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Now I will have the patient in an upright position and assess the head and neck. The head should be centered midline and accessory neck muscles should be symmetric while the head should be erect and still. Now I will have the patient drop their head to their neck and roll their head in a circle. There should be no limit of movement or discomfort. Next I will test muscle strength of cranial nerve #11 (Spinal Accessory) which is motor. First by having them move/shrug their shoulders against resistance assessing their trapezius. Then I will assess the sternocleidomastoid by turning their head side to side resisting the movements with my hand. I am noting strength and contraction of muscle groups.

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