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Clinical Examination of the Cervical and Thoracic Spine and Thorax

Examination Map HISTORY

Past Medical History

Prior history of injury

Headaches/chest pain

Use of eyewear

Psychosocial factors

History of the Present Condition

Pain characteristics

Radicular symptoms

Mechanism of injury

FUNCTIONAL ASSESSMENT

Movement and posture

INSPECTION

Inspection of the Lateral Structures

Cervical and thoracic curvature

Posture

Inspection of the Anterior Structures

Level of the shoulders

Position of the head

Shape of the chest

Inspection of the Posterior Structures

Bilateral soft tissue comparison

Breathing patterns

Skin folds

Chest shape

Palpation

Palpation of the Anterior Neck and Thorax

Hyoid

Thyroid cartilage

Cricoid cartilage

Carotid artery

Lymph nodes

Sternocleidomastoid

Scalenes

Sternum

Ribs and costal cartilage

Palpation of the Posterior Cervical and Thoracic Structures

Occiput and superior nuchal line

Transverse processes

Spinous processes

Supraspinous ligaments

Trapezius

Levator scapulae

Scapular muscles

Costovertebral junction

Paravertebral muscles

JOINT AND MUSCLE FUNCTION ASSESSMENT

Goniometry

Flexion

Extension

Lateral bending

Rotation

Active Range of Motion

Flexion

Extension

Lateral bending

Rotation

Manual Muscle Tests

Capital, Cervical, and Combined Capital and Cervical Flexion

Capital, Cervical, and Combined Capital and Cervical Extension

Lateral Flexion

Rotation and Flexion

Neck Flexor Endurance Test

Passive Range of Motion

Flexion

Extension

Lateral Bending

Rotation

JOINT STABILITY TESTS

Joint Play Assessment

Spring test

Mobility of the first rib

NEUROLOGICAL EXAMINATION

Upper Limb Nerve Tension Test

Upper Quarter Screen

Upper Motor Neuron Lesions

  • Babinski test

  • Oppenheim test

  • Beevor's sign

REGION-SPECIFIC PATHOLOGIES

Cervical Radiculopathy

Cervical compression test

Spurling test

Cervical distraction test

Vertebral artery test

Intervertebral Disc Lesions

Shoulder abduction test

Valsalva maneuver (see Chapter 10)

Degenerative Joint and Disc Disease

Cervical Instability

Facet Joint Dysfunction

Brachial Plexus Pathology

Brachial plexus traction test

Thoracic Outlet Syndrome

Adson's test

Allen test

Costoclavicular syndrome test

Roos test

Thoracic Spine Pathologies

Scheuermann's disease

Rib fracture

  • Rib compression test

  • Costochondral injury

Thorax Pathologies

Splenic injury

Kidney trauma

Commotio cordis

Note: The procedures described in this chapter should not be performed until the possibility of a cervical spine fracture and/or dislocation has been ruled out.

Table 11-1Key Signs and Symptoms Associated With Serious Pathological Cervical Spine Conditions
Table 11-2Possible Pathology Based ...

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