Winged scapula

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Winged scapula

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Winged scapula

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Winged scapula

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A 46-year-old woman presents to her primary care physician to evaluate left-sided shoulder pain and weakness for two weeks. The patient had a recent axillary lymph node dissection for breast cancer surveillance. Vital signs are within normal limits. The patient has normal sensation in the upper extremities on physical exam with 5/5 strength bilaterally. When asked to cross her arms, a notable physical examination finding is demonstrated in the image below. Which of the following anatomic structures is responsible for this patient’s symptoms?  


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Mastectomy and winged scapula p. 456

Stab wounds and winged scapula p. 456

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Summary

Winged scapula, also known as scapular winging, is a condition characterized by protrusion or prominence of the medial border of the scapula away from the rib cage. This creates a visible "wing-like" appearance of the scapula on the back and may cause difficulty in moving the arm and shoulder. Winged scapula is caused by weakness or paralysis of the serratus anterior muscle. It can be a result of nerve damage, trauma, muscular dystrophy, or other neuromuscular disorders. Treatment for winged scapula depends on the underlying cause. Physical therapy, exercises, and stretching can help to strengthen the muscles and improve range of motion. In some cases, surgery may be necessary to repair or reconstruct damaged muscles or nerves.

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