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DOC Left Upper Arm Exam
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Inspection (swelling, erythema, ecchymosis, warmth, wounds, deformity)
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Inspection Abnormal?
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Inspection ALL NORMAL?
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Swelling?
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Ecchymosis?
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Erythema?
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Increased Warmth?
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Masses?
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Open Wounds?
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Deformity?
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Inspection Comments
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Tenderness (Prox/Mid/Distal 1/3, Clavicle, Acromion)
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Tenderness Abnormal?
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Tenderness ALL NORMAL?
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Proximal 1/3?
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Mid 1/3?
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Distal 1/3?
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Clavicle?
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Acromion?
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Tenderness Comments
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Range of Motion (shoulder, elbow, wrist)
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ROM Abnormal?
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ROM ALL NORMAL?
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Decreased Shoulder ROM?
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Decreased Elbow ROM?
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Decreased Wrist ROM?
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ROM Comments
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Neurologic (med, rad, ulnar, axil sensation and motor)
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Neurologic Abnormal?
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Neurologic ALL NORMAL?
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Decreased Median Nerve Sensation?
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Comments
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Decreased Median Nerve Motor Function?
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Comments
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Decreased Radial Nerve Sensation?
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Comments
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Decreased Radial Nerve Motor Function?
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Comments
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Decreased Ulnar Nerve Sensation?
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Comments
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Decreased Ulnar Nerve Motor Function?
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Comments
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Decreased Axillary Nerve Sensation?
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Comments
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Decreased Axillary Nerve Motor Function?
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Comments
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Vascular
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Radial Pulse Palpable?
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Vascular Comments
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Imaging and Labs
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Humerus X-Ray?
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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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Impression comments
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Comments:
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Elbow X-Ray?
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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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Impression comments
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Comments:
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Ultrasound Utilized?
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Normal US Findings
• • •
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Normal US Comments
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Abnormal US Findings
• • •
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Abnormal US Comments
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Impression:
• • •
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Ultrasound Comments:
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