Psychiatry
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Facial and Oral Movements:

1. Muscles of Facial Expression:
[comment memo="e.g. movements of forehead, eyebrows periorbital area, cheeks, including frowning blinking, smiling, grimacing"]
[radio name="MusclesofFacialExpression" value="0|1|2|3|4"]
2. Lips and Perioral Area:
[comment memo="e.g., puckering, pouting, smacking"]
[radio name="LipsandPerioralArea" value="0|1|2|3|4"]
3. Jaw:
[comment memo="e.g. biting, clenching, chewing, mouth opening, lateral movement"]
[radio name="Jaw" value="0|1|2|3|4"]
4. Tongue:
[comment memo="Rate only increases in movement both in and out of mouth. NOT inability to sustain movement. Darting in and out of mouth."]
[radio name="Tongue" value="0|1|2|3|4"]

Extremity Movements:

5. Upper (arms, wrists, hands, fingers):
[comment memo="Include choreic movements (i.e., rapid, objectively purposeless, irregular, spontaneous) athetoid movements (i.e., slow, irregular, complex, serpentine). Do not include tremor (i.e., repetitive, regular, rhythmic)"]
[radio name="Upper" value="0|1|2|3|4"]
6. Lower (legs, knees, ankles, toes):
[comment memo="e.g., lateral knee movement, foot tapping, heel dropping, foot squirming, inversion and eversion of foot."]
[radio name="Lower" value="0|1|2|3|4"]

Trunk Movements:

7. Neck, shoulders, hips:
[comment memo="e.g., rocking, twisting, squirming, pelvic gyrations"]
[radio name="Trunk" value="0|1|2|3|4"]

Global Judgments

8. Overall severity of abnormal movements:
[radio name="Overall" value="0|1|2|3|4"]
9. Incapacitation due to abnormal movements:
[radio name="Incapacitation" value="0|1|2|3|4"]
10. Patient’s awareness of abnormal movements:
[comment memo="Rate only patient’s report. No awareness=0. Aware, no distress=1. Aware, mild distress=2. Aware, moderate distress=3. Aware, severe distress=4."]
[radio name="Awareness" value="0|1|2|3|4"]

Dental Status

11. Current problems with teeth and/or dentures:
[radio name="Teethproblems" value="No|Yes"]
12. Are dentures usually worn?
[radio name="Dentures" value="No|Yes"]
13. Edentia?
[radio name="Endentia" value="No|Yes"]
Facial and Oral Movements:

1. Muscles of Facial Expression:
e.g. movements of forehead, eyebrows periorbital area, cheeks, including frowning blinking, smiling, grimacing

2. Lips and Perioral Area:
e.g., puckering, pouting, smacking

3. Jaw:
e.g. biting, clenching, chewing, mouth opening, lateral movement

4. Tongue:
Rate only increases in movement both in and out of mouth. NOT inability to sustain movement. Darting in and out of mouth.


Extremity Movements:

5. Upper (arms, wrists, hands, fingers):
Include choreic movements (i.e., rapid, objectively purposeless, irregular, spontaneous) athetoid movements (i.e., slow, irregular, complex, serpentine). Do not include tremor (i.e., repetitive, regular, rhythmic)

6. Lower (legs, knees, ankles, toes):
e.g., lateral knee movement, foot tapping, heel dropping, foot squirming, inversion and eversion of foot.


Trunk Movements:

7. Neck, shoulders, hips:
e.g., rocking, twisting, squirming, pelvic gyrations


Global Judgments

8. Overall severity of abnormal movements:

9. Incapacitation due to abnormal movements:

10. Patient’s awareness of abnormal movements:
Rate only patient’s report. No awareness=0. Aware, no distress=1. Aware, mild distress=2. Aware, moderate distress=3. Aware, severe distress=4.


Dental Status

11. Current problems with teeth and/or dentures:

12. Are dentures usually worn?

13. Edentia?

Result - Copy and paste this output:

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