OrthoFracs Logo

Examination of the Cervical Spine

Examination of the Cervical Spine

Look

  • Looking for Asymmetry
    • Fracture malunion, nonunion
    • Scoliosis
    • Muscular – Torticollis
    • Tumours, Glands

Anterior

  • General
    • Syndromes – Marfans, Turners
    • Dysmorphic facies
    • Height
      • Marfan’s
      • skeletal dysplasia (Down’s, achondroplasia, etc.)
  • Landmarks
    • Hyoid C3, Thyroid C4/5, Cricoid C6
  • Sternum
    • Excavatum, Carinatum
  • Muscles
    • Sternocleidomastoid
      • Torticollis + facial asymmetry
  • Axilla
    • freckles

Lateral

  • Cervical Lordosis
  • Thoracic Kyphosis (Normal 21-33)
    • in Scheuermann’s, Ankylosing Spondylitis, Fracture
  • Gibbus

Posterior

  • Hair line – Klippel-Feil
  • Neck webbing
  • Shoulder height – Sprengels
  • Skin lesions
    • hairy naevus, café au lait, neurofibromas
  • Wasting
  • List

Gait

  • Ataxic
    • e.g. Arnold Chiari or posterior column
  • Broad based, halting
  • Spastic
  • Heel walk, toe walk
  • Heel-toe walk for myelopathy/Cb disease
  • Rhombergs - posterior column
    • -ve with eyes open, +ve with eyes shut
  • cerebellar
    • +ve with eyes open & closed