1. Cervical Exam Vitals Appearance. Mood, Orientation Visual Inspection
Seated BP (L & R), Respiration, Pulse, Ht, Wt, Temp
Appearance. Mood, Orientation
A&OX3, No Apparent Distress, Well Dev. Well Nour
Visual Inspection
Cervical Muscle symmetry, Cervical Posture (P-A & Lat)
Palpation
Musculature, Interspinous spaces, Thyroid, Trachea, Lymph, EENT, other
Sensory
UE Dermatomes, Other Sensory
Sharp/Dull, Vib, Position sense

2. Cervical Exam Motor Reflexes UE UE Deltoids (C5) Biceps (C6)
Wrist Extension (C6)
Triceps (C7)
Finger Extension (C7)
Finger Flexion (C8)
Finger Adduction (T1)
Reflexes UE
Biceps (C5)
Triceps (C7)
Brachioradialis (C6)
Hoffman’s

3. Cervical Exam Circumferential Measurements Arm @ 5” proximal to elbow
L & R
5” distal to elbow
Tracheal
Upper neck
Pharyngeal
Lower neck

4. Cervical Exam ROM Flexion Extension Rotation Lat Flexion 50 ° 60 °
80 °
Lat Flexion
45 °

5. Cervical Exam Orthopedics
Bakody
Dejerine’s Triad*
Distraction
Foraminal Compress
Jackson’s Compression
Max Foraminal Compression
Shoulder Depression
Spinal Percussion*
Spurlings
Swallowing
Valsalva*
* This test shows up in more than 1 Exam

6. Cervical Exam Orthopedics
BAKODY SIGN:
Procedure: patient seated, actively places palm of hand on top of head, raising the elbow to even with head.
(+): if relieves/ pain or radiation.
Indicates: nerve root compression.

7. Cervical Exam Orthopedics
DEJERINE’S TRIAD*:
Procedure: patient seated, then cough, sneeze, and strain.
(+): pain.
Indicates: disc protrusion, spinal cord tumor or spinal compression fracture.

8. Cervical Exam Orthopedics
DISTRACTION :
Procedure: patient seated , and the dr. distracts the patient’s head upward.
(+): if  or  pain.
Indicates: 1. if pain – muscle spasm.
2. If no pain – IVF encroachment.
Clinical note: the higher the poundages of static cervical traction, the more unstable the nerve compression syndrome is.

9. Cervical Exam Orthopedics
FORAMINAL COMPRESSION TEST:
Procedure: patient seated in neutral position and dr. applies downward pressure on the head. The dr. rotates the head in 1 direction and applies downward pressure on the head, and repeats in the other direction.
(+): if localized or radicular pain.
Indicates: 1. if localized – IVF encroachment if radicular – nerve root compression.
Clinical note: with compression maneuvers the neck may collapse or buckle. This is found in grade II or greater sprains.

10. Cervical Exam Orthopedics
JACKSON’S COMPRESSION TEST:
Procedure: patient seated and actively rotates head to right and left. Then the dr. laterally bends the patient’s head to each side and applies downward pressure.
(+):  local or radicular pain.
Indicates: nerve compression from – SOL, sublux., inflammation, D.J.D, tumor, or disc herniation.

11. Cervical Exam Orthopedics
MAX FORAMINAL COMPRESSION:
Procedure: patient seated and actively rotates and hyperextends the neck towards the side of radicular complaint. Then rotates and maximally flexes head towards side of complaint.
(+): reproduction of symptoms.
Indicates: IVF encroachment.

12. Cervical Exam Orthopedics
SHOULDER DEPRESSION:
Procedure: patient seated and dr. separates the patient’s head and shoulder on side of complaint.
(+):  or reproduced radicular pain.
Indicates: brachial plexus stretch or dural adhesions (sharp/burning pain).

13. Cervical Exam Orthopedics
SPINAL PERCUSSION*:
Procedure: patient seated with head flexed, dr. percusses the sp’s and paravertebral musculature.
(+): if localized or radiating.
Indicates: 1. local – fracture or severe sprain.
2. radicular – IVD syndrome.
Clinical note: ultrasound may aggravate the condition.

14. Cervical Exam Orthopedics
SPURLING’S TEST:
Procedure: patient seated, dr. bops patient on head.
(+):  pain.
Indicates: nerve root compression, spondylosis, disc diseases.

15. Cervical Exam Orthopedics
SWALLOWING:
Procedure: patient seated and takes a drink.
(+): if painful swallowing.
Indicates: SOL, ligamentous sprain, muscular strain, or fracture, disc protrusion, tumor, osteophyte at the anterior portion of the c/spine.

16. Cervical Exam Orthopedics
VALSALVA*:
Procedure: do I have to explain???
(+): /reproduce pain.
Indicates: space occupying lesion (herniated disc or tumor), or osteophyte.