e-book Musculoskeletal Examination 2nd Edition

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The discussion on the Spine has been expanded to three chapters -- Cervical, Thoracolumbar Spine and Sacroiliac Joint. That means your payment information is always protected, and never gets seen by anyone. Return any item within 30 days of delivery. Contact Us Need help? Contact us. Password Password required!

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Forgot Your Password? Create an Account. Explore Departments. Free Returns. Epler and M. Most importantly, this program will prepare you to perform an organized, integrated, and clinically useful RMSE of the neck. The cervical spine consists of seven vertebrae, increasing progressively in size from C1 to C7.

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C1 and C2 deserve special comment because they have unique features Fig. C1 atlas lacks a vertebral body but consists of anterior and posterior arches and two cup-shaped lateral masses Fig.

Musculoskeletal Physical Examination, 2nd Edition

These joints make small contributions to flexion and extension nodding and lateral flexion. C2 axis has a vertebral body anteriorly and from it a fingerlike peg projects superiorly Fig. This bony process called the odontoid or dens dont and dens from Latin for tooth sits snuggly against the anterior arch of the atlas. The two are held together by the fibrous transverse ligament, which runs behind the odontoid process Fig.

C3 through C7 are more typical vertebrae and possess an anterior weight-bearing element, the vertebral body , and posterior elements, including the neural arch and facet joints Fig.

The neural arch is made up of two pedicles attached to the vertebral body and two laminae which fuse in the midline to form the spinous process Fig. Three pairs of bony processes project from each arch close to the junction of the pedicles and laminae: two transverse processes, two superior articular processes, and two inferior articular processes Fig. Together, the superior and inferior articular processes form the facet apophyseal joints.

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In addition, C3 through C7 frequently have unique bony projections posteriorly and laterally from the superior end plate of each vertebra which articulate with the beveled inferolateral surface of the vertebra above to form the uncovertebral joints of Luschka Fig. These joints permit greater movements at the cervical spine compared with the thoracic and lumbar spine, and also provide lateral stability to the diskovertebral complex, forming a barrier to extrusion of disk material posterolaterally.


The C3 through C7 vertebrae allow cervical spinal flexion, extension, lateral bending, and rotation. In the resting neutral position, the posterior process of C7 vertebra prominens is palpable in the midline at the base of the neck.

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Particularly useful background information includes age; occupation and recreational activities; a history of injury or arthritis; and any prior neck problems. Once pain characteristics are established, additional historical features may help focus the diagnostic evaluation.

Joint-by-Joint Musculoskeletal Physical Exam: Hip

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