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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]
TOS can involve only part of the hand (as in the pinky and adjacent half of the ring finger), all of the hand, or the inner aspect of the forearm and upper arm. Pain can also be in the side of the neck, the pectoral area below the clavicle, the armpit/axillary area, and the upper back (i.e., the trapezius and rhomboid area).
The sternocleidomastoid muscle is tested by asking the patient to turn their head to the left or right against resistance. [8] One-sided weakness of the trapezius may indicate injury to the nerve on the same side of an injury to the spinal accessory nerve on the same side (Latin: ipsilateral) of the body being assessed. [8]
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 ...
The lifter stands erect, hands about shoulder width apart, and slowly raises the shoulders as high as possible, and then slowly lowers them, while not bending the elbows, or moving the body at all. [2] The lifter may not have as large a range of motion as in a normal shrug done for active flexibility. It is usually considered good form if the ...
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The range of motion at the shoulder may be limited by pain. A painful arc of movement may be present during forward elevation of the arm from 60° to 120°. [4] Passive movement at the shoulder will appear painful when a downward force is applied at the acromion but the pain will ease once the force is removed. [2]
A variety of methods may be used to diagnose axillary nerve palsy. The health practitioner may examine the shoulder for muscle atrophy of the deltoid muscle. [2] Furthermore, a patient can also be tested for weakness when asked to raise the arm. [2] The deltoid extension lag sign test is one way to evaluate the severity of the muscle weakness.