Try it
General Surgery · Breast: axillary surgery complications
Sample itemAfter a level III axillary clearance, a woman finds that the medial border of her scapula lifts away from the chest wall when she pushes against a wall. Which nerve has been injured?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Long thoracic nerve
The long thoracic nerve runs on the surface of serratus anterior on the medial wall of the axilla and is at risk when the axillary tissue is cleared. Its injury paralyses serratus anterior and causes a winged scapula. The thoracodorsal nerve is preserved with the vessels on the posterior wall.
Option by option
A. Intercostobrachial nerve
Intercostobrachial injury gives numbness of the upper medial arm, with no motor loss.
B. Thoracodorsal nerve
Thoracodorsal injury weakens latissimus dorsi, affecting adduction and internal rotation of the arm.
C. Medial pectoral nerve
Medial pectoral injury denervates pectoralis minor and part of pectoralis major without winging.
D. Long thoracic nerve (correct)
Correct. Serratus anterior paralysis produces winging of the scapula.
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 General Surgery questions
- HerniaA groin hernia that passes medial to the inferior epigastric vessels through Hesselbach'…
- BurnsA 70 kg adult has burns over 40% of the body surface. By the Parkland formula, what tota…
- HerniaA hernia that enters the inguinal canal through the deep ring, lateral to the inferior e…
- Intestinal obstructionWhat is the commonest cause of small bowel obstruction in adults?