FUNCTION -- Shoulder Shrugging and Head Turning

TEST I -- Shoulder Shrugging
The clinician should palpate the trapezius muscles bilaterally to assess bulk and tone. Subsequently the clinician should offer resistance against the tops of the shoulders while the patient shrugs. The clinician should also place the palm of one hand across the cheek of the patient, the patient should receive instruction to rotate the head about the longitudinal axis, with the face turning in the direction of the hand of the clinician against some resistance. At the same time, the opposite hand of the clinician should be placed firmly over the sternocleidomastoid muscle of interest (i.e., located opposite to the direction of movement of the face).

INTERPRETATION
A significant loss of muscular mass and tone may reflect defects involving cranial nerve XI, probably accompanied by weakness. Weakness with a loss of mass may also arise with damage to higher centers, but the loss of mass tends to be less pronounced in such cases and may be accompanied by elevated muscle tone.