Extremity-Sorgenfrey - Palmer College of Chiropractic, Intranet ...

PALMER COLLEGE OF CHIROPRACTICSYLLABUSEXTREMITY ADJUSTING (TECH 81617)Summer 20135 credit hoursI. Technique Director: John Strazewski, D.C., M.S. Ed.II.III.Meeting Dates: Mondays through FridaysMeeting times and location: TECH81617 01 at 12:05 p.m. andTECH81617 02 at 1:00 p.m.; both in Room W214Course Director: Glenn Sorgenfrey, D.C., Associate ProfessorOffice location: W217Office phone: 884-5231Office hour: 10:15 hour or by appointmentE mail: Sorgenfrey_g@palmer.eduCourse Instructors: (back-ups): TBAIV.Pre-requisite Courses: All TECH courses 1-5 triV. Co-requisite Courses: NoneVI.VII.VIII.This course is a pre-requisite to: CLIN 82831 Clinic ICLIN 82821 Clinic Case Corr ICourse description: This course places emphasis on the analytical aspects of extremity care.Consultation, examination, and X-ray techniques are covered to determine when and when not to adjustthe extremities. Analysis and adjusting of the entire appendicular skeleton are taught.Course goals: The students will be able to locate palpable landmarks in the upper and lower extremities,use a neuromuscular examination to determine joint dysfunction and devise an appropriate correctionand course of patient management.Students enrolled in this course are eligible to participate in an associated learning lab to further practicetheir examination and adjusting skills. The learning lab provides student access to faculty supervisionoutside of their assigned class hour. The lab is available on Monday from 3:45-4:35, Tuesdays from9:20-10:10 and also on Friday from 9:20-10:10. Details concerning this lab can be found atw3.palmer.edu/technique/Learning Lab.htm.1

IX. Course OutcomesA. Knowledge students will possess upon completion of the course:A1. Appreciate the need to explain what will be done when administering the chiropractic adjustment ormanipulation, discuss risks, and recognize the potential for patient apprehension and concern.A2. Value patient privacy and modesty in the course of administering chiropractic adjustments ormanipulation.A3. Be aware of the need to reassess and modify chiropractic adjustment or manipulation appropriate tothe needs of the patient.K1 Recognize clinical indicators of normal or abnormal joint function.K2 Interpret clinical findings to determine the need for chiropractic care of the upper and lowerextremitiesK3 Formulate a chiropractic listing from abnormal clinical findings.K4 Demonstrate an appropriate adjusting procedure based on clinical findings.K5 Explain how to monitor effects of extremity adjusting.K6 Formulate a management plan on a patient with extremity dysfunction.B. Skills students will possess upon completion of the course:S1 Position the patient for an extremity adjustment.S2 Palpate the extremity joints for dysfunctionS3 Demonstrates a proper chiropractic set up on a simulated patient.XI. Evaluation Methods:A. Class participation credit 4 pointsB. Shoulder practical 16 pointsC. Elbow, wrist and hand practical 20 pointsD. Upper extremity written 30 pointsE. Hip and knee practical 24 pointsF. Foot and ankle practical 24 pointsG. Final practical 28 pointsH. Final written 50 pointsTotal 196 pointsXII.Evaluation Schedule: See course calendar on Technique Dept. website,http://w3.palmer.edu/technique or the SunGARD https://portal.palmer.edu/default2

XIII.Grading Standard:184-196 points = A170-183 points = B156-169 points = C155 points or below = FXIV. Policies relating to the course:A. Academic Adjustments for Qualified Students with Disabilities Statement:Palmer College of Chiropractic makes reasonable academic adjustments for qualified students withdisabilities, as required by law. Any qualified student with a disability who requires a reasonableacademic adjustment to perform the academic and technical standards requisite to participation inthis course is to contact the Disabilities Coordinator to request such an academic adjustment.B. Statement on religious observance:In order to accommodate an individual student’s participation in religious observances, PalmerCollege requires that the student advises each of their instructors, in writing, at the beginning of anacademic term the holiday and date of observance the student is requesting relief from theircourse(s). This policy does not in any way release the student from the responsibility of satisfyingall requirements necessary for the successful completion of any course.C. Statement on Academic Integrity:Students are expected to comply with Palmer’s Student Code of Ethics. Students are stronglyencouraged to carefully read the entire Student Code of Ethics as published in the StudentHandbook. Cheating, plagiarism, other acts of dishonesty and/or any other violation of Palmer’sStudent Code of Ethics may result in the filing of a charge of misconduct under the StudentDisciplinary Code as described in the Student Handbook. Students charged with misconduct will beassigned a grade of “Incomplete” until the charge(s) is concluded in accordance with the StudentDisciplinary Code as described in the Student Handbook. Sanctions up to and including denial ofacademic credit, suspension or dismissal from the College may be imposed upon students found tohave violated the Code of Student Ethics. Please refer to the Palmer Student Handbook. You mayaccess the Student Handbook online at: http://www.palmer.edu/news2.aspx?id=1688. Further,students, as a condition of admission, agree to abide by all palmer College of Chiropracticregulations contained the College Catalog, Student Handbook, other publications and notices placedon official College bulletin boards, including its website.D. All other policies pertaining to Technique courses are available at the Technique Departmentwebsite, http://w3.palmer.edu/technique.XIV. Course Text(s)Required Materials: NoneSuggested materials: Extremities: Adjusting and Evaluation, BurnsXV. Other materials required by the course: Gown/towel to be placed between the skin and the adjustingequipment.XVI. Recommended reading/resources:A. Radiographic Positioning for the Chiropractor, PercuocoB. Physical Examination of the Spine and Extremities, HoppenfeldC. Joint Pain, MennelD. The Physiology of the Joint, Upper Extremity, KapandjiE. The Physiology of the Joint, Lower Extremity, KapandjiF. Radiographic Positioning and Related Anatomy, MeschanG. AMA Guide--Evaluation of Permanent ImpairmentH. What You Should Know About Extremity Adjusting, Heron3

