Serratus anterior muscle
The serratus anterior muscle is a fan-shaped muscle at the lateral wall of the thorax. Its main part lies deep under the scapula and the pectoral muscles. It is easy to palpate between the pectoralis major and latissimus dorsi muscles. In athletic bodies the muscle may be even visible to the naked eye along the ribs underneath the axilla.
The serratus anterior muscle originates from the 1st to 10th rib and inserts at the anterior surface of the scapula. Due to its course it has a “serrated” or “saw-toothed” appearance.
Superior part: Ribs 1-2, Intercostal fascia
Middle part: Ribs-3-6
Inferior part: Ribs 7-8/9/10 (+ external oblique muscle)
Superior part: Anterior and posterior surface of superior angle of scapula
Middle part: Anterior surface of entire medial border of scapula
Inferior part: Anterior and posterior surface of inferior angle of scapula
Long thoracic nerve (C5- C7)
Mnemonics: 'SALT' (stands for serratus anterior - long thoracic) & 'C5, 6, 7 raise your arms to heaven!'
|Blood supply||Superior and lateral thoracic arteries, thoracodorsal artery branches|
|Function||Scapulothoracic joint: Draws scapula anterolaterally, Suspends scapula on thoracic wall, Rotates scapula (draws inferiorly angle laterally)|
This article will discuss the anatomy of the serratus anterior muscle.
Origin and insertion
The serratus anterior muscle originates at the 1st to 9th rib and inserts at the ventral surface of the medial border of the scapula. The muscle is further divided into three parts:
- Superior part: 1st to 2nd rib → superior angle of the scapula
- Intermediate part: 2nd to 3rd rib → medial border of the scapula
- Inferior part: 4th to 10th rib → medial border and inferior angle of the scapula.
The inferior part of the muscle is the most prominent and powerful one.
Wondering how you're going to revise the anatomy of the serratus anterior muscle? Our handy trunk wall muscle anatomy chart has your back.
The innervation is supplied by the long thoracic nerve (C5-7), a branch of the brachial plexus.
The innervation for the serratus anterior is very easy to remember if you just know the right mnemonics! 'SALT' stands for 'Serratus Anterior = Long Thoracic' and will help you remember the name of the nerve, while knowing 'C5, 6, 7 raise your arms to heaven!' means you'll never forget the nerve roots associated with it!
The vascular supply to the serratus anterior comes from the superior and lateral thoracic arteries (branches of the axillary artery) as well as branches from the thoracodorsal artery (branch of subscapular artery).
The contraction of the entire serratus anterior leads to a anterolateral movement of the scapula along the ribs. Due to the pull of the inferior part at the lower scapula, the shoulder joint is shifted superiorly. This shifting now enables to lift the arm above 90° (elevation).
In contrast, the superior part depresses the scapula and thus acts antagonistically. Another function of the serratus anterior is the active stabilization of the scapula within the shoulder. Finally in a fixed scapula the muscle lifts the ribs and acts as an accessory inspiratory muscle.
A damage of the long thoracic nerve can lead to a functional loss of the serratus anterior. Common causes are operations in the axilla (e.g. lymph node removal), a compression due to carrying heavy loads (e.g. backpack) and trauma.
Typical symptoms include trouble elevating the arm and a generally unstable shoulder. Another classic sign is the medial “wing-like” tilting of the scapula (scapula alata).