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SPINAL ROM
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CERVICAL ROM
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Flexion
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Extension
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L Rotation
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R Rotation
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L Lat Flexion
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R Lat. Flexion
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Cervical ROM WNL
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TS ROM
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THORACIC ROM
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Flexion
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Extension
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L Rotation
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R Rotation
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L Lat Flexion
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R Lat. Flexion
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Thoracic ROM all WNL
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LUMBAR ROM
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Flexion
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Extension
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L Rotation
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R Rotation
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L Lat. Flexion
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R Lat. Flexion
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Lumbar ROM all WNL
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ORTHOPEDIC TESTING
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Cervical Ortho's
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Cervical
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Foraminal Compression (LOCAL) (+)
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Side
• • •
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Foraminal Compression (RADIC) (+)
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Location
• • •
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Cervical Distraction (LOCAL) (+)
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Cervical Distraction Test (RADIC) (+)
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Left Shoulder Depression Test (+)
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L Depression Radic Location
• • •
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Right Shoulder Depression Test (+)
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R Depression Radic Location
• • •
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O'Donahue's Manuever Strain (+)
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O'Donahue's Manuever Sprain (+)
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Dejerine's triad (+)
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Cervical Exam Comments
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Thoracic Ortho's
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Thoracic
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Schepelmann's (Left) (+)
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Schepelmann's (Right) (+)
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Thoracic Spinous Percussion (+)
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Location
• • •
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Thoracic Exam Comments
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Lumbar Ortho's
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Lumbar
|
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Straight Leg Raise (local) (+)
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Side
• • •
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Straight Leg Raise (radic) (+)
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Location
• • •
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Bragard's (radic) (+)
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Location
• • •
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Kemp's (local) (+)
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Side
• • •
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Kemp's (radic) (+)
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Side
• • •
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Minor's Sign (+)
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Valsalva
• • •
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Fabre/Patrick's test (Left) (+)
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Fabre/Patrick's test (Right) (+)
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Yeoman's (Left) (+)
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Yeoman's (Right) (+)
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Hibb's (Left) (+)
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Hibb's (Right) (+)
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Dejerine's triad (+)
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Lumbar Exam Comments
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Upper Extremity
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Shoulder orthopedic exams
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Hawkin's - Kennedy
• • •
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Yergason's Test
• • •
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Dawburns Test
• • •
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Empty Can
• • •
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Speeds Test
• • •
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Codman's drop arm Test
• • •
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Dugas Test
• • •
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comments:
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Elbow Exam
|
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Ortho Test Left
• • •
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Ortho Test Right
• • •
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Left Elbow pain
• • •
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Right Elbow pain
• • •
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Wrist exam
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Left Wrist pain
• • •
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Right Wrist pain
• • •
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comments:
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Lower Extremity exam
|
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Hip
|
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Fabre/Patrick's test
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comments
|
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Knee Exam
|
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McMurray's Test
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Side:
• • •
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Apley's compression Test
|
Side:
• • •
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Drawer's Test
|
Side:
• • •
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Varus stress Test
|
Side:
• • •
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Valgus stressTest
|
Side:
• • •
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Ankle Exam
|
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Drawer's Test
|
Side:
• • •
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Squeeze Test
|
Side:
• • •
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Inversion Test
|
Side:
• • •
|
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Eversion Test
|
Side:
• • •
|
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BASIC SPINAL NEURO
|
|
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REFLEXES
|
|
|
L C5-6 (bicep)
|
R C5-6 (bicep)
|
|
L C5-6 (brachioradialis)
|
R C5-6 (brachioradialis)
|
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L C7-8 (tricep)
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R C7-8 (tricep)
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Upper extrem reflexes WNL
|
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Left L2-4 (patellar)
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R L2-4 (patellar)
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Left S1-2 (Achilles)
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Right S1-2 (Achilles)
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Lower extrem reflexes WNL
|
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MOTOR STRENGTH (MYOTOMES)
|
|
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L C5 (deltoid)
|
R C5 (deltoid)
|
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L C6 (bicep / wrist extension)
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R C6 (bicep / wrist extensors)
|
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L C7 (tricep / wrist flexors)
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R C7 (tricep / wrist flexors)
|
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L C8 (finger flexors)
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R C8 (finger flexors)
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L T1 (finger add / abd)
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R T1 (finger add / abd)
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Upper Extrem WNL
|
|
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L L1-L2 (hip flexion)
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R L1-L2 (hip flexion)
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L L3 (knee extension)
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R L3 (knee extension)
|
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L L4 (tib anterior)
|
R L4 (tib anterior)
|
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L L5 (great toe extension)
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R L5 (great toe extension)
|
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L S1-S2 (plantar flexion)
|
R S1-S2 (plantar flexion)
|
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Lower Extrem WNL
|
|
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DERMATOMES
|
|
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C5 dermatome
• • •
|
|
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C6 dermatome
• • •
|
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C7 dermatome
• • •
|
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C8 dermatome
• • •
|
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T1 dermatome
• • •
|
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Upper Extrem Dermatomes WNL
|
|
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L1-L2 dermatome
• • •
|
|
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L3 dermatome
• • •
|
|
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L4 dermatome
• • •
|
|
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L5 dermatome
• • •
|
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S1 dermatome
• • •
|
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Lower Extrem Dermatomes WNL
|
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ADDITIONAL NEURO
|
|
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Concussion
|
|
|
Smooth Pursuits
|
Abnormal
• • •
|
|
comments:
|
|
|
Saccades
|
Abnormal
• • •
|
|
comments:
|
|
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Optokinetic Reflex
|
Abnormal
• • •
|
|
comments:
|
|
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Near point convergence
|
Abnormal
• • •
|
|
comments:
|
|
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Cranial Nerve Exam
|
|
|
CRANIAL NERVES
|
|
|
CN I: (olfactory)
• • •
|
|
|
CN 2/3 (optic / oculomotor) RIGHT
|
CN2/3 Right Eye (acuity, eye movement)
• • •
|
|
CN 2/3 (optic / oculomotor) LEFT
|
CN 2/3 LEFT
• • •
|
|
Oculomotor CN 3, 4, 6 WNL
|
Abnormal how? (oculomotor, trochlear, abducens)
|
|
CN 5 (trigeminal) WNL
|
CN 5 (sensory of face, chewing)
• • •
|
|
CN 7 (facial) WNL
|
CN 7 Grading (movements & taste)
• • •
|
|
CN 8 (acoustic / vestibulocochlear) WNL
|
CN 8 Grading (sound / balance)
• • •
|
|
CN 9 (glossopharyngeal) WNL
|
CN 9 Grading (gag / swallow)
• • •
|
|
CN 10 (vagus) WNL
|
CN 10 Grading (gag, swallow, speech)
• • •
|
|
CN 11 (spinal accessory)
|
CN 11 Grading (shrugs + head rotation)
• • •
|
|
CN 12 (hypoglossal) WNL
|
CN 12 (tongue straight & in cheek)
• • •
|
|
comments
|
|
|
Babinski Reflex (+)
|
|
