Supraclavicular nerves

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Supraclavicular nerves
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The nerves of the scalp, face, and side of neck. (Supraclavicular nerves visible at bottom.)
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Plan of the cervical plexus. (Superficial descending labeled at bottom left.)
Details
FromC3–C4 of cervical plexus
InnervatesCutaneous innervation of the skin above and below the clavicle
Identifiers
Latin nervi supraclaviculares
TA98 A14.2.02.024
TA2 6391
FMA 65414
Anatomical terms of neuroanatomy

The supraclavicular nerve is a cutaneous (sensory) nerve of the cervical plexus that arises from the third and fourth cervical (spinal) nerves. It emerges from beneath the posterior border of the sternocleidomastoid muscle, then split into multiple branches. Together, these innervate the skin over the shoulder.

Contents

The supraclavicular nerve can be blocked during shoulder surgery.

Anatomy

Origin

The supraclavicular nerve is a branch of the cervical plexus [1] that arises from cervical (spinal) nerves C3-C4 [2] [1] with the predominant contribution from C4. [1]

Course

It emerges at the posterior border of the sternocleidomastoid muscle alongside the other three cutaneous branches of the cervical plexus, then promptly divides into several branches. [1] The nerves descend in the posterior triangle of the neck beneath the platysma muscle and the deep cervical fascia.[ citation needed ] Near the clavicle, the supraclavicular nerves perforate the fascia and the platysma muscle to become cutaneous. They are arranged, according to their position, into three groups—anterior, middle, and posterior. [2]

Medial supraclavicular nerves

The medial supraclavicular nerves or anterior supraclavicular nerves (nn. supraclaviculares anteriores; suprasternal nerves) cross obliquely over the external jugular vein and the clavicular and sternal heads of the sternocleidomastoideus, and supply the skin as far as the middle line. They furnish one or two filaments to the sternoclavicular joint. [3]

Intermedial supraclavicular nerves

The intermedial supraclavicular nervemiddle supraclavicular nerves (nn. supraclaviculares medii; supraclavicular nerves) cross the clavicle, and supply the skin over the pectoralis major and deltoideus, communicating with the cutaneous branches of the upper intercostal nerves.

Lateral supraclavicular nerves

The lateral supraclavicular nerve or posterior supraclavicular nerves [4] (nn. supraclaviculares posteriores; supra-acromial nerves) pass obliquely across the outer surface of the trapezius and the acromion, and supply the skin of the upper and posterior parts of the shoulder.

Function

The supraclavicular nerves together innervate the skin over the shoulder. [2]

Clinical significance

A supraclavicular nerve block is useful when performing surgery on the shoulder, anaesthetising a large area of skin. [5]

The supraclavicular nerves are vulnerable during surgery on the clavicle, and must be identified early on in surgeries to reduce the risk of nerve injury and neuroma. [6]

Additional images

Related Research Articles

<span class="mw-page-title-main">Axillary nerve</span> Nerve of the human body near the armpit

The axillary nerve or the circumflex nerve is a nerve of the human body, that originates from the brachial plexus at the level of the axilla (armpit) and carries nerve fibers from C5 and C6. The axillary nerve travels through the quadrangular space with the posterior circumflex humeral artery and vein to innervate the deltoid and teres minor.

<span class="mw-page-title-main">Lesser occipital nerve</span> Nerve of the head and neck

The lesser occipital nerve is a cutaneous spinal nerve of the cervical plexus. It arises from second cervical (spinal) nerve (C2). It innervates the skin of the back of the upper neck and of the scalp posterior to the ear.

<span class="mw-page-title-main">Great auricular nerve</span> Cutaneous nerve of the head

The great auricular nerve is a cutaneous (sensory) nerve of the head. It originates from the second and third cervical (spinal) nerves (C2-C3) of the cervical plexus. It provides sensory innervation to the skin over the parotid gland and the mastoid process, parts of the outer ear, and to the parotid gland and its fascia.

<span class="mw-page-title-main">Subclavian artery</span> Major arteries of the upper thorax, below the clavicle

In human anatomy, the subclavian arteries are paired major arteries of the upper thorax, below the clavicle. They receive blood from the aortic arch. The left subclavian artery supplies blood to the left arm and the right subclavian artery supplies blood to the right arm, with some branches supplying the head and thorax. On the left side of the body, the subclavian comes directly off the aortic arch, while on the right side it arises from the relatively short brachiocephalic artery when it bifurcates into the subclavian and the right common carotid artery.

<span class="mw-page-title-main">Sternocleidomastoid muscle</span> Cervical muscle

The sternocleidomastoid muscle is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The sternocleidomastoid is innervated by the accessory nerve.

<span class="mw-page-title-main">Levator scapulae muscle</span> Slender skeletal muscle at the back and side of the neck

The levator scapulae is a slender skeletal muscle situated at the back and side of the neck. It originates from the transverse processes of the four uppermost cervical vertebrae; it inserts onto the upper portion of the medial border of the scapula. It is innervated by the cervical nerves C3-C4, and frequently also by the dorsal scapular nerve. As the Latin name suggests, its main function is to lift the scapula.

<span class="mw-page-title-main">Omohyoid muscle</span> Human neck muscle

The omohyoid muscle is a muscle in the neck. It is one of the infrahyoid muscles. It consists of two bellies separated by an intermediate tendon. Its inferior belly is attached to the scapula; its superior belly is attached to the hyoid bone. Its intermediate tendon is anchored to the clavicle and first rib by a fascial sling. The omohyoid is innervated by the ansa cervicalis of the cervical plexus. It acts to depress the hyoid bone.

