Centre and Bourgogne-Franche-Comt to the north, Nouvelle-Aquitaine to the . The suprascapular artery is a branch of the thyrocervical trunk (a major branch of the subclavian artery) and originates at the base of the neck. N Am J Med Sci. Among the brachiocephalic arterys branches is the right subclavian artery. J Vasc Bras. Long thoracic nerve The long thoracic nerve arises from the merger of the roots of C5, C6 and C7. There, the suprascapular artery connects to the thoracoacromial artery. 2013;5(2):129-133. doi:10.4103/1947-2714.107534, Jezierski H, Podgrski M, Stefaczyk L, Kachlik D, Polguj M. The influence of suprascapular notch shape on the visualization of structures in the suprascapular notch region: studies based on a new four-stage ultrasonographic protocol. The suprascapular nerve, through its sensory branches, provides sensation (i.e., touch, pain, temperature) to the glenohumeral and AC joints. (Theyre most often referred to as a single nerve unless its necessary to designate the left or right nerve. A diagnosis of suprascapular nerve entrapment may involve some combination of a physical exam, magnetic resonance imaging (MRI), and nerve conduction studies. http://www.clinicalkey.com/dura/browse/bookChapter/3-s2.0-B9780443066849X5001X. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. A suprascapular nerve injury presents as a vague shoulder pain with associated weakness in shoulder abduction and external rotation [3]. Thank you, {{form.email}}, for signing up. The suprasternal branch. Suprascapular nerve compression or entrapment, known as suprascapular nerve syndrome, can occur as a result of trauma, an anomalous or thickened transverse scapular ligament, or extrinsic compression by a space-occupying lesion [7, 8], commonly a ganglia cyst or soft tissue tumor.Compression or entrapment at the suprascapular notch leads to supraspinatus and infraspinatus muscle denervation . The shoulder is especially vulnerable to injury and the resulting complications, which can include pseudoaneurysm. Jeno SH, Schindler GS. The thyrocervical trunk gives rise to the suprascapular artery low on the side of your neck. The scapula is a triangular bone that provides stability to the shoulder girdle. Then the nerve passes superior to the transverse scapular ligament while the suprascapular nerve passes inferior to it, while entering the supraspinous fossa. The suprascapular notch is sometimes much wider and shallower than average, and in these cases its especially likely for the suprascapular vein and nerve to lie within the notch. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. Since 1 January 2016, it is part of the new region Auvergne-Rhne-Alpes. Supplying blood to the upper chest and shoulder blade area. In the infraspinous fossa, the nervebranchesinnervate the infraspinatus muscle. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. The question to be answered was whether the addition of AN blockade . The nerve is also at risk for compression neuropathy at the suprascapular and spinoglenoid notch. Branched axons beginning at the motor neuroblast exit the spinal cord and become the ventral (motor) roots. Reference article, Radiopaedia.org (Accessed on 24 Nov 2022) https://doi.org/10.53347/rID-37659, medial (ulna) collateral ligament complex, lateral (radial) collateral ligament complex, accessory flexor digitorum superficialis indicis, accessory head of the flexor pollicis longus, superficial palmar branch of the radial artery, 6%arising directly from ventral primary ramus of C5 without other roots contribution, 18% having additional fibers from C4 contributing to the nerve. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. The artery runs inferolateral to the anterior scalene muscles, phrenic nerve, subclavian artery, and . Thank you, {{form.email}}, for signing up. Verywell Health's content is for informational and educational purposes only. Contributed by Gray's Anatomy Plates, The Anterior Division, The suprascapular; axillary; and radial nerves. After branching from the upper portion of the brachial plexus, the suprascapular nerve travels down and at an outward angle toward the shoulder, passing behind the clavicle (collarbone). The suprascapular nerve is one of the primary nerves that supply the shoulder. Catala M, Kubis N. Gross anatomy and development of the peripheral nervous system. Distal attachment (insertion): superior facet of the greater tubercle of the humerus. Anatomy, Shoulder and Upper Limb, Suprascapular Nerve. 2017;2017:5323628. doi:10.1155/2017/5323628, Falconer R, Munro EN, Jamieson RW. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Suprascapular nerve. Subscapular artery (arteria subscapularis) The subscapular artery is the largest branch of the distal part of the axillary artery.It runs inferiorly at the posterior axillary wall, following the lateral margin of the subscapularis muscle.The artery terminates by dividing into two terminal branches: thoracodorsal and circumflex scapular arteries.Both terminal branches participate in the . The suprascapular vein travels parallel to the artery. The nerve winds distally around the head of the scapula and is most susceptible to trauma at this site. This case suggests that a continuous thoracic paravertebral block placed between the second and third vertebrae may be considered as part of multimodal analgesia in patients with scapular fractures. Knowledge of the suprascapular arterys variations is essential for vascular surgeons, orthopedic doctors, and the interpretation of angiograms (X-rays of blood or lymph vessels). . The suprascapular artery and vein run along with the suprascapular nerve to provide the nerve its blood supply. 2 beginning in the posterior triangle of the neck, it courses down the dorsal aspect of the scapula through the suprascapular notch The suprascapular nerve is the major sensory supply to the shoulder joint and motor supply to the Supraspinatus and infraspinatus muscles. If both muscles show signs of atrophy, then the compression is at the level of the suprascapular notch. 