Bauhaus-Universität Weimar

Titel:
The Cyclopaedia of Anatomy and Physiology, vol. 4: Pla [corr.: Ple] - Wri
Person:
Todd, Robert Bentley
PURL:
https://digitalesammlungen.uni-weimar.de/viewer/image/lit29465/756/
SPINAL ACCESSORY NERVE. 
746 
lowest root may tie attached to the spinal 
chord opposite the fourth, fifth, sixth, or 
seventh cervical nerve, but more frequently 
between the fifth and sixth ; and that when its 
roots are extended over a more limited por¬ 
tion of the spinal chord, this is compensated 
for by their being proportionally stronger.* 
Anatomists have differed as widely in their 
account of the particular column or tract of 
the spinal chord to which the roots of the 
spinal accessory are attached, as they have 
done regarding the extent of the spinal chord 
over which these roots stretch. This is a 
point in the anatomy of the nerve which has 
assumed greater importance since the dis¬ 
covery by Sir Charles Bell, of the separate 
functions of the anterior and posterior roots 
of the spinal nerves, and is of much more 
interest to the modern, than it was to the 
older anatomists. The filaments of origin or 
roots of this nerve that come from the spinal 
chord are attached to the chord near the 
posterior lateral groove separating its posterior 
and middle columns, and close upon the pos¬ 
terior roots of the spinal nerves, so that we 
can readily understand how some anatomists 
should describe these roots as arising from 
the middle column, and others describe them 
as springing from the posterior column.-j- 
Among the modern anatomists we find Bel- 
lingeri, who has attended particularly to the 
anatomy of this nerve, describing it as arising 
from the middle or lateral column of the 
* Huber (De Medulla Spinali, et speciatim de 
Nervis ab eâ provenientibus, p. 13.) says that this 
nerve commences opposite the seventh cervical, but he 
afterwards speaks of it arising opposite the sixth. 
Lobstein (De Nervo Spinali ad Par Yagum Ac- 
cessorio, p. 233, as reprinted in Ludwig’s Script. 
Neurol. Min. Selec. tom. ii. Lipsiæ, 1792) describes 
it as arising under the sixth pair of cervical nerves 
by a slender beginning. Bellingeri (De Medulla 
Spinali, Nervisque ex eâ prodeuntibus, p. 74, 1823) 
places its origin opposite the seventh cervical nerve. 
Cruveilhier (Anatomie Descriptive, tom. iv. p. 899, 
1835) says that its origin seldom passes below the 
level of the fifth pair of cervical nerves, but it may 
arise opposite the sixth and even the seventh pair. 
Bendz (De Connexu inter Nervum Yagum et Ac- 
cessorium Willisii, p. 22, 1836) describes its lowest 
root as arising from the spinal chord in the region 
of the fifth or sixth cervical nerves, and rarely as low 
as the posterior root of the seventh cervical. Valentin 
(Soemmering vom Baue des menschlichen Körpers. 
Hirn und Nervenlehre, S. 513, 1841) states that its 
most frequent origin is opposite the sixth, or between 
the sixth and seventh cervical nerves ; sometimes it 
arises opposite the fourth or fifth, or it may extend 
as far as the seventh, and in rare cases as far as the 
first dorsal. Krause (Handbuch der menchlichen 
Anatomie, Erster Band, S. 1066 : Hannover, 1842) 
says that it usually arises opposite the upper part 
of the roots of the seventh cervical, seldom higher. 
Bernard (Archives Generales de Médecine, 4ième 
série, tom. iv. p. 410, 1844) describes it as arising 
by a series of bifid or trifid nervous filaments, which 
extend, in man, from the origin of t he pneumogastric 
to a point opposite the fourth or fifth pair of cervical 
nerves. 
f Bolando (Recherches Anatomiques sur la Mo¬ 
elle Ablongée) and Serres (Anatomie Comparée 
du Cerveau, tom. i.) have stated that the lower 
fibres of tliis nerve come from the anterior column 
of the spinal chord. 
spinal chord*, while Bischofff and Bernard]; 
trace its origin to the posterior column ; and 
Bendz $ states that while nearly the whole 
of its roots come from the middle column, a 
few arise between the posterior roots of the 
spinal nerves and from the posterior column.|[ 
From my own examinations of the attach¬ 
ments of this nerve, I had arrived at the con¬ 
clusion that it arises from the posterior part 
of the middle column, and that its middle and 
inferior roots are attached along the course 
of the decussating fibres of the pyramidal 
column, which form the posterior part of the 
middle column of the ehord.^f Stilling says** 
that the lower and middle roots of this nerve 
can be traced to the anterior grey substances 
in the chord, from which the anterior roots 
of the spinal nerves arise, and that, in an 
anatomical point of view, they must be re¬ 
garded as performing the same functions as 
the anterior roots of the spinal nerves ; while 
the upper roots, or those which are attached 
to the medulla oblongata, differ in a marked 
manner, in regard to their origin, from the 
lower and middle roots. He states that these 
upper roots above the first cervical nerve 
arise from a grey mass in the medulla ob¬ 
longata, which he styles the accessory-kernel 
(accessorius-kernf f ), and that they resemble 
closely the lower filaments of origin of the 
par vagum. These upper roots of the acces¬ 
sory do not arise from the gelatinous sub¬ 
stance from which, according to Stilling, the 
posterior roots of the spinal nerves spring, 
yet they come into closer relation with it the 
nearer they approach to the commencement 
of the roots of the vagus. The upper fi¬ 
bres of the accessory, though not continuous 
with the posterior roots of the spinal nerves, 
are yet, he believes, analogous to these; and 
this view is strengthened by their presenting 
the same connection with the roots of the 
hypoglossal as is found between the roots of 
* De Medulla Spinali, Nervisque ex eâ prode¬ 
untibus, pp. 51. 55, 1823. 
f Nervi Accessorii Willisii Anatomia et Physio- 
logia, p. 11. Darmstadii, 1832. 
X Archives Générales de Médecine, 4ième sérié, 
tom. iv. pp. 409, 410, 1844. 
§ Tractatus de Connexu inter Nervum Yagum 
et Accessorium Willisii, pp. 22. 39. Hauniae, 1836. 
Il Lobstein (De Nervo Spinali, in Ludwig’s 
Scriptores Nevrologici Minores Selecti, torn. ii. 
p. 233.) also describes some of the filaments of 
origin of the spinal accessory as coming from the 
spinal chord between the fasciculi which consti¬ 
tute the posterior roots of the spinal nerves, and 
has represented these in fig. 1. Those who may 
wish to ascertain the opinions of other anatomists 
as to the particular column of the spinal chord into 
which this nerve is implanted, and the extent of 
its attachment to the cervical portion of the spinal 
chord, may consult the monographs of Bischoff and 
Bendz quoted above, and especially that of the 
former of these authors. 
On some points in the anatomy of the me¬ 
dulla oblongata, in Edinburgh Medical and Surgical 
Journal for 1841. 
** Ueber die Textur und Function der Medulla 
Oblongata, pp. 55. 57. Erlangen, 1843. 
ft He describes the position and structure of this 
accessorius-kern at p. 23. of the work quoted.
        

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