scholarly journals Sonoanatomy revisited: the long thoracic nerve

2019 ◽  
Vol 21 (3) ◽  
pp. 349 ◽  
Author(s):  
Ke-Vin Chang ◽  
Wei-Ting Wu ◽  
Kamal Mezian ◽  
Ondřej Naňka ◽  
Levent Özçakar
Keyword(s):  
Distal Segment ◽  
Serratus Anterior Muscle ◽  
Accidental Injury ◽  
Serratus Anterior ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Long Thoracic Nerve ◽  
Scanning Method ◽  
Thoracic Nerve ◽  
Scapular Winging

The long thoracic nerve (LTN) arises from the C5, C6 and C7 roots and innervates the serratus anterior muscle. Scapular winging is the landmark manifestation of LTN neuropathy and may develop after an accidental injury during selective cervical nerve root or inter-scalene brachial plexus blocks. Although its sonoanatomy has been described in the previous literature, how to gradually identify the entire nerve course has rarely been discussed. In this regard, the present paper aims to elaborate the scanning method of the LTN from its origin to its distal segment.

A cadaveric study of the serratus anterior muscle and the long thoracic nerve

2008 ◽  
Vol 17 (5) ◽  
pp. 790-794 ◽  
Author(s):  
Junichiro Hamada ◽  
Emi Igarashi ◽  
Keiichi Akita ◽  
Tomoyuki Mochizuki
Keyword(s):  
Cadaveric Study ◽  
Serratus Anterior Muscle ◽  
Serratus Anterior ◽  
Long Thoracic Nerve ◽  
Thoracic Nerve

Magnetic resonance imaging of dynamic scapular winging secondary to a lesion of the long thoracic nerve

2016 ◽  
Vol 83 (6) ◽  
pp. 747-749 ◽  
Author(s):  
Christelle Nguyen ◽  
Henri Guerini ◽  
Jennifer Zauderer ◽  
Alexandra Roren ◽  
Paul Seror ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Long Thoracic Nerve ◽  
Thoracic Nerve ◽  
Scapular Winging

Surgical anatomy of the cervical and infraclavicular parts of the long thoracic nerve

2006 ◽  
Vol 104 (5) ◽  
pp. 792-795 ◽  
Author(s):  
R. Shane Tubbs ◽  
E. George Salter ◽  
James W. Custis ◽  
John C. Wellons ◽  
Jeffrey P. Blount ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Axillary Artery ◽  
Surgical Anatomy ◽  
Proximal Portion ◽  
Neurosurgical Procedures ◽  
Serratus Anterior ◽  
Long Thoracic Nerve ◽  
Scalene Muscle ◽  
Thoracic Nerve ◽  
Two Sides

Object There is insufficient information in the neurosurgical literature regarding the long thoracic nerve (LTN). Many neurosurgical procedures necessitate a thorough understanding of this nerve's anatomy, for example, brachial plexus exploration/repair, passes for ventriculoperitoneal shunt placement, pleural placement of a ventriculopleural shunt, and scalenotomy. In the present study the authors seek to elucidate further the surgical anatomy of this structure. Methods Eighteen cadaveric sides were dissected of the LTN, anatomical relationships were observed, and measurements were obtained between it and surrounding osseous landmarks. The LTN had a mean length of 27 ± 4.5 cm (mean ± standard deviation) and a mean diameter of 3 ± 2.5 mm. The distance from the angle of the mandible to the most proximal portion of the LTN was a mean of 6 ± 1.1 cm. The distance from this proximal portion of the LTN to the carotid tubercle was a mean of 3.3 ± 2 cm. The LTN was located a mean 2.8 cm posterior to the clavicle. In 61% of all sides the C-7 component of the LTN joined the C-5 and C-6 components of the LTN at the level of the second rib posterior to the axillary artery. In one right-sided specimen the C-5 component directly innervated the upper two digitations of the serratus anterior muscle rather than joining the C-6 and C-7 parts of this nerve. The LTN traveled posterior to the axillary vessels and trunks of the brachial plexus in all specimens. It lay between the middle and posterior scalene muscles in 56% of sides. In 11% of sides the C-5 and C-6 components of the LTN traveled through the middle scalene muscle and then combined with the C-7 contribution. In two sides, all contributions to the LTN were situated between the middle scalene muscle and brachial plexus and thus did not travel through any muscle. The C-7 contribution to the LTN was always located anterior to the middle scalene muscle. In all specimens the LTN was found within the axillary sheath superior to the clavicle. Distally, the LTN lay a mean of 15 ± 3.4 cm lateral to the jugular notch and a mean of 22 ± 4.2 cm lateral to the xiphoid process of the sternum. Conclusions The neurosurgeon should have knowledge of the topography of the LTN. The results of the present study will allow the surgeon to better localize this structure superior and inferior to the clavicle and decrease morbidity following invasive procedures.

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