QuestionSBA
QuestionChoice
This patient demonstrates winging of the scapula, a complication of surgical damage to the long thoracic nerve. C5,C6,C7 are the correct spinal nerve roots, making this option partially correct. However the pectoralis minor is not associated with damage to the long thoracic nerve, and not associated with winging of the scapula. Instead, pectoralis minor is innervated by the medial pectoral nerve which has spinal nerve roots C8-T1. This option is therefore incorrect.
10007767
c
C5,C6,C7 and pectoralis minor
QuestionChoice
This patient demonstrates winging of the scapula, a recognised complication of surgery in the axilla. The nerve that is affected is known as the long thoracic nerve, which originates from the ventral rami of the C5,C6,C7 spinal roots of the brachial plexus. The muscle innervated by this nerve is known as the serratus anterior muscle, which is responsible for holding the medial border of the scapula against the ribcage. Hence when this muscle is paralysed, the medial border of the scapula is no longer held against the ribcage, resulting in winged scapula appearance.
10007765
a
C5,C6,C7 and serratus anterior
QuestionChoice
This patient demonstrates winging of the scapula, a complication of surgical damage to the long thoracic nerve. The long thoracic nerve is supplied by C5,C6,C7. By contrast, C3,C4,C5 are the roots of the phrenic nerve which innervates its own ipsilateral hemidiaphragm.
10007766
b
C3,C4,C5 and serratus anterior
QuestionChoice
This patient demonstrates winging of the scapula, a complication of surgical damage to the long thoracic nerve (C5,C6,C7). The subscapularis is innervated by the upper and lower subscapular nerves, and paralysis of it does not lead to winging of the scapula.
10007769
e
C5,C6 and subscapularis
QuestionChoice
This patient demonstrates winging of the scapula, a complication of surgical damage to the long thoracic nerve (C5,C6,C7). The pectoralis major muscle is innervated by the medial and lateral pectoral nerves, and paralysis of it does not lead to winging of the scapula.
10007768
d
C4,C5,C6 and pectoralis major
Concept
Chapter
2693
4433
Long thoracic nerve damage
Topic
145
Orthopaedics
14100
A 42-year-old woman with breast cancer is scheduled for a mastectomy with axillary clearance. After the operation she presents with a 'funny looking' right shoulder. On examination, her right scapula is noted to protrude when she is asked to place her right hand against a wall and push.

Which of the following the spinal nerve roots and associated muscle is implicated in this injury?
a