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Cervical Exam
Pain Diagram
Observation Cervical
Observation WNL
Bruising
[+] Bruising Comments
• • •
Swelling
[+] Swelling Comments
• • •
Redness
[+] Redness Comments
• • •
Antalgia
Antalgia
ABN Posture
• • •
Cervical Flexion (Active - 50 Normal)
With Pain
Cervical Extension (Active - 60 Normal)
With Pain
L Cervical Lateral Flexion (Active - 45 Normal)
With Pain
R Cervical Lateral Flexion (Active - 45 Normal)
With Pain
L Cervical Rotation (Active - 80 Normal)
With Pain
R Cervical Rotation (Active - 80 Normal)
With Pain
Palpation/Spasm/Tissue Changes
Area:
Severity - term
Finding
Progress:
Severity - 0-4
Maximum Compression Test
• • •
Cervical Distraction
Shoulder Depression Test
• • •
Valsalva
Sharp Purser
Brudzinski
Lumbopelvic Exam
Pain Diagram
Observation Lumbopelvic
Observation WNL
Antalgia
[+] Antalgia Comments
• • •
Bruising
[+] Bruising Comments
• • •
Swelling
[+] Swelling Comments
• • •
Redness
[+] Redness Comments
• • •
ABN Posture
• • •
ABN Leg Length
Step Deformity
[+] Step Deformity Comments
• • •
Scoliosis
[+] Scoliosis Comments
• • •
Trendelenburg's Sign
[+] Trendelenburg's Sign
• • •
Lumbar ROM Exam
ROM WNL
Lumbar Flexion (Active - 90 Normal)
With Pain
Lumbar Extension (Active - 30 Normal)
With Pain
L Lumbar Lateral Flexion (Active - 30 Normal)
With Pain
R Lumbar Lateral Flexion (Active - 30 Normal)
With Pain
L Lumbar Rotation (Active - 30 Normal)
With Pain
R Lumbar Rotation (Active - 30 Normal)
With Pain
Palpation/Spasm/Tissue Changes
Area:
Severity - term
Finding
Progress:
Severity - 0-4
Othopedic Tests Lumbopelvic
Valsalva Maneuver
LEFT Kemp's Test
[+] LEFT Kemp's Comments
• • •
RIGHT Kemp's Test
[+] RIGHT Kemp's Comments
• • •
LEFT Slump Test
[+] LEFT Slump Test Comments
• • •
RIGHT Slump Test
[+] RIGHT Slump Test Comments
• • •
LEFT SLR
[+] LEFT SLR Comments
• • •
RIGHT SLR
[+] RIGHT SLR Comments
• • •
LEFT Laguerre's Test
[+] LEFT Laguerre's Test
• • •
RIGHT Laguerre's Test
[+] RIGHT Laguerre's Test
• • •
LEFT FABERE
RIGHT FABERE
Spinous Percussion
[+] Spinous Percussion
• • •
LEFT Yeoman's Test
RIGHT Yeoman's Test
LEFT Hibb's Test
RIGHT Hibb's Test
SIJ Compression
[+] SIJ Compression
• • •
Shoulder
Pain Diagram
Observation shoulder
Observation WNL
[+] Bruising Comments
• • •
Bruising
[+] Swelling Comments
• • •
Swelling
[+] Redness Comments
• • •
Redness
Atrophy
• • •
ABN Posture
• • •
GH Sulcus Sign
AC Joint Step Defect
Observation Comments
Shoulder ROM Exam
ROM WNL
Flexion (180)
Flexion Symptoms
• • •
Extension (50)
Extension Symptoms
• • •
Abduction (180)
ABD Symptoms
• • •
Adduction (35)
ADD Symptoms
• • •
Internal Rotation (90)
IR Symptoms
• • •
External Rotation (80)
ER Symptoms
• • •
Horizontal ABD (30)
Horiz. ABD Symptoms
• • •
Horizontal Adduction (130)
Horiz. ADD Symptoms
• • •
[+} Painful Arc
• • •
Motor Function
Grade 5/5
• • •
Grade 4/5
• • •
Grade 3/5
• • •
Grade 2/5
• • •
Grade 1/5
• • •
Grade 0/5
• • •
Pain with MMT
• • •
Othopedic Tests shoulder
Codman's Test
[+] Codman's Test
• • •
Dugas Test
[+] Dugas Test
• • •
Apley's Test
[+] Apley's Test
• • •
Lift-Off Test
Hawkins-Kennedy Test
[+] Hawkins-Kennedy Test
• • •
Neer's Test
[+] Neer's Test
• • •
Empty Can Test
[+] Empty Can Test
• • •
Speed's Test
Yergason's Test
[+] Yergason's Test
• • •
Clunk Test
[+] Clunk Test
• • •
Crank Test
[+] Crank Test
• • •
O'Brien's Test
[+] O'Brien's Test
• • •
Kim Test
Anterior Apprehension Test
[+] Anterior Apprehension Test
• • •
Posterior Apprehension Test
[+] Posterior Apprehension Test
• • •
Load & Shift Test
[+] Load & Shift Test
• • •
Elbow
Pain Diagram
Observation elbow
Observation WNL
Bruising
[+] Bruising Comments
• • •
Swelling
[+] Swelling Comments
• • •
Redness
[+] Redness Comments
• • •
ABN Posture
• • •
Atrophy
• • •
Observation Comments
Elbow ROM Exam
ROM WNL
Flexion (150)
Flexion Symptoms
• • •
Extension (0)
Extension Symptoms
• • •
Supination (90)
Supination Symptoms
• • •
Pronation (90)
Pronation Symptoms
• • •
Motor Function elbow
Grade 5/5
• • •
Grade 4/5
• • •
Grade 3/5
• • •
Grade 2/5
• • •
Grade 1/5
• • •
Grade 0/5
• • •
Pain with MMT
• • •
Othopedic Tests elbow
Valgus Stress Test
[+] Valgus Stress Test
• • •
Varus Stress Test
[+] Varus Stress Test
• • •
Cozen's Test
[+] Cozen's Test
• • •
Reverse Cozen's Test
[+] Reverse Cozen's Test
• • •
Mill's Test
[+] Mill's Test
• • •
Reverse Mill's Test
[+] Reverse Mill's Test
• • •
DDX Impressions

Master Objective Exam Medical Form

Chiropractor

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Published: Dec. 15, 2017, 4:49 p.m.
Doctor: Dr. History Physical
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