1.

For every joint, I will be inspecting and palpating for

a. Symmetry
b. Signs of inflammation
c. Bone deformities
d. Condition of the surrounding tissue
e. Ease of ROM
Stand
2. Inspection
a. Spine
b. Paravertebral muscles
Bend over
Stand upright
c. Upper and lower extremities
i. Muscle
1. Bulk
2. Mass
3. Tone
ii. Skeletal configuration
3. Palpation
a. Back
i. Spinous processes
ii. Paravertebral muscles
b. Hip
i. Iliac crest
ii. ASIS
iii. Greater trochanter
Sit
c. Shoulder
i. SC joint
ii. Clavicle
iii. AC joint
iv. Coracoid process
v. Greater tubercle
vi. Bicipital tendon and groove
Right upper extremity
d. Elbow (70 degree angle)
i. Medial and lateral epicondyles
ii. Olecranon process
e. Wrist
i. Dorsal
ii. Medial
iii. Lateral aspects
f. Fingers
i. MCP
ii. PIP
iii. DIP
Move onto the left.
Right lower extremity
g. Knee
i. Patellar tendon
ii. Tibial tuberosity
iii. Medial and lateral
1. femoral condyles
2. tibial plateaus
3. joint spaces

h. Ankles
i. Anterior aspect
ii. Medial and lateral malleoli
iii. Achilles tendon
i. Toes
i. MTP
ii. PIP
iii. DIP
Move onto the left.
4. Sensation (BILATERALLY)
a. C6
i. Anterior lateral arm
ii. Lateral wrist
iii. Thumb
b. C7
i. Index
ii. Middle fingers
c. C8
i. Ring
ii. Little fingers
d. T4
i. Nipple line
e. T10
i. Umbilicus
f. L1
i. Inguinal
g. L4
i. Lateral thigh
ii. Across knee
iii. Medial calf
h. L5
i. Lateral calf
ii. Big toe
i. S1
i. Lateral foot
ii. Sole of foot
5. ROM
a. Shoulder
i. Flexion / Extension
ii. Abduction / Adduction
iii. Internal / External rotation
b. Elbows
i. Flexion / Extension
ii. Supination / Pronation
c. Wrist
i. Flexion / Extension
ii. Radial / Ulnar deviation
d. Fingers
i. Make a fist - flexion
ii. Open fist extension and abduction
iii. Fingers together adduction
e. Knees
i. Flexion / Extension
f. Ankles
i. Plantar flexion / Dorsiflexion (point your foot toward the floor/ceiling)

ii. Inversion / Eversion (bend your heel inward/outward)

6. Muscle Strength (when you feel my hands, push against them)
a. Grading scale: 0 5
i. 0 no muscle contraction
ii. 1 trace
iii. 2 active movement without gravity
iv. 3 active movement with gravity
v. 4 active movement with some resistance
vi. 5 active movement with full resistance and without fatigue
b. Shoulder
i. AB-duction
1. Deltoid
2. C5, C6
ii. AD-duction
1. Pectoralis Major
2. C5-T1
c. Elbow
i. Flexion
1. Biceps
2. C5, C6
ii. Extension
1. Triceps
2. C6, C7, C8
d. Wrist
i. Extension
1. Radial nerve
2. C6, C7, C8
e. Hand Grip Strength
i. C7, C8, T1
f. Thumb opposition
i. Median nerve
ii. C8, T1
g. Finger AB-duction
i. Ulnar nerve
ii. C8, T1
h. Hip
i. Flexion (one at a time)
1. Iliopsoas
2. L2, L3, L4
3. BILAT
ii. Extension (one at a time)
1. Gluteus Maximus
2. S1
3. BILAT
iii. AB-duction
1. Gluteus Medius, Minimus
2. L4, L5, S1
iv. AD-duction
1. Adductors
2. L2, L3, L4
i. Knee
i. Flexion
1. Hamstrings
2. L4, L5, S1, S2
ii. Extension

1. Quadriceps
2. L2, L3, L4
j.

Ankle
i. Dorsiflexion
1. Tibialis Anterior
2. L4, L5
ii. Plantar flexion
1. Gastrocnemius
2. S1

7. Deep Tendon Reflexes

a. Grading scale: 0 4+
i. 0 no response
ii. 1+ low normal
iii. 2+ normal
iv. 3+ brisker than average
v. 4+ hyperactive with clonus
b. Brachioradialis
i. C5, C6
c. Biceps
i. C5, C6
d. Triceps
i. C6, C7
BILAT
e. Patellar
i. L2, L3, L4
f. Ankle
i. S1
BILAT
8. Cutaneous Reflexes
a. Abdominal
i. Above umbilicus
1. T8, T9, T10
ii. Below umbilicus
1. T10, T11, T12
b. Plantar
i. L5, S1
ii. BILAT
9. Coordination
a. Gait
i. Symmetry
ii. Length of stride