Chapter 85 - Disorders of the Scapula

Question 1

medial winging is caused by pathology in what nerve?

Answer 1

long thoracic nerve, causing serratus anterior weakness

Question 2

lateral winging (trap) is caused by pathology in what nerve?

Answer 2

spinal accessor nerve (trapezius), causes the inferior pole of the scapula to go lateral and inferior

Question 3

rhomboid mediated lateral winging is caused by pathology in what nerve?

Answer 3

dorsal scapular nerve, winging is less severe than that seen in trapezius mediated scapular winging

Question 4

Sprengel Deformity

Answer 4

congenital absence or hypoplasia of the scapula 2/2 disruption of embryonic subclavian blood supply

Question 5

when should surgical correction of a sprengel’s deformity be performed?

Answer 5

between age 3-8 (after 8, increased risk of neurologic injury)

Question 6

what should be worked up pre-operatively in a Sprengel’s deformity?

Answer 6

imaging to look for an omovertebral bar ( a bony bar connecting the superomedial scapula to a lower cervical vertebra

Question 7

what is sprengel’s deformity seen in?

Answer 7

klippel feil (approximately 1/3 have Sprengel deformity)
congenital scoliosis
upper extremity anomalies
diastematomyelia
kidney disease

Question 8

types of SICK scapula syndrome

Answer 8

1: associated with labral pathology - lateral scapular prominence
2: associated with labral pathology - medial scapular prominence
3: associated with SAD and rotator cuff pathology rather than labrum