The Purposeof the test is To assess the integrity of the alar ligaments and thus upper cervical stability.


Keep The patient is supine position


Place one hand on the occiput and use the other hand to palpate the spinous process of C2.


Laterally flex or u can say... rotate the head to one side; ...now you should feel the spinous process move to the opposite side.

Then Repeat on the other side.

So Absence of the spinous process moving to the opposite side may indicate alar ligament injury.

Keep in mind If you block the spinous process of C2 from moving, you may stress the ligament.

You should encounter a firm end-feel in this case.

Significant movement may indicate ligamentous injury.

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