Can winging of the medial scapula occur due to cranial nerve injury?

• A. No, it's not possible.
• B. Yes, specifically in CN 11 injury.
• C. Yes, but only in thoracic nerve injury.
• D. No, only lower motor neuron injuries cause this.

Answer: (B)

Winging of the medial border of the scapula can occur as a result of injury to certain cranial nerves, particularly the accessory nerve (cranial nerve XI). This nerve innervates the sternocleidomastoid and trapezius muscles, which play integral roles in stabilizing the scapula. When the accessory nerve is injured, the trapezius muscle may weaken or become paralyzed, leading to an inability to properly stabilize the scapula against the thoracic wall. This can manifest as winging of the scapula, where the medial border protrudes away from the thorax.

Even though other nerve injuries, such as those to the long thoracic nerve, can also cause scapular winging, the option specifying cranial nerve XI focuses on a specific type of injury that can result in this condition. Thus, cranial nerve injuries, particularly to the accessory nerve, can directly contribute to the manifestation of scapular winging.