The neck is usually palpated with the patient supine so that the muscles are relaxed and the head may be passively controlled. Venous thrombosis, mediastinal tumors, and inflammatory exudates may produce visible and palpable edema in the neck. Unlike the lumbar region, cervical disc herniations are not frequently associated with severe trauma however, nerve root or cord compression has a high incidence. Keep in mind that tumors of the cervical spine are usually secondary and that chronic degenerative disc disease and congenital anomalies may be asymptomatic for many years. Check head tilt, sway, carriage during rest and gait, and other abnormal postural expressions. Note relationship of neck, head, and shoulders from an A–P, lateral, and rotational standpoint. Inspect for abnormal shadows, neck contours, curvatures, and restricted movements. If the thyroid is visible, note its size, shape, symmetry, and presence of nodules. Have the patient swallow, and note the function of the cricoid cartilage area and possible superior movement of the thyroid gland. Thyroglossal cysts, usually in the midline, often move headward when the tongue is protruded. Check for fixed or movable masses, and transilluminate if present. Note any parotid or submaxillary gland enlargement (eg, infection, duct stone, tumor) if this has not been done previously. Observe congenital defects such as pteryigium colli (webbed neck) or congenital torticollis.
BODYLINE NECK DECOMPRESSOR SKIN
Some examiners prefer to inspect and palpate the anterior neck in the supine position and palpate the posterior aspect in the supine position.Ĭheck for scars (eg, surgical, tubercular adenitis, trauma), blisters, discolorations, skin texture and lesions, and pulsatile movements.
With the patient in the sitting position, inspect first for gross abnormalities and then details. Abnormalities in the neck may be of local etiology (eg, infection, neoplasm, trauma) or be a manifestation of a general disorder (eg, curvature, spondylosis, leukemia, systemia). Pain is often referred to the neck from the TMJ, mandibular or dental infection, or sinus infection.Īs with all gross and regional inspection, the observation process begins when the examiner first is introduced to the patient and continues through the history and examination process. Nonpharyngeal pain on swallowing may be traced to an anterior cervical spinal pathology such as bony protuberance or osteophytes, infection, mass or tumor. Neck pain must be differentiated as to its date of onset and chronology, site and distribution, type (intermittent, constant), duration (acute, chronic), character (sharp, dull, lanciating), relation to posture (rest, occupation, recreation), and associated problems. Nowhere in the spine is the relationship between the osseous structures and the surrounding neurologic and vascular beds as intimate or subject to disturbance as it is in the neck. Many peripheral nerve symptoms in the shoulder, arm, and hand will find their origin in the brachial plexus and cervical spine. Cervical flexion, extension, and rotation contribute to one's scope of vision.įrom a biomechanical viewpoint, primary cervical dysarthrias may reflect themselves in the total habitus from a neurologic viewpont, insults many manifest themselves throughout the motor, sensory, and autonomic nervous systems. From a musculoskeletal viewpoint, the neck provides stability and support for the cranium, and a flexible and protective spine for movement, balance adaptation, and housing of the spinal cord and vertebral artery. In general, the neck viscerally serves as a channel for vital vessels and nerves, the trachea, esophagus, spinal cord, and as a site for lymph and endocrine glands. Occipital and Upper Cervical Vertebral ListingsĬhapter 8: Physical Examination of the Neck and Cervical Spine Major Effects of Upper Cervical Subluxations Orthopedic and Neurovascular Compression Tests Please review the complete list of available books.Ĭlassification of Musculoskeletal Disorders
Schafer's books are now available on CDs, with all proceeds being donated However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.Īll of Dr. There is no charge for individuals to copy and file these materials. The following materials are provided as a service to our profession. Schafer, DC, PhD, FICC's best-selling book: Physical Examination of the Neck and Cervical Spineįrom R. CHAPTER 8: PHYSICAL EXAMINATION OF THE NECK AND CERVICAL SPINE
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