Eleventh Nerve

The eleventh (spinal accessory) nerve is a motor nerve that originates in-tracranially in the medulla and also in the cervical spinal cord. It is both a cranial nerve and a spinal nerve. It innervates the sternomastoid muscle and the upper portion of the trapezius muscle.

How to Test the Spinal Accessory Nerve If you have the patient face you, put your hand on the right side of his head as in Figure 9-3A, and ask him to turn to the right against the resistance of your hands, you will not learn anything. You cannot see or feel the left sternomastoid effectively.

However, if you ask him to turn his head to the right as far as he can, unresisted, and then you attempt to bring the head back to the facing position against his resistance, you will see, as in Figure 9-3b, the size of the left sternomastoid and feel the strength of it.

To test the trapezius,

Figure 9-3. A. The wrong way to examine the left sternomastold. The patient attempts to turn his head to his right against resistance. B. The correct way to examine the left sternomastold. The patient turns his head to the right unresisted. The examiner then attempts to bring the head back to the forward position as the patient resists.

Figure 9-3. A. The wrong way to examine the left sternomastold. The patient attempts to turn his head to his right against resistance. B. The correct way to examine the left sternomastold. The patient turns his head to the right unresisted. The examiner then attempts to bring the head back to the forward position as the patient resists.

• Stand behind the patient. Look at the patient's neck, back, and shoulders. Do they appear to be symmetrical, and are the muscles the same size and bulk on the two sides?

• Hold the upper edge of the muscle between your thumb and fingers and ask him to shrug his shoulders upward toward the ears.

Compare the speed, size (thickness), and strength of the right and left sides.

Was this article helpful?

0 0

Post a comment