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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 four commonly used central pain stimuli are: 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
Symptoms are often minimal – if symptomatic, a posterior shoulder or scapular burning type of pain may be reported. 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 ...
The spinal component of the accessory nerve provides motor control of the sternocleidomastoid and trapezius muscles. [8] The trapezius muscle controls the action of shrugging the shoulders, and the sternocleidomastoid the action of turning the head. [8] Like most muscles, control of the trapezius muscle arises from the opposite side of the ...
The pain does not resolve on its own, even after typical first-aid self-care such as ice, heat, and rest. [4] Electromyography (EMG) has been used to identify abnormal motor neuron activity in the affected region. [5] A physical exam usually reveals palpable trigger points in affected muscles and taut bands corresponding to the contracted muscles.
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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 severity and appearance of the winged scapula varies by individuals as well as the muscles and/or nerves that were affected. [2] [3] Pain is not seen in every case. In a study of 13 individuals with facioscapulohumeral muscular dystrophy (FSHD), none of the individuals complained of pain. Fatigue, however, was a common characteristic and ...