Supraclavicular nerves

Anatomy

Origin

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

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.**** The nerves descend in the posterior triangle of the neck beneath the platysma muscle and the deep cervical fascia. 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.

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.

Intermedial supraclavicular nerves

The intermedial supraclavicular nerve middle 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 (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.

Clinical significance

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

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.

Additional images

File:Gray784.png|Dermatome distribution of the trigeminal nerve File:Gray811and813.PNG|Cutaneous nerves of right upper extremity. File:Gray812and814.svg|Diagram of segmental distribution of the cutaneous nerves of the right upper extremity. File:Gray1210.png|Side of neck, showing chief surface markings.

References

References

1. Sinnatamby, Chummy S.. (2011). "Last's Anatomy".
2. Rea, Paul. (2016-01-01). "Chapter 3 - Neck". Academic Press.
3. IMAIOS–supraclavicular
4. [http://www.biology-online.org/dictionary/Posterior_supraclavicular_nerve Biology-online]
5. Neal, Joseph M.. (2008-01-01). "Chapter 47 - Upper Extremity Blocks". Mosby.
6. (2015-01-01). "18 - Clavicle nonunion and malunion". Woodhead Publishing.