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Cervical region
Spine
• 33 bones
• 24 mobile individual segments
– 7 cervical
– 12 thoracic
– 5 lumbar
• 2 lordotic 1 kyphotic
• Vertebral foramen
• Costal process
Anatomy of vertebra
• Body
• 2 pedicles
• 2 sup facets
• 2 inf facets
• Trans process
• Lamina
• Spinous process
• Cord - canal
Relation of various parts of body
Anatomy of cervical spine
Ligaments of spine
Strap muscles of neck
Muscles of cervical spine
1. Semispinalis Capitus
2. Iliocostalis Cervicis
3. Longissimus Cervicus
4. Longissimus Capitus
Problems
• Strain & Sprain
• Ivdp
• Facet artropathy
• Infection
– Septic
– Tuberculous
• Vascular
History
• When/how
• Intensity
• Diurnal variation
• Movements
• Deglutation
• Vomiting
• Trauma
• Constitutional symptoms
Neurological history
• Pain first/weakness first
• Progression
• Sensory
• Motor
• ADL affected
• Tight/loose
• Clonus
• Jerky movements
• Locomotion/list
Examination
• Look
• Touch
• Move
• Measure
Inspection
• Posterior
– Inion
– Vertebra prominens
– Muscle spasm
– Both shoulders
– Scapula
– Interscapular region
Anterior
• C3 – hyoid
• C4-5 - thyroid cartilage
• C6 – cricoid cartilage
• Sternum
• Notch
Palpation
• Bone
– Spinous process
– Transverse
process
– Hyoid
– Cricoid Ring
– Inion
– Scapula
• ROM
• Flexion (80 to 90o)
• Extension (70o)
• Lateral flexion (L & R) (20 to 45o)
• Rotation (L & R) (70 to 90o)
• Shoulder elevation & depression
• PROM
– Tissue stretch end feel for all
Examination
– Flexion
• Scalenes
• Longus coli
– Extension
• Levator scapulae
• Trapezius
• Splenius, semispinalis, & longissimus cervicis
Examination
– Lateral flexion
• Trapezius
• Longus capitus
• Sternocleidomastoid
– Rotation
• Levator scapulae
• Sternocleidomastoid
– Shoulder elevation
Sternomastoid
Extension strength
Flexion strength
Lateral flexion
Examination
Upto 1100
Circulatory
• Carotid
• Brachial
• Radial