QuestionSBA
QuestionChoice
This answer is correct. The examination findings describe winging of the scapula that occurs due to paralysis of serratus anterior which normally keeps the scapula against the thoracic cage. This is caused by damage to the long thoracic nerve, which can occur during radical mastectomy.
10007366
a
Long thoracic nerve
QuestionChoice
This answer is incorrect. The axillary nerve innervates the deltoid. Whilst damage would result in weakness of shoulder abduction, it would also cause loss of sensation over the regimental badge area. The axillary nerve is most commonly damaged by shoulder dislocation.
10007367
b
Axillary nerve
QuestionChoice
This answer is incorrect. The radial nerve does not innervate the muscles that move the shoulder joint. Damage to the radial nerve results in wrist drop and sensory loss over the first 3.5 digits of the dorsum of the hand.
10007370
e
Radial nerve
QuestionChoice
This answer is incorrect. The spinal accessory nerve (CN XI) innervates the trapezius and sternocleidomastoid and is not commonly damaged during radical mastectomy. Whilst damage would result in weak shoulder abduction, scapular winging is much less prominent than in long thoracic nerve injury.
10007369
d
Spinal accessory nerve
QuestionChoice
This answer is incorrect. The thoracodorsal nerve innervates latissumus dorsi and damage would result in weakness of shoulder extension and adduction.
10007368
c
Thoracodorsal nerve
Concept
Chapter
2693
4591
Long thoracic nerve injury
Topic
145
Orthopaedics
14020
A 62-year-old woman attends a follow-up appointment with her surgeon following a radical mastectomy for breast cancer 6 weeks ago. She complains of pain and weakness in her right shoulder.

On examination, the right scapula is visibly protruding from the back and there is weakness on flexion and abduction of the right shoulder. There are no sensory deficits.

Which of the following nerves was most likely damaged during the operation?
a