I. Illustrated Essentials in Orthopedic Physical Assessment, EvansJ. Hammer, W., Functional Soft Tissue Examination and Treatment by Manual Methods, AspenPublicationXVIII. See the calendar link for the department website, http://w3.palmer.edu/technique, or at the SunGARDsite, https://portal.palmer.edu/default.XIX. Topic outline:Week 1 -- Introduction to extremities and shoulder ROM, O/NWeek 2 -- Shoulder examination and adjusting proceduresWeek 3 – Shoulder exam and adjusting proceduresWeek 4 – Upper extremity x-ray exam and practiceWeek 5 -- Shoulder girdle practice and practicalWeek 6 -- Elbow examination and adjusting procedures Wrist examWeek 7 – Wrist adjusting procedures, practice; hand exam and adjusting procedures;Week 8 -- Elbow, wrist and hand practical; Upper extremity written; Hip examination and adjustingprocedures, knee orthopedic examinationWeek 9 -- Knee adjusting procedures, practice;Week 10 – Hip and knee practical examination Ankle exam and adjusting proceduresWeek 11 -- Ankle and foot exam and adjusting proceduresWeek 12 -- Ankle and foot practical; practice, orthotics discussionWeek 13 – Final practical;Week 14 -- TMJ exam and adjusting procedures; Make-up examsWeek 15 -- Final writtenXX. Developed: 1990 Reviewed/Revised: February 2013* This syllabus does not constitute a contract. The purpose of the document is to provide a guide to students.The professor reserves the right to alter, amend or modify the conduct of the class at his discretion.4

Dr. Sorgenfrey’s Extremity Class Rubric for Practical ExaminationsPracticals pointBreakdownsMiss 1 item = 3 pointsMiss 2 items or 1 reconsider= 2 pointsMiss 3 items or 1 reconsider& 1 item = 1 pointMiss 4 items or 2reconsiders = 0 pointsOrthopedicTestsPerformance, patientPlacement,DS, SCP,CP, positive,indicationAdjustingSet-upsDS, PP, CHCP, SCP,SH, SP,SSP, TP, RI,TQ, STAB.LOC,Question (found in theLibrary on reserve).Procedure5

Simulated Patient EvaluationGrading SheetDr. Sorgenfrey - ExtremitiesExtremity Scenario - Card #Categories to be Graded1 Case History0 = no questions asked1 = asks question(s) regarding the scenario on the card2 = asks questions needed to make a good working diagnosis(Examiner provides answers to student’s questions)2 Differential Diagnoses:0 = none given2 = diff dx 1 subluxation from another subluxation4 = diff dx subluxation(s) from soft tissue, visceral, or otherStudent:_____________Matric: _____________Date: __________Points Possible0 1 20 2 43 Visualization-ROM-Ortho-Neuro2 = for each area covered to rule out differential diagnoses above.VisualizationROMOrthoNeuro4 Pain PointVerbalized and pointed out location where pain point would be for the diffdx5 Fluid Motion1 = for FM for actual subluxation2 = if did FM for any differential dx0 2 4 60 20 1 26Least to Most InvasiveDid the student work using less invasive procedures before using moreinvasive procedures? 0 27Traction Adjustment:(write down move you asked student to perform)8 Thrusting Adjustment:(write down move you asked student to perform)Post Checks, Patient InstructionsFM if appropriate, pain point, ROM, neurologic tests, other.Patient instructions (if appropriate)0 1 2 3 40 1 2 3 40 1 2Total Points28 PossibleGrader’s Initials: __________Comments:6