The serratus anterior is the most important scapular stabiliser, holding the medial border of the scapula flat against the thoracic wall and rotating the glenoid upward during arm elevation. Its loss produces the classic medial scapular winging.
An expanded entry for Serratus Anterior.
| Origin | Outer surfaces of ribs 1-9, the first rib by a single digitation, ribs 2-4 by separate digitations, ribs 5-9 by interdigitating with the external oblique |
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| Insertion | Costal surface of the medial scapular border, the superior angle (upper slips), medial border, and inferior angle (lower slips) |
| Nerve Supply | Long thoracic nerve (C5, C6, C7) |
| Blood Supply | Lateral thoracic artery and thoracodorsal artery |
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It protracts and upwardly rotates the scapula and holds it against the chest wall, essential for pushing and overhead reaching.
Long thoracic nerve injury (from viral illness, stretch, or iatrogenic causes) produces serratus anterior palsy with classic medial scapular winging, the medial border lifts away from the thorax when the arm is elevated. Treatment is conservative, most resolve over 12-24 months. The long thoracic nerve is at risk during axillary lymph node dissection and first rib resection.
Observed as a visible medial border and inferior angle winging during arm elevation or wall push-up.
Medial scapular winging from long thoracic nerve palsy producing inability to fully elevate the arm, managed conservatively with physiotherapy over 12-24 months.
Other versions of this entry: Serratus Anterior · Serratus Anterior (Full)
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