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Chiropractic Methods I: skills analysis 1 - #33010


 

 

Department of Principles and Methods Faculty
Coordinator: Link Larson , DC
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30.0
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The fundamental terminology and skills used by the chiropractor during patient assessment (PARTS) are introduced; including patient observation and postural assessment; visual recognition and palpation of topographical landmarks; segmental motion palpation; and the physical and radiographic recognition of vertebral dysrelationships.

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Course Objectives
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  1. COGNITIVE SKILLS:

    1. Understand and use terminology common to chiropractic methods.
    2. Know the P.A.R.T.S acronym, and understand its contents.
    3. Integrate static findings and Xray findings in the analysis of the spine and skeletal system.
    4. Be able to give static listings from palpatory and Xray assessment of spinal radiographs.

  2. PSYCHOMOTOR SKILLS:

    1. Prepare a patient for chiropractic examination.
    2. Statically palpate individual spinal vertebrae, the pelvis, the ribs, and the upper/lower extremities, and assess regional R.O.M of the cervical, thoracic and lumbar spine.
    3. Perform a postural analysis on a patient.
    4. Locate active and latent trigger points.
    5. Assess for paraspinal tenderness, temperature, tone and texture.
    6. Equipment management

  3. AFFECTIVE SKILLS:

    1. Proper gowning of patients to respect and maintain their comfort zones in the performance of static palpation, and postural analysis.
    2. Appropriate touch of patients to respect and maintain their comfort zones in the performance of static palpation, and postural analysis. This includes the ability to communicate with the patient what examination procedure is about to be performed, why it is necessary to perform it, and how it will be performed.
    3. Respect for the patient's tolerance levels when performing testing procedures.
Materials
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A. Required Text(s):
  1. Class notes
  2. Chiropractic Technique; 2nd edition; Bergmann and Peterson

B. Recommended Text(s):
  1. Clinically Oriented Anatomy (4th ed.); Moore & Dalley

C. Required Materials for Lab:
  1. Gowns and shorts to be worn in class
  2. Skin marking pencil
  3. Highly Recommended: Spine with the pelvis attached
Assignments
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  1. Practice material covered in class weekly
  2. Postural Evaluation
  3. Reading assignments
Attendance
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Attendance at lectures is expected with students being prepared to participate. Attendance in laboratory is required.
Grading Criteria
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  1. Examinations
    1. Final Practical Lab Exmination - 50 points
    2. Final Written Examination - 50 points

    Make up examinations are given with an excused absence. The usual fee will be charged, as outlined in the Student Handbook.

  2. Attendance - 5 points will be awarded for your attendance at, and successful completion of, each weekly laboratory session/assignment. Eleven to twelve lab sessions are scheduled; a maximum of 50 attendance points will be credited toward the course grade. More than three absences will result in failure of this class.

    In other words, no more than 1-2 absences are allowed during the term without your course grade being impacted. Holidays or weather-related considerations may decrease the total number of lab sessions for an individual section. Accommodation of attendance credit will be equitably made if such circumstances arise during the trimester.
  3. UHS - PATIENT ASSIGNMENT: Completion of the learning objectives that will be discussed in class; 50 points possible.

Guaranteed grades are as follows:

A = 100 - 93% of total possible points
B = 92 - 86%
C = 85 - 80%
D = 80 - 75%
F = <75%
Course Competencies
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COGNITIVE DOMAIN


Students will understand the definition of the following terms and be able to use them appropriately:

a. anatomical position v. distortion
b. prone w. lesion
c. supine x. palpation
d. lateral y. palpatory skills
e. medial z. static palpation
f. transverse plane aa. palpatory diagnosis
g. horizontal plane ab. referred pain
h. sagittal plane ac. ropiness
i. median plane ad. rotation/spin
j. midsagittal plane ae. subluxation
k. frontal plane af. misalignment

l. coronal plane

 ag. contraction
m. ventral/anterior ah. altered interosseous spacing
n. dorsal/posterior ai. foraminal encroachment
o. cranial/superior/cephalad aj. malposition
p. caudal/inferior ak. myofacial trigger point
q. proximal al. homolateral
r. distal am. ipsilateral
s. bogginess an. contralateral
t. static listings (flexion/extension/ rotation/lateral flexion/ anterolisthesis/retrolisthesis lateral listhesis) ao. contact points on hand (index, pisiform, calcaneal, thenar, hypothenar, thumb, metacarpal, web, index, proximal interphalangeal, distal interphalangeal, distall)
u. diagnosis  


    Students will be able to interpret the P.A.R.T.S acronym

    Students will be able to interpret the following Houston subluxation listings:

  1. H: right/left rotation
  2. H: right/left lateral flexion
  3. H: flexion/extension
  4. H: anterolisthesis
  5. H: retrolisthesis
  6. H: right/left lateral listhesis
  7. H: LR,LLF
  8. H: LR,RLF
  9. H: RR,RLF
  10. H: RR,LLF


Conditions:
None

PSYCHOMOTOR DOMAIN


Through development of static spinal palpatory and postural examination skills, students will be able to identify and palpate the following structures:

a. Hyoid bone j. Transverse processes C1, T1-T12
b. Jugular notch k. Spinous processes C2-L5
c. Styloid process l. Articular pillars C2-C6
d. EOP m. Mammillary processes L1-L5
e. Inferior angle of the scapula n. Ribs 1-12 (costovertebral, posterior angle, sternocostal)
f. Xiphoid process o. Mastoid process
g. Umbilicus  
h. Iliac crests  
i. P.S.I.S  

