Serratus Anterior Muscle Anatomy, winged scapula - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 7 ноя 2013
- Educational video describing the anatomy of the Serratus Anterior muscle.
Serratus anterior muscle originates on the superolateral surfaces of the upper 8 or 9 ribs and inserts into the medial border on the anterior side of the scapula. The serratus anterior muscles are divided into 3 parts: serratus anterior superior, serratus anterior intermediate, serratus anterior inferior.
The serratus anterior muscle is the most powerful “protractor” of the scapula. The scapula is moved laterally and anteriorly along the chest wall. The serratus anterior muscles are sometimes called the “boxer’s muscle” or the “big swing muscle” . with the same motion that occurs from throwing a punch, the serratus anterior muscles are responsible for pulling of the scapula forward and around the rib cage. The serratus anterior muscle is innervated by the long thoracic nerve.
The deficit of the serratus anterior muscle is most commonly caused due to impingement injury of the long thoracic nerve. The long thoracic nerve arises from three nerve roots, the fifth, sixth, and seventh cervical nerves. The long thoracic nerve then passes between the clavicle and first rib, then down along the lateral chest wall giving innervation to the serratus anterior muscle. If the serratus anterior muscle becomes paralyzed, the condition known as “medial winging of the scapula” may occur. The long thoracic nerve can be injured by:
•Trauma
•Pressure
•Neuritis/inflammation
•Surgery
Signs/symptoms of long thoracic nerve injury
•Medial winging of the scapula
•Difficulty elevating arm
•Weakness
•Pain
•Spasms: periscapular muscles trying to compensate for deformity
•Cosmetic deformity
Clinical evaluation tests for medial winging of the scapula:
•Wall test: the patient is asked to face a wall, standing about two feet from the wall and then push against the wall with flat palms at waist level in order to identify a long thoracic nerve injury.
•The resistance of forward flexion test: this is the resisted forward flexion test in which the patient resists the examiner’s attempt to bring down the forward flexed upper limbs.
Lateral scapular winging is different than medial winging of the scapula. Lateral scapular winging is due to dysfunction of the trapezius muscle. Lateral scapular winging involves injury to the spinal accessory nerve.
Treatment of medial scapular winging
•Non-operative:
•Observation for a minimal of 18 months- wait for nerve to recover without surgery
•MRI to indicate if a lesion is pressing on the nerve
•Muscle test and EMG
•Serratus anterior strengthening
Operative
•Pectoralis major transfer
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Gosh this was absolutely brilliant. Thank you so much. So nice to put things into perspective by seeing it in a video! Thanks guys x
Huge help for the future occupational therapist! thank you
Amazing! Wish I had met you in PT school. Or even better in A&P prereqs. Thank you
This channel is best to present very clear information and demonstrations about the body muscles
Thank you for your great videos 🙏
شكرًا جزيلا يا دكتورنا :) ويوفقك ربي بعلمك
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Serratus Anterior Muscle Anatomy is innervated by the long thoracic nerve. I't was hard to sleep at night at this time due to this event/complexity. Very good description in this video!
Excellent video , thanks for sharing !
You're a life saver 🙌 thanks for this amazing video
oh my god your video is super clear and detailed !
감사합니다.
Very thorough video! Loved it 😁
This video was very helpful sir thank you
thank you for your help
Great information!
Excellent Video
super graphics, thank you...
You're the Best #1
Thank You So Much!!!
Greatly Appreciated!!!
#Salute
awesome video as always doc :))
Great video
I will never forget the name of this mussle ... More then 20 years ago i started feeling pain in this area ... two weeks later i was not able to sleep anymore because of the pain. Docs didn't take me seriously. Then i noticed i couldn't lift my right arm the way i could before, just halfway. I used to be a good gymnast. Doing a handstand was out of the question now, cause i just felt over to the right side, cause there was a severe weakness. I was in severe pain for two weeks, then checked the function on both arm in a mirrow, just lifting my arms in front of me and on the right side, where it was so hard to lift my arm, i noticed my shoulder blade was sticking out in a weird way. So i went to the hospital and they gave me an MRI and i had a paralysis of the serratus Anterior muscle... I got physiotherapy and electrotherapy for more than a year, cause they said otherwise the mussle could have 'died off'/not functioning anymore' ... Greatful i got the right therapy ... but even now there's still a weakness in that aria and it tents to get blocked easily a s well ..
