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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]
The dorsal scapular nerve is at risk for intraoperative injury when detaching the rhomboid and levator scapulae insertions due to its proximity to the medial scapular border. [15] This is of particular concern because the dorsal scapular nerve innervates all three muscles transferred in the Eden–Lange procedure. [citation needed]
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). Discoloration of the hands, one hand colder than the other hand, weakness of the hand and arm muscles, and tingling are commonly present.
Injury to the accessory nerve can result in neck pain and weakness of the trapezius muscle. Symptoms will depend on at what point along its length the nerve was severed. [5] Injury to the nerve can result in shoulder girdle depression, atrophy, abnormal movement, a protruding scapula, and weakened abduction. [5]
A self-limiting spontaneously occurring form of torticollis with one or more painful neck muscles is by far the most common ('stiff neck') and will pass spontaneously in 1–4 weeks. Usually the sternocleidomastoid muscle or the trapezius muscle is involved. Sometimes draughts, colds, or unusual postures are implicated; however, in many cases ...
The two muscles most commonly inhibited during this first part of an overhead motion are the serratus anterior and the lower trapezius. [10] These two muscles act as a force couple within the glenohumeral joint to properly elevate the acromion process, and if a muscle imbalance exists, shoulder impingement may develop.
An example of trapezius function is an overhead press. When activating together, the upper and lower fibers also assist the middle fibers (along with other muscles such as the rhomboids) with scapular retraction/adduction. The trapezius also assists in abduction of the shoulder above 90 degrees by rotating the glenoid upward.
Some injuries, particularly lesions, can paralyse the serratus anterior muscle to produce a winged scapula. [3] [12] This is most prominent when the arm is lifted forward or when the patient pushes the outstretched arm against a wall. However, even winging may not be evident until the trapezius stretches enough to reveal an injury several weeks ...