Range of Motion
FlexionCervical flexion is performed by being in an upright position (standing or sitting), shoulders should be square and spine is in a neutral position. Patient attempts to touch chin to chest. Patient may show signs of compensation by rounding shoulders forward. Tongue depressor may be held between teeth for a reference.
Goniometry Placement: Center: Over the external auditory meatus. Proximal Arm: Perpendicular to the ground. Distal Arm: With the base of the nares. Normal Range: 40-70 degrees http://www.carlespineinstitute.com/assets/images/exercise_images/009.jpg Retrieved: 11/18/2015
Lateral RotationCervical rotation is performed by being in an upright sitting position on a non-movable object, shoulders should be square and spine is in a neutral position. Patient attempts to turn head and bring chin parallel with shoulder. Patient may show signs of compensation by rotation the torso in the direction opposite of the movement being performed.
Goniometry Placement: Center: Over spinous process of C7 Proximal Arm: Spinous processes of thoracic vertebrae, perpendicular to the ground. Distal Arm: Midline of the head. Normal Range: 70-90 degrees (test bilaterally) |
Extension Cervical extension is performed by being in an upright position (standing or sitting), shoulders should be square and spine is in a neutral position. Patient attempts to look upwards as far as possible. Patient may show signs of compensation by retracting the scapulae and bending lower spine.
Goniometry Placement: Center: Over the external auditory meatus. Proximal Arm: Perpendicular to the ground. Distal Arm: With the base of the nares. Normal Range: 60-80 degrees https://myclinicspace.com/myuploads/myimages/Neck004b.jpg Retrieved: 11/18/2015
Lateral FlexionLateral flexion is performed by being in an upright position (standing or sitting), shoulders should be square and spine is in a neutral position. Patient attempts to touch left ear to left shoulder and right ear to right shoulder. This offers bilateral comparison cervical lateral flexion. Patient may show signs of compensation by elevating the shoulder girdle.
Goniometry Placement: Center: Over the center of the cranium on-top of the head. Proximal Arm: Parallel to an imaginary line of the acromial processes. Distal Arm: In line with the tip of the nose. Normal Range: 40-50 degrees (test bilaterally) |
http://www.carlespineinstitute.com/assets/images/exercise_images/007.jpg Retrieved: 11/18/15
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http://www.montereyspine.com/assets/exercises/neck_turn.jpg Retrieved 11/18/15
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Manual Muscle Testing
https://s-media-cache-ak0.pinimg.com/736x/c3/fc/39/c3fc391f136b97e5d19f6e3417101865.jpg Retrieved: 11/20/15
Flexion |
Extension |
Patient Position: Supine, shoulders are abducted to 90 degrees with the elbows flexed to 90 degrees.
Examiner Position: Examiner stands next to patient's head on the lateral side. Places hand over sternum and other hand on top of forehead. Starting Position: The cervical spine and head are in the neutral position. Stabilization: Stabilize over the sternum. Palpation: Sternocleidomastoid at anterolateral neck and anterior scalene just posterior to sternocleidomastoid. Motion: Patient flexes the neck and examiner applies downward resistance to the patient's forehead while stabilizing over the sternum. Prime Movers: Sternocleidomastoid (Spinal accessory: CN XI, C2, C3) Anterior scalene (Dorsal rami: C4, C5, C6) Longus capitis (branches of CN, C4, C5, C6, C7, C8) Longus colli (anterior rami, C2, C3, C4, C5, C6) Rectus capitis anterior (suboccipital nerve: C1) Anterior scalene (C4, C5, C6) Lateral FlexionPatient Position: Hook seated, good posture, with cervical and spine in the neutral position.
Examiner Position: Examiner stands behind patient placing one hand on the acromioclavicular joint of the shoulder and one hand on the temporal bone of the head. Starting Position: Seated with the cervical spine and head in the neutral position. Stabilization: Over the acromioclavicular joint on the side towards the motion. Motion: Patient flexes neck laterally and examiner applies resistance over the temporal bone on the side toward the motion. Prime Movers: Sternocleidomastoid (spinal accessory: CN XI, C2, C3) Scalenes (dorsal rami: C3-C8) Paraspinal muscles on the side being tested |
Patient Position: Prone, the patient's shoulders are abducted to 90 degrees and the elbows are flexed to 90 degrees.
Examiner Position: Examiner stands next to patient's head on the lateral side. Places hand over superior aspect of the thoracic spine and hand over back of head. Starting Position: The cervical spine and head are in the neutral position. Stabilization: Stabilize over the superior aspect of the thoracic spine. Palpation: Posterior cervical region. Motion: Patient slightly extends neck and examiner applies downward resistance to back of the head while stabilizing at thoracic spine. Prime Movers: Trapezius (upper one third) (spinal accessory: CN XI) Levator scapulae (dorsal subscapular: C3, C4, C5) Cervical extensor muscles RotationPatient Position: Supine, the shoulders are abducted to 90 degrees and the elbows flexed to 90 degrees.
Examiner Position: The examiner stands to the side of the patient and places one hand over the sternum and one hand over the temporal bone of the head. Starting Position: Patient is supine with the head rotated to the side opposite being tested. Stabilization: Over the sternum. Motion: Patient starts with head rotated to opposite side being tested, examiner applies pressure over the temporal bone toward the side of the motion. Prime Movers: Sternocleidomastoid (accessory nerve CN XI, C2, C3) |