TEST AND MEASURES ● Chest Pain
SUBJECTIVE: Pain ● Fatigue
Severity ● Shoulder and Arm Pain
1. Verbal Pain Scale (0-10) Neurological
2. Visual Analog Scale ● Hearing and Visual Changes
a. For pediatrics ● Frequent headache w/o hx of injury
b. For geriatrics ● Faint Spells
3. McGill Pain Questionnaire ○ Syncope
a. Emotional or Affective Component ● Sudden Weakness
Mechanism of Onset ● Hx of Injury
1. Provocative Factors or Aggravating Genitourinary | Gastrointestinal
2. Palliative Factors or Alleviating or Relieving ● Frequent abdominal pain
Centralization ● Frequent Nausea and Vomiting
● Localized ● GERD or Heartburn
● (-) Radiating Pain ● Menstrual Irregularities
● Good Prognosis
Peripheralization OBJECTIVE : Vital Signs
● (+) Radiating Pain Blood Pressure
● Poor Prognosis ● Normal: <120/80
Referred ○ Updated: 110/70
● Internal Organ Pain Systolic Diastolic
Pain Characteristics Prehypertensive 120-139 80-89
Type of Pain Quality Origin Stage 1 140-159 90-99
Vascular Throbbing , Pounding , Blood Vessels Stage 2 .>160 >100
Diffuse
Cramping Dull , Aching , Cramping Muscle Respiratory Rate
● Normal: 12-20 cpm
Bone Dull , Deep, Nagging Bone ○ Eupnea
(OA,RA) ○ Tachypnea: >20 cpm
○ Bradypnea: <12 cpm
Sympathetic Burning Thoracolumbar
Nerve Nerves Pulse Rate
● Normal: 60-100 bpm
Nerve Root Sharp , Shooting Nerve Root ○ Tachycardia: >100 bpm
○ Bradycardia: <60 bpm
Nerve Sharp , Lighting like Nerve
● Grading of Pulse
Fracture / Sharp , Intolerable Pain Bone / Joint ○ 0 - Absent
Dislocation ○ 1 - Thready
○ 2 - Weak
○ 3 - Normal
Red Flag Signs
○ 4 - Bounding
Cancer
Irregular Pulses
● Unexplained weight loss
● Consistent at night Pulsus Tardus Weak amplitude , Delayed , ↓SV/CO
● Loss of appetite
Pulsus Bisfriens 2 Abnormal Systolic Beats , Aortic Stenosis ,
● Unusual lumps or growth
Regurgitation
Cardiovascular
● Shortness of breath Pulsus Alterans Alternating weak and strong beats
● Dizziness
, Pulsus Paradoxus Abnormal respiration during inspiration Hand
➤Pericarditis (Pericardial Friction)
➤Cardiac Tamponade Finger MCP
Flexion 90
Temperature
● Normal: 37 celsius Extension 45
○ Normothermia
Finger PIP
○ Hyperthermia: >37 celsius
○ Hypothermia: <37 celsius Flexion 100
Range of Motion Extension 0
● Tools: Goniometer and Tape measure
Finger DIP
Upper Extremity
Flexion 90
Shoulder
Extension 0
Flexion 180
Thumb CMC
Extension 60
Flexion 15
Abduction 180
Extension 20,80
Medial Rotation 70
Abduction 70
Lateral Rotation 90
Thumb MCP
Elbow and Forearm
Flexion 50
Flexion 150
Extension 0
Extension 0
Thumb IP
Pronation 80
Flexion 80
Supination 80
Extension 20
Wrist
Capsular Pattern
Flexion 80
Extension 70
Radial Deviation 20
Ulnar Deviation 30
SUBJECTIVE: Pain ● Fatigue
Severity ● Shoulder and Arm Pain
1. Verbal Pain Scale (0-10) Neurological
2. Visual Analog Scale ● Hearing and Visual Changes
a. For pediatrics ● Frequent headache w/o hx of injury
b. For geriatrics ● Faint Spells
3. McGill Pain Questionnaire ○ Syncope
a. Emotional or Affective Component ● Sudden Weakness
Mechanism of Onset ● Hx of Injury
1. Provocative Factors or Aggravating Genitourinary | Gastrointestinal
2. Palliative Factors or Alleviating or Relieving ● Frequent abdominal pain
Centralization ● Frequent Nausea and Vomiting
● Localized ● GERD or Heartburn
● (-) Radiating Pain ● Menstrual Irregularities
● Good Prognosis
Peripheralization OBJECTIVE : Vital Signs
● (+) Radiating Pain Blood Pressure
● Poor Prognosis ● Normal: <120/80
Referred ○ Updated: 110/70
● Internal Organ Pain Systolic Diastolic
Pain Characteristics Prehypertensive 120-139 80-89
Type of Pain Quality Origin Stage 1 140-159 90-99
Vascular Throbbing , Pounding , Blood Vessels Stage 2 .>160 >100
Diffuse
Cramping Dull , Aching , Cramping Muscle Respiratory Rate
● Normal: 12-20 cpm
Bone Dull , Deep, Nagging Bone ○ Eupnea
(OA,RA) ○ Tachypnea: >20 cpm
○ Bradypnea: <12 cpm
Sympathetic Burning Thoracolumbar
Nerve Nerves Pulse Rate
● Normal: 60-100 bpm
Nerve Root Sharp , Shooting Nerve Root ○ Tachycardia: >100 bpm
○ Bradycardia: <60 bpm
Nerve Sharp , Lighting like Nerve
● Grading of Pulse
Fracture / Sharp , Intolerable Pain Bone / Joint ○ 0 - Absent
Dislocation ○ 1 - Thready
○ 2 - Weak
○ 3 - Normal
Red Flag Signs
○ 4 - Bounding
Cancer
Irregular Pulses
● Unexplained weight loss
● Consistent at night Pulsus Tardus Weak amplitude , Delayed , ↓SV/CO
● Loss of appetite
Pulsus Bisfriens 2 Abnormal Systolic Beats , Aortic Stenosis ,
● Unusual lumps or growth
Regurgitation
Cardiovascular
● Shortness of breath Pulsus Alterans Alternating weak and strong beats
● Dizziness
, Pulsus Paradoxus Abnormal respiration during inspiration Hand
➤Pericarditis (Pericardial Friction)
➤Cardiac Tamponade Finger MCP
Flexion 90
Temperature
● Normal: 37 celsius Extension 45
○ Normothermia
Finger PIP
○ Hyperthermia: >37 celsius
○ Hypothermia: <37 celsius Flexion 100
Range of Motion Extension 0
● Tools: Goniometer and Tape measure
Finger DIP
Upper Extremity
Flexion 90
Shoulder
Extension 0
Flexion 180
Thumb CMC
Extension 60
Flexion 15
Abduction 180
Extension 20,80
Medial Rotation 70
Abduction 70
Lateral Rotation 90
Thumb MCP
Elbow and Forearm
Flexion 50
Flexion 150
Extension 0
Extension 0
Thumb IP
Pronation 80
Flexion 80
Supination 80
Extension 20
Wrist
Capsular Pattern
Flexion 80
Extension 70
Radial Deviation 20
Ulnar Deviation 30
