history_exam




History

[?]
Due to
Areas involved
Radiating to
Radiating to other
Describe symtoms
Pain severity
Associated symptoms
Pain with
Describe pain
Worse
Worse other
Better
Better other
Pain effected
Effected other
Previous history
Previous history explain
Previous treatment
Previous treatment other
Current treatment
Current treatment other
Recent scans
[?]
Scan location
Medications
Medications other
Vitamins supplements
Vitamins supplements other
Recent or major surgeries
Current or past health problems
Family history of major illness

Musculosketal Exam


Constitutional

Ht
Wt
Bp
General appearance
General appearance other
Current symptoms
Symptoms other

Mechanical MecKenzie Exam

Cervical
Cervical wnl
Thoracic
Thoracic wnl
Lumbar
Lumbar wnl
Cerv rom
Cerv flexion rom
Cerv flexion pain
Cerv flexion response
Cerv extension rom
Cerv extension pain
Cerv extension response
Cerv lt lat flex rom
Cerv lt lat flex pain
Cerv lt lat flex response
Cerv rt lat flex rom
Cerv rt lat flex pain
Cerv rt lat flex response
Cerv lt rotation rom
Cerv lt rotation pain
Cerv lt rotation response
Cerv rt rotation rom
Cerv rt rotation pain
Cerv rt rotation response
Thor rom
Thor flexion rom
Thor flexion pain
Thor flexion response
Thor extension rom
Thor extension pain
Thor extension response
Thor lt lat flex rom
Thor lt lat flex pain
Thor lt lat flex response
Thor rt lat flex rom
Thor rt lat flex pain
Thor rt lat flex response
Thor lt rotation rom
Thor lt rotation pain
Thor lt rotation response
Thor rt rotation rom
Thor rt rotation pain
Thor rt rotation response
Lumb rom
Lumb flexion rom
Lumb flexion pain
Lumb flexion response
Lumb extension rom
Lumb extension pain
Lumb extension response
Lumb lt lat flex rom
Lumb lt lat flex pain
Lumb lt lat flex response
Lumb rt lat flex rom
Lumb rt lat flex pain
Lumb rt lat flex response
Lumb lt rotation rom
Lumb lt rotation pain
Lumb lt rotation response
Lumb rt rotation rom
Lumb rt rotation pain
Lumb rt rotation response

Orthopedic Neurological

Cervical test
Lt cervical comp
Lt cervical comp response
Rt cervical comp
Rt cervical comp response
Soto hall
Soto hall response
Lt shoulder depression
Lt shoulder depression response
Rt shoulder depression
Rt shoulder depression response
Ditraction test
Ditraction test response
Extremity other
Extremity other response
Lumbar test
Left slr
Left slr response
Right slr
Right slr response
Lt braggards
Lt braggards response
Rt braggards
Rt braggards response
Lt patricks faber
Lt patricks faber response
Rt patricks faber
Rt patricks faber response
Lt elys
Lt elys response
Rt elys
Rt elys response
Milgrams
Milgrams response
Lt yeomans
Lt yeomans response
Rt yeomans
Rt yeomans response

Palpatory Tenderness

Oc c1
C1 c2
C2 c3
C3 c4
C4 c5
C5 c6
C6 c7
C7 t1
T1 t2
T2 t3
T3 t4
T4 t5
T5 t6
T6 t7
T7 t8
T8 t9
T9 t10
T10 t11
T11 t12
T12 l1
L1 l2
L2 l3
L3 l4
L4 l5
L5 si
Si
Reflexes
Bicep left
Bicep right
Brachio left
Brachio right
Tricep left
Tricep right
Patellar left
Patellar right
Achilles left
Achilles right
Vbi
Neurology
C5 motor
C5 sensation
C6 motor
C6 sensation
C7 motor
C7 sensation
C8 motor
C8 sensation
T1 motor
T1 sensation
L4 motor
L4 sensation
L5 motor
L5 sensation
S1 motor
S1 sensation
Coordination sensation
Muscle testing
Cerv flex strgth
Cerv flex tone
Cerv flex spasm
Cerv flex pain
Scm strgth
Scm tone
Scm spasm
Scm pain
Upper trap strgth
Upper trap tone
Upper trap spasm
Upper trap pain
Mid trap strgth
Mid trap tone
Mid trap spasm
Mid trap pain
Lower trap strgth
Lower trap tone
Lower trap spasm
Lower trap pain
Scalenes strgth
Scalenes tone
Scalenes spasm
Scalenes pain
Subscap strgth
Subscap tone
Subscap spasm
Subscap pain
Supraspin strgth
Supraspin tone
Supraspin spasm
Supraspin pain
Teres strgth
Teres tone
Teres spasm
Teres pain
Quadriceps strgth
Quadriceps tone
Quadriceps spasm
Quadriceps pain
Psoas strgth
Psoas tone
Psoas spasm
Psoas pain
Tfl strgth
Tfl tone
Tfl spasm
Tfl pain
Piriformis strgth
Piriformis tone
Piriformis spasm
Piriformis pain
Gluteus strgth
Gluteus tone
Gluteus spasm
Gluteus pain
Hamstring strgth
Hamstring tone
Hamstring spasm
Hamstring pain
Quad lum strgth
Quad lum tone
Quad lum spasm
Quad lum pain
Lat dorsi strgth
Lat dorsi tone
Lat dorsi spasm
Lat dorsi pain
Infrspinatus strgth
Infrspinatus tone
Infrspinatus spasm
Infrspinatus pain
Diagnosis
Diagnosis other
Treatment plan
Treatment plan other
Frequency
Frequency other