|
Height
|
Weight
|
|
Blood Pressure
/
|
Pulse
|
|
Cervical Spine Flexion
|
Pain with C/S flexion?
|
|
Cervical Spine Extension
|
Pain with C/S extension?
|
|
Cervical Spine Right Lateral Fle
|
Pain with C/S Rt. lateral flex?
|
|
Cervical Spine Left Lateral Flex
|
Pain with C/S Lt. lateral flex?
|
|
George's Maneuver Positive?
|
Foramina Compression
• • •
|
|
Shoulder Depression
• • •
|
Cervical Distraction Positive?
|
|
Bakody's Sign
|
Adson's Sign
|
|
Eden's Sign
|
Isometric C/S Extension
/
|
|
Isometric C/S Flexion
/
|
Isometric Left Lateral Flexion
/
|
|
Isometric C/S Right Lateral Flex
/
|
|
|
Biceps Reflex
• • •
|
Triceps Reflex
• • •
|
|
Patellar Reflex
• • •
|
Achilles Reflex
• • •
|
|
L/S Flexion
|
Pain with L/S flexion?
|
|
L/S Extension
|
Pain with L/S extension?
|
|
L/S Right Lateral Flexion
|
Pain with L/S right lateral flex
|
|
L/S Left Lateral Flexion
|
Pain with L/S left lateral flex?
|
|
Deep Overhead Squat
• • •
|
Pain with Deep Overhead Squat?
|
|
Multi-Segmental Rotation Right
• • •
|
Multi-Segmental Rotation Right
|
|
Multi-Segmental Rotation Left
• • •
|
Multi-Segmental Rotation Left
|
|
Trendelenberg Test
• • •
|
Kemp's Test
• • •
|
|
Advancement
• • •
|
Posture
• • •
|
