Page 272 - 2023 SMOG Digital

FORMS

Vital Functions

Assessment Reference Charts

MUSCULOSKELETAL INJURY and PERIPHERAL NERVE ASSESSMENT
UPPER EXTREMITIES
INJURY to Consider MOTOR Testing SENSATION Testing NERVE
Elbow Injury Index and Little Finger Abduction Little Finger Ulnar
Wrist Fracture or Dislocation Thenar Contraction with Opposition Index Finger Median Distal
Supracondylar Fracture of Humerus Index Tip Extension None Median, Anterior Interoseous
Anterior Shoulder Dislocation Elbow Flexion Radial Forearm Musculocutaneous
Distal Humeral Shaft,
Anterior Shoulder Dislocation Thumb, Finger group Extension First Dorsal Web Space Radial
Anterior Shoulder Dislocation,
Proximal Humerus Fracture Deltoid Lateral Shoulder Axillary
LOWER EXTREMITIES
Pubic Rami Fractures Knee Extension Anterior Knee Femoral
Obturator Ring Fractures Hip Adduction Medial Thigh Obturator
Posterior Tibial Toe Flexion Sole of Foot Knee Dislocation
Fibular Neck Fracture,
Knee Dislocation Ankle Eversion Lateral Dorsum of Foot Superficial Peroneal
Fibular Neck Fracture, Dorsal 1st-2nd Web
Compartment Syndrome Ankle / Toe Dorsiflexion Space Deep Peroneal
Posterior Hip Dislocation Plantar Flexion Foot Sciatic Nerve
Acetabular Fracture Hip Abduction Upper Buttocks Superior Gluteal
Acetabular Fracture Hip Extension Lower Buttocks Inferior Gluteal

MUSCLE STRENGTH GRADING

SCORE EXAM RESULT
0 Total Paralysis
1 Palpable or Visible Contraction
2 Full Range of Motion Without Gravity
3 Full Range of Motion Against Gravity
4 Full Range of Motion, but Less than Normal Strength
5 Normal Strength
NT Not Testable

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