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A 43-Year-Old Woman Was Seen in the Emergency Department with a Large

Question 3

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A 43-year-old woman was seen in the emergency department with a large abscess in the middle of the right posterior triangle of the neck. The abscess was red, hot, and fluctuant. The abscess showed evidence that it was pointing and about to rupture. The physician decided to incise the abscess and insert a drain. The patient returned to the department for the dressings to be changed 5 days later. She stated that she felt much better and that her neck was no longer painful. However, there was one thing that she could not understand. She could no longer raise her right hand above her head to brush her hair.
-The following statements explain the signs and symptoms in this case, suggesting that the spinal part of the accessory nerve had been incised, except which?


A) To raise the hand above the head, it is necessary for the trapezius muscle, assisted by the serratus anterior, to contract and rotate the scapula so that the glenoid cavity faces upward.
B) The trapezius muscle is innervated by the spinal part of the accessory nerve.
C) As the spinal part of the accessory nerve crosses the posterior triangle of the neck, it is deeply placed, being covered by the skin, the superficial fascia, the investing layer of deep cervical fascia, and the levator scapulae muscle.
D) The surface marking of the spinal part of the accessory nerve is as follows: Bisect at right angles a line joining the angle of the jaw to the tip of the mastoid process. Continue the second line downward and backward across the posterior triangle.
E) The knife opening the abscess had cut the accessory nerve.

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