Dorsal Scapular Nerve

Authors

Affiliations

Nate Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

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

Dorsal Scapular n. Muscle Innervations
Muscle	Origin	Insertion	Innervation	Action
Levator scapulae	C1-C4 TP3 C1-C4 TP [@gilroyAtlasAnatomy2020]	Superior angle of Scapula3 Superior angle of Scapula [@gilroyAtlasAnatomy2020]	Dorsal scapular n.3 Cervical spinal nn.3 C3 - C43 Dorsal scapular n. [@gilroyAtlasAnatomy2020] Cervical spinal nn. [@gilroyAtlasAnatomy2020] C3 - C4 [@gilroyAtlasAnatomy2020]	Cervical I/L sidebend [@gilroyAtlasAnatomy2020] Scapula Elevation NA Downward rotation NA
Rhomboid major	T1-T4 SP3 T1-T4 SP [@gilroyAtlasAnatomy2020]	Medial border of scapula (below scapular spine)3 Medial border of scapula (below scapular spine) [@gilroyAtlasAnatomy2020]	Dorsal scapular n.3 C4 - C53 Dorsal scapular n. [@gilroyAtlasAnatomy2020] C4 - C5 [@gilroyAtlasAnatomy2020]	Scapula Retraction NA Downward rotation NA Stabilization [@gilroyAtlasAnatomy2020]
Rhomboid minor	C6 & C7 SP3 C6 & C7 SP [@gilroyAtlasAnatomy2020]	Medial border of scapula (above scapular spine)3 Medial border of scapula (above scapular spine) [@gilroyAtlasAnatomy2020]	Dorsal scapular n.3 C4 - C53 Dorsal scapular n. [@gilroyAtlasAnatomy2020] C4 - C5 [@gilroyAtlasAnatomy2020]	Scapula Retraction NA Downward rotation NA Stabilization [@gilroyAtlasAnatomy2020]

Muscle	Origin	Insertion	Nerve	Action
Levator Scapulae	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Posterior Muscles/levator_scapulae.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Posterior Muscles/levator_scapulae.html#insertion	?var:ref-levator-scapulae.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Posterior Muscles/levator_scapulae.html#action
Rhomboid Major	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Posterior Muscles/rhomboid_major.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Posterior Muscles/rhomboid_major.html#insertion	?var:ref-rhomboid-major.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Posterior Muscles/rhomboid_major.html#action
Rhomboid Minor	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Posterior Muscles/rhomboid_minor.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Posterior Muscles/rhomboid_minor.html#insertion	?var:ref-rhomboid-minor.nerve	?var:ref-rhomboid-minor.action

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.

3.

Gilroy AM, MacPherson BR, Wikenheiser JC, Voll MM, Wesker K, Schünke M, eds. Atlas of Anatomy. 4th ed. Thieme; 2020.