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A 40-year-old semi-professional quarterback presents with non-specific shoulder pain and fatigue. He describes soreness at the base of his neck and over his deltoid and reports weakness with overhead activities. A clinical photo of his exam is seen in Figure A. Ultimately you decide to treat his condition with serratus anterior strengthening and stretching. However, what additional physical exam finding is most likely present?
Support of the inferior-medial scapular border during arm elevation decreases pain and improves range of motion
After the shoulder is placed in abduction and external rotation, it falls into internal rotation
The shoulder is placed in front of the body in internal rotation and hand presses on the abdomen, however the elbow falls back toward the body
With the patient supine, the shoulder is placed in abduction and external rotation – which causes discomfort
The patient’s arm is passively external rotated and abducted while his head turns to the contralateral extremity, which causes a decrease in the radial pulse.
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A 42-year-old male sustains a flail chest injury and subsequently undergoes operative stabilization of his chest wall. At first follow-up, the inferior angle of his ipsilateral scapula translates medially with any attempt at overhead activity. Injury to which of the following structures would cause this abnormality?
Spinal accessory nerve
C8 and T1 nerve roots
Upper and lower subscapular nerves
Long thoracic nerve
A 72-year-old male presents with left shoulder and scapular pain after a fall 2 months ago. A clinical picture is shown in Figure A. Which of the following is most likely affected?
Nerve roots C4-7
Nerve roots C6-7
Cranial nerve XI
Nerve roots C3-5
Cranial nerve XII
A collegiate swimmer develops medial winging of the scapula. If the EMG and nerve conduction studies are abnormal, the most likely nerve roots to be involved are?
C7, C8, T1
C6, C7, C8
C5, C6, C7
C4, C5, C6
C3, C4, C5
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
pectoralis transfer to the medial border of the scapula.
pectoralis transfer to the inferior border of the scapula.
lateral transfer of the levator scapulae only.
lateral transfer of the levator scapulae and rhomboid minor and major.
latissimus dorsi transfer.
A patient presents complaining of right shoulder pain and weakness following a neck exploration surgery. On exam, he is noted to have winging of the scapula. His EMG shows denervation of the trapezius muscle. This condition is best described as:
Lateral winging due to spinal accesory nerve injury
Medial winging due to spinal accesory nerve injury
Lateral winging due to long thoracic nerve injury
Medial winging due to long thoracic nerve injury
Scapular dyskinesia due to cervical radiculopathy
Injury to the long thoracic nerve can result in which of the following clinical entities?
Teres minor atrophy
Latissimus dorsi atrophy
Medial scapular winging
Lateral scapular winging
A 21-year-old male who is training to become a professional mixed martial artist complains of weakness with forward flexion of the right arm. Four months ago, he sustained several blows and kicks to his right upper extremity, torso, and flank during consecutive training sessions. Physical exam shows the deformity shown in Figure A. Which of the following muscles labeled in Figure B is most likely deficient and leading to his symptoms?
A patient develops shoulder dysfunction and is noted to have medial winging of the scapula. If the EMG shows an abnormaility, which nerve is most likely to be involved?