Cervical Spine
History:
1.What was the mechanism of injury?
2.Did the head strike anything?
3.Did you hear or feel anything at time of injury?
4.Was there any back involvement?
5.Did you lose consciousness?
6.How did the symptoms begin?
7.Where is the pain?
8.Is the pain sharp or dull?
9.Constant or intermittent?
Localized or diffuse?
10.
Aggravated by movement?
11.
Relieved by rest?
12.
Are there any abnormal sensations such as numbness, tingling, burning, or radiating
13.
pain?
14. Paralysis or paresthesia?
15. Did the symptoms occur right away or later?
16. Do you have any problems sleeping?
17. Do you have headaches? Describe location and intensity of headaches.
18. Is the pain affected by laughing, coughing, or sneezing?
19. Was there any previous injury?
20. What was the treatment?
21. What was the diagnosis?
22. Were you fully recovered?
/22 TOTAL
Observations (compare to opposite side if possible):
1. Deformities
2. Movement and position
3. Signs of trauma
4. Skin color
5. Skin temperature
6. Abnormalities
7. Alignment of neck and back
8. Iliac crest
9. Leg length
10. Scoliosis
11. Winged scapula
12. Sprengel’s deformity
13. Forward head
14. Torticollis or wryneck
15. Lordosis
16. Kyphosis
17. Compare
18. Symmetry
19. Shoulder height
20. Muscle spasm
/20 TOTAL
Palpations (Bone):
1. Spinous processes
2. Transverse processes
3. Hyoid
4. Cricoid ring
5. Occiput/inion
6. Scapula
/6 TOTAL
Palpations (Soft Tissue):
1. Interspinous ligament
2. Supraspinous ligament
3. Thyroid
4. Lymph nodes
5. Sternocleidomastoid
6. Levator scapulae
7. Latissimus dorsi
8. Serratus anterior
9. Teres minor
10. Infraspinatus
11. Subscapularis
12. Rhomboid major
13. Rhomboid minor
14. Trapezius (I, II, & III)
/14 TOTAL
Passive/Active ROM:
1. Spine Flexion
2. Spine Extension
3. Spine Lateral Flexion
4. Spine Rotation
5. Shoulder Elevation
6. Shoulder Depression
/6 TOTAL
Special Tests:
1. Vertebral Artery Test
2. Distraction Test
3. Compression Test
4. Valsalva Test
5. Swallowing/Cough Sign
6. Adson Test
7. Spurling’s Sign
8. Grip Strength
9. Wiggle fingers & toes
10. Pinch & react to pain
/ 10 TOTAL
Neurological (Sensory):
1. C2-C3: Occipital area and angle of jaw
2. C4: Supraclavicular area
3. Axillary Nerve Patch: Lateral aspect of shoulder
4. C5: Lateral upper arm
5. C6: Lateral forearm, thumb, and index finger
6. C7: Middle finger and palmar aspect of hand
7. C8: Small finger, ring finger, and medial portion of palmar surface
8. T1: Medial side of forearm and elbow
9. T2: Medial aspect of upper arm
10. T3: Medial aspect of upper arm
/ 10 TOTAL
Neurological (Motor):
1. C1-C2: Neck flexion
2. C1-C2: Neck extension
3. C3: Neck lateral flexion
4. C4: Shoulder elevation
5. C5: Shoulder abduction and external rotation
6. C6: Elbow flexion and wrist extension
7. C7: Elbow extension and wrist flexion
8. C8: Thumb abduction and ulnar deviation
9. T1: Finger approximation
/9 TOTAL
Reflexes:
1. Biceps (C5-C6)
2. Supinator (C5-C6)
3. Triceps (C7-C8)
/3 TOTAL
Circulatory:
1. Carotid
2. Brachial
3. Radial
/3 TOTAL
TOTAL
History (22)
Observation (20)
Palpation-Bone (6)
Palpation-Soft tissue (14)
Passive/Active ROM (6)
Special Tests (10X2=20)
Neurological-Sensory (10)
Neurological-Motor (9)
Reflexes (3)
Circulatory (3)
/113 TOTAL