CHIROPRACTIC EXAMINATION

TEST: Negative Positive R L RANGE OF MOTION: Cervical

Both Lumbar
Foramina Compression
Flexion _______
Neck Distraction _______
Shoulder Depressor
Adson's Extension _______
Valsalva's Sign _______
Minor's Sign
Lewin's Test Right Rotation _______
_______
Adam's Sign
Left Rotation _______
Kemp's Test
_______
Heel-and-Toe Test
Right lateral flexion _______
Laseque's Test
_______
Goldthwaite
Left lateral flexion _______
Braggard's Test _______

Fabere-Patrick Test REFLEXES: Right

Left
Bilateral Straight Leg
Raiser Biceps ______
Bilateral Leg Lowering _______
Hoover's Sign
Soto Hall Test Level Tricep ______
_________ _______
Babinski
Brachioradialis ______
Ely's Heel to Buttock _______

Nachlas Test Patellar ______

_______
Yeoman's
Achilles ______
Femoral Stretch Test _______

Derifield Leg Test

Palpation -- tenderness Level
_________ Dynamometer: ______
Palpation -- spasm Level ______
_________
Well Leg Raise Test

Thomas Test

X-Rays: Cervic Thoracic Lumba Pinwheel Test: R Arm L Arm Both R Leg L Leg
al r Both
 Hyperesthesia
Subluxation ______ ________ ______
_ _ Hypoesthesia
Fracture ________
______ ______
Spina Bifida _ ________ _ Observation:
Occulta Normal
______ ______
_ _ Atrophy
Osteoporosis
Lipping and Mild Moderate Severe
spurring
Osteoarthritic
changes
Degen. Joint
Disease
Disc degeneration
Curve (Hyper)
Curve (Hypo)
Spondylolisthesis