Anatomy – MCQ 64 – Injury to the long thoracic nerve

After radical mastectomy there was injury to the long thoracic nerve. The integrity of the nerve can be tested at the bedside by asking the patient to :
A. Shrug the shoulders
B. Raise the arm above the head on the affected side
C. Touch the opposite shoulder
D. Lift a heavy object from the ground

Correct answer : B. Raise the arm above the head on the affected side

• Long thoracic nerve (Nerve of Bell) supplies the serratus anterior muscle
• Serratus anterior rotates the inferior angle of scapula laterally during abduction of the arm above the head – hence it is impaired in injury to long thoracic nerve
• Winging of scapula is another classical feature of long thoracic nerve injury