REIDER PART 2
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312 Chapter 8 Cervical and Thoracic Spine

Flexors

When fired togethcr, the two sternocleidomastoids are the principal flexor muscies of the neck. To test flexion strength, the examiner places a resisting palm against the paticnt s forehead and stabilizes the thorax if necessary with the other hand. The patient is instructed to flex the neck against the examiner^>s resistance as forcefully as pos-sible. Contraction of both sternoclcidomastoid muscies should be quite visible, and the examiner should be unable to ovcrcomc the patients inherent muscle strength (Fig. 8-25).

Extensors

Extension of the cervical spine is powered by the poste-rior intrinsic neck muscies and upper portion of the trapezius. Extension is tested in a manner analogous to the test of flexion strength. The examiner places the resisting hand on the patient’s occiput and instructs the paticnt to extend the neck as forcefully as possible (Fig. 8-26). Again, the examiner should be unable to over-come the normal intrinsic muscle strength of the neck extcnsors.

Lateral Benders

Lateral bending of the neck is powered primarily by the scalene muscies. To test the strength of these muscies, the examincr places the palm of one hand on the correspon-ding side of the patient’s head and a stabilizing hand on the contralateral shouldcr. The patient is then instructed

Figurę 8-26. Assessing extension strength.

Figurę 8-25. Assessing flexion strength.

Figurę 8-27. Assessing lateral bending strength.