ACCESSORY (XI) NERVE

The cranial root of the accessory nerve is smaller than the spinal root. It exits the skull through the jugular foramen and unites for a short distance with the spinal root. Its fibers innervate the pharyngeal and palatal muscles, except tensor veli palatini. 

Because the cranial part of accessory nerve (CN XI) leaves the jugular foramen as joining the CN X, it is sometimes considered part of the plexus as well

The tensor veli palatini is supplied by the medial pterygoid nerve, a branch of mandibular nerve, the third branch of the trigeminal nerve – the only muscle of the palate not innervated by the pharyngeal plexus

The spinal accessory nerve (cranial nerve XI) is a motor nerve (special visceral efferent) that innervates the sternocleidomastoid and trapezius muscles. The trapezius, a broad, flat, triangular muscle, has fibers in its superior part that originate from the external occipital protuberance and the superior nuchal line, the ligamentum nuchae, and the spinous processes of vertebrae C-7 through T-4.

These upper fibers pass laterally to insert onto the acromion and the spine of the scapula. Activation of this part of the muscle results in elevation of the point of the shoulder (acromion moves superiorly), as in shrugging.

The muscles that promote movement of the arm away from the midline of the body include the deltoid, subscapularis, supraspinatus, and infraspinatus muscles which are innervated by branches of the brachial plexus, not the spinal accessory nerve (CN XI).

When there is damage to the spinal accessory nerve, they may also have difficulty elevating (abducting) the arm above a horizontal plane because the superior fibers of the trapezius, along with the serratus anterior, externally rotate the scapula about an anteroposterior axis, which is required for elevation of the arm beyond a horizontal plane.

However, this is a question of “magnitude”: loss of trapezius function would have greater effect on scapular elevation than rotation (i.e. serratus anterior is better able to compensate for loss of external rotation than levator scapulae can for elevation).

The trapezius adducts the scapula, whereas the major arm adductors include the pectoralis major, teres major, latissimus dorsi, and coracobrachialis muscles. These muscles are innervated by branches of the brachial plexus.

The muscles that act to laterally rotate the arm include the teres minor, infraspinatus, supraspinatus, and the dorsal portion of the deltoid muscles. These muscles are innervated by branches of the brachial plexus, not the spinal accessory nerve (CN XI).

Ans.’c’  Stylopharyngeus

Stylopharyngeus muscle is the only muscle in pharynx supplied by the glossopharyngeal nerve.