In a neck with perfect posture (as seen for instance in young children) the head is balanced above the shoulders. In this position the load on each vertebra of the cervical spine is spread evenly between the two facet (apophyseal) joints at the back and the intervertebral disc and vertebral body at the front. The<unk>  is characterised by a posture with vagi at the head sitting somewhat forward of the shoulders (i.e., the ear lobe is anterior to a vertical line through the point of the shoulder (acromion process)). This can be very marked, with the back of the skull positioned anterior to the breastbone (sternum). The chin is poked forward. When the patient is asked to look up at the ceiling, the<unk> ed-forward upper thoracic curve does not change as viewed from the side. Rather, the lower cervical spine 'hinges' backward at C5/6/7, a movement pattern known as 'swan-necking'. This indicates that the upper back vertebrae have frozen in their habitual flexed positions, with the surrounding collagen of the ligaments, joint capsules and fascia shortening to reinforce this hypomobility. (This is the dowager's hump of the elderly of earlier generations, now observable in modern (2016) late teenagers.) Symptoms include overuse muscle pain and fatigue along the back of the neck and reaching down to the mid-back, often starting with the upper trapezius muscle bellies between the shoulders and neck. Cervicogenic headache from the joints and muscle attachments at the top of the neck is common. The compressive load on the cervical facet joints predisposes to acute joint locking episodes, with pain and movement loss. In older patients with already diminished cervical foramina spaces and/or osteophytes, nerve root irritation and impingement can trigger referred pain down the arm(s).
IHunch
DICOM
OHVIRA
Ices
AURA
Pomp
Stimson line
DrawMD