How do you test nerve accessory?

Examination of the accessory nerve involves assessing two muscles: the trapezius and sternocleidomastoid. When assessing the trapezius, ask the patient to shrug their shoulders, then apply resistance. Accessory nerve weakness will present with weak or no resistance to your downward force.

How do you test accessory muscles?

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Ask him to shrug the shoulders and to not let you push the shoulders. Down. This assesses the upper trapezius. For the sternocleidomastoid ask the patient to rotate the head in both directions.

How do you test for spinal accessory nerve damage?

Diagnosis. The diagnosis of spinal accessory nerve palsy starts with a careful medical history and physical examination of the patient. Your doctor may employ imaging techniques such as electromyography (EMG) and nerve tests, as confirmatory measures.

Which muscles would you test to assess the spinal accessory cranial nerve?

Accessory Nerve. The accessory nerve is a purely motor branch to the trapezius and sternocleidomastoid muscles: Sternocleidomastoid can be assessed by asking the patient to turn their head to each side, against the examiners resistance.

What is nerve accessory?

The accessory nerve provides motor function (movement) to two muscles essential to neck and shoulder movement, the sternocleidomastoid (SCM) and the trapezius, as well as to the larynx (voice box) and other structures in the throat. It’s the 11th of the 12 cranial nerves and is often referred to as CN XI.

What are symptoms of accessory nerve damage?

Patients with spinal accessory nerve palsy generally present with dull posterior shoulder pain, drooping of the shoulder, forward elevation and abduction weakness, and an inability to shrug the affected shoulder (Fig. 47.5). Visible atrophy of the trapezius muscle is usually present.

What are symptoms of vagus nerve damage?

Potential symptoms of damage to the vagus nerve include:

  • difficulty speaking.
  • loss or change of voice.
  • difficulty swallowing.
  • loss of the gag reflex.
  • low blood pressure.
  • slow heart rate.
  • changes in the digestive process.
  • nausea or vomiting.

What is spinal accessory neuropathy?

Spinal accessory neuropathy (SAN) causes impaired arm mobility and pain. The spinal accessory nerve is often injured during surgical procedures such as neck dissection for tumor resection or cervical lymph node biopsy. Other traumatic injuries may also occur.

How do you treat accessory nerves?

Nonsurgical treatment for spinal accessory nerve injuries involve physical therapy to reduce pain and restore function. Surgery may be necessary for some spinal accessory nerve injuries. Surgical options your doctor may recommend include: Nerve surgery.

Is accessory nerve motor or sensory?


The spinal accessory nerve is a purely motor entity. It innervates both the trapezius and the sternocleidomastoid muscles.

What number is the spinal accessory nerve?

Cranial Nerve 11

Neuroanatomy, Cranial Nerve 11 (Accessory)

How deep is the spinal accessory nerve?

The spinal accessory nerve enters the deep surface of the sternocleidomastoid muscle approximately 5 cm (2-3 finger breadths) inferior to the apex of the mastoid process (Grant, 1940; Williams, 1995). Treves (1907) notes that this distance is 2.5 cm inferior to the tip of the mastoid process.

What happens when cranial nerve 12 is damaged?

The hypoglossal nerve can be damaged at the hypoglossal nucleus (nuclear), above the hypoglossal nucleus (supranuclear), or interrupted at the motor axons (infranuclear). Such damage causes paralysis, fasciculations (as noted by a scalloped appearance of the tongue), and eventual atrophy of the tongue muscles.