Pectoral region injuries

Question 1

Winging of scapula

What causes it?

What are the 2 test to identify injury?

What causes long thoracic nerve injury?

Answer 1

• long thoracic nerve damage > serratus anterior x contract > medial border of scapula not held against chest wall > scapula protrudes posteriorly
• 1. patient place palm on wall and push. 2. hold and pull unaffected shoulder with affected limb
• Trauma, mastectomy, wearing heavy backpacks

Question 2

Axillary Lymphadenopathy

What is it?

What causes it?

Answer 2

• Enlargement of axillary lymph node
• Infection of upper limb, infection of pectoral region and breast, metastases from breast cancer or melanoma, lymphoma

Question 3

Axillary Lymph node dissection

What is it?

When is it performed?

Where are the surgical levels?

What is the complication?

Answer 3

• Removal of lymph node
• Staging of breast cancer
• I - below pec minor, II - under pec minor, III - above pec minor
• lymphoedema, long thoracic nerve damage, thoracodorsal nerve damage