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Main article: Cranial nerves
Nerve: Accessory nerve
Course and distribution of the glossopharyngeal, vagus, and accessory nerves.
Plan of upper portions of glossopharyngeal, vagus, and accessory nerves.
Latin n. accessorius
Gray's subject #206 913
Innervates sternocleidomastoid muscle, trapezius muscle
MeSH A08.800.800.120.060

The accessory nerve (or "Spinal accessory nerve") is the eleventh of twelve cranial nerves. It leaves the cranium through the jugular foramen along with the glossopharyngeal nerve (IX) and vagus nerve (X). It innervates the sternocleidomastoid muscle (sternomastoid) and trapezius muscle on the ipsilateral side.

There are two parts to the accessory nerve:

  • A spinal part, that innervates the muscles around the neck.
  • A cranial part, that splits off, and quickly combines with the vagus nerve. The cranial part of nerve XI can be thought of doing the exact same things as the vagus.

Testing the accessory nerve

Getting a person to shrug their shoulders while you push down tests trapezius. When a person turns their head, especially against force, sternocleidomastoid should be prominent.

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Major nerves (also see Peripheral nervous system)

Cranial nerves: I olfactory | II optic | III oculomotor | IV trochlear | V trigeminal | V1 ophthalmic (lacrimal, frontal, supratrochlear, supraorbital, nasociliary, ciliary ganglion) | V2 maxillary (sphenopalatine ganglion) | V3 mandibular (buccal - auriculotemporal - lingual - inferior alveolar - otic ganglion) | VI abducens | VII facial (chorda tympani, nervus intermedius) | VIII vestibulocochlear (cochlear, vestibular) | IX glossopharyngeal | X vagus (recurrent laryngeal, Alderman's nerve) | XI accessory | XII hypoglossal

Posterior spinal nerves: greater occipital

C1-C4 - Cervical plexus: lesser occipital | greater auricular | lesser auricular | phrenic | ansa cervicalis

C5-C8, T1 - Brachial plexus: supraclavicular branches (dorsal scapular, suprascapular, long thoracic) | lateral cord (musculocutaneous, lateral antibrachial cutaneous, lateral head of median nerve) | medial cord (ulnar, medial head of median nerve, medial antibrachial cutaneous, medial brachial cutaneous) | posterior cord (axillary, radial)

T2-T11: intercostal

T12, L1-L5 - Lumbar plexus: iliohypogastric | ilioinguinal | genitofemoral | lateral femoral cutaneous | femoral | obturator

S1-S4 - Sacral plexus: gluteal | posterior femoral cutaneous | tibial | sciatic | sural | common peroneal

S2-S5 - Pudendal plexus: perforating cutaneous | pudendal | visceral | muscular | anococcygeal

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