Physical Exam

C-spine and Neck Palpation

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Video coming September 2026

How to Perform

With the patient seated or standing and the neck muscles relaxed, palpate the posterior midline over the cervical spinous processes from the occiput downward, then palpate the paraspinal muscles, the trapezius, and the lateral neck, noting any tenderness, step-off, muscle spasm, or masses.

How to Interpret

This test’s findings are all below your current evidence filter.

References

Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. N Engl J Med. 2000;343(2):94-99. PMID 10891516.
Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med. 2000;343(2):94-99. PMID: 10891516.
Jin Y, He YS, Zhang MM, Parajuly SS, Chen S, Zhao HN, Peng YL. Value of contrast-enhanced ultrasonography in the differential diagnosis of enlarged lymph nodes: a meta-analysis of diagnostic accuracy studies. Asian Pac J Cancer Prev. 2015;16(6):2361-2368. doi:10.7314/apjcp.2015.16.6.2361. PMID: 25824765.
Roberts DJ, Leigh-Smith S, Faris PD, Blackmore C, Ball CG, Robertson HL, Dixon E, James MT, Kirkpatrick AW, Kortbeek JB, Stelfox HT. Clinical presentation of patients with tension pneumothorax: a systematic review. Ann Surg. 2015;261(6):1068-1078. PMID: 25563887.
Myburgh C, Larsen AH, Hartvigsen J. A systematic, critical review of manual palpation for identifying myofascial trigger points: evidence and clinical significance. Arch Phys Med Rehabil. 2008;89(6):1169-1176. PMID: 18503816.
Fijten GH, Blijham GH. Unexplained lymphadenopathy in family practice. An evaluation of the probability of malignant causes and the effectiveness of physicians' workup. J Fam Pract. 1988;27(4):373-376. PMID: 3049914.
Koullias GJ, Korkolis DP, Wang XJ, Hammond GL. Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients. Eur J Cardiothorac Surg. 2004;25(5):852-855. PMID: 15082293.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.