A patient has fallen off a ladder and presents to the doctor with issues elevating the scapula and rotating their head. Which cranial nerve was most likely injured?

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Consider the clinical scenario: a patient who has fallen and now has difficulty elevating the scapula and rotating the head. These functions are primarily mediated by the muscles of the shoulder girdle and neck that are innervated by a specific cranial nerve.
Option 1: Accessory nerve (CN XI). The spinal accessory nerve innervates the sternocleidomastoid (which helps rotate the head) and the trapezius (which elevates the scapula). Injury to CN XI can lead to weakness in elevating the scapula and turning the head, matching the presentation described.
Option 2: Vagus (CN X). The vagus nerve controls many autonomic and some laryngeal muscles, but it is not responsible for scapular elevation or rotation of the head. Therefore, this option does not explain the observed deficits.
Option 3: Trigeminal nerve (CN V). This nerve primarily mediates facial sensation and muscles of mastication. It does not govern scapular elevation or neck rotation, so it is inconsistent with the symptoms.
Option 4: Hypoglossal nerve (CN XII). The hypoglossal nerve controls tongue movements. Its impairment would produce tongue-related deficits rather than problems with the scapula or head rotation, making this option unlikely.
Option 5: Facial nerve (CN VII). The facial nerve controls facial expression and some autonomic functions but not the actions of elevating the scapula or rotating the head, so it does not fit the clinical picture.
In summary, the combination of impaired scapular elevation and head rotation aligns with injury to the nerve supplying the trapezius and sternocleidomastoid, namely the accessory nerve (CN XI), while the other listed nerves do not explain these specific motor deficits.

ANATOMY 2300 AU2025 (34636) Unit 4 Exam - Requires Respondus LockDown Browser

A patient has fallen off a ladder and presents to the doctor with issues elevating the scapula and rotating their head. Which cranial nerve was most likely injured?

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