Observation: Cervical
- Demeanour, expressions of pain or discomfort, general ability of movement
- Posture, Head carriage, chin position, lordotic curve, shoulder position
- Skin for scars, lesions, hair anomalies, pigmentation, swelling, asymmetry,
bruising - Unilateral shoulder drooping, atrophy (wasting at the shoulder girdle may
indicate C4-5 and C5-6 stenosis or compromise) - Observe for gross deformities such as torticollis, Sprengel’s deformity, scoliosis,
swelling - Pelvis/LEX/Feet
- Upper limb screen while standing
- Gait analysis enables you to identify the possibility of neurological aetiology
such as cervical myelopathy (wide-based unsteady gait; this is also similar in
cerebellar dysfunction)
Screen: Cervical
ALWAYS SCREEN THE ADJACENT REGIONS
Thoracic screen (standing or seated Tx sidebending and
rotation)
1st rib
UEX elevation (painful arc, scapulohumeral rhythm)
TMJ
Observational views: Cervical
Posterior View:
• Muscular symmetry (upper traps, SCM)
• Axis SP in midline?
• Lower shoulder on dominant side? (this is normal)
• Deltoid atrophy (axillary nerve involvement)
Lateral View:
• Vertically oriented forehead
• Tip of chin in line with manubrium. If anterior to manubrium, then consider
anterior head carriage
• Cervical lordosis
• Ear symmetry, inflammation, lesions, discharge etc
Anterior View:
• Side shift of head (antalgic posture for disc)
• Slight head tilt (upper Cx dysfunction)
• Eyes: ptosis, redness, swelling, nystagmus etc
• Facial symmetry
Active ROM: Cervical
- Flexion
- Extension
- Sidebending
- Rotation
- Rotation with head flexed (AA)
Passive ROM: Cervical
Supine
- Flexion
- Extension
- Sidebending
- Rotation
- Rotation with head flexed (AA)
Active resisted ROM: Cervical
- Flexion
- Extension
- Sidebending
- Rotation
