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89. A 65-year-old woman comes to the physician because of a 1-day history of a burning, tingling rash on her right breast. Physical examination shows several grouped vesicles on an erythematous base over the lateral aspect of the right breast; some of the vesicles have crusted over. This patient's pain sensation is most likely being transmitted via which of the following nerves? A) Ansa cervicalis B) Axillary nerve C) Fifth intercostal nerve D) Long thoracic nerve E) Posterior cervical plexus

89. A 65-year-old woman comes to the physician because of a 1-day history of a burning, tingling rash on her right breast. Physical examination shows several grouped vesicles on an erythematous base over the lateral aspect of the right breast; some of the vesicles have crusted over. This patient's pain sensation is most likely being transmitted via which of the following nerves? A) Ansa cervicalis B) Axillary nerve C) Fifth intercostal nerve D) Long thoracic nerve E) Posterior cervical plexus

Human Anatomy & Physiology (11th Edition)
Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
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### Clinical Scenario and Question for Medical Education **Case Presentation:** A 65-year-old woman comes to the physician because of a 1-day history of a burning, tingling rash on her right breast. Physical examination shows several grouped vesicles on an erythematous base over the lateral aspect of the right breast; some of the vesicles have crusted over. This patient’s pain sensation is most likely being transmitted via which of the following nerves? **Options:** A) Ansa cervicalis B) Axillary nerve C) Fifth intercostal nerve D) Long thoracic nerve E) Posterior cervical plexus **Analysis:** This case involves a patient presenting with symptoms typically indicative of shingles (herpes zoster) characterized by grouped vesicles on an erythematous base. The location of the rash and the nerve pathologies help in identifying the correct neural involvement. **Educational Notes:** - **Ansa cervicalis**: This nerve is part of the cervical plexus and innervates infrahyoid muscles. It is not typically associated with cutaneous sensation in the breast area. - **Axillary nerve**: This nerve provides both motor innervation to the deltoid and teres minor muscles and sensory innervation to the skin over part of the shoulder. It does not typically transmit pain or sensation from the breast area. - **Fifth intercostal nerve**: Intercostal nerves are responsible for sensory innervation of the chest wall and overlying skin. The fifth intercostal nerve specifically provides sensory input from the thoracic area, particularly the lateral aspect of the breast. - **Long thoracic nerve**: This nerve innervates the serratus anterior muscle and is not involved in sensory innervation of the skin. - **Posterior cervical plexus**: The posterior branches of the cervical plexus provide sensory innervation to the back of the head and neck. It does not typically innervate the skin of the breast. **Correct Answer:** C) Fifth intercostal nerve This educational content aims to enhance the understanding of neural pathways and their clinical significance, particularly in the context of dermatologic presentations typical of neurocutaneous disorders like shingles.
Transcribed Image Text:### Clinical Scenario and Question for Medical Education **Case Presentation:** A 65-year-old woman comes to the physician because of a 1-day history of a burning, tingling rash on her right breast. Physical examination shows several grouped vesicles on an erythematous base over the lateral aspect of the right breast; some of the vesicles have crusted over. This patient’s pain sensation is most likely being transmitted via which of the following nerves? **Options:** A) Ansa cervicalis B) Axillary nerve C) Fifth intercostal nerve D) Long thoracic nerve E) Posterior cervical plexus **Analysis:** This case involves a patient presenting with symptoms typically indicative of shingles (herpes zoster) characterized by grouped vesicles on an erythematous base. The location of the rash and the nerve pathologies help in identifying the correct neural involvement. **Educational Notes:** - **Ansa cervicalis**: This nerve is part of the cervical plexus and innervates infrahyoid muscles. It is not typically associated with cutaneous sensation in the breast area. - **Axillary nerve**: This nerve provides both motor innervation to the deltoid and teres minor muscles and sensory innervation to the skin over part of the shoulder. It does not typically transmit pain or sensation from the breast area. - **Fifth intercostal nerve**: Intercostal nerves are responsible for sensory innervation of the chest wall and overlying skin. The fifth intercostal nerve specifically provides sensory input from the thoracic area, particularly the lateral aspect of the breast. - **Long thoracic nerve**: This nerve innervates the serratus anterior muscle and is not involved in sensory innervation of the skin. - **Posterior cervical plexus**: The posterior branches of the cervical plexus provide sensory innervation to the back of the head and neck. It does not typically innervate the skin of the breast. **Correct Answer:** C) Fifth intercostal nerve This educational content aims to enhance the understanding of neural pathways and their clinical significance, particularly in the context of dermatologic presentations typical of neurocutaneous disorders like shingles.
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