The middle slips of serratus anterior connect the middle medial scapular border to the chest wall, coordinating the transition between upper protraction and lower upward rotation functions.
| Origin | Outer surfaces of ribs 3-5 |
|---|---|
| Insertion | Costal surface of the medial scapular border — middle segment |
| Nerve Supply | Long thoracic nerve (C5, C6, C7) |
| Blood Supply | Lateral thoracic artery |
| Actions | Protracts the scapula; Contributes to upward scapular rotation |
|---|
Middle serratus slips are the zone targeted in selective long thoracic nerve block for serratus spasticity. Their clinical contribution to scapular winging is intermediate between the more critical upper and lower portions.
Palpable along the lateral chest wall ribs 3-5 during resisted shoulder protraction.
Partial long thoracic nerve injury involving the middle slips producing incomplete scapular winging with preserved lower-slip rotation function.
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