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OrthoVellum

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Hand & Upper Limb
intermediate
X-Type

Scapular Winging - Long Thoracic vs Spinal Accessory Nerve, Diagnosis and Treatment

Shoulder Disorders

A 32-year-old woman presents with progressive shoulder weakness and visible "bump" on her back that becomes more prominent when she pushes against a wall. She had undergone a lymph node biopsy in the posterior triangle of the neck 3 months earlier. Examination shows the MEDIAL border of the scapula is prominent and displaced LATERALLY, with weakness of shoulder abduction and flexion particularly beyond 90 degrees. The winging becomes MORE prominent when she pushes forward against a wall with her arms extended. The surgeon discusses the differential diagnosis of scapular winging, nerve injury patterns, and treatment options. Regarding scapular winging and its causes:

Mark each as TRUE or FALSE

A

LONG THORACIC NERVE injury causes SERRATUS ANTERIOR paralysis; the MEDIAL border of scapula wings pr...

B

SPINAL ACCESSORY NERVE injury causes TRAPEZIUS paralysis; the LATERAL border of scapula wings with I...

C

Long thoracic nerve injury causes TRAPEZIUS paralysis; spinal accessory causes SERRATUS ANTERIOR par...

D

DORSAL SCAPULAR NERVE injury causes RHOMBOID weakness with MEDIAL border winging, but the scapula di...

E

Treatment: observation and physical therapy for 12-24 months (many recover spontaneously); persisten...

Answer the questions to see explanations

Click T (True) or F (False) for each option