General: Alert & oriented x3. There is no evidence of rash involving the body.
Head: Head is norm cephalic and without evidence of extra cranial trauma. Temporal arteries are not tender to palpation and do not appear indurated. There are no temporal or cranial bruits. There is no tenderness along the frontal or maxillary sinuses.
Ears: TMs are intact and clear with normal canals and hearing. Weber is midline. Air conduction is greater than bone conduction.
Nose: No deformity, discharge, inflammation, or lesions.
Mouth: No deformity or lesions with good dentition.
Neck: His neck is supple with full range of motion of his neck with head turning on both directions/ There is some mild reduced range of motion of his/her neck with head turning on both directions. There is no meningeal signs. There is a negative Lhermitte sign. The nuchal and shoulder trapezius muscle are normal/tight but without spasm. There is not superimposed cervical paraspinous or nuchal trapezius muscle spasm. There are 2+ brisk carotid upstrokes without a definite bruit. There is no thyromegaly.
Lungs: Clear bilaterally to A & P.
Heart: Regular rate and rhythm,. S1 and S2 are present.
There is no S3 gallop, S4 gallop, murmur or click.Heart: Regular rate and rhythm, S1S2, without murmurs, rubs, gallops, or clicks. Msk: Pulses: Pulses are normal in all 4 extremities.
Extremities: On exmaination of the extremities there is full range of motion of all joints with no signs of inflammation includinig