Shoulder Nerve injury ,Injuries - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes common nerve injury conditions around the shoulder.
The axillary nerve
The axillary nerve arises from the posterior cord of the brachial plexus. The axillary nerve runs anteriorly across the subscapularis muscle. The nerve passes through the quadrangular space. Within the quadrangular space, the nerve is joined by the posterior humeral circumflex artery. The axillary nerve supplies the muscles of the deltoid and teres minor, giving sensation over the shoulder area.
When the nerve is injured
•Weakness of shoulder abduction
•Atrophy of the deltoid
•Numbness in the deltoid region.
The axillary nerve is commonly injured due to fractures or dislocations of the shoulder joint. When the axillary nerve is injured within the quadrangular space, there will be pain and paresthesia with overhead activity.
The injury is usually diagnosed with angiogram or MRI. It is a difficult diagnosis.
The musculocutaneous nerve
•The musculocutaneous nerve arises from the lateral cord of the brachial plexus and supplies the coracobrachialis and biceps muscles of the shoulder. It also supplies the brachialis muscle on the lateral side of the arm. The musculocutaneous nerve arises from the lateral cord of the brachial plexus and can be injured form shoulder trauma or surgery.
•Injury to the musculocutaneous nerve may produce weakness of elbow flexion and weakness of forearm supination.
•Diagnosis: tests the biceps muscle by having the patient flex a fully supinated forearm against resistance. With the injury to the nerve, the patient will have numbness in the anterolateral forearm (lateral antebrachial cutaneous nerve).
The long thoracic nerve
•The long thoracic nerve is derived from the nerve roots of C5, C6, and C7. The long thoracic nerve supplies the serratus anterior muscle.
•Medial winging of the scapular is most commonly caused by a deficit in the serratus anterior due to the injury of the long thoracic nerve.
Spinal accessory nerve
•The spinal accessory nerve controls specific muscles of the shoulder and the neck.
•Injury to the spinal accessory nerve results in wasting of the trapezius, causing the scapular to translate laterally. Disruption of this nerve will cause painless limitation of the active elevation of the arm and weakness of the trapezius muscle.
Dorsal scapular nerve
•The dorsal scapular nerve arises from the C5 nerve root. The dorsal scapular nerve supplies the muscles of the rhomboids minor and major.
•Injury to the dorsal scapular nerve results in rhomboids winging. The scapula will adopt a similar position to trapezius (lateral) winging with arm elevation.
Suprascapular nerve
•The suprascapular nerve arises from the upper trunk of the brachial plexus. The suprascapular nerve passes under the transverse scapular ligament at the suprascapular notch. The transverse scapular artery runs above the transverse scapular ligament. The artery and the nerve join and the pass through the spinoglenoid notch under the inferior scapular ligament. the suprascapular nerve gives branches to the supraspinatus muscle and branches to the infraspinatus muscle.
•Nerve compression at the suprascapular notch affects both the supraspinatus and infraspinatus muscles causing a decrease in abduction and loss of external rotation.
•Nerve compression at the spinoglenoid notch affects only the infraspinatus muscle causing loss of external rotation. Spinoglenoid notch compression can occur in volleyball players and is usually associated with cysts, ganglia, or SLAP tears.
•The infraspinatus is the primary external rotator of the shoulder.
Neuropathic shoulder joint (Charcot joint)
Destructive process of the shoulder joint associated with the neurosensory deficit. Patients with syringomyelia, diabetes mellitus, syphilis, or other neuropathies may be prone to Charcot joint.
Get an MRI of the cervical spine in patients with Charcot shoulder joint.

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