    Through development of palpatory and observational skills, students will be able to identify the following structures:

    a. Sternum (manubrium, body, xiphoid)
    b. Chondrosternal joints
    c. Pectoralis major
    d. Coracoid process
    e. Pectoralis minor insertion at the coracoid
    f. Humerus/antebrachium
  • Greater tuberosity
  • Lesser tuberosity
  • Bicipital groove
  • Supraspinatus insertion
  • Biceps muscle OI
  • Triceps muscle O/I
  • Medial/Lateral epicondyle
  • Olecranon fossa
g. Elbow/brachium
  • Olecranon process ulna
  • Radial head
  • Medial/Lateral collateral ligaments
  • Cubital Fossa - biceps insertion, brachial artery,
  • Course of the radius & ulna
  • Radial & ulnar styloid
  • Brachioradialis mm.
h. Wrist and hand
  • Carpals (including pisiform & hook of hamate)
  • Flexor retinaculum
  • Metacarpal - phalangeal (MP) joints
  • Proximal (PIP) & Distal (DIP) interphalangeal joints

i. Greater trochanter

j. Pubis/pubic symphysis
k. Femur/thigh

  • Quadriceps muscles
  • Hamstring muscles
  • Medial/Lateral femoral condyles
  • Adductor tubercle
m. Knee
  • Patella (including patellar tendon & groove)
  • Tibial tuberosity
  • Medial/Lateral tibial plateau
  • Popliteal space
n. Leg
  • Fibula head & course of fibula
  • Course of tibia
  • Anterolateral muscles of the leg
    • tibialis anterior
    • extensor hallucis
    • peroneus longus & brevis
  • Medial & Lateral melleolus
o. Ankle & Foot
  • Talus
  • Calcaneus
  • Achilles' tendon
  • Cuboid
  • Navicular
  • Cuneiform 1-3
  • Metatarsals 1-5
  • MP, PIP & DIP joints
  • Observe the transverse & longitudinal arches in and off weight bearing

Students will be able to perform a postural analysis in a P-A and Lateral view, using the following landmarks

a. mastoid processes e. Achilles
b. a-c joint f. inferior angle of scapula
c. iliac crests g. greater trochanter
d. knee h. lateral malleolus/base of fifth metatarsal

    Students will be able to statically evaluate for spinal listings at all spinal levels.

    Students will be able to assess spinal and pelvic motion segments according to the following components of the P.A.R.T.S acronym for the manifestations of a subluxations:

  1. Pain: through the use of
    1) palpatory tenderness
    2) tenderness during static assessment
  2. Asymmetry: through the use of
    1) postural analysis
    2) static osseous alignment
    3) observation
    4) Xray observation
  3. Tone, Texture, Temperature
    1) through static palpation of spinal/paraspinal structures 
    2) locate active and latent trigger points
    3) through use and interpretation o fthe Nervoscope

    Students will be familiar with the following equipment
    a. Adjusting tables c. Spines/Skeletons
    b. Plumbline d. View boxes


AFFECTIVE DOMAIN


  1. Proper gowning of patients to respect and maintain their comfort zones in the performance of static palpation, and postural analysis.
  2. Appropriate touch of patients to respect and maintain their comfort zones in the performance of static palpation, and postural analysis. This includes the ability to communicate with the patient what examination procedure is about to be performed, why it is necessary to perform it, and how it will be performed.
  3. Respect for the patient's pain tolerance level when performing any provocative testing procedure such as static palpation.
Weekly Calendar of Learning Objectives
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Week Dates Topics/Learning objectives
Week 1

Session 1 Orientation, appropriate attire, , identifying chiropractic contact points on the hand. Points of the head,jaw and TMJ

Week 2 Session 2 Scapula, Thoacic spine, Touch, Terms, Spinal Evaluation
Week 3 Session 3 Thoracic Spine C2, C6, Cervical ROM, XYZ axis
Week 4 Session 4 Pelvis Lumbar ROM, Gillet testing
Week 5

Session 5 Lumbar spine, "joint Play"
Week 6 Session 6 Cervical Spine Postural Analysis
Week 7 Session 7 Mock Practical
Week 8

Session 8 Listings and PARTS
Week 9 Session 9 Soft Tissue evaulation, Nervoscope
Week 10

Session 10 Shoulder, Hip, Ribs, C motion "end play"

Week 11 Session 11 Elbow, Arm Knee, Leg
Week 12

Session 12 Wrist, Hand, Ankle, Foot and Muscle tesing

Week 13 Session 13 Reveiw
Week 14 FINAL EXAMINATIONS AS SCHEDULED
Week 15 FINAL EXAMINATIONS AS SCHEDULED
Please Note
This schedule of lecture and lab topics and quizzes and exams may be changed during the course of the trimester as circumstances require. Whenever possible, such changes will be announced in class before the date and time in question. You are responsible for anything that transpires during lectures and labs, even when you are unable to attend. In the event that you miss a class session, make sure you check with a classmate about any announcements or schedule changes which may have been made. Makeup exams are allowed only according to the policies described in the current student handbook, which is available in the Student Affairs office.
Maintained by Northwestern College of  Chiropractic
Last updated: 9-5-06
 

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