CN XI: accessory nerve

B. procedure CN XII: Hypoglossal nerve 1. From behind, look for atrophy or asymmetry of the trapezius muscles. 2. Ask the patient to shrug their shoulders up and try to push them down ( trapezius muscles) 3. Ask the patient to turn their head (sternocleidomastoid muscles) against resistance. B. procedure 4. Watch and palpate in mouth for wasting, fasciculation. 1. Inspect the tongue the sternomastoid muscle on the opposite side. 2. Ask the of accessory nerve produce weakness of both muscles N.B. lesionpatient to protrude their tongue and note any deviation on the same side. 3. Ask the patient to move his tongue from side to side N.B. If the tongue deviates to one side when protruded, this suggests a hypoglossal nerve lesion. If it is an LMN lesion, the protruded tongue will deviate towards the side of the lesion