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Alternatively, or in addition to intraoperative procedures, postoperative procedures can also help in recovering the function of a damaged spinal accessory nerve. For example, the Eden-Lange procedure, in which remaining functional shoulder muscles are surgically repositioned, may be useful for treating trapezius muscle palsy. [4] [5]
The accessory nerve is tested by evaluating the function of the trapezius and sternocleidomastoid muscles. [8] The trapezius muscle is tested by asking the patient to shrug their shoulders with and without resistance. The sternocleidomastoid muscle is tested by asking the patient to turn their head to the left or right against resistance. [8]
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.
The five muscles that comprise the function of the shoulder girdle are the trapezius muscle (upper, middle, and lower), levator scapulae muscle, rhomboid muscles (major and minor), serratus anterior muscle, and pectoralis minor muscle. [3]
The posterior axioappendicular muscles are described as two sub-groups: [1] [3] Superficial Posterior Axioappendicular muscles (or the extrinsic shoulder muscles) Trapezius; Latissimus dorsi; Deep Posterior Axioappendicular muscles (or the intrinsic shoulder muscles) Levator scapulae; Rhomboid minor; Rhomboid major
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.
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 trapezius squeeze - which involves gripping and twisting a portion of the trapezius muscle in the patient's shoulder [1] mandibular pressure - this is the manual stimulation of the mandibular nerve , located within the angle of the jaw