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Accessory Nerve Disorder
Accessory nerve disorder is an injury to the spinal accessory nerve which results in diminished or absent function of the sternocleidomastoid muscle and upper portion of the trapezius muscle. Signs and symptoms Patients with spinal accessory nerve paralysis often exhibit signs of lower motor neuron disease such as diminished muscle mass, fasciculations, and partial paralysis of the sternocleidomastoid and trapezius muscles. Interruption of the nerve supply to the sternocleidomastoid muscle results in an asymmetric neckline, while weakness of the trapezius muscle can produce a drooping shoulder, winged scapula, and a weakness of forward elevation of the shoulder. Causes Medical procedures are the most common cause of injury to the spinal accessory nerve. In particular, radical neck dissection and cervical lymph node biopsy are among the most common surgical procedures that result in spinal accessory nerve damage. London notes that a failure to rapidly identify spinal accessory ne ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Accessory Nerve
The accessory nerve, also known as the eleventh cranial nerve, cranial nerve XI, or simply CN XI, is a cranial nerve that supplies the sternocleidomastoid and trapezius muscles. It is classified as the eleventh of twelve pairs of cranial nerves because part of it was formerly believed to originate in the brain. The sternocleidomastoid muscle tilts and rotates the head, whereas the trapezius muscle, connecting to the scapula, acts to shrug the shoulder. Traditional descriptions of the accessory nerve divide it into a spinal part and a cranial part. The cranial component rapidly joins the vagus nerve, and there is ongoing debate about whether the cranial part should be considered part of the accessory nerve proper. Consequently, the term "accessory nerve" usually refers only to nerve supplying the sternocleidomastoid and trapezius muscles, also called the spinal accessory nerve. Strength testing of these muscles can be measured during a neurological examination to assess funct ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Sternocleidomastoid Muscle
The sternocleidomastoid muscle is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The sternocleidomastoid is innervated by the accessory nerve. Etymology and location It is given the name ''sternocleidomastoid'' because it originates at the manubrium of the sternum (''sterno-'') and the clavicle (''cleido-'') and has an insertion at the mastoid process of the temporal bone of the skull. Structure The sternocleidomastoid muscle originates from two locations: the manubrium of the sternum and the clavicle. It travels obliquely across the side of the neck and inserts at the mastoid process of the temporal bone of the skull by a thin aponeurosis. The sternocleidomastoid is thick and narrow at its centre, and broader and thinner at either end. The sternal head is a round fasciculus, tendinous in front, fleshy behind, arising from the upper part of the front of the manubriu ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Trapezius Muscle
The trapezius is a large paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It moves the scapula and supports the arm. The trapezius has three functional parts: an upper (descending) part which supports the weight of the arm; a middle region (transverse), which retracts the scapula; and a lower (ascending) part which medially rotates and depresses the scapula. Name and history The trapezius muscle resembles a trapezium, also known as a trapezoid, or diamond-shaped quadrilateral. The word "spinotrapezius" refers to the human trapezius, although it is not commonly used in modern texts. In other mammals, it refers to a portion of the analogous muscle. Similarly, the term "tri-axle back plate" was historically used to describe the trapezius muscle. Structure The ''superior'' or ''upper'' (or descending) fibers of the trapezius originate from the sp ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Lower Motor Neuron Disease
A lower motor neuron lesion is a lesion which affects nerve fibers traveling from the lower motor neuron(s) in the anterior horn/anterior grey column of the spinal cord, or in the motor nuclei of the cranial nerves, to the relevant muscle(s). One major characteristic used to identify a lower motor neuron lesion is flaccid paralysis – paralysis accompanied by loss of muscle tone. This is in contrast to an upper motor neuron lesion, which often presents with spastic paralysis – paralysis accompanied by severe hypertonia. Signs and symptoms * Muscle paresis or paralysis * Fibrillations * Fasciculations – caused by increased receptor concentration on muscles to compensate for lack of innervation. * Hypotonia or atonia – Tone is not velocity dependent. * Hyporeflexia - Along with deep reflexes even cutaneous reflexes are also decreased or absent. * Strength – weakness is limited to segmental or focal pattern, Root innervated pattern The extensor plantar reflex is usually ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Fasciculation
A fasciculation, or muscle twitch, is a spontaneous, involuntary muscle contraction and relaxation, involving fine muscle fibers. They are common, with as many as 70% of people experiencing them. They can be benign, or associated with more serious conditions. When no cause or pathology is identified, they are diagnosed as benign fasciculation syndrome. Diagnosis The most effective way to detect fasciculations may be surface electromyography (EMG). Surface EMG is more sensitive than needle electromyography and clinical observation in the detection of fasciculation in people with amyotrophic lateral sclerosis. Deeper areas of contraction can be detected by electromyography (EMG) testing, though they can happen in any skeletal muscle in the body. Fasciculations arise as a result of spontaneous depolarization of a lower motor neuron leading to the synchronous contraction of all the skeletal muscle fibers within a single motor unit. An example of normal spontaneous depolarizati ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Paralysis
