Accessory nerve

Accessory nerve
Accessory nerve 
  Accessory nerve motor. Spinal nucleus dobavochnogo nerve occurs in the lower section of the medulla oblongata, and gray matter of the spinal cord at the level of C1C5. Aksony these cells form a 6 – 7 rootlets, which extend to the lateral surface of the spinal cord and merge into a common trunk. Barrel accessory nerve enters the cavity Th 
Turnip through the foramen magnum. 

Spinal part of accessory nerve also contains efferent fibers from the cervical segments of the brain and spinal afferent fibers nodes received through 
with front and rear mozgovymi spinal roots. 

Cerebral part of the kernel are in the lower section of the medulla oblongata: anterior nucleus in the reticular formation, back behind the central canal. Fibers from these 
nuclei come P5 spines between olive and the lower leg of the cerebellum. 
Behind the cerebellar tonsils cerebral and spinal parts form a common trunk, which comes with a pair of X in the anterior jugular holes. 

Coming out of the hole, additional nerve divides into two branches: 
1) the inner branch consists mainly of fibers tserebralnoy part, goes to the vagus nerve and left him in the pharyngeal, laryngeal and cardiac branches; 
2) the outer branch emerges from the cranial cavity through the jugular hole on the neck and innervates grudinoklyuchichnosostsevidnuyu and trapezius muscles. The functions of these muscles is to tilt the head sideways to turn a person in the opposite direction, lift under arm and acromion of the scapula upward, ie shrug, when conducting the scapula to the spine). 

  Symptoms defeat 
  The defeat of the nucleus, roots or trunk of accessory nerve is accompanied by the development of flaccid paralysis of the trapezius and sternal-klyuchichnosostsevidnoy muscles. The patient difficult to turn heads in a healthy way, at the patient side of the shoulder is omitted, limited lifting arms above the horizontal level. 

During stimulation of cortical or subcortical structures may experience cramps in the form of tremors of the head in the opposite direction, or there is spastic 

torticollis. Kernel accessory nerve has bilateral cortical innervation. Central paralysis of the trapezius muscle and grudinoklyuchichnosostsevidnoy can occur only when bilateral lesion korkovoyadernyh ways.


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