Injury to the spinal accessory nerve may be managed with transcutaneous nerve stimulation and, in some cases, Eden-Lange muscle transfer. This statement identifies management for injuries to which nerve?

Injury to the spinal accessory nerve may be managed with transcutaneous nerve stimulation and, in some cases, Eden-Lange muscle transfer. This statement identifies management for injuries to which nerve?

• A. Median nerve
• B. Ulnar nerve
• C. Radial nerve
• D. Spinal accessory nerve

Answer: (D)

The concept being tested is injuries to the nerve that controls the muscles stabilizing the shoulder blade. The spinal accessory nerve (cranial nerve XI) innervates the trapezius and sternocleidomastoid. When this nerve is damaged, the trapezius becomes weak, leading to drooping of the shoulder, difficulty lifting the arm above horizontal, and scapular instability. Management often includes neuromuscular electrical stimulation to help preserve or regain muscle activity and, in cases where nerve function doesn’t recover, surgical muscle transfer like the Eden-Lange procedure to mimic trapezius function by repositioning other scapular retractors. The other nerves listed don’t supply the trapezius and aren’t treated with Eden-Lange transfers, so they don’t fit this scenario.

The concept being tested is injuries to the nerve that controls the muscles stabilizing the shoulder blade. The spinal accessory nerve (cranial nerve XI) innervates the trapezius and sternocleidomastoid. When this nerve is damaged, the trapezius becomes weak, leading to drooping of the shoulder, difficulty lifting the arm above horizontal, and scapular instability. Management often includes neuromuscular electrical stimulation to help preserve or regain muscle activity and, in cases where nerve function doesn’t recover, surgical muscle transfer like the Eden-Lange procedure to mimic trapezius function by repositioning other scapular retractors. The other nerves listed don’t supply the trapezius and aren’t treated with Eden-Lange transfers, so they don’t fit this scenario.