A 15-year-old boy is brought to the office for the evaluation of an enlarged mass in the neck. He has a 6-week history of expanding discrete masses in the neck that are associated with night sweats, fever, and fatigue. On examination, the patient has cervical lymphadenopathy. He underwent an excisional biopsy of the lymph nodes on the right side of the neck, particularly in the right posterior triangle of the neck. One month later, the patient presented for follow-up he complains of difficulty raising the arm overhead. Examination showed decreased right arm abduction above 100 degrees with right shoulder droop. This patient's presentation is consistent with paralysis affecting which of the following nerves?

Question

Quizplus · Accepted Answer

Eductional Objective: The spinal accessory nerve passes in the posterior triangle of the neck. Injuries at this level would lead to trapezius muscle paralysis. Patients may present with shoulder drooping, impaired abduction above 100 degrees, and lateral displacement of the scapula following accessory nerve injury.

A 15-Year-Old Boy Is Brought to the Office for the Evaluation