Shoulder Pathology MCQs

A 28-year-old patient presents with symptomatic scapular winging following a posterior triangle lymph node biopsy. On examination, the scapula rests in a translated lateral and downwardly rotated position. The winging is accentuated when the patient abducts the arm against resistance. Which nerve is most likely injured?

The clinical photograph in Figure 27 shows a palsy of what nerve/associated muscle? Review Topic

A 47-year-old man undergoes a posterior cervical procedure for a benign tumor. Postoperatively, severe dysfunction with decreased forward elevation and abduction develops and he has lateral winging of the scapula. What is the recommended treatment to best restore motion and function? Review Topic

During an arthroscopic SLAP (Superior Labrum Anterior to Posterior) repair on a right shoulder, the surgeon prepares to place a suture anchor at the 1 o'clock position on the glenoid rim. Deep drill penetration past the far cortex at this specific location places which of the following neurovascular structures at greatest risk of injury?

A 40-year-old motorcyclist presents after a high-speed crash with massive soft tissue swelling over the left shoulder. Radiographs demonstrate lateral displacement of the scapula, an intact but widened acromioclavicular joint, and a severely displaced clavicle fracture. Radial pulses are diminished. Which nerve injury is most common in this scenario?

A 28-year-old professional weightlifter presents with a dull, aching pain in his right posterior shoulder and neck. On examination, there is pronounced lateral winging of the scapula, which is exacerbated during resisted external rotation and shoulder abduction. He recently had a minor lymph node biopsy in the posterior triangle of his neck. Injury to which of the following nerves is the most likely cause of his scapular winging?

A 32-year-old carpenter presents with right shoulder weakness and a dull ache in the shoulder blade. On physical examination, when the patient pushes against a wall with arms extended forward, the medial border of the right scapula becomes prominent. Injury to which nerve is the most likely cause of this finding?

A 65-year-old male with an irreparable posterosuperior rotator cuff tear and a positive Hornblower's sign undergoes a latissimus dorsi tendon transfer. During the harvest of the tendon, which neurovascular bundle is at greatest risk and must be carefully protected?

A 42-year-old female presents with persistent shoulder pain and weakness 4 weeks after undergoing a lymph node biopsy in the posterior cervical triangle. On physical exam, she demonstrates lateral winging of the scapula and an inability to actively abduct the shoulder past 90 degrees. Injury to which of the following nerves is the most likely cause?

A 26-year-old female presents with lateral scapular winging and an inability to actively abduct her arm past 90 degrees. She recently underwent a lymph node biopsy in the posterior cervical triangle. Which nerve was most likely injured?

A 26-year-old female complains of a painful clunking sensation at the superomedial border of her scapula with active elevation of the arm. She has failed 6 months of physical therapy and injections. She is scheduled for arthroscopic bursectomy and partial scapulectomy. Which bursa is most commonly inflamed in this condition?

A 35-year-old carpenter presents with a dull ache in his shoulder and weakness with overhead activities after carrying heavy beams over his right shoulder for several weeks. On physical examination, lateral winging of the scapula is noted, which worsens when the patient attempts to abduct the arm. Which nerve is most likely injured, and which muscle is affected?

Scapulothoracic dissociation is a high-energy injury characterized by complete disruption of the scapulothoracic articulation. Which neurovascular injury is most commonly associated with this condition and dictates limb viability?

A 19-year-old male undergoes open reduction and internal fixation of a displaced midshaft clavicle fracture using a superiorly applied pre-contoured plate. Postoperatively, he complains of a numb patch of skin over his anterior chest wall. Which nerve was most likely injured during the surgical approach?

A 40-year-old female presents with shoulder pain, inability to actively abduct the arm beyond 90 degrees, and lateral scapular winging following a posterior triangle cervical lymph node biopsy. Which of the following tendon transfers (Eden-Lange procedure) is classically indicated for her condition?

A 32-year-old male presents with shoulder pain and weakness 6 weeks after a blunt trauma to the posterolateral neck. Physical examination reveals prominent medial winging of the scapula when the patient pushes against a wall. Which muscle and associated nerve have most likely been injured?

A 29-year-old female presents with shoulder weakness and aching pain following a posterior triangle neck lymph node biopsy. On examination, the resting position of her scapula is translated laterally and rotated downwardly. Attempted shoulder abduction results in the medial border of the scapula becoming less prominent (lateral winging). What is the most likely injured nerve?

A 35-year-old male complains of a prominent right shoulder blade after heavy weightlifting. Examination demonstrates lateral winging of the scapula that worsens with resisted active abduction. Injury to which of the following nerves is the most likely cause?