1st Edition
Special Tests of the Cardiopulmonary, Vascular, and Gastrointestinal Systems
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.
