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long thoracic nerve
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The long thoracic nerve is responsible for innervation of the serratus anterior.

Winging of the scapula can be observed in paralysis of either the trapezius or the serratus anterior. To determine which muscle (or nerve supplying the muscle: accessory nerve to trapezius, long thoracic nerve to serratus anterior) is injured, observe the following on physical exam:

1. Upon holding arms outstretched in front of the body and leaning against a wall supported with hands, trapezius winging becomes less pronounced, while serratus anterior winging becomes more pronounced.

2. Upon abduction of the arm, trapezius winging becomes more pronounced, while serratus anterior winging becomes less pronounced or does not change.

3. Upon flexion of the arm, trapezius winging becomes less pronounced, while serratus anterior winging increases in severity.
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