This document provides information about conducting a subjective cervical spine examination. It discusses the anatomy of the cervical spine, possible causes of cervical pain, and components of the subjective examination. The subjective examination includes using a body chart to document the location, quality, and characteristics of pain. It also involves asking special questions about symptoms like dizziness and assessing factors like aggravating activities, easing techniques, and how symptoms impact daily living. The goal is to gather detailed self-reported information from the patient to guide the physical examination and evaluation of their cervical condition.

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2. CERVICAL SPINE SUBJECTIVE
EXAMINATION
Dr. Alam Zeb AmiR
DPT(KMU), MSPT(KMU)
alamzebamir92@gmail.com

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6. CERVICAL SPINE
 Consist of seven vertebrae(C1-7)
 C1(atlas),C2(axis)
 C1,C2,C7 called atypical vertebrae
 C3-C7 called typical vertebrae
 All cervical vertebrae have unique transverse
foramina.
Functionally it is divided in two regions:
 Upper cervical Spine (C0-2)
 Lower cervical spine(C3-C7)
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7. CERVICAL SPINE
 Seven vertebrae
 C 1-7
 More flexible
 Supports the head
 Wide range of motion
 Rotation to left and right
 Flexion
 Up and down
 Peripheral nerves
 Arms
 Shoulder, Chest and diaphragm

8. Flexion/Extension Side flexion
Rotation

9. OC1 motion:
 Flexion/extension, and limited side bending
 C1-C2 motion
 Rotation/ slight flex/ext, and side bending
 Half of the total cervical rotation occur at C1-C2
 C3-C7 motion
 Flex/ext/rotation/side-bending
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12. POSSIBLE CAUSES OF PAIN AND/OR LIMITATION OF
MOVEMENT
● Trauma
– Whiplash
– Fracture of vertebral body, spinous or transverse
process
– Ligamentous sprain
– Muscular strain
● Degenerative conditions
– Spondylosis – degeneration of C2–C3 intervertebral
disc
– Arthrosis – degeneration of zygapophyseal joints
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13. POSSIBLE CAUSES OF PAIN AND/OR LIMITATION OF
MOVEMENT
● Inflammatory conditions
– Rheumatoid arthritis
– Ankylosing spondylitis
● Neoplasm
● Infection
● Headache
– Migraine
– Tension-type headache
– Cluster headache
• Cervical rib
• Torticollis
• Hypermobility syndrome
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14. SUBJECTIVE EXAMINATION
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Location
Referred
pain
MOI
Quality
Depth
Intensity
Constant or
Intermittent
Aggravating
Factors
Easing
Factors
24 -hour
pattern

15. SUBJECTIVE EXAMINATION
 Body chart
 Area of current symptoms
 Areas relevant to the region being examined
 Quality of pain
 Intensity of pain
 Depth of pain
 Abnormal sensation
 Constant or intermittent symptoms
 Behaviour of symptoms
 Severity and irritability of symptoms
 Twenty-four hour behaviour of symptoms
 Function
 Stage of the condition
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16.  Special questions
 History of the present condition (HPC)
 Past medical history (PMH)
 Social and family history
 Plan of the physical examination
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18. BODY CHART
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19. SPECIAL QUESTIONS FOR CERVICAL SPINE
 Signs of some Cervical Arterial Dysfunction, upper
cervical instability, disease of inner ear
 5 D’s
 Dizziness
 Drop attacks
 Dysphagia (swallowing problems)
 Dysarthria (speech problems)
 Diplopia ( Double vision)

20. Subjective
Examination
Body
Chart
Type & area
of symptom
Depth
Quality
Intensity
Abnormal
Sensation
Relationship
of
Symptoms
Behavior of
Symptoms
Aggravating
factors
Easing
Factors
Severity &
Irritability
24 hrs
behavior
Daily Activity
Stage of
Condition
Special
Questions
General
Health
Drugs
Steroids
Anticoagulant
s
Weight loss
– recurrent
unexpected
Rheumatoid
Arthritis
Spinal Cord
Cauda
equina
symptoms
Dizziness
X-ray
(recent)
History of
Present Illness
How it
started?
Past Medical
History
Relevant
Medical
History
Previous
Attacks
Effects of
previous
treatments
Social & Family
History
Age
Gender
Home of
work
situation
Dependents
Leisure
Activities

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