Radicular statement (lumbar spine)

 

 

Last name :

Smith

Name :

Bill

Doctor :

Fleming

Initial evaluation :

11/11/2000

Sex :

Male

Date :

12/12/2000

Diagnosis

Nerve root encroachment of L5/S1

 

Myotoms

 

 

L

R

 

L

R

Iliopsoas (L2)

 

 

Gastronemius (S1)

 

X

Quadriceps (L3-L4)

 

 

Gluteus maximus (S1-S2)

 

 

Tibialis anterior (L4)

 

 

Extensor digitorum longus (S2)

 

 

Hallux (L5)

 

 

Eversor (L5-S1)

 

 

Hamstrings (L5-S1)

 

 

 

 

 

                   

Reflexes

 

L

R

 

L

R

Patellar

 

 

Achilles Tendon

 

X

 

Special tests

 

+

-

 

+

-

Amyotrophy

 

X

Babinski's test

 

X

Deep tendon reflex

X

 

Slump's test

 

X

Tripod

X

 

Valsalva

 

X

sphincter control

 

X

Pain when coughing

X

 

Left SLR

 

X

Right SLR

60 °

 

 

Remarks

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