Physical Examination Findings General Conscious, coherent, wheelchair-borne, not in cardiorespiratory distress Vital Signs BP: 110/70 (right and left arm, seated) PR: 79 beats/min,regular RR: 19 breaths/min, regular Temp: not assessed

Measurements Height: not assessed Weight: not assessed BMI: not assessed   Skin Dry skin, No skin discolorations, No skin lesions

HEENT Normocephalic, no facial asymmetry Normal eye position and alignment, hyperemic sclera, pink conjunctiva, no corneal and lens opacities, no exudates No ear deformities, lesions, nodules, discharge, odor, swelling, redness, foreign bodies, (+) dry cerumen Nose and throat not assessed

Chest and Lungs Not assessed Heart   Abdomen

Extremities Brachial Radial Femoral Popliteal Posterior Tibia Dorsalis Pedis Right ++ Regular Not assessed + Left (0) = absent (+) = decreased (++) = normal (+++) = hyperactive (Br) = bruit

Musculoskeletal Examination Cervical Spine Inspection No skin changes, no swelling, no deformities Range of Motion Active Passive Flexion Normal Extension Side Flexion (right and left) Rotation (right and left) Palpation No palpable nodules, no tenderness

Musculoskeletal Examination Shoulder Joint Range of Motion Active Passive Forward flexion (right and left) Normal Extension (right and left) Not assessed Abduction (right and left) Limited Internal and external rotation (right and left) None Palpation No palpable nodules, no tenderness

Musculoskeletal Examination Forearm Inspection No skin changes, no swelling, no deformities Range of Motion Active Passive Pronation Normal Supination None – Left side Limited – Right side Palpation No palpable nodules, no tenderness

Musculoskeletal Examination Wrist Inspection No skin changes, no swelling, no deformities Range of Motion Active Passive Flexion Limited Extension Ulnar deviation Radial deviation Palpation No palpable nodules, no tenderness

Musculoskeletal Examination Inspection Active Movement Passive Movement Left Hand Boutonniere’s deformity on all fingers Can make a fist (flexion at MCP) Finger abduction : thumb and index Finger adduction: thumb and index (-) extension at MCP on all fingers (-) flexion/extension at PIP and DIP Thumb: flexion/extension at MCP Index: flexion/extension at MCP Middle: flexion/extension (limited) at MCP Ring: flexion/extension (limited) at MCP Little: flexion at MCP Right hand Boutonniere’s deformity – thumb, middle, ring Swan neck deformity – index, little finger Middle: flexion at MCP Ring: flexion at MCP Little: flexion at MCP

Musculoskeletal Examination Knees Inspection Swelling of both knees Range of Motion Active Passive Flexion Normal Extension None Limited Palpation No palpable nodules, no tenderness

Musculoskeletal Examination Ankle joint and foot Inspection No deformities Range of Motion Active Passive Plantar Flexion Normal Dorsiflexion Inversion Eversion Toe extension Toe flexion Palpation No palpable nodules, no tenderness

Neurologic Examination CN II: (+) Red-orange reflex CN VIII: Rinne (+), Weber – no lateralization