This document provides information on performing a physical examination of the cervical spine (neck). It lists the most common symptoms as pain, stiffness, deformity, numbness/tingling in the upper limbs, headache, and tension. Common neck problems mentioned include torticollis, cervical spondylosis, spinal stenosis, and myelopathy. The physical examination involves inspection for deformities, asymmetry, and head posture, palpation of the neck in prone or sitting positions, and assessing the range of motion through flexion, extension, lateral flexion, and rotation. Special tests check for issues like foraminal compression, cord compression, and thoracic outlet syndrome.

1. Physical Examination of
Cervical Spine / Neck
Andhika Yudistira
Apley
McRae
Magee

2. Most common Symptoms
• Pain
• Stiffness
• Deformity
• Numbness, tingling, and weakness of upper
limbs
• Headache
• Tension

3. Most Common Problems in The Neck
• Torticollis
• Klippel-Feil Syndrome
(Cervical-Vertebral
Synostosis)
• Cervical Spondylosis
• OPLL
• Spinal Stenosis
• Cervical Myelopathy
• Infection
• Rheumatoid Arthritis
• Ankylosing Spondylitis
• Thoracic Outlet
Syndrome
• Whiplash
• Barre-Lieou Syndrome

4. Physical Examination

5. Inspection (Look)
• Any Deformity
• Any Asymmetry
• Ocular problems
(due to abnormal
head posture)
• Abnormal Head
posture (due to
ocular problems)

6. Palpation (Feel)
• Prone position, or
• Sitting position
• Examiner standing at
the back

7. Move
Normal Range of Movement
- Flexion
- Extension
- Lateral Flexion
- Rotation

8. Movement

11. Another Special Tests
• Foraminal Compression Test
• Distraction Test
• Shoulder Depression Test
• Vertebral Artery (Cervical Quadrant) Test
• Brachial Plexus Tension Test
• Shoulder Abduction Test
• Valsava Test

12. Checking for T.O.S
• Compression of
brachial plexus
and subclavian
artery over the 1st
rib
• Sometimes from
“cervical rib”
• Between anterior
and middle
scalene muscle

16. Checking for Cord Compression
• Narrowing of the spinal canal
• Muscle weakness greater in upper limb
• Arms : Lower motor signs at the level of
compression
• Legs : exaggerated reflexes, clonus, extensor
plantar response, loss of proprioception,
broad based or ataxic gait.
• Sensory deficit is not dermatomal

18. Checking for T.O.S
Please consider T.O.S if these symptoms occur :
- Paresthesia
- Wasting of thenar or hypothenar
- Sympathetic disturbances
- Vascular impairment
- Radial artery pulse +/-

20. THANK YOU