|
Height
|
Weight
|
|
Blood Pressure
/
|
Pulse
|
|
Cervical Sp Flex / 60
|
Pain with C/S flexion?
|
|
Cervical Sp Ext / 50
|
Pain with C/S extension?
|
|
Cervical Sp Rt. Rot / 80
|
Pain in C/S Rt. Rot?
|
|
Cervical Sp Lt. Rot / 80
|
Pain in C/S Lt. Rot?
|
|
Cervical Sp RLF / 45
|
Pain with C/S Rt. lateral flex?
|
|
Cervical Sp LLF / 45
|
Pain with C/S Lt. lateral flex?
|
|
George's Maneuver Positive?
|
Foraminal Compression
• • •
|
|
Shoulder Depression
• • •
|
Cervical Distraction Positive?
|
|
Isometric C/S Flexion
/
|
Isometric C/S Extension
/
|
|
Isometric C/S Right Lateral Flex
/
|
Isometric Left Lateral Flexion
/
|
|
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?
|
|
Trendelenberg Test
• • •
|
Kemp's Test
• • •
|
|
SLR Right
|
Minor's Sign
|
|
SLR Left
|
|
|
Dejurene's Triad
|
Posture Saggital Plane
• • •
|
|
Posture Frontal Plane
• • •
|
Myospasm
• • •
|
|
Trigger Points
• • •
|
L/E Strength - L
|
|
Inflammation
• • •
|
U/E Strength - L
|
|
L/E Strength - R
|
Pulse Ox
|
|
U/E Strength - R
|
|
|
Tongue Deviaton
|
|
|
Free form
|
|
