1、Assessment of spine脊柱的功能檢查Content內容基本思路頸部基于功能解剖頸部的功能解剖7個椎體鉤椎關節（uncovertebral joint）椎間孔與椎動脈（ foramen intervertebrale and vertebral artery）頸神經根（ Cervical nerve root ）The cervical spine forms a lordosis dependent on the immediately inferior aspect of the spine, which has a thoracic kypothesis and the l

2、umbar lordosis all essentially dependent on the lumbosacral angleThe upper cervical complexConsists of the occiput, the atlas and the axisDifferent from lumbar spineoccipital-atlas movementPermit 10 degree of flexion and 25 degree of extension for a total of 35 degrees of motionAtlas and AxisAtlas r

3、otates about odontoid process of axis 45 degree in both directions for a total of 90 degreesLigaments of the occipital-atlas-axis segmentLigaments-1Ligaments Lower cervical complexMovement of the upper cervical spine-occiput, atlas, and axis, is both flexion-extension and rotationSimilar movement oc

4、curs in the lower cervical spine (C3-C7)Weight-bearing of typical cervical vertebra:Large arrow indicates anterior portion-vertebrae and disc-bearing 50% of loadSmall arrowsl zagapophyseal joints, which share half the load (25% each)Mechanical limitation of lower segment cervical vertebraeFlexion is

5、 limited by posterior ligaments and impingement of facetsIn extension, inferior aspect of superior vertebra impinges on anterior aspect of superior facet, and capsule of facets also limits motionCapital extensionCapital extensors attach to skull and extend head on cervical spineCervical extensionCer

6、vical extensors originate from and attach to cervical spine. They alter cervical curvatureCapital flexorsRectus capitis anterior and lateralHyoideus and suprahyoid muscles舌骨肌和舌骨上肌Longus capitis頭長肌Scalenus medius and anticus前斜角肌和中斜角肌Sternocleidomastoid 胸鎖乳突肌Analysis what happened to the movement物理治療檢查主觀評定客觀評定主觀檢查年齡、性別癥狀特征：位置、性質、程度及變化規律損傷機制：外傷、勞損既往史社會因素特殊問題客觀檢查視診：靜態與動態體格檢查：運動、關節運動、觸診、特殊檢查骨骼、肌肉、韌帶、神經、功能視診頭頸雙肩背部腰部骨盆與下肢皮膚骨性標志肌肉的豐滿程度運動的節律與運動控制常見觀察標志常見的異常姿勢-頭頸部肩及肩胛肩及上肢問題頸部疼痛當你發現有姿勢有異常的時候運動的評估主動運動被動運動運動節律主動運動屈曲伸展側屈旋轉被動運動被動關節活動被動加壓/被動持續關節被動肌肉收縮能力檢查-肌力檢查關節被動檢查頸椎側向頸椎前、后頸椎旋轉