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Additional muscle deficits can contraindicate tendon transfer, namely the serratus anterior muscle or the muscles-to-be-transferred themselves. Serratus anterior muscle deficit is another cause of scapular winging and decreases the efficacy of an Eden–Lange procedure, but it can be overcome with a simultaneous pectoralis major transfer .
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]
After fracture of the clavicle, the sternocleidomastoid muscle elevates the medial fragment of the bone. The trapezius muscle is unable to hold up the distal fragment owing to the weight of the upper limb, thus the shoulder droops. The adductor muscles of the arm, such as the pectoralis major, may pull the distal fragment medially, causing the ...
Trapezius palsy, due to damage of the spinal accessory nerve, is characterized by difficulty with arm adduction and abduction, and associated with a drooping shoulder, and shoulder and neck pain. [8] Intractable trapezius palsy can be surgically managed with an Eden–Lange procedure .
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]
Damage results in an inability to shrug the shoulders or raise the arm above the head, particularly due to compromised trapezius muscle innervation. The external jugular vein's superficial location within the posterior triangle also makes it vulnerable to injury.
The second category is the lateral winging which is caused by injury of the spinal accessory nerve. Severe atrophy of the trapezius is seen with accidental damage to the spinal accessory nerve during lymph node biopsy of the neck. There are numerous ways in which the long thoracic nerve can sustain trauma-induced injury.
Whiplash associated disorders sometimes include injury to the cerebrum. In a severe cervical acceleration–deceleration syndrome, a brain injury known as a coup contrecoup injury occurs. A coup contrecoup injury occurs as the brain is accelerated into the cranium as the head and neck hyperextend, and is then accelerated into the other side as ...