Dr. Ebraheim’s educational animated video describes Cervical Spine Nerve Root examination and its indications.
Neck pain and shoulder pain or referred pain to the scapula may overlap. Shoulder pain tends to be located on the postero-lateral aspect of the deltoid muscle. Neck pain tends to be localized over the trapezius muscles and may radiate to the upper extremity. Radicular pain from irritation of a nerve root in the cervical spine is associated with paresthesia, numbness or weakness in the dermatomal distribution. The combination of shoulder pain and neck pathology is not uncommon.
•Herniated C4-C5 bulge: motor function: C5 shoulder abduction, C5 elbow flexion. Deltoid C5, biceps C5. Sensory C5. Biceps reflex is primarily C5.
•Herniated disc C5-C6 bulge: motor function: C6 elbow flexion, C6 wrist extension (extensor carpi radialis longus and brevis), biceps C6, wrist extensors C6. Sensory: thumb and radial hand. C6 brachioradialis reflex.
•Herniated disc C6-C7 bulge: C7 elbow extension, C7 wrist flexion, finger extension, triceps C7, wrist flexors C7. Sensory C7. C7 triceps reflex.
•Herniated disc C7-T1 bulge: C8 finger flexion (flexor digitorum superficialis).
•Herniated disc T1-T2 bulge: T1 abduction of the fingers (palmar interossei muscles (ulnar)). T1 sensory.
Test for cervical radiculopathy:
The Spurling's test is used to assess nerve root pain. The patient should be seated with the head turned towards the affected side and the clinician standing behind the patient. downward compressive force to the top of the patient’s head is applied. The test is positive when the compressive force being placed on the cervical spine causes radiating pain down the patient’s arm.
Shoulder abduction test: the patient’s symptoms are relieved by shoulder abduction and placing the hand over the head. This test helps to differentiate between cervical spine pathology and other causes of shoulder pain. It is an important test for the cervical radicular compressive disease. This is also important in regards to exam questions. The relief of the symptoms occurs due to decreased tension on the nerve roots.

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Background music provided as a free download from YouTube Audio Library.
Song Title: Stale Mate