Physical examination maneuver

Physical Exam

Cranial Nerve XI

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How to Perform

Ask the patient to shrug the shoulders against your downward resistance. Ask the patient to turn the head to one side against resistance applied to the jaw, and then turn to the other side against resistance, comparing the two sides.

How to Interpret

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References

  • Kelley MJ, Kane TE, Leggin BG. Spinal accessory nerve palsy: associated signs and symptoms. J Orthop Sports Phys Ther. 2008;38(2):78-86. doi:10.2519/jospt.2008.2454. PMID: 18560187.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 9, 2026.