Dorsal Scapular Nerve

Authors

Affiliations

Nate Yomogida, PT, DPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, PT, DPT

Doctor of Physical Therapy

B.A. in Neuroscience

Origin

• The dorsal scapular nerve is innervated by the C5 Nerve Root¹.
• The dorsal scapular nerve frequently shares a trunk with the Long Thoracic Nerve¹.
• The Dorsal Scapular Nerve comes off of the C5 nerve root prior to the formation of the Superior Trunk

Path

Note

“The former passes through the scalenus medius anterior internally, and scalenus posterior laterally, with the presence of some tendinous tissues”¹

“This pierces the scalenus medius and runs along the levator scapulae muscle and the medial border of the scapula under the rhomboid muscles.”²

Innervation

The posterior (dorsal) scapular nerve provies motor innervation to the rhomboids and the levator scapulae muscles¹.

Motor Innervation

• Lev scap
• Rhomboid Minor
• Rhomboid Major

Warning: No 'action' link found for variable 'ref-rhomboid-minor' in YAML data.
Warning: No 'action' link found for variable 'ref-rhomboid-minor' in YAML data.
Warning: No 'action' link found for variable 'ref-rhomboid-minor' in YAML data.
Warning: No 'action' link found for variable 'ref-rhomboid-minor' in YAML data.
Warning: No 'action' link found for variable 'ref-rhomboid-minor' in YAML data.
Warning: No 'action' link found for variable 'ref-rhomboid-minor' in YAML data.
Warning: No 'action' link found for variable 'ref-rhomboid-minor' in YAML data.
Warning: No 'action' link found for variable 'ref-rhomboid-minor' in YAML data.
Warning: No 'action' link found for variable 'ref-rhomboid-minor' in YAML data.

Table 1: Dorsal scapular nerve Muscle Innervations

Muscle	Origin	Insertion	Innervation	Action
Levator scapulae	C1-C4 TP	Superior angle of Scapula	Dorsal scapular n. Cervical spinal nn. C3 - C4	Scapula: Elevation, Downward rotation Cervical: I/L sidebend
Rhomboid major	T1-T4 SP	Medial border of scapula (below scapular spine)	Dorsal scapular n. C4 - C5	Scapula: Retraction assist, Downward rotation, Stabilization
Rhomboid minor	C6 & C7 SP	Medial border of scapula (above scapular spine)	Dorsal scapular n. C4 - C5	Scapula: Retraction assist, Downward rotation, Stabilization

Dysfunction

Causes

Dorsal scapular nerve lesions can result from trauma or from a forward posture of the head and the neck¹. Forward posture can place increased tension on the anterior cervical spine which can produce hypertonicity and/or hypertrophy of the Middle Scalene muscle¹.

Clinical Presentation

Patients with dorsal scapular nerve impingement will complain of scapular pain radiating to the lateral shoulder and arm¹

A dorsal scapular n. lesion can result in levator scapulae paralysis which would present as a sagging (depressed) shoulder girdle.

References

1.

Dutton M. Dutton’s Orthopaedic Examination, Evaluation, and Intervention. 5th ed. McGraw Hill Education; 2020.

2.

Hochschild J. Functional Anatomy for Physical Therapists. Georg Thieme Verlag; 2016.