Paralysis (also known as plegia) is a loss of motor function in one or more muscles. Paralysis can also be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory damage. In the United States, roughly 1 in 50 people have been diagnosed with some form of permanent or transient paralysis. The word "paralysis" derives from the Greek παράλυσις, meaning "disabling of the nerves" from παρά (''para'') meaning "beside, by" and λύσις (''lysis'') meaning "making loose". A paralysis accompanied by involuntary tremors is usually called "palsy". Causes Paralysis is most often caused by damage in the nervous system, especially the spinal cord. Other major causes are stroke, trauma with nerve injury, poliomyelitis, cerebral palsy, peripheral neuropathy, Parkinson's disease, ALS, botulism, spina bifida, multiple sclerosis, and Guillain–Barré syndrome. Temporary paralysis occurs during REM sleep, and dysregulation of this system can lead ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Winged Scapula
A winged scapula (scapula alata) is a skeletal medical condition in which the shoulder blade protrudes from a person's back in an abnormal position. In rare conditions it has the potential to lead to limited functional activity in the upper extremity to which it is adjacent. It can affect a person's ability to lift, pull, and push weighty objects. In some serious cases, the ability to perform activities of daily living such as changing one's clothes and washing one's hair may be hindered. The name of this condition comes from its appearance, a wing-like resemblance, due to the medial border of the scapula sticking straight out from the back. Scapular winging has been observed to disrupt scapulohumeral rhythm, contributing to decreased flexion and abduction of the upper extremity, as well as a loss in power and the source of considerable pain. A winged scapula is considered normal posture in young children, but not older children and adults. Signs and symptoms The severity ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Radical Neck Dissection
The neck dissection is a surgical procedure for control of neck lymph node metastasis from squamous cell carcinoma (SCC) of the head and neck. The aim of the procedure is to remove lymph nodes from one side of the neck into which cancer cells may have migrated. Metastasis of squamous cell carcinoma into the lymph nodes of the neck reduce survival and is the most important factor in the spread of the disease. The metastases may originate from SCC of the upper aerodigestive tract, including the oral cavity, tongue, nasopharynx, oropharynx, hypopharynx, and larynx, as well as the thyroid, parotid and posterior scalp. History of neck dissections * 1906 – George W. Crile of the Cleveland Clinic describes the radical neck dissection. The operation encompasses removal of all the lymph nodes on one side of the neck, and includes removal of the spinal accessory nerve (SAN), internal jugular vein (IJV) and sternocleidomastoid muscle (SCM). * 1957 – Hayes Martin describes routine use of ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Lymph Node Biopsy
Lymph node biopsy is a test in which a lymph node or a piece of a lymph node is removed for examination under a microscope (see: biopsy). The lymphatic system is made up of several lymph nodes connected by lymph vessels. The nodes produce white blood cells (lymphocytes) that fight infections. When an infection is present, the lymph nodes swell, produce more white blood cells, and attempt to trap the organisms that are causing the infection. The lymph nodes also try to trap cancer cells. Imaging studies include CXR, CT scans of Abdomen,chest, pelvis, neck and PET scans. CBC, ESR, serum ferritin, bone marrow aspiration. Indications The test is used to help determine the cause of lymph node enlargement (swollen glands or lymphadenitis). It may also determine whether tumors in the lymph node are cancerous or noncancerous. Enlarged lymph nodes may be caused by a number of conditions, ranging from very mild infections to serious malignancies. Benign conditions can often be distinguishe ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Neurological Examination
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, but not deeper investigation such as neuroimaging. It can be used both as a screening tool and as an investigative tool, the former of which when examining the patient when there is no expected neurological deficit and the latter of which when examining a patient where you do expect to find abnormalities. If a problem is found either in an investigative or screening process, then further tests can be carried out to focus on a particular aspect of the nervous system (such as lumbar punctures and blood tests). In general, a neurological examination is focused on finding out whether there are lesions in the central and peripheral nervous systems or there is another diffuse process that is troubling the patient. Once the patient has been ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Range Of Motion
Range of motion (or ROM), is the linear or angular distance that a moving object may normally travel while properly attached to another. It is also called range of travel (or ROT), particularly when talking about mechanical devices and in mechanical engineering fields. For example, a sound volume control knob. As used in the biomedical field and by weightlifters, range of motion refers to the distance and direction a joint can move between the flexed position and the extended position. The act of attempting to increase this distance through therapeutic exercises (range of motion therapy—stretching from flexion to extension for physiological gain) is also sometimes called range of motion. Measuring range of motion Each specific joint has a normal range of motion that is expressed in degrees. The reference values for the normal ROM in individuals differ slightly depending on age and gender. For example, as an individual ages, they typically lose a small amount of ROM. Analog ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Muscle Atrophy
Muscle atrophy is the loss of skeletal muscle mass. It can be caused by immobility, aging, malnutrition, medications, or a wide range of injuries or diseases that impact the musculoskeletal or nervous system. Muscle atrophy leads to muscle weakness and causes disability. Disuse causes rapid muscle atrophy and often occurs during injury or illness that requires immobilization of a limb or bed rest. Depending on the duration of disuse and the health of the individual, this may be fully reversed with activity. Malnutrition first causes fat loss but may progress to muscle atrophy in prolonged starvation and can be reversed with nutritional therapy. In contrast, cachexia is a wasting syndrome caused by an underlying disease such as cancer that causes dramatic muscle atrophy and cannot be completely reversed with nutritional therapy. Sarcopenia is age-related muscle atrophy and can be slowed by exercise. Finally, diseases of the muscles such as muscular dystrophy or myopathies can cause ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
