A 55-Year-Old Man Is Being Evaluated for a 4-Week History

A 55-year-old man is being evaluated for a 4-week history of right shoulder pain.  The pain worsens when actively abducting the shoulder or when lying on the shoulder at night.  The patient also has weakness with abduction and external rotation of the right shoulder.  He has attempted treatment with over-the-counter analgesics with limited relief.  MRI of the shoulder shows a partial rotator cuff tear, and the patient is scheduled for surgical repair.  Immediately before the surgery, he receives anesthesia with an injection between the right anterior and middle scalene muscles in order to block the C3 through C7 nerve roots of the cervical and brachial plexuses.  Which of the following muscles is most likely to be paralyzed due to the anesthesia?

A) Cricothyroid
B) Diaphragm
C) Intercostal
D) Platysma
E) Sternocleidomastoid

Correct Answer:

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