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Cervical Exam

Cervical Exam. Vitals Seated BP (L & R), Respiration, Pulse, Ht, Wt, Temp Appearance. Mood, Orientation A&OX3, No Apparent Distress, Well Dev. Well Nour Visual Inspection Cervical Muscle symmetry, Cervical Posture (P-A & Lat) Palpation

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Cervical Exam

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  1. Cervical Exam • Vitals • Seated BP (L & R), Respiration, Pulse, Ht, Wt, Temp • Appearance. Mood, Orientation • A&OX3, No Apparent Distress, Well Dev. Well Nour • Visual Inspection • Cervical Muscle symmetry, Cervical Posture (P-A & Lat) • Palpation • Musculature, Interspinous spaces, Thyroid, Trachea, Lymph, EENT, other • Sensory • UE Dermatomes, Other Sensory • Sharp/Dull, Vib, Position sense

  2. Motor UE Deltoids (C5) Biceps (C6) Wrist Extension (C6) Triceps (C7) Finger Extension (C7) Finger Flexion (C8) Finger Adduction (T1) Reflexes UE Biceps (C5) Triceps (C7) Brachioradialis (C6) Hoffman’s Cervical Exam

  3. Cervical Exam • Circumferential Measurements • Arm @ 5” proximal to elbow • L & R • Forearm @ 5” distal to elbow • L & R • Tracheal • Upper neck • Pharyngeal • Lower neck

  4. Cervical Exam ROM • Flexion • 50 ° • Extension • 60 ° • Rotation • 80 ° • Lat Flexion • 45 °

  5. Bakody Dejerine’s Triad* Distraction Foraminal Compress Jackson’s Compression Max Foraminal Compression Shoulder Depression Spinal Percussion* Spurlings Swallowing Valsalva* Cervical Exam Orthopedics * This test shows up in more than 1 Exam

  6. Cervical Exam Orthopedics • BAKODY SIGN: • Procedure: patient seated, actively places palm of hand on top of head, raising the elbow to even with head. • (+): if relieves/ pain or radiation. • Indicates: nerve root compression.

  7. Cervical Exam Orthopedics • DEJERINE’S TRIAD*: • Procedure: patient seated, then cough, sneeze, and strain. • (+): pain. • Indicates: disc protrusion, spinal cord tumor or spinal compression fracture.

  8. Cervical Exam Orthopedics • DISTRACTION : • Procedure: patient seated , and the dr. distracts the patient’s head upward. • (+): if  or  pain. • Indicates: 1. if pain – muscle spasm. • 2. If no pain – IVF encroachment. • Clinical note: the higher the poundages of static cervical traction, the more unstable the nerve compression syndrome is.

  9. Cervical Exam Orthopedics • FORAMINAL COMPRESSION TEST: • Procedure: patient seated in neutral position and dr. applies downward pressure on the head. The dr. rotates the head in 1 direction and applies downward pressure on the head, and repeats in the other direction. • (+): if localized or radicular pain. • Indicates: 1. if localized – IVF encroachment. 2. if radicular – nerve root compression. • Clinical note: with compression maneuvers the neck may collapse or buckle. This is found in grade II or greater sprains.

  10. Cervical Exam Orthopedics • JACKSON’S COMPRESSION TEST: • Procedure: patient seated and actively rotates head to right and left. Then the dr. laterally bends the patient’s head to each side and applies downward pressure. • (+):  local or radicular pain. • Indicates: nerve compression from – SOL, sublux., inflammation, D.J.D, tumor, or disc herniation.

  11. Cervical Exam Orthopedics • MAX FORAMINAL COMPRESSION: • Procedure: patient seated and actively rotates and hyperextends the neck towards the side of radicular complaint. Then rotates and maximally flexes head towards side of complaint. • (+): reproduction of symptoms. • Indicates: IVF encroachment.

  12. Cervical Exam Orthopedics • SHOULDER DEPRESSION: • Procedure: patient seated and dr. separates the patient’s head and shoulder on side of complaint. • (+):  or reproduced radicular pain. • Indicates: brachial plexus stretch or dural adhesions (sharp/burning pain).

  13. Cervical Exam Orthopedics • SPINAL PERCUSSION*: • Procedure: patient seated with head flexed, dr. percusses the sp’s and paravertebral musculature. • (+): if localized or radiating. • Indicates: 1. local – fracture or severe sprain. • 2. radicular – IVD syndrome. • Clinical note: ultrasound may aggravate the condition.

  14. Cervical Exam Orthopedics • SPURLING’S TEST: • Procedure: patient seated, dr. bops patient on head. • (+):  pain. • Indicates: nerve root compression, spondylosis, disc diseases.

  15. Cervical Exam Orthopedics • SWALLOWING: • Procedure: patient seated and takes a drink. • (+): if painful swallowing. • Indicates: SOL, ligamentous sprain, muscular strain, or fracture, disc protrusion, tumor, osteophyte at the anterior portion of the c/spine.

  16. Cervical Exam Orthopedics • VALSALVA*: • Procedure: do I have to explain??? • (+): /reproduce pain. • Indicates: space occupying lesion (herniated disc or tumor), or osteophyte.

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