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The first 25 slides, exactly as they appear. The full deck has 39 content slides.
Orthopaedics
Scapular Winging
Built from Pillemer — Physical Signs in Orthopaedics and Neurology
What’s inside
6 sections · 39 slides
Overview
- What this topic teaches you
- How we will build the picture
- The big idea in one slide
The Three Stabilisers
Which muscles hold the scapula to the chest, and how each pulls
- Meet the three muscles that prevent winging
- Serratus anterior and its pull on the scapula
- How serratus anterior normally works
- Trapezius and its pull on the scapula
- How trapezius normally works
- Rhomboids major and minor and their pull
- How the rhomboids normally work
- The one rule that ties it together
- Medial versus lateral winging at a glance
Serratus Anterior Paralysis
The commonest winging - and why the scapula rides up and rotates in
- What happens when serratus anterior dies
- The combined shift in serratus anterior palsy
- A worked example of serratus winging
- Reading the serratus pattern
Trapezius Paralysis
Lateral winging, and the superior angle that rotates outward
- What happens when trapezius fails
- Trapezius loss lets the scapula drift outward
- Trapezius paralysis in a real patient
- Reading the trapezius pattern
Rhomboid Paralysis
The rarest winging - lateral shift with the lower tip swinging out
- What happens when the rhomboids fail
- The pattern of rhomboid paralysis
- Telling rhomboid from trapezius winging
Common Tests
Simple manoeuvres that unmask each type of winging
- Why we provoke the muscles
- Bedside manoeuvres for each type of winging
- Which test for which muscle
- One-page summary of the three winging types
- The three types side by side
- Key takeaways
- The golden rule
- A winged scapula is displaced laterally. How do you decide between trapezius and rhomboid paralysis?
- References
- Physical Signs in Orthopedic and Neurologic Disorders: A Practical Guide