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The fibres of the spinal accessory nerve originate solely in neurons situated in the upper spinal cord, from where the spinal cord begins at the junction with the medulla oblongata, to the level of about C6. [1] [7] These fibres join to form rootlets, roots, and finally the spinal accessory nerve itself.
The trapezius [4] is a large paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It moves the scapula and supports the arm. The trapezius has three functional parts: an upper (descending) part which supports the weight ...
There are several options of treatment when iatrogenic (i.e., caused by the surgeon) spinal accessory nerve damage is noted during surgery. For example, during a functional neck dissection that injures the spinal accessory nerve, injury prompts the surgeon to cautiously preserve branches of C2, C3, and C4 spinal nerves that provide supplemental innervation to the trapezius muscle. [3]
The superficial group, also known as the appendicular group, is primarily associated with movement of the appendicular skeleton. It is composed of trapezius, latissimus dorsi, rhomboid major, rhomboid minor and levator scapulae. It is innervated by anterior rami of spinal nerves, reflecting its embryological origin outside the back.
The accessory nerve nucleus is in the anterior horn of the spinal cord around C1-C3, where lower motor neuron fibers mark its origin. The fibers from the accessory nerve nucleus travel upward to enter the cranium via the foramen magnum. The internal carotid artery to reach both the sternocleidomastoid muscles and the trapezius.
The trapezius is attached to the superior lip, and a rough tubercle is generally seen on that portion of the spine which receives the tendon of insertion of the lower part of this muscle. The deltoideus is attached to the whole length of the inferior lip .
The long thoracic nerve arises from the anterior rami of cervical spinal nerves C5, C6, and C7. [1] [2] [3] The root from C7 may occasionally be absent. [4] The roots from C5 and C6 pierce through the scalenus medius, while the C7 root passes in front of the muscle. [citation needed]
The brachial plexus is a network of nerves (nerve plexus) formed by the anterior rami of the lower four cervical nerves and first thoracic nerve (C5, C6, C7, C8, and T1).This plexus extends from the spinal cord, through the cervicoaxillary canal in the neck, over the first rib, and into the armpit, it supplies afferent and efferent nerve fibers to the chest, shoulder, arm, forearm, and hand.