Physical Examination
The cause of common neck pain is not usually determined on physical examination. Range of motion of the neck and areas of tenderness in the neck and shoulder girdle muscles are noted. In patients with neurologic symptoms, a neurological examination including motor, sensory, and reflex testing in upper and lower extremities may help narrow findings to specific nerve roots (Table 26.7). The presence of hyperreflexia, clonus, Babinski's sign, and abnormal gait may indicate myelopathy.
|
Disk |
Nerve root |
Pain |
Motor weakness |
Decreased sensation |
Decreased reflex |
|
C4-5 |
C5 |
Medial scapula, lateral arm to |
Deltoid, supraspinatus, |
Lateral upper arm |
Supinator |
|
elbow |
infraspinatus | ||||
|
C5-6 |
C6 |
Lateral forearm, thumb, index |
Biceps, brachioradialis, wrist |
Thumb and index |
Biceps |
|
finger |
extensors |
finger | |||
|
C6-7 |
C7 |
Medial scapula, posterior arm, |
Triceps, wrist flexors, finger |
Posterior arm, |
Triceps |
|
dorsum forearm, third finger |
extensors |
third finger | |||
|
C7-T1 |
CS |
Medial forearm, fifth finger |
Thumb flexors, abductors, |
Fifth finger | |
|
intrinsic hand muscles |
Modified from Carette (2005)-with permission.
Modified from Carette (2005)-with permission.
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