ask the patient to flex and extend head; a spatula held in the mouth acts as a pointer to enable the range of movement to be measured by goniometer: normal range is 130 degrees. The occipito-atlantoid joint is primarily involved.
lateral flexion: ask the patient to tilt his head laterally from a neutral position; normal range is 45 degrees. Whole of cervical spine involved.
rotation: ask the patient to look over his shoulder - normal range is 80 degrees to either side. Rotation is a function of the atlanto-axial joint.
palpate the radial pulse and then apply traction to the arm; cessation of pulsation is suggestive of a cervical rib.
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