Which nerve is primarily associated with winging of the scapula?

The long thoracic nerve of Bell is primarily associated with winging of the scapula because it innervates the serratus anterior muscle. This muscle plays a crucial role in stabilizing the scapula against the thoracic wall during arm movements. When the long thoracic nerve is injured or compromised, the serratus anterior cannot function properly, leading to winging of the scapula, where the medial border of the scapula protrudes away from the thorax.

Winging can often be observed during pushing movements or when the patient attempts to raise their arms. The pathology arises from the inability of the serratus anterior to hold the scapula flat against the chest wall, which is why the long thoracic nerve is directly linked to this particular condition. Understanding the anatomy and function of the nerves and muscles involved helps to clearly illustrate the mechanisms behind winging of the scapula.