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| Name | Accessory Nerve || Cranial Nerve 11, Pathway, Nerve Lesion |
| Video Uploader | Video From Let's make medicine easy |
| Upload Date | This Video Uploaded At 04-07-2024 15:02:31 |
| Video Discription | The accessory nerve, also known as the spinal accessory nerve or cranial nerve XI, is a mixed nerve with both motor and sensory functions. It has two components: the spinal portion and the cranial portion. ## 🧠 Anatomical Course ### Spinal Component - Arises from neurons in the upper spinal cord (C1-C5/C6 spinal nerve roots) - Enters the cranial cavity through the foramen magnum - Traverses the posterior cranial fossa and exits the skull through the jugular foramen - Descends along the internal carotid artery to innervate the sternocleidomastoid muscle - Crosses the posterior triangle of the neck to supply the trapezius muscle ### Cranial Component - Arises from the lateral aspect of the medulla oblongata - Exits the cranium through the jugular foramen - Combines with the vagus nerve (CN X) at the inferior ganglion of the vagus nerve - Distributed through the vagus nerve, considered part of CN X ## 💪 Motor Function The accessory nerve innervates two muscles: 1. **Sternocleidomastoid**: Lateral flexion and rotation of the neck when acting unilaterally, extension of the neck when acting bilaterally 2. **Trapezius**: Elevation and rotation of the scapula during arm abduction (upper fibers), retraction of the scapula (middle fibers), and depression of the scapula (lower fibers) ## 🏥 Clinical Relevance ### 🩺 Examination of the Accessory Nerve - Ask the patient to rotate their head and shrug their shoulders, both normally and against resistance - Observe for muscle wasting in the sternocleidomastoid and trapezius in cases of long-standing nerve damage ### 🚑 Accessory Nerve Lesions - Most commonly caused by iatrogenic injury during procedures such as cervical lymph node excision, biopsy, or central line insertion - Clinical features include muscle wasting and partial paralysis of the sternocleidomastoid, resulting in inability to rotate the head or weakness in shoulder shrugging - Damage to the muscles may cause an asymmetrical neckline Citations: [1] https://www.ncbi.nlm.nih.gov/books/NBK507722/ [2] https://teachmeanatomy.info/head/cranial-nerves/accessory/ [3] https://www.kenhub.com/en/library/anatomy/the-accessory-nerve [4] https://www.physio-pedia.com/Accessory_Nerve_Cranial_Nerve_11 [5] https://www.sciencedirect.com/topics/neuroscience/accessory-nerve Qqfqed01j6w |
| Category | Education |
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