The left spinal accessory nerve is examined by asking the patient to turn the head to the right against the resistance of the examiner's hand. This is demonstrated in Figure 21-18. The right spinal accessory nerve is examined by reversing the directions.
An alternative test is to evaluate the trapezius muscles. The examiner places both hands on the patient's trapezius muscles. Both muscles are palpated between the examiner's thumbs and index fingers. The patient is then asked to shrug the shoulders against the resistance of the examiner's hands. Both sides should move equally. This technique is demonstrated in Figure 21-19.
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