While doing excision of cervical lymph nodes, inadveent injury to which nerve causes drooping of shoulder
**Core Concept**
The question requires knowledge of the anatomical relationships between the cervical lymph nodes and surrounding nerves, particularly those involved in controlling shoulder movement. The correct answer involves identifying a nerve that, when injured, leads to weakness or paralysis of the muscles responsible for shoulder elevation, resulting in drooping of the shoulder.
**Why the Correct Answer is Right**
The long thoracic nerve (LTN) is responsible for innervating the serratus anterior muscle, which plays a crucial role in stabilizing the scapula and facilitating its upward rotation during shoulder abduction. Injury to the LTN can lead to winging of the scapula, a condition characterized by the scapula protruding outward and downward, which can result in a drooping shoulder. The LTN originates from the roots of the brachial plexus, specifically C5-C7, and courses along the lateral aspect of the thoracic wall to reach the serratus anterior muscle.
**Why Each Wrong Option is Incorrect**
**Option A:** The accessory nerve (cranial nerve XI) primarily innervates the sternocleidomastoid and trapezius muscles, which are involved in neck rotation and scapular elevation, respectively. While injury to the accessory nerve can lead to weakness in these muscles, it is not directly associated with drooping of the shoulder.
**Option B:** The suprascapular nerve innervates the supraspinatus and infraspinatus muscles, which are involved in shoulder abduction and external rotation, respectively. Injury to this nerve can lead to weakness in these movements but is not directly associated with drooping of the shoulder.
**Option C:** The axillary nerve innervates the deltoid and teres minor muscles, which are involved in shoulder abduction and external rotation, respectively. Injury to this nerve can lead to weakness in these movements but is not directly associated with drooping of the shoulder.
**Clinical Pearl / High-Yield Fact**
Injury to the long thoracic nerve can occur during surgical procedures involving the cervical lymph nodes, such as neck dissections, and can result in winging of the scapula and drooping of the shoulder. It is essential to identify and preserve this nerve during such procedures to prevent this complication.
**Correct Answer:** B. Long thoracic nerve.