Surgery · Breast (Benign, Carcinoma Breast, Staging, Treatment)

During axillary lymph node dissection for breast cancer, the surgeon identifies a long, thin nerve running along the chest wall in the medial portion of the axilla that must be preserved to prevent winging of the scapula. Which nerve is this?

  • A Thoracodorsal nerve
  • B Long thoracic nerve of Bell
  • C Intercostobrachial nerve
  • D Medial pectoral nerve
Correct answer: B. Long thoracic nerve of Bell

Explanation

The long thoracic nerve of Bell innervates serratus anterior and runs on the medial axillary wall. Injury causes winging of the scapula, the classic deficit. The thoracodorsal nerve supplies latissimus dorsi. The intercostobrachial nerve is a sensory branch causing medial arm numbness when divided. The medial pectoral nerve innervates pectoralis major and minor.

Reference: Gray's Anatomy for Students, 4th ed.

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