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Question: 1 / 555

Which nerve is likely injured in a patient unable to shrug their shoulder with scapular winging after brachial plexus surgery?

Suprascapular nerve

Axillary nerve

Long thoracic nerve

Spinal accessory nerve

The spinal accessory nerve plays a critical role in shoulder movement and scapular stability. It innervates the sternocleidomastoid and trapezius muscles, both of which are essential for shoulder elevation and the ability to shrug the shoulder. When there is an injury to this nerve, particularly in the context of brachial plexus surgery, patients may experience difficulty in performing shoulder shrugging due to weakness in the trapezius muscle. This leads to scapular winging, as the trapezius is responsible for maintaining the position of the scapula against the thoracic wall. Hence, the inability to shrug the shoulder along with the presentation of scapular winging strongly indicates injury to the spinal accessory nerve.

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