<span class="mw-page-title-main">Cervical plexus</span> Network of nerves in the neck

The cervical plexus is a nerve plexus of the anterior rami of the first four cervical spinal nerves C1-C4. The cervical plexus provides motor innervation to some muscles of the neck, and the diaphragm; it provides sensory innervation to parts of the head, neck, and chest.

<span class="mw-page-title-main">Platysma muscle</span> Human neck muscle

The platysma muscle is a superficial muscle of the human neck that overlaps the sternocleidomastoid. It covers the anterior surface of the neck superficially. When it contracts, it produces a slight wrinkling of the neck, and a "bowstring" effect on either side of the neck.

<span class="mw-page-title-main">Scalene muscles</span> Muscles on the sides of the neck

The scalene muscles are a group of three muscles on each side of the neck, identified as the anterior, the middle, and the posterior. They are innervated by the third to the eighth cervical spinal nerves (C3-C8).

<span class="mw-page-title-main">Nerve plexus</span> Network of nerve fibres

A nerve plexus is a plexus of intersecting nerves. A nerve plexus is composed of afferent and efferent fibers that arise from the merging of the anterior rami of spinal nerves and blood vessels. There are five spinal nerve plexuses, except in the thoracic region, as well as other forms of autonomic plexuses, many of which are a part of the enteric nervous system. The nerves that arise from the plexuses have both sensory and motor functions. These functions include muscle contraction, the maintenance of body coordination and control, and the reaction to sensations such as heat, cold, pain, and pressure. There are several plexuses in the body, including:

<span class="mw-page-title-main">Intercostal nerves</span> Nerves in the thorax and abdomen

The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and differ from the anterior rami of the other spinal nerves in that each pursues an independent course without plexus formation.

<span class="mw-page-title-main">Posterior cutaneous nerve of thigh</span> Sensory nerve that supplies the back of the thigh, leg, buttock, and perineum

The posterior cutaneous nerve of the thigh is a sensory nerve of the thigh. It is a branch of the sacral plexus. It supplies the skin of the posterior surface of the thigh, leg, buttock, and also the perineum.

<span class="mw-page-title-main">Posterior triangle of the neck</span> Region of the neck

The posterior triangle is a region of the neck.

<span class="mw-page-title-main">Transverse cervical nerve</span>

The transverse cervical nerve is a cutaneous (sensory) nerve of the cervical plexus that arises from the second and third cervical spinal nerves (C2-C3). It curves around the posterior border of the sternocleidomastoideus muscle, then pierces the fascia of the neck before dividing into two branches. It provides sensory innervation to the front of the neck.

<span class="mw-page-title-main">Nerve point of neck</span>

The nerve point of the neck, also known as Erb's point, is a site at the upper trunk of the brachial plexus located 2–3 cm above the clavicle. It is named for Wilhelm Heinrich Erb. Taken together, there are six types of nerves that meet at this point.

<span class="mw-page-title-main">Muscular triangle</span>

The inferior carotid triangle, is bounded, in front, by the median line of the neck from the hyoid bone to the sternum; behind, by the anterior margin of the sternocleidomastoid; above, by the superior belly of the omohyoid.

<span class="mw-page-title-main">Subclavian triangle</span>

The subclavian triangle, the smaller division of the posterior triangle, is bounded, above, by the inferior belly of the omohyoideus; below, by the clavicle; its base is formed by the posterior border of the sternocleidomastoideus.

<span class="mw-page-title-main">Occipital triangle</span>

The occipital triangle, the larger division of the posterior triangle, is bounded, in front, by the Sternocleidomastoideus; behind, by the Trapezius; below, by the Omohyoideus.

<span class="mw-page-title-main">Cervical lymph nodes</span> Lymph nodes found in the neck

Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to a number of different pathological conditions including tumours, infection and inflammation.

References

PD-icon.svgThis article incorporates text in the public domain from page 928 of the 20th edition of Gray's Anatomy (1918)

  1. 1 2 3 4 Sinnatamby, Chummy S. (2011). Last's Anatomy (12th ed.). pp. 333–335. ISBN   978-0-7295-3752-0.
  2. 1 2 3 Rea, Paul (2016-01-01), Rea, Paul (ed.), "Chapter 3 - Neck", Essential Clinically Applied Anatomy of the Peripheral Nervous System in the Head and Neck, Academic Press, pp. 131–183, ISBN   978-0-12-803633-4 , retrieved 2021-01-06
  3. IMAIOS–supraclavicular
  4. Biology-online
  5. Neal, Joseph M. (2008-01-01), Benzon, Honorio T.; Rathmell, James P.; Wu, Christopher L.; Turk, Dennis C. (eds.), "Chapter 47 - Upper Extremity Blocks", Raj's Practical Management of Pain (Fourth Edition), Philadelphia: Mosby, pp. 871–887, ISBN   978-0-323-04184-3 , retrieved 2021-01-06
  6. Chase, S.; Menendez, M. E.; Ring, D. C. (2015-01-01), Greiwe, R. Michael (ed.), "18 - Clavicle nonunion and malunion", Shoulder and Elbow Trauma and its Complications, Woodhead Publishing Series in Biomaterials, Woodhead Publishing, pp. 389–402, ISBN   978-1-78242-449-9 , retrieved 2021-01-06