Clinical Examination of the Cervical Spine

Welcome and Introduction

• Presenter: Dr. Jarrett Welsh, a chiropractor, sports physician, and certified athletic trainer.
• Dominique Williams serves as the patient model.
• Focus: Examination in a clinical setting, not on-field.

Initial Patient Assessment

• Observe overall presentation as the patient enters.
• Look for:
  • Shoulder height
  • Head tilt (forward, backward, lateral)
• Record history:
  • Previous occurrences
  • Past treatments and sources

Examination Steps

1. Range of Motion Tests:

   • Look down, up, return to neutral.
   • Ear to shoulder (both sides).
   • Look over each shoulder.

2. Foraminal Compression Test:

   • Explain the test and possible sensations to the patient.
   • Apply pressure while guiding the head through different positions.

3. Shoulder Depression Test:

   • Apply downward pressure on the shoulder while stabilizing the head.
   • Avoid excessive force to prevent false positives.

4. Adson's Test:

   • Check for pulse changes indicating tight pectorals or posture issues.
   • Instruct the patient to extend arm and check for pulse reduction during positional changes.

5. Cervical Distraction Test:

   • Lift the patient's head gently to check for relief of discomfort.

Additional Tests

Packet Tests Overview

• Focus on tests for pain and paresthesia, indicating potential issues like herniated discs.

• Spring Test:

  • Avoid due to potential discomfort and pain.
  • Alternative method: Manual side-to-side checks.

• Upper Limb Tension Test:

  • Test for neurological symptoms through passive range of motion.
  • Stop if pain or paresthesia occurs during the procedure.

• Brachial Plexus and Shoulder Abduction Tests:

  • Test for nerve compression or relief of symptoms.

• Vertebral Artery Test:

  • Rarely used due to potential provocation of symptoms.
  • Handle with care, avoiding pressure around the neck.

Conclusion

• These tests are a quick overview for initial cervical spine examination.
• Some tests may be omitted if sufficient information is gathered from others.
• Emphasize careful handling and patient communication throughout the process.