Rec and Care: Clinical Lab Exam 2: Cercal Spine

Bony anatomy: cervical vertbrae C1 - atlas

soft divet at the top of the head, cannot feel, deep

Bony anatomy: cervical vertebrae C2 - axis

first bump you can feel

Bony anatomy: typical cervical vertebrae

projections along spine, muscle attachment point

Anterior aspect - hyoid bone

angle of the jaw, go straight down , squeeze lightly , swallow to locate , C3

Anterior aspect - thyroid cartilage

finger slide down to adams apple

Anterior aspect - first cricoid ring

C6 , just below the thyroid

Anterior aspect - carotid tubercle

Anterior aspect - slide off the cricoid ring, either side, first bump encountered

Anterior aspect - carotid pulse

soft divot between cricoid ring and carotid tubercle , below joint line

Anterior aspect - transverse process of T1

find mastoid process by ear, and slide down from here , earlobe and down, very close to other process , side flex to get muscle to relax

posterior aspect - occiput and inion

on the back of the head, hook of bone , up into the hairline, a bump, landmark for the suboccipitals

posterior aspect - mastoid processes

jaw bone, by the earlobes

posterior aspect -- spinous process: C6

above prominent point on spine , pointer finger will disappear

posterior aspect -- spinous process: C7

chin down, most prominent point on spine

posterior aspect -- spinous process: T1

just below C7, place three fingers along the spine, bottom finger on this process

posterior aspect --facet joints

patient supine, find CT spinous processes, fingers go off to either side of the spine, feel along the flat/bony feelings, push up and in to feel them, sometimes rotated out of position
- flex and extend

Muscle testing C-spine: Flexion

touch toes

Muscle testing C-spine: extension

lean backwards

Muscle testing C-spine: side flexion

hand on thigh, slide down, both directions

Muscle testing C-spine: rotation

hand across chest, and rotate shoulders both ways

reflexes: biceps C5,C6

reflexes: triceps C7,C8

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reflexes: brachioradialis C5, C6

special tests: foraminal compression

cervical nerve root
maximally compressing the facets

special tests: distraction test

cervical nerve root
hook hands underneath, scooping jaw and head

special tests: shoulder depression

brachial plexus
hands behind the back, seated,pull down elbow traction, while pulling the head to the opposite side

special tests: vertebral artery test

dizziness
seated straight; compress vertebral artery, head to the same side, and hold for a minute,
positive = dizzy, double vision etc
- any rotational activities
m

myotomes: shoulder elevation

shrug shoulder up, push down, resisted
C4

myotomes: shoulder abduction

Bring arms out to the side and push down at the elbow
C5

myotomes: elbow flexion/ wrist flexion

hands in fists facing together, resist and push down
C6

myotomes: elbow extension/ wrist extension

Pull hand up, hand in fist and resist OR push wrist in, hand blocking and resist
C7

myotomes: thumb extension

double thumbs up pushing thumbs down towards you
C8

myotomes: finger abduction

carotid hands up in the air, go between the fingers and resist pushing them together, can also do all fingers at once
T1