Anatomy of the spinal root of accessory nerve
- Firm in texture
- Arises from motor cells in the lateral part of the anterior column of the gray substance of the medulla spinalis
- Extends as low as the fifth cervical nerve
- Passes through the lateral funiculus of the medulla spinalis
- Emerges on the surface and forms a single trunk

Pathway of the spinal root of accessory nerve
- Ascends between the ligamentum denticulatum and the posterior roots of the spinal nerves
- Enters the skull through the foramen magnum
- Directed to the jugular foramen
- Lies in the same sheath of dura mater as the vagus nerve
- Separated from the vagus nerve by a fold of the arachnoid

Connections of the spinal root of accessory nerve
- Receives filaments from the cranial part of the nerve in the jugular foramen
- May join the vagus nerve for a short distance and then separate again
- Runs in front of or behind the internal jugular vein as it exits the jugular foramen
- Gives filaments to the Sternocleidomastoideus muscle
- Joins with branches from the second cervical nerve

Course of the spinal root of accessory nerve
- Descends obliquely behind the Digastricus and Stylohyoideus muscles
- Pierces the Sternocleidomastoideus muscle
- Courses obliquely across the posterior triangle of the neck
- Ends in the deep surface of the Trapezius muscle
- Forms a plexus with the third and fourth cervical nerves beneath the Trapezius

Additional information
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The spinal root of accessory nerve (or part) is firm in texture, and its fibers arise from the motor cells in the lateral part of the anterior column of the gray substance of the medulla spinalis as low as the fifth cervical nerve.

Spinal root of accessory nerve
Brain stem sagittal section (11 visible near bottom center)
Plan of upper portions of glossopharyngeal, vagus, and accessory nerves.
Details
Identifiers
Latinradix spinalis nervi accessorii, pars spinalis nervi accessorii
TA98A14.2.01.186
TA26354
Anatomical terms of neuroanatomy

Passing through the lateral funiculus of the medulla spinalis, they emerge on its surface and unite to form a single trunk, which ascends between the ligamentum denticulatum and the posterior roots of the spinal nerves; enters the skull through the foramen magnum, and is then directed to the jugular foramen, through which it passes, lying in the same sheath of dura mater as the vagus, but separated from it by a fold of the arachnoid.

In the jugular foramen, it receives one or two filaments from the cranial part of the nerve, or else joins it for a short distance and then separates from it again.

As it exits from the jugular foramen, it runs backward in front of the internal jugular vein in 66.6% of cases, and behind it in 33% of cases.

The nerve then descends obliquely behind the Digastricus and Stylohyoideus to the upper part of the Sternocleidomastoideus; it pierces this muscle, and courses obliquely across the posterior triangle of the neck, to end in the deep surface of the Trapezius.

As it traverses the Sternocleidomastoideus it gives several filaments to the muscle, and joins with branches from the second cervical nerve.

In the posterior triangle it unites with the second and third cervical nerves, while beneath the Trapezius it forms a plexus with the third and fourth cervical nerves, and from this plexus fibers are distributed to the muscle.

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