Mnemonic

Serratus Anterior and the Long Thoracic Nerve

A memory aid for the thoracic wall attachment of serratus anterior and its nerve.

Expansion

Arises from the outer surface of the upper eight or nine ribs, supplied by the long thoracic nerve

Expansion

  • Origin - outer surfaces of the upper eight or nine ribs
  • Insertion - medial border of the scapula, on its costal surface
  • Nerve - long thoracic nerve, roots C5, C6, C7
  • Action - protracts and rotates the scapula, holding it against the chest wall

Because the nerve descends on the outer surface of the muscle in the mid-axillary line, it lies directly in the surgical field of an axillary node clearance and in the path of a lateral chest wall injury.

Denervation produces a winged scapula that becomes obvious when the patient pushes against a wall, the medial border lifts away from the thoracic cage.