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Physical Examination
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Feet pain/numbness draw
|
|
Body pain and numbness loc
|
Leg ext ROM right (desc)
|
|
Leg ext ROM left (desc)
|
Leg flex ROM right (desc)
|
|
Leg Flex ROM L (desc)
|
Internal rotation R knee (desc)
|
|
Internal rotation L knee (desc)
|
External rotation ROM right (des
|
|
External rotation ROM L (desc)
|
Varus instability left knee
|
|
Varus instability right knee
|
Valgus instability left knee
|
|
Valgus instability right knee
|
Patellar apprehension left knee
|
|
Patellar apprehension right knee
|
Midline joint pain left knee
|
|
Midline joint pain right
|
Edema Present (choose)
• • •
|
|
Patellar ballottement
|
|
|
Dermatome Eval
• • •
|
DERMATOME COMMENTS
|
|
Kemps Test
• • •
|
Kemps radiating loc/add comments
|
|
Milgrams test
• • •
|
Milgrams test rad into/add comm
|
|
SLR test
• • •
|
Radiates into/comm
|
|
Yeomans test
• • •
|
Yeomans rad into/comm
|
|
Hibbs test
• • •
|
Hibbs rad/comm
|
|
Lachman's test
• • •
|
Lachman's Comments
|
|
McMurray's test
• • •
|
McMurray's test comments
|
|
Drawer test
• • •
|
Drawer test comments
|
|
Spinal (Thoracic)
• • •
|
Thoracic pain
• • •
|
|
Thoracic radiation of pain
|
Lumbar region ROM
• • •
|
|
Lumbar pain
• • •
|
Lumbar pain radiation
|
|
Postural assessment
• • •
|
NEURO EXAM EDEMA (loc/severity)
• • •
|
|
Monofilament exam
• • •
|
Temp percept sensation abn foot
|
|
Skin temp/tone
• • •
|
Abnormal comments
|
|
Muscle Strength
• • •
|
Vibration Perception
• • •
|
|
Motor changes, active ROM
• • •
|
Degree of abnormality
|
|
Reflexes
• • •
|
|
