Shoulder Pathology MCQs

A 45-year-old female undergoes a cervical lymph node biopsy in the posterior triangle of her neck. Postoperatively, she reports a dull ache in her shoulder and difficulty with overhead activities. Examination reveals a laterally displaced and rotated scapula. Which nerve and corresponding muscle were most likely injured?

A 25-year-old patient presents with right shoulder pain and weakness when lifting objects above his head. Examination reveals medial scapular winging that worsens when the patient pushes against a wall. Injury to which of the following nerves is the most likely cause?

A lower trapezius tendon transfer is performed for a patient with a massive, irreparable posterosuperior rotator cuff tear to restore active external rotation. What is the primary motor innervation to the transferred muscle?

A 35-year-old female presents with shoulder weakness 3 months after a posterior triangle cervical lymph node biopsy. On physical examination, the shoulder exhibits lateral winging of the scapula when she abducts her arm. Injury to which nerve is responsible for this physical finding?

A 35-year-old female presents with shoulder pain and weakness 4 weeks after a posterior cervical triangle lymph node biopsy. On examination, the affected shoulder droops, and the scapula rests lateral to the midline and wings when she abducts her arm. Injury to which of the following nerves is the most likely cause?

A 24-year-old manual worker presents with painful crepitus and snapping at the superomedial border of his scapula. Non-operative management has failed after 6 months. Imaging reveals a skeletal prominence at the superomedial angle. What is the anatomical name of this structure commonly responsible for this syndrome?

A 35-year-old male develops medial scapular winging following a prolonged viral illness. Electromyography confirms neuropathy of the affected muscle's primary nerve. Which nerve roots predominantly supply this injured nerve?

A 32-year-old female presents with shoulder pain and a deformity of her scapula following a posterior triangle lymph node biopsy. On examination, the scapula is translated laterally and superiorly, with prominent winging that worsens with active shoulder abduction. Injury to which nerve is the most likely cause?

A 30-year-old female presents with shoulder pain and an inability to abduct her arm beyond 90 degrees after undergoing a lymph node biopsy in the posterior triangle of the neck. On exam, she has lateral winging of the scapula. Which nerve was most likely injured?

A 26-year-old mechanic sustains a traction injury to his neck and shoulder. He demonstrates medial scapular winging that worsens when pushing against a wall. Which nerve is injured and which muscle is affected?

A 40-year-old woman develops lateral winging of the scapula and a drooping shoulder three weeks after a posterior triangle neck lymph node biopsy. Which nerve was most likely injured, and what is the preferred definitive tendon transfer if nonoperative management fails?

A 32-year-old female presents with shoulder weakness and lateral scapular winging 4 weeks after an excisional lymph node biopsy in the posterior cervical triangle. Which nerve is most likely injured, and which muscle is denervated?

A 34-year-old female presents with chronic numbness and tingling in the ulnar distribution of her right hand, accompanied by intrinsic muscle weakness. She has a positive Roos test and a positive Adson maneuver. A cervical radiograph reveals bilateral cervical ribs. Electromyography (EMG) shows decreased SNAP amplitude in the ulnar nerve and denervation in the abductor pollicis brevis. What is the most likely diagnosis?

A patient is diagnosed with neurogenic thoracic outlet syndrome. Surgical decompression is planned involving the interscalene triangle. Which structure courses anterior to the anterior scalene muscle, remaining outside the confines of the interscalene triangle?

A 21-year-old collegiate pitcher is diagnosed with SICK scapula syndrome (Scapular malposition, Inferior medial border prominence, Coracoid pain, and dysKinesis). Examination shows significant anterior tilt of the scapula. Tightness of which of the following muscular structures is the primary driver of this anterior tilt?

A 35-year-old male presents with the inability to actively raise his right arm above shoulder level following an axillary lymph node dissection 3 months ago. Physical examination reveals prominent medial winging of the scapula that worsens when pushing against a wall. Which nerve is most likely injured?

A 28-year-old female hair stylist complains of vague aching in her right arm, paresthesias in the ulnar distribution, and fatigue that worsens when working with her arms overhead. Wright's test is positive. If this represents neurogenic thoracic outlet syndrome (TOS), compression of the brachial plexus most commonly occurs within which anatomic space?

A 24-year-old male complains of a painful grinding and snapping sensation at the superomedial border of his scapula with arm movement. Physical therapy and multiple steroid injections have failed to provide relief. If operative intervention (bursectomy/partial scapulectomy) is planned, which bursa is the primary target?

A 42-year-old patient presents with lateral scapular winging following a posterior cervical lymph node biopsy. The scapula is translated laterally, with the inferior pole rotated laterally. Which of the following procedures is most appropriate for a symptomatic, refractory case?