1st Edition

Special Tests of the Cardiopulmonary, Vascular, and Gastrointestinal Systems

    Organized in a user-friendly format, Special Tests of the Cardiopulmonary, Vascular, and Gastrointestinal Systems provides a unique, compact, and concise summary of over 95 special tests and exam procedures.

    Drs. Dennis O’Connell, Janelle O’Connell, and Martha Hinman have organized Special Tests of the Cardiopulmonary, Vascular, and Gastrointestinal Systems by the different systems and describe each special test in terms of clinician action, normal findings, positive findings, special considerations, and references. Each major body region covered also includes a brief section on its history.

    Features:
    • Includes more than 95 different tests and exam procedures such as Respiratory Rate Rhythm, Carotid Artery Auscultation, Ankle-Brachial Index Test, Palpation of Abdominal Organs and Aorta, Two-and Six-Minute Walk Tests, the Talk Test, and Non-Exercise VO2max Tests
    • More than 125 photographs and illustrations, including “how-to” photographs.
    • Specific references based upon the latest evidence available.
    • Includes 6 appendices covering topics such as Maximal Aerobic Power, Treadmill Calibration, and Astrand-Rhyming Nomogram.
    • User-friendly, spiral, lay-flat binding.

    In addition to the special tests categories, a submaximal exercise evaluation section has been added for clinicians who believe exercise is an excellent preventive and rehabilitative tool but who may be unfamiliar with the topic.

    Special Tests of the Cardiopulmonary, Vascular, and Gastrointestinal Systems is a must-have resource for students and clinicians in physical therapy, athletic training, and occupational therapy looking to recall the specifics of a particular test or learning it for the first time.

    Also serves as a great companion to the popular texts, Special Tests for Orthopedic Examination, Third Edition and Special Tests for Neurologic Examination.
     

    Dedication

    Acknowledgments

    About the Authors

    Preface

    Foreword by Donald K. Shaw, PT, PhD, FAACVPR

    Introduction

    Section One: Examination of the Cardiovascular System

    Cardiovascular Disease Risk Factors

    Heart Rate—Resting (Adults)

    Heart Rate—Resting (Infants-Adolescents)

    Pulses

    Blood Pressure Measurement

    Pulse Pressure

    Rate-Pressure Product or Double Product

    Acute Chest Pain—Cardiac Origin

    Angina Pain Rating Scale

    Other Sources of Chest Pain

    Cardiac Inspection and Palpation

    Auscultation

    Jugular Venous Distension

    Section Two: Examination of the Pulmonary System

    Respiratory History

    Inspection of the Thorax

    Pulmonary Anatomy

    Respiratory Rate

    Respiratory Rhythm

    Respiratory Depth and Symmetry of Movement

    Thoracic Depth, Width, and Diameter

    Thoracic Excursion Measurement via Circumference

    Palpation of Tactile Fremitus

    Percussion

    Diaphragmatic Excursion

    Auscultation Technique and Normal Sounds

    Auscultation of Transmitted Voice Sounds

    Oxygen Saturation

    Chest Disorders

    Dyspnea With Activities of Daily Living

    Dyspnea at Rest

    Dyspnea During Activity

    Section Three: Examination of the Abdomen

    Inspection

    Auscultation of the Abdominal Vasculature

    Percussion of the Abdomen

    Light Palpation of the Abdomen

    Deep Palpation of the Abdomen

    Deep Palpation of the Abdomen—Bimanual Technique

    for the Liver

    Deep Palpation of the Abdomen—Bimanual Technique

    for the Spleen

    Deep Palpation of the Abdomen—Bimanual Technique

    for the Kidneys

    Deep Palpation of the Aorta

    BlumbergÆs Sign (Rebound Tenderness)

    MurphyÆs Sign

    Iliopsoas Muscle Test for Appendicitis

    Obturator Muscle Test for Appendicitis

    Assessment of Diastasis Recti (Done)

    Section Four: Examination of the Peripheral

    Vascular System

    Peripheral Vascular History: Differential Diagnosis

    for Arterial and Venous Diseases

    Assessing the Integumentary System for Skin Cancer

    Skin Turgor

    Skin Temperature

    Figure-of-Eight Methods for Measuring Limb Edema

    Volumetric Measures of Limb Edema

    (Water Displacement Method)

    Girth Measurements and Estimated Limb Segment Volume

    Capillary Refill Time Test (CRTT)

    Elevation Pallor

    Stoop Test

    Treadmill Time to Claudication

    Active Pedal Plantarflexion (APP)

    Intermittent Claudication Test

    AllenÆs Test for Hand Circulation

    Vertebral Artery Test

    Roos Test for Thoracic Outlet Syndrome (TOS)

