NPTE Practice Questions: Scapular Dysfunction

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Do you struggle with long NPTE questions? Today's practice question takes a look at the tough physical therapy concept, scapular dysfunction.
NPTE Practice Question:
Bobby is a 56 year-old carpenter who presents with poor posturing and intermittent paresthesias into his right forearm and hand. He complains of discomfort when his right arm is kept overhead for prolonged periods. During the examination, right rotary winging and an elevated right scapula is noted. Which of the following is the BEST intervention to address this patient's condition?
A. Chest press and static stretching of the deep neck flexors
B. Static stretching of the upper trapezius and levator scapulae
C. Wall push-ups and static upper trapezius stretching
D. Static stretching of the pectoralis minor and elevator scapulae
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Disclaimer: The PT Hustle along with the contents of this video including the question and rationale are not affiliated with the National Physical Therapy Examination® (NPTE) or property of Federation of State Boards of Physical Therapy® (FSBPT). The information contained in this video should not be taken as medical advice. The information provided in this training should not be used as the sole source of clinical, legal, or medical advice. Please use sound clinical judgment based upon the best evidence when treating yourself or a patient.
Music credit: The Future Bass by Starjammusic

[@andrewcox5162]

Love these videos thank you so much.

[@ThePTHustle]

Andrew Cox thank you Andrew!!! This is such a pleasure making them!

[@oleesaisaac]

Sir, quick question. So if the question said "medial border winging" C will have been the answer right?

[@ThePTHustle]

Oleesa Isaac yessir!

[@oleesaisaac]

The PT Hustle thank you

[@Samantha-wh8jx]

I had a quick question. I thought that part of pec minor's role was as a downward rotator of the scapula. How does a tight pec minor contribute to rotary winging? Thank you!

[@ThePTHustle]

Rotary Winging is when the inferior angle moves away from the midline as compared to the other side. Pectoralis Minor when tight, causes the inferior angle to move away from midline because of anterior tilting.

[@MuradAlamKaram]

i need to signup for NPTE PTA preparation course

[@danielscott3214]

I know this wasnt an option but, I studied that paralysis of the long thoracic nerve (innervates serratus anterior) can weakness of the serratus anterior causing scapular winging. Have you seen that in the clinic?

[@ThePTHustle]

Yes, a long thoracic nerve palsy can cause weakness of the serratus anterior and associated scapular winging. I have definitely come across this multiple times in the clinic. Especially younger males who have hypermobility and poor serratus anterior strength.