Cervical spine

Cervical spine

Look Ensure that the shoulders, back muscles and scapulae can be seen. Look for muscle wasting and asymmetry of the neck creases and check that the shoulders are level and that there is a normal cervical lordosis (range 20–40°). Feel Stand behind the patient and support the patient’s chin. /uni25CF Soft tissues . Feel for spasm of the paraspinal muscles. /uni25CF Bone . Palpate the spinous processes (tenderness and alignment); the spinous processes of C7 (vertebra promin ens) and T1 are usually large and are easily palpable at the base of the neck. - Move Motion occurs in three planes: flexion/extension, lateral bend - ing and rotation ( Figure 35.4 ). /uni25CF Flexion (45°)/extension (55°) . Ask the patient to bend their neck forwards – place the chin on the chest. - Measure the distance from the chin to the sternum. Ask the patient to extend their neck by looking up at the ceiling.

(b) (a) Figure 35.3 (a) kyphosis. (b, c) Figure 35.2 Plumb line. (c) Standing sagittal pro /f_i le showing cervical and lumbar lordosis, with thoracic Normal alignment whole spine from front and behind patient.

/uni25CF Right/left rotation (70°) . Ask the patient to look over each shoulder while not moving the chest wall. /uni25CF Right/left lateral bending (40°) . Ask the patient to lay their ear on their ipsilateral shoulder.

Figure 35.4 Cervical spine /f_l exion/extension (a, b) , rotation (c)