Shoulder Pathology MCQs

A 22-year-old collegiate pitcher is diagnosed with true neurogenic thoracic outlet syndrome (TOS). In this condition, the compression typically involves a cervical rib or fibrous band compressing which specific component of the brachial plexus?

A 24-year-old athlete presents with medial scapular winging noticeable during forward elevation of the arm. EMG confirms an isolated nerve injury. Which muscle is primarily affected and what is the typical mechanism of injury?

A 30-year-old female presents with progressive right shoulder weakness and a dull ache following a cervical lymph node biopsy performed three months ago. On examination, when she attempts to push against a wall with her arms elevated, the medial border of her right scapula translates laterally and superiorly. Injury to which of the following nerves and corresponding muscle deficit is most likely responsible for her condition?

A 55-year-old female with poorly controlled type 1 diabetes presents with insidious onset of profound shoulder stiffness and pain. She is diagnosed with adhesive capsulitis (frozen shoulder). Histological and biochemical analysis of the capsule in this condition is most likely to show an upregulation of which of the following cytokines?

During exploration of a brachial plexus injury 5 months post-trauma, a neuroma-in-continuity is identified at the upper trunk. Intraoperative nerve stimulation across the neuroma yields a reproducible nerve action potential (NAP). What is the most appropriate next step in management?

In brachial plexus reconstruction for a complete C5-C6 root avulsion, transferring the distal spinal accessory nerve to the suprascapular nerve is considered. Which of the following muscles must have confirmed, robust baseline function prior to sacrificing the distal spinal accessory nerve?

A 30-year-old male complains of right shoulder weakness and a prominent shoulder blade after a heavy traction injury to his neck and shoulder. On examination, there is marked prominence of the medial border of the scapula, especially when pushing against a wall. Injury to which of the following nerves is the most likely cause?

Figure 17 shows the clinical photograph of a 45-year-old female tennis player who has right arm pain and weakness with elevation after undergoing a cervical biopsy several months ago. The cause of her shoulder weakness is damage to the

A 38-year-old man has winging of the ipsilateral scapula after undergoing a transaxillary resection of the first rib 3 weeks ago. What is the most likely cause of this finding?

A 20-year-old-man sustained a scapular fracture after attempting to grab a beam as he fell through a ceiling at a job site 3 months ago. A clinical photograph is shown in Figure 36. He now reports pain in the anterior shoulder and difficulty with overhead activities. What nerve roots make up the involved peripheral nerve?

A 56-year-old woman who underwent axillary node dissection 4 months ago now reports shoulder pain, weakness of forward elevation, and obvious winging of the scapula. What structure has been injured?

A 50-year-old man reports left shoulder pain and weakness after undergoing a lymph node biopsy in his neck 2 years ago. Examination reveals winging of the left scapula. Electromyography shows denervation of the trapezius. Surgical treatment for this condition involves

A 48-year-old carpenter presents with chronic aching pain and weakness in his right shoulder, particularly with overhead work. On examination, he has atrophy of the supraspinatus and infraspinatus muscles, and weakness with resisted external rotation. Sensation is intact. EMG/NCS confirm denervation of these muscles. What is the MOST likely cause of his symptoms?

A 35-year-old male presents with a visible 'winging' of his right scapula, particularly when he pushes against a wall. He reports difficulty with overhead activities. What nerve is MOST likely injured?

A 40-year-old female presents with a progressive inability to elevate her arm overhead. On examination, she has severe atrophy of the deltoid muscle, and sensory loss over the lateral aspect of the shoulder (regimental badge area). What is the MOST likely nerve injury?

A 28-year-old male presents with a dull ache in his right shoulder and difficulty lifting his arm above shoulder level after blunt trauma to the posterior neck. Examination reveals lateral winging of the scapula. Which nerve is most likely injured?

A 24-year-old weightlifter presents with a dull ache in his right shoulder and noticeable lateral scapular winging. Examination reveals weakness in shoulder abduction, but normal forward elevation. Which nerve has most likely been injured?

A 25-year-old athlete sustains a direct blow to the shoulder and subsequently presents with medial winging of the scapula. Injury to which of the following nerves is the most likely cause?

A 25-year-old man presents with prominent medial scapular winging when asked to push against a wall, following a heavy traction injury to his shoulder. Electromyography confirms an isolated nerve palsy. From which specific nerve roots does the affected nerve originate?

A patient presents with shoulder weakness and lateral winging of the scapula following a lymph node biopsy in the posterior triangle of the neck. Which nerve was injured, and which muscle is paralyzed?