Cervical Spine/ Neck

Question 1

What 8 things do we do?

Answer 1

1. Sanitize hands
2. Inspect cervical spine and verbalize findings (TART): posture (patient looks relaxed), erythema, bruising
3. Palpate cervical spine (skin, SP, TP and cervical muscles, trachea and thyroid
4. ROM
5. UE strength test
6. Sensory test of shoulder (C4)
7. Bilateral bicep DTR
8. Roos test

Question 2

3. Palpate cervical spine (skin, SP, TP and cervical muscles, trachea and thyroid

Answer 2

1. Palpate cervical spine on the skin (skin, SP, TP and cervical muscles)
2. Trachea: inspect and palpate the sides of the trachea; it should be midline
   - Should be midline
   - Grasp the trachea with two fingers
3. Thyroid:
   - Have patient slightly flex neck
   - Come from behind the patient and place fingers of both hands on patients neck so that the index fingers lie just below the cricoid cartilage
   - Have patient swallow so the thyroid rise up
   - Move it to the sides and palpate it
   - Observe for contour and symmetry.

Question 3

(1 pt.) Perform range of motion of cervical spine (include all Flexion/Extension, Sidebending, Rotation)

Answer 3

Flexion
Extension
SB
Rotation

Question 4

(1 pt.) Perform upper extremity strength testing and verbalize finding

Answer 4

• Normal: +5/5

Question 5

(1 pt.) Perform Sensory testing on upper extremity

Answer 5

• Shoulder is C4

Question 6

Bilateral Bicep DTR

Answer 6

• Bicep DTR

+2/4 is normal

Question 7

Roos test

Answer 7

• Roos Test:
o Have patient abduct shoulder to 90 degrees
o ER elbow flexed to 90
o Tell patient to open and close fist for up to 3 minutes
o +: pain
 => thoracic outlet syndrome