TEST & MEASUREMENT V/S: BP: N: 120/80 mmHg

S: Location Pain, Severity of Pain, Type, PR: 60-100bpm

Palleative/Provocative
RR: 16-20cpm
O: Vital Sign: Pulse: AbN, Factors Affect: Temp
Temp: 37 C
A: ROM, MMT, Anthropometric, NeuroAna, DTR,
Sensory: Superficial, Cortical, Deep NB: 80/55 mmHg

Tone Ass, Coordination Ass, Fxnal Ass, Balance Ass. PR: 120 – 140 (125) bpm

LOCATION OF PAIN RR: 20-30 cpm

Line of body Diagram: “Ginger Bread Man” Pedia: inc Temp

ADV: 1. Boundaries of pain Geria: dec. Temp

2. Compensation “

3. Type of Pain Types of HPN

SEVERITY OF PAIN I. 140/90mmHg

II. 160/100
1. Numerical pain scale: 0-10 Pts. III. 180/110
2. Visual Analog Scale: 10 cm line; 2 VAS line IV. 200/120
super; severe
3. Mc Gill questionnaire: assess the affective & Malignant HPN: 220/140 mmHg, can lead to death
emotional, type of pain.
Factors that affect Temp
TYPE OF PAIN
Gender: F>M
Dull, cramping – m.m
Heightened emotion: inc
Deep, nagging - Bone
Env’t: weather
Sharp, shooting - n.root
Menstruation: Inc
Bright, lightning – nerve
Night: inc.
Pounding, aching –blood vessel
Pulse AbN:
Burning, aching – sympathetic n.
1. Pulsus Tardus: low amplitude pulse
2. “ Alterans: alt. Pulse lead to L ventric. Prob
3. “ Paradoxus: inc PR during exercise
Palleative Dec PR: inhale ( COPD, Pericarditis

Palleative/Provocate ROM

Quality of Sx End Feels

Radiation of Sx : Pain N: 1. Soft –M.M

Severity of Sx; 2. Hard – bone to bone

Temporal Characteristic: onset/duration/pain 3. firm – tissue stretch

AbN: Neuro Ass:

1. Hard Capsular : frozen shd Superficial: stroking of skin can cause contraction of
2. Empty: Bursitis m.m.
3. m.m spasm “ Pulikat”
1. Abdominal reflex
MMT: Beaver’s sign: stimulus: tickle navel
T7-T9 upper umbilicus: Umbilicus goes up
0 zero No contraction T11-T12 Lower “ : Umbilicus goes down
* during sit-up
1 trace palpable contraction
2. Cremasteric Reflex: gentle stroking of medial
2 poor full ROM, gravity eliminated thigh : ipsilateral erection of testicle
3 fair “ ,against gravity Bulbocavernous reflex: SCI
4 good “ ,mod. resistance : spinal shock w/in 24 hrs
5 Normal “ ,max. resistance Stimulus: pinch/ pressure on glans penis

G prognosis: if contraction on Anal ; spinal shock

subside
MMT Face:
Pudendal Reflex
Zero: no contraction
Apply: Pressure/pinch clitoris, other hand on Anal
Trace: palpable ‘ : non-fxnal
Plantar Reflex: Lat to Med. MT
Fair : w/ fxnal w/ difficulty
AbN: fanning of Toes: Babinski
Normal: Fxnal w/o difficulty
N: flexion of Toes

Anthropometric
Babinski like Reflex
LLD ; ALL apparent leg length (pelvic Obliquity)
Gordon: gastroc/calf m.m (squeeze)
Umbilicus to Med. Malleoli
Stransky: abduct little toe
TLL true leg length (bone shortened)
Chaddock: lat. Malleoli (stroke)
ASIS to med. Malleoli
OppenHeum: Tibial crest ( med. Tibial crest)

Stump Measurement
Bing: Flick: & Gonda: pinprick for Little Toe
AEA: Acromion to End of Stump

BEA: Med. Epicondyle to EOS

Piottwski: tap Tibialis Ant.
AKA: inguinal line (T12) to EOS
Hoffman: Flick 1 finger: other finger will Flex
BKA: Medial Tibial Plateau to EOS
DTR: TONE ASS:

BICEP: C5-C6 SPASTICITY: VELOCITY DEPENDENT

BRACHIO: C6-C7 RIGIDITY; NON-VELOCITY DEPENDENT

TRICEPS: C6 C7 C8

QUADS: L3-L4 MODIFIED ASHWORTH SCALE

HAMS: MED: L5-S1 0:NORMAL

LAT: S1-S2 1: SLIGHT INC. M.M. TONE END RANGE

1+ : “ “ ; LESS THAN HALF OF RANGE

Sensory ASS: 2: MARKED INC. M.M TONE ; MORE THAN HALF

Superficial: 3: CONSIDERABLE INC. M.M. TONE; ALL THROUGH

OUT
HOT: 40 – 45 C
4: RIGIDITY
COLD: 5-10 C

PAIN: BLUNT END

RIGIDITY:
LT. TOUCH : BRUSH
COGWHEEL: RATCHER-LIKE; SERIES OF BREAK AWAY
ANALGESIA: TOUCH
LEAD PIPE: CONSTANT RIGIDITY ; MORE SEVERE
ANESTHESIA: PAIN

THEMENESTHESIA: TEMP
COORDINATION:

CEREBELLUM:
CORTICAL:
DYSMETRIA
STEREOGNOSIS; SHAPE
DYSDIADOCHOKINESIA
BAROGNOSIS: WEIGHT
DYSARTHRIA
GRAPHESTHESIA: LETTERS & NUMBERS
RECOGNITION ATAXIA

TOPOGNOSIA: TOUCH NYSTAGMUS

DEEP: VIBRATION: TUNING FORK TREMOR (INTENTION)

PROPRIOCEPTION ; POS’N SENSE HYPOTONIA

KINESTHESIA; MOV’T SENSE REBOUND PHENOMENON

BASAL GANGLIA: KURTSKI: MG

BRADYKINESIA RANKINS: LEVEL OF DISABILITY OF STROKE

RIGIDITY BALANCE ASS:

AKINESIA BERG BALANCE:

TREMOR (RESTING) POMA: PERFORMANCE ORIENTED MOBILITY

ASSESSMENT : ADL
CHOREA

ATHETOSIS

DYSTONIA

DORSAL COLUMN;

EQUILIBRIUM: DYNAMIC AND STATIC

BALANCE: ROMBERG’S TEST: STANDING BLIND

FOLDED

FXNAL ASS:

INDEPENDENT: 100% PX ALONE

SUPERVISION: 100% PX ALONE W/ SUPERVISION

CLOSE GUARDING: 100% “ W/ PT BEDSIDE

CONTACT “: “ W/ CONTACT GUARDING

MINIMAL ASSIST: 75% PX, 25% PT

MOD. ASSIST: 50% PX, 50%PT

MAX ASSIST: 25% PX, 75% PT

TOTAL ASSIST: 100% PT; PASSIVE MOV’T

Scales:

FIM: 7 SCALES

WEEFIM: PEDIA

BARTHEL: 0-100 PTS. PERFORMANCE ADL

FUGL MEYER: FXNAL OUTCOME OF STROKE PX

KARNOFSKI: CANCER