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Cervical Spine Neck

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Cervical Spine Neck

Basic Anatomy of the Cervical Spine (neck)
There are seven neck bones, or cervical vertebrae, often noted as C1 through C7.
Between all of the bones except C1-C2, lies a cartilage disc.

There are 8 exiting cervical nerve roots that provide information regarding sensation, proprioception and strength to the head, neck, arm, forearm and hand. There are many layers of muscle in the neck that help it to perform several motions: flexion (head movement downward, chin toward chest), extension (head movement upward), lateral flexion (side bending, ear toward shoulder on the same side) and rotation. Textbook normal ranges of movement are listed below.

Neck Movement Textbook Normal Range of Motion
Flexion 2 finger widths between chin and chest, about 40 degrees
Extension 75 degrees
Lateral Flexion /Side bend (Left and Right) 35-45 degrees
Rotation (Left and Right) 80-90 degrees

There are several factors that predispose and individual to neck problems. Posture plays a large role. Forward head and rounded shoulder posture, when slumped in sitting or with stooped standing, is often a contributing factor to neck stiffness, weakness and pain. Also repetitive, static postures or trauma to the area can lead to cervical strain and/or sprain. Posture and ergonomic issues need to be addressed for full recovery.

Clinical Presentation
Some common symptoms patients with neck problems report are: headache; neck pain; pain, numbness/tingling, weakness into shoulder blade region, arm and/or hand; stiffness with neck movements leading to decreased functional mobility (i.e. inability to turn head when driving; inability to sit at the computer for lengthy periods of time). Some "red flags", or reasons why you should seek medical attention, associated with neck pathology are: unexplained night pains, nausea/vomiting, vertigo, severe headache, visual disturbances, facial numbness/paralysis, change in mental status (drowsiness, disorientation), difficulty with speech and hearing difficulties.

The most common levels involved in referred pain from the neck are C5-6 and C6-7.


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