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Related Experiment Videos

Vulnerability of long thoracic nerve: an anatomic study

N A Ebraheim1, J Lu, B Porshinsky

  • 1Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43614, USA.

Journal of Shoulder and Elbow Surgery
|November 14, 1998
PubMed
Summary

This study maps the long thoracic nerve

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Area of Science:

  • Anatomy
  • Surgical Anatomy

Background:

  • The long thoracic nerve innervates the serratus anterior muscle.
  • Understanding its anatomical course is crucial for preventing iatrogenic injury during thoracic and shoulder surgeries.

Purpose of the Study:

  • To precisely delineate the anatomical trajectory of the long thoracic nerve.
  • To identify critical anatomical landmarks and reference lines for surgical navigation.

Main Methods:

  • Anatomical dissection of 40 cadaveric specimens.
  • Measurement of the nerve's course relative to the axillary lines and first two ribs.
  • Analysis of nerve angulation at the point of emergence from the axillary sheath.

Main Results:

  • The long thoracic nerve emerges from the axillary sheath and courses inferiorly and posteriorly.
  • It forms an average posterior angle of 30.7° +/- 4.3° relative to the anterior axillary line.
  • The nerve descends between the middle and posterior axillary lines, becoming angulated and stretched upon arm elevation.

Conclusions:

  • Detailed anatomical mapping of the long thoracic nerve provides critical data for surgeons.
  • Awareness of its course and potential for stretching during arm movement can help prevent nerve injury.

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