Cervicothoracic Regional Exam Name

CC & significant history: D.O.B

Date:
Vital Signs: Height: Weight: Blood Pressure / mmHG Resp: /min

Observation: WNL Palpation: WNL

Development: good fair poor
L R
Posture
Skin Clavicle/Thoracic outlet
Antalgia: Levator scapulae
Asymmetry: Masseter

L R Mastoid **
Posterior c-spine mm
Head tilt
Rotator cuff
Head rotation
Rhomboids
Head carriage Anterior Posterior
Scalenes
Lordosis Hyper Hypo SCM

High Shoulder Suboccipitals

SPS/Erector spinae
Scoliosis
Temporalis
Kyphosis Hyper Hypo
Thyroid gland

Adams sign TMJ

Trapezius/rhomboids

ROM & Joint Play: WNL Neuologic: WNL MDT During Post L C R

Cervical spine AROM PROM Sensation WNL L R Protraction Co

Light touch C1
Retraction
L R L R Sharp/dull C2
RET-OP
Flexion (50) Vibration C3
RET-Mob
Extension (60) Motor (0-5) WNL L R RET-Ext
C4

Lateral Flexion Cervical exion (C1-C2) C5

Lateral flexion
Cervical extension (C2, C3, XI) L R C6
Rotation (80) **
Rotation C7
Craniocervial flexion Cervical lat. exion (C3)
L R
Cervical rotation (C1-4, XI) T1
Flexion rotation Flexion
T2
Trapezius (CN XI)(accessory) Supine RET
Extension rotation
T3
Deltoid (C5)(axillary) Sup. RET-Ext
Thoracic Spine L R
T4
Biceps (C6)(musculocut.)

..
Rotation T5
Triceps (C7, C8)(radial) Screening L R
Lumbar locked rotation T6
Cervical compression **
Wrist extensors (C6)(radial)
Wall Angel T7
Cervical distraction
Wrist exors (C7)(med./ulnar)
T4 mobility T8
Cervical instability
Interossei (C8, T1)(ulnar)
P-A compression
Gaze stability
Cranial nerves WNL DDX:
Rib spring
Hyperabduction
Sidelying Abduction test ** I (smell) VII (facial expres)
Kemps PLE
Push up test/quad rock II (light, vision) VIII (Weber, Roos
Rinne)
Scapulothoracic rhythm Shoulder depression

TMJ III, IV, VI (gaze) IX, X (ahhh)

Spurlings

Depression/Elevation V (bite, sensation) XI (trap/SCM) ULTT

Lateral deviation Valsalva

V, VII (corneal ref.) XII (tongue)