Winging of Scapula - Neurogenic causes

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Thanks Dr Krishnendu and Dr Anand for the answeres.I am not expecting more answeres since it is pure Neurology. I will give the conclusion now. 1. Long thoracic nerve palsy. The long thoracic nerve innervate the serrations anterior muscle.Serratus anterior weakness leads to the most pronounced weakness,which is accentuated with forward flexion of arms and decreased with the arm at rest.The medial ( superior) angle of the scapula is displaced closer to the midline,whereas the inferior angle swings laterally and away from the thorax. 2.Spinal accessory nerve palsy.The spinal accessory nerve innervatesthe teapezius muscle.Trapezius muscle weakness lead to mild winging of scapula rest,which is accelerated by arm adduction to 90 degrees and decreased by forward flexion to 90degree The superior( medial ) border of scapula is displaced away from the midline,but the inferior angleis medically rotated. Thus the shoulder I'd lower to the affected side because of the atrophy of trapezius muscle. 3. Dorsal scapular nerve palsy.The dorsal scapular nerve injervatesthe rhomboid muscle.Weakness of thus muscle produces minimal winging at rest, which is accentuated by slowly lowering the arm from the forwards overhead position and decreased by elevation of the arms overhead.The medial ( superior) angle I'ds displaced away from the midline ,and the inferior angle is laterally displaced. In addition ,there are many nonneurogenic causes causes of winging of scapula,including myopathies and muscular dystrophy. Both of you are well aware of these things. I wrote in detail for the benefit of students ,undergraduate & PGs

Fshd, high cervical brachial plexopathy , long thoracic nerve injury

Brachial plexopathy, motor neuron disease, LEMS

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