Breast: axillary surgery complications: practice question

A General Surgery 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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General Surgery · Breast: axillary surgery complications

Sample item

After 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

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is 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.

Why is "Intercostobrachial nerve" not the answer?

Intercostobrachial injury gives numbness of the upper medial arm, with no motor loss.

Why is "Thoracodorsal nerve" not the answer?

Thoracodorsal injury weakens latissimus dorsi, affecting adduction and internal rotation of the arm.

Why is "Medial pectoral nerve" not the answer?

Medial pectoral injury denervates pectoralis minor and part of pectoralis major without winging.

What concept does this question test?

It tests Breast: axillary surgery complications in General Surgery. Its injury paralyses serratus anterior and causes a winged scapula. The thoracodorsal nerve is preserved with the vessels on the posterior wall.

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 Breast: axillary surgery complications?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.