Did the electro therapy work
@@karlblake4596 yes, plus extra exercizes by physio....so i can lift things again, but still weaker than it used to be, not paralysed anymore though. I was lucky the diagnose was done quite quickly
@@karlblake4596 yes, it did reduce the pain and made the mussle stronger, along with physio therapy exercizes. I can lift things again, but this mussle is still a weak spot. Thankfully, it was discovered after 2 weeks since symptoms and pain started
Esli R thanks for reply I was a year without diagnosis and in physio therapy now fingers crossed I can get this muscle back firing on all 4
So you had pain down the side also nagging pain discomfort .
very good video perfect for a weekend
wowww in 5 mins i can understand and remembered very well rather than 1 hour class :')
This is amazing 😊
This is amazing! How did ppl learn anything before youtube??
thx from the heart
best video
serrates anterior palsy affect upward rotation too right?
I have winging of scapula as a result of neck injury c5 c6 c7, which happened almost 6 years ago. I m still in pain
As per the therapist, my curvature is lost and has a winging scapula, too.
My upper back develop knot often, and with little daily activities such as blanket folding, washing heavy dishes washing cost me a lot.
I only had an x-ray done 6 years ago. I requested the therapist for emg ncs, but he rejected my suggestion.
Taking physical therapy regularly for the last 3 years now, I feel burned out emotionally and financially as my career is ruined.
What do u suggest me should I get emg ncs test done, or should I consult neurophyican once again?
Did I make a mistake by rejecting the botox injection suggested by neurophyican early in the treatment?
Please advice
Thank you
i've had this problem for at least 4 years. 2 shoulder surgeries to no avail. i think this is what i have, long thoracic nerve injury. However, I tried doing serratus anterior release last night...it worked for about an hour or two. Just dig fingertips right under pec minor....I want to see if i can get dry needling done here. Hope this helps.
You need decompression surgery of the long throw if nerve
Sir please make a video on rib flare
Would pressure of this nerve cause rib cage pain
Sir plz tell me exercise for it
I've had winging scapula all my life, and never found the correct exercises to sort it out. Boxing and chin ups seem to have helped but my scapula still wings out like it is unconnected to my back.
Paul Richardson how did you come to know that it was scapular winging ?? Want to gain some knowledge on it !! Can you please help ??? Also in a normal person is the scapular medial border visible ???
what action involves the superior part?
Guys you need to stretch alout, bridge pose is the one that helped me the most. Then stretching and bridge again, everyday few minutes.
What is the bridge pose?
Nice music!
How can I recover it, doctor???I have been suffering this for 7 months
I have a brachial plexus injury. chest pain, severe intercostal pain, scapular winging, and I can't lift my arm above my shoulder or if i can it is shaky and difficult. I insist I have a long thoracic injury and docs don't listen. 6 years and no surgery to fix my shoulder.
You probably still do, so I thought I'd recommend you watch his Thoracic Outlet Syndrome video as well. One of the many others on the subject also has links to the surgeon's clinic. He recommends massage & self treatment first, but as a massage therapist I like how Dr. Ebraheim wants an MRI first, to see if there are structural anomalies causing it.
I'm not making a diagnosis, just pointing out things that I think will help.
I recommend stretching the Scalene muscles to everyone.
I have this on both shoulders
I could not find out a proper doctor for two years, world is suffering from too many illiterate educated people.
Thanks dr Babil I wish I could see you...
Thank you student from Kerala India
C8 ??? what is it????
So your saying there's no exercises for this
No u need decompression surgery of the nerve
0:41
Please in Telugu