Neck examination begins when the physician first meets the patient. If the patient moves his shoulders during neck movements, this indicates a decrease in neck joint range of motion. Or, a pain expression may appear on the patient's face during certain neck movements. Posture disorders to be corrected should be noted while the patient is in a comfortable posture. It should be noted that the neck is fully visible for examination. Muscle mass and symmetry in the neck, back and shoulders should be checked. Additionally, the skin is checked for scars or discoloration.
The next stage after visual examination is manual examination. The neck should be done systematically from the front and back. The muscles next to the spine, ligaments, and trigger points in the muscles around the shoulder should be examined from behind. Spinal protrusions should be examined by pressing manually for sensitivity.
The patient should be laid on the stretcher and it should be noted whether there are any differences in the muscles on the sides of the neck and the joints that connect the spine and are responsible for neck movement.
The width of neck movement is both active (patient's It is important to test both passively (the patient leaves his neck alone and the doctor moves the neck in certain directions). Active movement may be limited to one side due to pain, muscle tension, or muscle imbalance, but full range of motion is obtained during passive movement examination. Osteoarthritis can cause limitation of movement. In this case, the loss of range of motion observed in active movement is also present in passive examination.
First, the movement of the neck, bending backwards and to the side, and turning sideways should be examined. The total range of motion of the neck is not evenly distributed among the vertebrae. Approximately 50% of forward and backward bending is performed by the joint between the skull and the first cervical vertebra. Approximately 50% of lateral rotation occurs at the first and second vertebral joint. It is considered normal if the patient can touch his chest to his chin, look at the ceiling, and turn his chin to the front of the shoulder. In side bending, the angle between the head and the shoulder on the same side should be approximately 45 degrees.
The neck examination should include a complete neurological examination of the arms. Cervical disc herniations may be mild and may be overlooked. manual ka s test, sensory and reflex examinations should be performed to reveal possible mild cervical disc herniations.
In sensory evaluation, pain and light touch examination is performed with a needle tip.
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