The dorsal scapular artery arises from the third part of the subclavian artery (or from the transverse cervical artery as its deep branch) and passes posteriorly through the brachial plexus to supply the rhomboids, the levator scapulae, and the serratus posterior superior, running along the medial scapular border. It anastomoses with the suprascapular and circumflex scapular arteries around the scapula.
The dorsal scapular artery is encountered during posterior neck dissection, brachial plexus exploration, and first rib resection for thoracic outlet syndrome. Its proximity to the C5 nerve root as it passes through the brachial plexus makes it a landmark in brachial plexus surgery. The parascapular free flap (based on the circumflex scapular artery) is harvested along the lateral scapular border while the dorsal scapular artery territory supplies the more medial scapular periosteal flap.
The dorsal scapular artery passing through the posterior triangle and the brachial plexus trunks serves as a vascular landmark during brachial plexus exploration; it passes between or around the C5 trunk level and its identification guides the surgeon to the upper trunk and root levels.
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