Cervical Assessment

Question 1

Observation: Cervical

Answer 1

• 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)

Question 2

Screen: Cervical

Answer 2

ALWAYS SCREEN THE ADJACENT REGIONS
Thoracic screen (standing or seated Tx sidebending and
rotation)
1st rib
UEX elevation (painful arc, scapulohumeral rhythm)
TMJ

Question 3

Observational views: Cervical

Answer 3

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

Question 4

Active ROM: Cervical

Answer 4

1. Flexion
2. Extension
3. Sidebending
4. Rotation
5. Rotation with head flexed (AA)

Question 5

Passive ROM: Cervical

Answer 5

Supine

1. Flexion
2. Extension
3. Sidebending
4. Rotation
5. Rotation with head flexed (AA)

Question 6

Active resisted ROM: Cervical

Answer 6

• Flexion
• Extension
• Sidebending
• Rotation