Neck and Cervical Spine Examination Flashcards
What is the primary motion of the OA joint?
flexion and extension
-modified type I mechanics
What is the primary motion of the AA joint?
rotation
-atlas rotates around the dens of C2
What do we look for upon normal observation of the neck?
lordosis
distended jugular vein
masses or goiters
tracheal deviation
How do you observe the thyroid?
tip pt’s head back
locate thyroid and cricoid cartilage
inspect region below cricoid cartilage for gland
pt swallows: observe for symmetry and contour
What is the anterior triangle?
mandible, SCM, midline
what is the posterior triangle?
SCM, trapezius, clavicle
Where do we check for lymph nodes for this region?
occipital, pre and post auricular, submandibular, submental, tonsilar, and supraclavicular
How do you palpate the thyroid?
have pt flex neck to relax SCMs
place fingers below cricoid cartilage,
have pt swallow
use thumbs to displace trachea and palpate each lobe
if enlarged, listen over lateral lobes to detect bruit (hyperthyroidism)
What are some findings for the thyroid palpation?
Goiters
graves disease: soft
hashimoto’s thyroiditis: firm
thyroiditis: tenderness
Where does a cervical nerve root exit the spinal column?
it exits ABOVE the numbered vertebra
Name the muscle strength tests for each spinal nerve C1-T1
C1 is turning the head C2-4 is scapular elevation C5 is shoulder abduction C6 is elbow flexion C7 is elbow extension C8 is finger flexion T1 is finger abduction
Name all of the sensory exam dermatomes for C1-T1
C1-4 is behind the head region C4 is superior shoulder C5 is lateral upper arm C6 is lateral forearm C7 is middle finger C8 is medial wrist and forearm T1 is medial elbow and upper arm
Name the DTR’s for this region
C5 is biceps
C6 is Brachioradialis
C7 is triceps
What is spurling’s test?
compress the head down in neutral and then in extension, then sb/rotation toward dysfunction to be more specific
-+ if reproduction of symptoms (pain in distriubtion of nerve root)
What is the neck distraction test?
when there is releif of pain with cervical distration, it’s positive
-it’s just the opposite of the spurlings test
What is the valsalva test?
pt holds breath and bears down
-+ if increased pain or paresthesia, expecially in nerve root distribution
What are the thoracic outlet boundaries?
1st ribs, 1st thoracic vertebra, and the manubrium
brachial plexus, sublavian a. and v. are there
What is ROOS or EAST test?
make them quack like a duck for 3 minutes with their hands
+ if repro of symptoms
What is Adson Test?
abduct, extend, and ext rotate the shoulder while palpating the radial pulse, head is extended and rotated toward affected side, then the pts’ head is extended and rotated away from affected side
+ if loss or change in pulse, repro of symptoms
indicates compression of sublaviand a. between SCALENES, CERVICAL RIB, OR 1ST RIB
What is Wright’s hyperabduction test?
NV bundles compressed by tight pectoralis minor
-doc locates radial pulse on affected side, stand behind the pt and palpate the radial pulse with one hand, abduct the patients arm above his head with some extension
+if loss or change in pulse, pain, paresthesia
indicates NV entrapment by pec minor
What is the costoclavicular test?
extend shoulder and caudal pressure on shuolder noting change in radial pulse
-monitor radial pulse, extend the shoulder, with elbow extended and wrist supinated and apply caudal pressure on the shoulder
+ if decrease in radial pulse
indicates thoracic outlet synd due to decrease space between rib 1 and the clavicle
Nuchal rigidity
+ marked neck stiffness, found in a lot of bacterial meningitis cases
Brudzinski’s sign
+ if we see flexion in both hips and knees
-both of those test for inflammation in the subarachnoid space
What is subluxation?
facet dislocation
