Cervical Spine Diagnostics
Flexion/Extension
The patient sits in a relaxed, upright position with the arms folded so as to stabilize the shoulders and trunk. The examiner places one hand across the top of the head while the fingers of the other hand palpate the cervicothoracic junction (between C7 and T1). The palpating hand is used to "monitor" the quality and range of middle and lower cervical motion. The subjects head is gently moved forward until motion occurs at the C7-T1 junction. The normal angle of the displacement is approximately 45 degrees, with the subject's chin touching their sternum. This angle is obtained by estimating the angle between the tragus of the ear from the upright to the fully flexed position. Join Dr. Philip E. Greenman, D.O., F.A.A.O., as he demonstrates how to check the range of motion (ROM) for flexion and extension of the cervical spine.
Left/Right Sidebending
With the examiner behind the seated patient, left sidebending is initiated by placing the palm of the left hand on the top of the patient's head with the fingers overlying the right parietal area. Good support for passive motion occurs when the fingers cross the top of the head to the right side while the thenar eminence assists in initiation, control, and support of sidebending from the left. Light contact is a must, because a "heavy handed" approach may trigger muscular tension before the test is begun. Placing the right hand on the right shoulder helps monitor elevation as the neck is bent. The examiner should ask the patient to let the left ear drop toward the left shoulder as motion is initiated. When elevation of the opposite shoulder occurs, passive cervical ranges have been exceeded. The point just before shoulder movement is detected indicates the cervical range of motion end point. Then, reverse hand positions to compare right sidebending. The normal angle of displacement from vertical is usually 40-45 degrees in each direction. Join Dr. Philip E. Greenman, D.O., F.A.A.O., as he demonstrates how to check the range of motion (ROM) for left and right sidebending of the cervical spine.
Left/Right Rotation
With the examiner behind the seated patient, rightward axial rotation is evaluated by placing the right palm on the patient's frontal area while the left hand cradles the occiput. Gently turn the patient's head to the right until motion restriction is detected. Then reverse hand positions to compare leftward rotation. Normal displacement from the midline is usually 80-90 degrees, or until the chin is over the shoulder. Join Dr. Philip E. Greenman, D.O., F.A.A.O., as he demonstrates how to check the range of motion (ROM) for left and right rotation of the cervical spine.
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