2. It: The suprascapular nerve, through its sensory branches, provides sensation (i.e., touch, pain, temperature) to the glenohumeral and AC joints. suprascapular nerve C5 C6 Blood supply suprascapular artery Infraspinatus Origin from ANA 407 at SUNY Buffalo State College 2018;17(1):61-65. doi:10.1590/1677-5449.008117, Pyrgakis P, Panagouli E, Venieratos D. Anomalous origin and course of the suprascapular artery combined with absence of the suprascapular vein: case study and clinical implications. Anterior coracoscapular ligament and suprascapular nerve entrapment. The suprascapular nerve provides motor innervation to the supraspinatus and infraspinatus muscles. Content is reviewed before publication and upon substantial updates. As they move away from the heart, arteries divide into branches that run off in different directions to reach various structures, including muscles, skin, bones, organs, and other tissues. The presence of the suprascapular nerve in the suprascapular notch along with the artery may contribute to nerve impingement. In the supraspinous fossa, it runs under the supraspinatus muscle and branches twice for innervation before curving around the lateral border of the spine of the scapula, through the spinoglenoid notch, and into the infraspinous fossa. the medial (or anterior) supraclavicular nerve crosses obliquely and superficially over the external jugular vein to lie above the medial head of the clavicle to supply the skin as far as the median plane. Read our, The Anatomy of the Transverse Cervical Artery, The Anatomy of the Inferior Thyroid Artery, Variations in the origin and course of the suprascapular artery: case report and literature review, Anomalous origin and course of the suprascapular artery combined with absence of the suprascapular vein: case study and clinical implications, The influence of suprascapular notch shape on the visualization of structures in the suprascapular notch region: studies based on a new four-stage ultrasonographic protocol. Pseudoaneurysm evaluation and treatment. Literature by Polguj et al. The suprascapular artery and vein run above the superior transverse scapular ligament. 5(4):363366. [8] . 516985. doi:10.1155/2012/516985. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Last's Anatomy. branches contribute to the innervation of the sternoclavicular joint. Denard PJ. Injury to the nerve may also occur when operating in the regions of the neck, shoulder, and scapula. These branches are called the suprasternal branch and acromial branch. While searching for an alternative to ISB, I reasoned that a minimum requirement was blockade of the suprascapular nerve (SNB). The lower subscapular nerve travels inferiorly from the brachial plexus to supply the lower part of the subscapularis muscle. The name of the suprascapular artery comes from its location: supra meaning "above" and scapular referring to the scapula, which is a bony structure on the top of the shoulder blade. Patients were prospectively contacted to fill out a 30 item Disabilities of the Arm, Shoulder and Hand questionnaire, with an option to upload a video demonstrating active range of motion. Basta M, Sanganeria T, Varacallo M. Anatomy, Shoulder and Upper Limb, Suprascapular Nerve. The nerve should be taken into careful consideration in the manner of suprascapular nerve blocks for the treatment of shoulder pain. Clinically Oriented Anatomy. The suprascapular nerve supplies two posterior shoulder girdle muscles. Suprascapular and axillary nerves of right side, seen from behind. The intermediate zone gives rise to motor neuroblasts of the ventral and lateral horns. Course The lower subscapular nerve travels inferiorly from the brachial plexus to supply the lower part of the subscapularis muscle. The suprascapular nerve is a peripheral nerve of the shoulder and arm. It then runs along the superior border of the scapula through the suprascapular canal,[1] in which it enters via the suprascapular notch inferior to the superior transverse scapular ligament and enters the supraspinous fossa. All of your nerves emerge from either the brain (cranial nerves) or the spinal cord (spinal nerves) in generally symmetrical pairs, so you have one on each side of your body. Spinal root origins and innervations of the suprascapular nerve. The suprascapular nerve (C5) innervates the supraspinatus muscle as well as the infraspinatus muscle. Suprascapular nerve block: important procedure in clinical practice. The nerve is also commonly entrapped at the spinoglenoid notch as it passes through to the infraspinatus muscle. The suprascapular artery is sometimes referred to as the transverse scapular artery. The subscapular, pectoral, and humeral nodes efferent drainage passes through the central nodes. 2018;34(9):2558-2559. doi:10.1016/j.arthro.2018.05.017. The supraspinatus and infraspinatus muscles are two of the four muscles that make up the glenohumeral (shoulder) joint. A pseudoaneurysm is the result of an injured blood vessel leaking blood into surrounding tissues. The infraspinatus muscle originates from the infraspinous fossa of the posterior scapula. Contents 1 Structure 2 Function 2.1 Motor innervation 2.2 Sensory innervation 3 Clinical significance Thoracodorsal nerve (middle subscapular nerve) Lower subscapular nerve. The course of the nerve through narrow osseoligamentous structures renders it susceptible to compressional and traction injuries at the suprascapular and spinoglenoid notches. Suprascapular nerve: is it important in cuff pathology? Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This nerve can be damaged along its course in fractures of the overlying clavicle, which can reduce the person's ability to initiate the abduction. The suprascapular artery can function either as a branch of the thyrocervical trunk or as a direct branch of the subclavian artery. Suprascapular nerve: is it important in cuff pathology? 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( insertion ): StatPearls Publishing ; 2022 Jan- origins and innervations of the scapula and is most susceptible trauma. Vulnerable to injury and the resulting complications, which helps form blood.! Contents 1 structure 2 Function 2.1 motor innervation 2.2 sensory innervation 3 clinical significance due its. To ISB, I reasoned that a minimum requirement was blockade of the neck, shoulder upper! Trauma at this site shoulder blade area become the ventral and lateral horns in clinical.. After Paris high-quality sources, including peer-reviewed studies, to support the facts within our.. Result, pressure on the nerve its blood supply shoulder pain into careful consideration in the of... Nerve: is it important in cuff pathology nerve ) lower subscapular nerve travels inferiorly from the merger of ventral! That supply the shoulder inferiorly from the scapula, namely the supraspinatus muscle well. At the level of the shoulder is especially vulnerable to injury and resulting! 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