Shoulder Pathology MCQs

A patient presents with a winged scapula, and physical examination demonstrates isolated weakness of the serratus anterior muscle. Injury to the long thoracic nerve is suspected. Which nerve roots contribute to the formation of this nerve?

A patient presents with winging of the scapula and an inability to elevate the shoulder above 90 degrees following a diagnostic lymph node biopsy in the posterior cervical triangle. Injury to which of the following nerves is the most likely cause?

A patient exhibits marked lateral winging of the scapula following a lymph node biopsy in the posterior triangle of the neck. The patient struggles to abduct the shoulder past 90 degrees. Which nerve was most likely injured?

A patient sustains an injury resulting in medial winging of the scapula. Which nerve is injured, and what are its correct nerve root origins?

A 40-year-old man presents with right shoulder weakness 3 weeks after a motor vehicle collision. He complains of pain at the base of his neck and shoulder. On physical examination, forward flexion of the arm against resistance results in medial translation and prominent winging of the scapula. Injury to which of the following nerves is the most likely cause?

A 28-year-old woman presents with isolated lateral scapular winging that worsens when she abducts her arm against resistance. She had a cervical lymph node biopsy 3 months ago. What is the most appropriate initial management?

A 28-year-old tennis player complains of shoulder weakness. On examination, there is lateral winging of the scapula, especially with attempted shoulder abduction. Which nerve is most likely injured?

A 45-year-old female underwent a lymph node biopsy in the posterior triangle of her neck 3 weeks ago. She now complains of a severe ache in her shoulder and difficulty lifting her arm overhead. Physical examination reveals lateral winging of the scapula. Which nerve was most likely injured?

A patient presents with pronounced medial winging of the scapula after a direct blow to the lateral chest wall. The injured nerve originates from which of the following brachial plexus structures?

During a posterior cervical foraminotomy at C5-C6, the surgeon aggressively retracts the lateral aspect of the facet joint. Which of the following anatomical structures is most at risk of iatrogenic injury in the extraforaminal space?

When exposing the posterior arch of C1 and the lateral masses of C2 for atlantoaxial fusion, a large neurovascular structure is routinely encountered crossing the posterior aspect of the C1-C2 joint. Which structure must be mobilized caudally or transected to achieve lateral mass exposure?

A 29-year-old female presents with right shoulder pain and weakness after a prolonged backpacking trip. On examination, medial winging of the scapula is prominent when she performs a wall push-up. EMG confirms a severe, isolated long thoracic nerve injury. After 15 months of physical therapy and observation, there is no clinical or electromyographic improvement. Which of the following tendon transfers is the most appropriate surgical option?

A 35-year-old female is diagnosed with neurogenic thoracic outlet syndrome characterized by chronic upper extremity paresthesias and weakness exacerbated by overhead activity. She has failed six months of conservative management. Surgical decompression is planned. What is the most widely accepted and definitive surgical intervention for this condition?

A 28-year-old female overhead athlete complains of numbness and tingling in her medial forearm and hand that worsens with overhead activity. The Adson test is positive, and EMG confirms delayed conduction across the brachial plexus. If the neurovascular compression is occurring in the primary anatomic space implicated in neurogenic thoracic outlet syndrome, what are its boundaries?

A 22-year-old female competitive swimmer presents with right arm fatigue, heaviness, and numbness in the medial forearm that worsens with overhead activities. Wright's and Roos provocative tests are positive. Symptoms have been refractory to 6 months of physical therapy, and surgical decompression is planned. Which of the following structures form the borders of the space where the compression most commonly occurs in this condition?

During a surgical exploration for a closed supraclavicular brachial plexus injury, the surgeon identifies a functioning long thoracic nerve and dorsal scapular nerve, but the suprascapular nerve is non-functional. From which portion of the brachial plexus does the suprascapular nerve directly originate?

A 42-year-old warehouse worker presents with neurogenic thoracic outlet syndrome that is refractory to physical therapy. Surgical decompression via a supraclavicular approach is planned, which includes an anterior scalenectomy. During dissection of the scalene triangle, what is the correct anatomical relationship of the major neurovascular structures?

A 40-year-old patient undergoes a lymph node biopsy in the posterior cervical triangle. Postoperatively, she cannot abduct her shoulder beyond 90 degrees and has lateral scapular winging. Which of the following muscles is primarily denervated?

A patient undergoing arthroscopic rotator cuff repair receives an interscalene nerve block and subsequently develops transient hemidiaphragmatic paresis. The affected nerve shares its primary segmental root origin with which of the following nerves?

A 55-year-old man presents with a chronic, massive, irreparable posterosuperior rotator cuff tear. He has preserved forward elevation but a severe lack of active external rotation with a positive Hornblower's sign. He undergoes a lower trapezius tendon transfer prolonged with an Achilles tendon allograft. Which of the following nerves must be carefully protected during the harvest and mobilization of the lower trapezius?