lateral winging of scapula

 Lateral winging of scapula

Lateral winging → lateral border of scapula protrudes

• Cause: paralysis of trapezius (due to spinal accessory nerve injury, CN XI).

• Also from rhomboid paralysis (dorsal scapular nerve),

• Scapula drifts laterally and downward, shoulder droops, difficulty elevating arm above head.

• Bedside evaluation - Ask the patient to push against a wall

• Causes of lateral winging -

Neck dissection / lymph node biopsy (iatrogenic CN XI injury).

Trauma to posterior triangle of neck.