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Accessory nerve injury

The spinal cord of the accessory nerve originates from the nucleus of the accessory nerve on the dorsolateral side of the anterior horn cell group of the cervical 1 ~ 5 or cervical 1 ~ 6 spinal cord. The fibers from this nucleus penetrate from the outer side of the spinal cord and merge into a general trunk. They ascend between the dentate ligament and the posterior root of the spinal nerve, enter the skull through the foramen magnum, and converge with the fibers of the medulla oblongata. After leaving the jugular foramen, they separate from the medulla oblongata and form a trunk, and descend to the neck. In the internal carotid artery Between the veins and the deep face of the sternocleidomastoid muscle, the branches innervate the sternocleidomastoid muscle. Its trunk passes through the posterior triangle of the sternocleidomastoid muscle above the midpoint of the posterior edge, and penetrates obliquely downward into the deep surface of the trapezius muscle to dominate the muscle. If the accessory nerve is injured immediately after leaving the jugular foramen, it is often injured at the same time with other adjacent cerebral nerves. In the neck, the accessory nerve is particularly vulnerable to injury due to its shallow position across the posterior cervical triangle. Contusion and firearm injury are rare, and the most common is surgical accidental injury. When the lesion only invades the nerve root filaments of the nucleus oblongata of the accessory nerve, the symptoms are the same as when the vagus nerve is damaged, but there are no symptoms of neck muscles.


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