FICHA ORTOPEDIA

Exames Complementares:
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Queixa Principal:
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H.M.A:
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H.M.P:
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HISTÓRIA SOCIAL E FAMILIAR:

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MEDICAÇÃO ATUAL:
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SINAIS VITAIS
Horário:
P.A: __________ F.C: ___________ F.R: ______________

EXAME FÍSICO
Inspeção:
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Palpação:
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ADM:
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GONIOMETRIA:
Flexores de quadril:
Extensores de quadril:
Flexores de joelho:
Extensores de joelho:
Inclinação de tronco:
Flexão de tronco:
Extensão de tronco:
Dorsiflexores:
Plantiflexores:

ENCURTAMENTO MUSCULAR:
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TESTE DE FORÇA MUSCULAR:

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TESTES ESPECIAIS: LASÉGUE:

MILGRAM:

GAELSLEN (sacroiliaca ) :
PATRICK ( sacroiliaca) :