 His cognition is alert and oriented x 4.,PHYSICAL EXAMINATION:,EXTREMITIES:  Upper extremity range of motion is within functional limits, has 4-5 strength proximally and 5/5 distally. 
His cognition is alert and oriented x 4.,PHYSICAL EXAMINATION:,EXTREMITIES : Upper extremity range of motion is within functional limits , has 4 - 5 strength proximally and 5/5 distally .