Scapular winging is most associated with dysfunction of which nerve or muscle?

Scapular winging is most associated with dysfunction of which nerve or muscle?

• A. Spinal accessory nerve
• B. Dorsal scapular nerve
• C. Serratus anterior (long thoracic nerve) dysfunction
• D. Thoracodorsal nerve dysfunction

Answer: (C)

Scapular stability relies heavily on the serratus anterior, which holds the medial border of the scapula flat against the chest wall and helps protract the scapula during pushing movements. When the serratus anterior is weak due to injury of the long thoracic nerve, the medial border of the scapula can lift away from the rib cage, especially when the arm is pressed forward, producing the classic winging. Other nerves can affect the shoulder girdle, but they don’t produce that characteristic medial-winging pattern. The spinal accessory nerve supplies the trapezius, and its weakness can loosen shoulder position but isn’t as classically tied to winging as serratus anterior palsy. The dorsal scapular nerve affects rhomboids and levator scapulae, which alters scapular positioning in a different way. The thoracodorsal nerve controls latissimus dorsi, which isn’t a primary stabilizer of the scapula.

Scapular stability relies heavily on the serratus anterior, which holds the medial border of the scapula flat against the chest wall and helps protract the scapula during pushing movements. When the serratus anterior is weak due to injury of the long thoracic nerve, the medial border of the scapula can lift away from the rib cage, especially when the arm is pressed forward, producing the classic winging.

Other nerves can affect the shoulder girdle, but they don’t produce that characteristic medial-winging pattern. The spinal accessory nerve supplies the trapezius, and its weakness can loosen shoulder position but isn’t as classically tied to winging as serratus anterior palsy. The dorsal scapular nerve affects rhomboids and levator scapulae, which alters scapular positioning in a different way. The thoracodorsal nerve controls latissimus dorsi, which isn’t a primary stabilizer of the scapula.