Cervical spine Amir

1. .
1

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

4. 4

5. 5

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)
6

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
9

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
12

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
13

14. SUBJECTIVE EXAMINATION
14
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
15

16.  Special questions
 History of the present condition (HPC)
 Past medical history (PMH)
 Social and family history
 Plan of the physical examination
16

17. 17

18. BODY CHART
18

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

21. 21

22. 22