Starting Position



Head level, looking straight ahead.

Ending position



Chin on chest.

Clinical Significance



first: don’t forget general medicine! pain with passive neck flexion is one of the classic findings of infectious meningitis. (in the extreme, passive flexion of the neck causes flexion of the hips–Brudzinski’s sign)

second: although the extent of motion is usually best checked with passive motion (to exclude loss of motion due to motor failure), many physicians are reluctant to test head and neck motion passively–it’s too reminiscent of something from pro wrestling (ie, potentially harmful!)

The atlanto-occipital joint is responsible for approximately 50% of neck flexion and extension; the rest is distributed among the lower vertebrae

Limitations here could be from generalized arthritis or ankylosing spondylitis (check sacroiliac joints)

Figures