RMP Back Exam

NECK 
Neck Range of Motion: [select name="neck_rom" value="FROM|Decreased ROM"][conditional field="neck_rom" condition="(neck_rom).isNot('FROM')"]
turning right: [select name="neck_rom_turn_right" value="neck|slightly decreased|moderately decreased|markedly decreased"][select name="neck_rom_turn_right_pain" value="|, exacerbates pain|, ameliorates pain"]
turning left: [select name="neck_rom_turn_left" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="neck_rom_turn_left_pain" value="|, exacerbates pain|, ameliorates pain"]
tilting right: [select name="neck_rom_tilt_right" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="neck_rom_tilt_right_pain" value="|, exacerbates pain|, ameliorates pain"]
tilting left: [select name="neck_rom_tilt_left" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="neck_rom_tilt_left_pain" value="|, exacerbates pain|, ameliorates pain"]
Extension: [select name="neck_rom_extension" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="neck_rom_extension_pain" value="|, exacerbates pain|, ameliorates pain"]
Flexion: [select name="neck_extension" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="neck_rom_tilt_left_pain" value="|, exacerbates pain|, ameliorates pain"][/conditional]
[select name="neck_tenderness" value="No neck tenderness|Neck tenderness is noted "][conditional field="neck_tenderness" condition="(neck_tenderness).isNot('No neck tenderness')"][text name="neck_tenderness_pain" default=""][/conditional]
Palpation: [select name="neck_tenderness" value="no neck tenderness|neck tenderness is noted "][conditional field="neck_tenderness" condition="(neck_tenderness).isNot('no neck tenderness')"][text name="neck_tenderness_pain" default=""][/conditional][select name="neck_spasm" value="; no spasm is noted|; paracervical spasm is noted"][conditional field="neck_spasm" condition="(neck_spasm).isNot('; no spasm is noted')"][select name="neck_spasm_location" value="| on the right| on the left| bilaterally"][/conditional]

BACK
Back Range of Motion: [select name="spine_rom" value="FROM|Decreased ROM"][conditional field="spine_rom" condition="(spine_rom).isNot('FROM')"]
turning right: [select name="spine_rom_turn_right" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="spine_rom_turn_right_pain" value="|, exacerbates pain|, ameliorates pain"]
turning left: [select name="spine_rom_turn_left" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="spine_rom_turn_left_pain" value="|, exacerbates pain|, ameliorates pain"]
tilting right: [select name="spine_rom_tilt_right" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="spine_rom_tilt_right_pain" value="|, exacerbates pain|, ameliorates pain"]
tilting left: [select name="spine_rom_tilt_left" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="spine_rom_tilt_left_pain" value="|, exacerbates pain|, ameliorates pain"]
Extension: [select name="back_rom_extension" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="back_rom_extension_pain" value="|, exacerbates pain|, ameliorates pain"]
Flexion: [select name="back_flexion" value="normal|slightly decreased|moderately decreased|markedly decreased"][select name="back_flexion_pain" value="|, exacerbates pain|, ameliorates pain"][/conditional]
Palpation: [select name="spine_tenderness" value="no spinal tenderness|spinal tenderness is noted "][conditional field="spine_tenderness" condition="(spine_tenderness).isNot('no spinal tenderness')"][text name="spine_tenderness_pain" default=""][/conditional][select name="spine_spasm" value="; no spasm is noted|; paralumbar spasm is noted"][conditional field="spine_spasm" condition="(spine_spasm).isNot('; no spasm is noted')"][select name="spine_spasm_location" value="| on the right| on the left| bilaterally"][/conditional]

SCAR INSPECTION, BACK AND NECK
Scarring: [select name="spine_scar" value="no spinal scar|spinal scar is noted "][conditional field="spine_scar" condition="(spine_scar).isNot('no spinal scar')"][text name="spine_scar_location" default=""][/conditional]
[textarea name="spine_rom_text" default="Spine: additional comments                                                            "]
GAIT
[select name="gait_exam" value="normal gait|antalgic gait favoring right|antalgic gait favoring left|abnormal gait"][conditional field="gait_exam" condition="(gait_exam).isNot('normal gait')"][text name="gait_exam_description" default="describe gait abnormality"][/conditional]

REFLEXES
[select name="reflexes_lower" value="KJs and AJs 1+ and symmetrical|KJs and AJs 2+ and symmetrical|KJs and AJs 3+ and symmetrical|Asymmetrical reflexes noted"][conditional field="reflexes_lower" condition="(reflexes_lower).is('Asymmetrical reflexes noted')"]
Left KJ [select name="reflexes_lower_left_KJ" value="not tested|0|1+|2+|3+|4+ with clonus"],    Right KJ [select name="reflexes_lower_right_KJ" value="not tested|0|1+|2+|3+|4+ with clonus"]
Left AJ [select name="reflexes_lower_left_AJ" value="not tested|0|1+|2+|3+|4+ with clonus"],    Right AJ [select name="reflexes_lower_right_AJ" value="not tested|0|1+|2+|3+|4+ with clonus"][/conditional]