    Ankle-Brachial Index (ABI)

    HomansÆ Test

    WellÆs Clinical Prediction Rule for Deep Vein Thrombosis

    WellÆs Clinical Prediction Rule for Pulmonary Embolism

    Clinical Prediction Rule for Upper Extremity Deep Vein

    Thrombosis

    Cuff Test for Venous Insufficiency/Occlusion

    Venous Percussion, Tap, or Cough Test

    Venous Filling Time

    Pitting Edema

    Kaposi Stemmer Sign (Edema vs Lymphedema)

    Auscultation of Carotid Artery

    Section Five: Submaximal Exercise Evaluation

    Concepts of Submaximal Testing

    Oxygen Consumption and METs

    Metabolic Equivalents (METs)

    Measuring Exercise Heart Rate

    Predicting VO2max From Submaximal Heart Rate Data

    Max METs Normative Data

    Risk Stratification for Exercise Testing or Prescription

    General Exercise Test Procedural Information

    Bruce Treadmill Protocol

    Exercise Test or Exercise Session Termination

    Prediction of VO2max via Nonexercise Survey

    Duke Activity Status Index

    Two-Minute Walk Test

    Six-Minute Walk Test

    Six-Minute Walk Test on Treadmill for Younger Adults

    Timed One-Mile Walk

    Seated Step Test (SST)

    Tecumseh Step Test

    YMCA Step Test

    Astrand-Rhyming Cycle Ergometer Test

    YMCA Cycle Ergometer Test

    Single-Stage Treadmill Test

    Naughton Treadmill Protocol

    Wheelchair Test

    The Talk Test (Indirect Assessment of Anaerobic Threshold)

    Calculating Target Heart Rates

    Appendices

    Appendix A: Maximal Aerobic Power

    Appendix B: Monark Cycle Ergometer Calibration

    Appendix C: Treadmill Calibration

    Appendix D: HR-MET Chart Altug Book

    Appendix E: YMCA HR-VO2max Chart

    Appendix F: Astrand-Rhyming Nomogram

    Index

    Biography

    Dennis G. O’Connell, PT, PhD, CSCS, FACSM is a founding member of Hardin-Simmons University Department of Physical Therapy. He serves as a professor and the Shelton-Lacewell Endowed Chair. He is an adjunct professor at the Rocky Mountain University of Health Professions in Provo, Utah.    

    Dr. O’Connell received his Bachelor of Science in Physical Education from Manhattan College, his Master of Arts and PhD in Exercise Physiology from Kent State University and the University of Toledo, respectively. He obtained a second Bachelor of Science degree in Physical Therapy from The University of Texas Health Science Center at San Antonio.   

    Dr. O’Connell has 30 years of experience as an exercise physiologist and 15 years as a physical therapist. His clinical experience has centered on patients with cardiac, pulmonary, and musculoskeletal disorders, and ergonomic issues. In addition to providing pro bono services on-campus, he and his wife, Janelle, created HSU PT Ministries and have served with their students in Guatemala, Mexico, and Abilene, TX.   

    Janelle K. O’Connell, PT, PhD, DPT, ATC, LAT 
    is a founding member of Hardin-Simmons University Department of Physical Therapy where she currently serves as professor and department head.   Dr. O’Connell received her Bachelor of Science in Education from Central Michigan University, her Master of Arts in Exercise Physiology from Kent State University, and her PhD in Health Promotion from the University of Toledo. She has earned an entry-level MPT and a DPT from Hardin-Simmons University.    
    Dr. O’Connell has 14 years of experience as a physical therapist and has been an athletic trainer for 31 years. As an athletic trainer, Dr. O’Connell has worked in high school and collegiate sports and in athletic training education. She is a Certified Exercise Expert for Aging Adults and enjoys working with the elderly.    

    Martha R. Hinman, PT, EdD, CEEAA 
    is a professor in the Hardin-Simmons University Department of Physical Therapy and an adjunct professor at the University of Alabama at Birmingham and the University of Indianapolis. Dr. Hinman received her Bachelor of Science in Physical Therapy and her Master of Health Education from the Medical College of Georgia and earned her EdD in Allied Health Education and Administration at the University of Houston.    

    Dr. Hinman's 34 years of experience as a physical therapist have focused in the areas of wound care, orthopedics, and geriatric wellness. She is a Certified Exercise Expert for Aging Adults and has expertise in the assessment of fall and fracture risk in the elderly. Dr. Hinman has been involved in physical therapy education for 30 years and has served as an educational consultant and accreditation reviewer for numerous physical therapy programs across the United States.