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Cervical Spine Examination

MusculoskeletalYear 3

Cervical spine examination pairs local assessment with an upper limb neurological screen. This checklist covers both, plus Spurling's test and the myelopathy signs worth naming.

Marking points
27
Run-through
~7m
Progress
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1

Introduction

0/6

  • The shoulder is usually slightly lower on the side of handedness

2

Look

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  • Poor cervical posture with chin protrusion and increased upper cervical lordosis is common

3

Palpations

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  • Use back of hands and compare sides

  • Key landmarks: external occipital protuberance, C2 (1st bony spinous process below occiput), C5-6 apophyseal joint, C7 spinous process

  • Include upper trapezius muscle bulk

4

Movement

0/11

    • Normal = 45 degrees to each side

    • Upper: chin to neck, Lower: chin to chest

    • Upper: chin protrusion with extension, Lower: looking to ceiling

    • Tilt head sideways, ear to shoulder

    • Used to assess simple shoulder movements

  • If active ROM is reduced, try to establish whether pain or a true limitation in range is underlying this

5

Special tests

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  • Patient rotates head to side, examiner passively extends neck. Pain on same side suggests facet joint impingement

  • Elevate and externally rotate straight arm, then laterally flex head to opposite side and extend wrist

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