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Cervical Spine Exam:
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INSPECTION:
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Previous surgical wound (s) healed or not
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Surgical wound signs
• • •
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Inspection Normal
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Inspection Abnormal
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Inspection Abnormal
• • •
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Comments On Inspection:
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MUSCLE PALPATION:
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Musculature Normal
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Anterior Musculature Right
• • •
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Anterior Musculature Rt Location
• • •
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Anterior Musculature Left
• • •
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Anterior Musculature Lt Location
• • •
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Lateral Musculature Right
• • •
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Lateral Musculature Rt Location
• • •
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Lateral Musculature Left
• • •
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Lateral Musculature Lt Location
• • •
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Posterior Musculature Right
• • •
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Posterior Musculature Rt Location
• • •
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Posterior Musculature Left
• • •
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Posterior Musculature Lt Location
• • •
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Comments on musculature:
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BONY PALPATION:
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No Step Off Palpation
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Bony Prominence Normal
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There is ____ tenderness at
• • •
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Bony Palpation location
• • •
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Comments On Bony Palpation:
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RANGE OF MOTION:
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ROM FOR COMMERCIAL INSURANCE
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RANGE OF MOTION (NON NO FAULT/WC PATIENTS)
• • •
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IF NO FAULT OR WC CASE PLEASE ROM USE BELOW
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ROM Flexion Normal N=60
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ROM Flexion Abn N=60
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ROM Extension Normal N=45
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ROM Extension Abn N=45
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ROM Rotation Normal N=60
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ROM Rotation Right N=60
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ROM Rotation Left N=60
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ROM Sidebending Norm N=45
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ROM Sidebending Right N=45
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ROM Sidebending Left N=45
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Comments On ROM:
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REFLEXES:
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Biceps Reflexes Normal (C5/6)
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Biceps Reflexes Right (C5/6)
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Biceps Reflexes Left (C5/6)
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Triceps Reflexes Normal (C7)
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Triceps Reflexes Right (C7)
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Triceps Reflexes Left (C7)
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Brachioradialis Reflexes Normal (C6)
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Brachioradialis Reflexes Right (C6)
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Brachioradialis Reflexes Left (C6)
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Comments On DTR:
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MUSCLE/STRENGTH EXAM:
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Elbow Flexor Strength Normal (C5)
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Elbow Flexor Strength Right (C5)
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Elbow Flexor Strength Left (C5)
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Wrist Extensors Strength Normal (C6)
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Wrist Extensors Right (C6)
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Wrist Extensors Strength Left (C6)
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Elbow Extensors Normal (C7)
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Elbow Extensors Right (C7)
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Elbow Extensors Left (C7)
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Finger Flexor Strength Normal (C8)
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Finger Flexor Strength Right (C8)
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Finger Flexor Strength Left (C8)
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Finger Abduction (5th digit) Normal (T1)
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Finger Abduction (5th digit) Right (T1)
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Finger Abduction (5th digit) Left (T1)
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Comments On MMT:
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SENSATION EXAM:
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Dermatomes Normal
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Dermatomes Right
• • •
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Dermatomes Left
• • •
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Dermatomes/Sensation Comment
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PROVOCATIVE EXAMS:
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Spurling Test Normal
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Spurling Test Definition
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Spurling Test Right
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Spurling Test Left
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Facet Loading Norm
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Cervical Facet Loading Right
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Cervical Facet Loading Left
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Adson Test
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Adson Test Right
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Adson Test Left
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Adson Test Definition
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Compression Test Normal
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Compression Test Right
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Compression Test Left
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Compression Definition
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Valsalva Test Normal
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Valsalva Test Right
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Valsalva Test Left
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Valsalva Test Definition
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L'Hermittes Normal
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L'Hermitte's Right
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L'Hermitte's Left
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L'Hermitte's Definition
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Comments On Provocative Exams:
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UPPER MOTOR NEURON (UMN) SIGNS:
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Hoffman's Norm
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Hoffman's sign Right
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Hoffman's sign Left
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cervical spine diagram
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