Upper limb: nerve injury: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Upper limb: nerve injury

Sample item

After a radical mastectomy with axillary clearance, a woman finds that the medial border of the scapula protrudes when she pushes against a wall. Which nerve and muscle are affected?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Long thoracic nerve and serratus anterior

The long thoracic nerve runs on the surface of serratus anterior and is easily injured in axillary surgery. Loss of serratus anterior prevents the scapula from being held against the chest wall, causing medial winging that worsens on forward pushing.

Option by option

  • A. Thoracodorsal nerve and latissimus dorsi

    Latissimus dorsi weakness impairs adduction and extension of the arm but does not cause winging.

  • B. Dorsal scapular nerve and rhomboids

    Rhomboid weakness causes lateral winging, mild and seen on retraction.

  • C. Spinal accessory nerve and trapezius

    Trapezius weakness causes shoulder drooping with lateral winging, and is seen after neck dissection.

  • D. Long thoracic nerve and serratus anterior (correct)

    Correct. Serratus anterior weakness causes medial winging.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is D, Long thoracic nerve and serratus anterior. The long thoracic nerve runs on the surface of serratus anterior and is easily injured in axillary surgery.

Why is "Thoracodorsal nerve and latissimus dorsi" not the answer?

Latissimus dorsi weakness impairs adduction and extension of the arm but does not cause winging.

Why is "Dorsal scapular nerve and rhomboids" not the answer?

Rhomboid weakness causes lateral winging, mild and seen on retraction.

Why is "Spinal accessory nerve and trapezius" not the answer?

Trapezius weakness causes shoulder drooping with lateral winging, and is seen after neck dissection.

What concept does this question test?

It tests Upper limb: nerve injury in Anatomy. Loss of serratus anterior prevents the scapula from being held against the chest wall, causing medial winging that worsens on forward pushing.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Upper limb: nerve injury?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.