Accessory Nerve - History and Etymology

History and Etymology

In 1848, Jones Quain described the nerve as the "spinal nerve accessory to the vagus", recognizing that while a minor component of the nerve joins with the larger vagus nerve, the majority of accessory nerve fibers originate in the spinal cord. Quain also suggested spinal accessory nerve as a shortened form of the term; this term, and its more abbreviated variant, accessory nerve, have persisted to modern times. Throughout this interval, the nerve has never had a consistent name among investigators and medical practitioners. Some use accessory nerve and spinal accessory nerve interchangeably; others distinguish between spinal accessory nerve and cranial accessory nerve; still others use accessory nerve to refer to both spinal and cranial components of the nerve.

In Neuroanatomy and the Neurologic Exam, Terence R. Anthoney provides a historical account of the usage of the terms accessory nerve, spinal accessory nerve, and cranial accessory nerve, summarized in the following excerpt:

To summarize, then, the eleventh cranial nerve was called both the "accessory nerve" and the "spinal accessory nerve" as early as 1848—"accessory" referring to its fibers which became accessory to the vagus nerve and "spinal" referring to its largely spinal origin. When it became recognized, as early as 1893, that the "accessory" fibers to the vagus nerve came from the same medullary nuclei as the rest of the vagal efferent fibers, people began to view the "accessory" fibers as part of the vagus nerve proper, leaving the eleventh cranial nerve to originate solely from its spinal nucleus. This shift was reinforced by the neuroclinicians, who could only test the integrity of the spinal portion of the nerve separately anyway. Because of the shift to just a spinal origin for the nerve, the word "accessory" came to be associated with the "true"—i.e., spinal—component of the nerve, no longer being considered in the context of "accessory to the vagus." This association has been reinforced by referring to the spinal nucleus of origin as the "(spinal) accessory nucleus."

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