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DOC Cervical Spine Exam
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Inspection (lordosis, erythema, ecchymosis, masses)
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Inspection Abnormal?
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Inspection ALL NORMAL?
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Loss of Lordosis?
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Erythema?
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Ecchymosis?
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Masses?
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Inspection Comments
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Tenderness (Paraspinous, Central)
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Tenderness Abnormal?
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Tenderness ALL NORMAL?
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Paraspinous?
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Central/Midline?
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Tenderness Comments
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Range of Motion (flex/ext, rotation)
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ROM Abnormal?
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ROM ALL NORMAL?
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Limited Flexion (45 Degrees)?
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Limited Extension (45 Degrees)?
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Limited Right Rotation (45 Degrees)?
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Limited Left Rotation (45 Degrees)?
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ROM Comments
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Strength (C5 Delt, C6 Wrist, C7 Tri, C8 Interossei, T1 Interossei)
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Strength Abnormal?
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Strength ALL NORMAL?
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C5 Deltoid
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C6 Wrist
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C7 Tricep
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C8 Interossei
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T1 Interossei
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Strength Comments
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Sensation (C5 Lat, C6 Rad, C7 Finger, C8 Ulnar, T1 Med)
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Sensation Abnormal?
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Sensation ALL NORMAL?
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C5 Lateral Arm?
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C6 Radial Forearm?
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C7 Middle Finger?
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C8 Ulnar Forearm?
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T1 Medial Arm?
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Sensation Comments
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Reflexes
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Triceps 2+ ?
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Brachioradialis 2+ ?
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Reflex Comments
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Gait (antalgic gate, reciprocal heel/toe w/o asst device)
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Wide Based Myelopathic Gate?
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Gait Comments
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Imaging and Labs
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Cervical Spine X-Rays?
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X-Ray Views?
• • •
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Comparison
• • •
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Comparison Date and Comments
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Normal Findings
• • •
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Normal Comments
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Abnormal Findings
• • •
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Abnormal Comments
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Impression:
• • •
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Comments
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Ultrasound Utilized?
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Ultrasound Comments:
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