A 30-year-old woman undergoes axillary lymph node dissection for breast carcinoma. Postoperatively she develops a winged scapula. Which nerve has been injured?

• A Dorsal scapular nerve
• B Thoracodorsal nerve
• C Spinal accessory nerve
• D Long thoracic nerve ✓

Explanation

The long thoracic nerve (C5, C6, C7) runs on the external surface of serratus anterior on the medial chest wall and is injured during axillary surgery, producing serratus anterior paralysis and a winged scapula that worsens on wall push-up. The thoracodorsal nerve supplies latissimus dorsi and causes weak adduction when injured. Dorsal scapular nerve injury affects rhomboids and produces a less obvious scapular winging closer to the spine.

Reference: Gray's Anatomy for Students, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.