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Postural Findings
SHOULDER
Shoulder ROM - Active/Passive
(L) Abduction /180
/
(R) Abduction /180
/
(L) Horizontal Adduction /50
/
(R) Horizontal Adduction /50
/
(L) Internal Rotation /90
/
(R) Internal Rotation /90
/
(L) External Rotation /90
/
(R) External Rotation /90
/
(L) Flexion /180
/
(R) Flexion /180
/
(L) Extension /50
/
(R) Extension /50
/
Reproduction of Pain/Symptoms
• • •
Notes
Shoulder Manual Muscle Testing (MMT)
Findings
Shoulder Orthopedic Tests
Findings
Shoulder Soft Tissue Findings
Shoulder Soft Tissue: 1
• • •
Finding(s)
• • •
Shoulder Soft Tissue: 2
• • •
Finding(s)
• • •
Shoulder Soft Tissue: 3
• • •
Finding(s)
• • •
Notes
Shoulder Joint Findings
Joint: 1
• • •
Restriction
• • •
Joint: 2
• • •
Restriction
• • •
Joint: 3
• • •
Restriction
• • •
Notes
Neuromuscular Patterns
Findings
Additional Shoulder Findings
Findings
ELBOW
Elbow ROM - Active/Passive
(L) Flexion /150
/
(R) Flexion /150
/
(L) Extension /0
/
(R) Extension /0
/
(L) Supination /90
/
(R) Supination /90
/
(L) Pronation /90
/
(R) Pronation /90
/
Reproduction of Pain/Symptoms
• • •
Notes
Elbow Manual Muscle Testing (MMT)
Findings
Elbow Orthopedic Tests
Findings
Elbow Soft Tissue Findings
Elbow Soft Tissue: 1
• • •
Finding(s)
• • •
Elbow Soft Tissue: 2
• • •
Finding(s)
• • •
Elbow Soft Tissue: 3
• • •
Finding(s)
• • •
Notes
Elbow Joint Findings
Joint: 1
• • •
Restriction
• • •
Joint: 2
• • •
Restriction
• • •
Joint: 3
• • •
Restriction
• • •
Notes
Additional Elbow Findings
Findings
WRIST/HAND
Wrist/Hand ROM - Active/Passive
(R) Flexion /90
/
(L) Flexion /90
/
(R) Extension /70
/
(L) Extension /70
/
(R) Radial Deviation /20
/
(L) Radial Deviation /20
/
(R) Ulnar Deviation /55
/
(L) Ulnar Deviation /55
/
(R) Thumb Flexion /50
/
(L) Thumb Flexion /50
/
(R) Thumb Extension /50
/
(L) Thumb Extension /50
/
(R) Thumb Abduction /70
/
(L) Thumb Abduction /70
/
(R) Thumb Adduction /30
/
(L) Thumb Adduction /30
/
Notes
Reproduction of Pain/Symptoms
• • •
Wrist/Hand Manual Muscle Testing (MMT)
Findings
Wrist/Hand Orthopedic Tests
Findings
Wrist/Hand Soft Tissue Findings
Wrist/Hand Soft Tissue: 1
• • •
Finding(s)
• • •
Wrist/Thumb Soft Tissue: 2
• • •
Finding(s)
• • •
Wrist/Thumb Soft Tissue: 3
• • •
Finding(s)
• • •
Notes
Wrist/Hand Joint Findings
Joint: 1
• • •
Restriction
• • •
Joint: 2
• • •
Restriction
• • •
Joint: 3
• • •
Restriction
• • •
Notes
Additional Wrist/Hand Findings
Findings

Upper Extremity MSK Exam Medical Form

Physical Therapist

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Published: Feb. 17, 2016, 5:35 p.m.
Doctor: Dr. History Physical
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