Inspect the neck for any obvious swelling or deform- ity from the front, back and sides. The patient may also be in obvious pain.
Observe the muscles for spasm or shortening. Short- ening of the sternomastoid may be due to spasm, trau- ma or a congenital cause. The latter may result in a torticollis, in which the patient holds the neck rotated to the side opposite the lesion.
An enlarged thyroid gland or cervical lymph nodes may be visible. An abscess may point in part of the neck.
Abnormal posture of the neck may be due to fracture of a vertebra, be the result of trauma, osteomyelitis or a secondary tumour. The neck may also be held in an abnormal posture because of disc prolapse or rheu- matoid arthritis.
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