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Approved by University Studies Sub-Committee February 4, 2009
Approved by Faculty Senate February 23, 2009
WINONA STATE UNIVERSITY
COLLEGE OF NURSING & HEALTH SCIENCES
DEPARTMENT OF HEALTH, EXERCISE & REHABILITATIVE SCIENCES
HERS 392 – INJURY RECOGNITION OF THE LOWER BODY (3 SH)
SPRING 2009
Professor: Shellie F. Nelson, Ed.D., ATC, ATR
Office: 363 Maxwell Hall
Phone: 507-457-5214
Email:
WSU Athletic Training Web Page: http://www.winona.edu/athletictraining
CATALOG DESCRIPTION:
Advanced course in the evaluation and recognition of athletic related injuries from the lumbar spine downward.
Prerequisites: HERS 191, 292, 314, 380 Course Applies to Athletic Training Majors ONLY
University Studies: This course satisfies the requirements for an Upper Division Oral Communications Flag of the University Studies Curriculum.
MAJOR FOCUS:
The student will take an in depth view of the etiology and clinical testing of common injury pathologies related to athletics.
TEXTBOOKS: (Required)
Hoppenfeld S. Physical Examination of the Spine and Extremities, New York, Apppleton-Century- Crofts, 1976
Kendall FP, McCreary EK, Provance PG. Muscles Testing and Function. 4th Edition. Baltimore, Williams and Wilkins, 1994
Starkey C, & Ryan J. Evaluation of Orthopedic and Athletic Injuries. 2nd Edition. F.A. Davis, 2002.
OUTCOMES:
Upon completion of the course, the student will be able to:
Demonstrate knowledge of anatomy relevant to covered pathologies by using profession specific language in oral/practical testing situations.
Verbally describe and demonstrate appropriate manual muscle testing procedures.
Produce Evaluation Scripts containing: relevant anatomy, palpation, AROM/PROM, clinical tests, special tests, functional tests, Muscle origin, insertion, action, innervation (nerve name, branch and root), and nuerological examination that includes: myotomes, dermatomes and reflexes.
Verbally describe using profession specific language and demonstrate appropriate clinical assessment tests and neurovascular clinical examinations.
Participate in summative mock injury situations. Students will: act as an “injured” athlete by interpreting, synthesizing, and modifying provided information and students will also “examine” the “injured” athlete using learned interviewing techniques and clinical assessment techniques. “Examiners” will use profession specific documenting techniques and then verbally present “pertinent positives and negatives”, findings, and treatment to the instructor.
Students will participate in an oral/practical examination 4-5 times each semester and be expected to verbally describe and demonstrate clinical skills learned.
Reproduce specific information covered in class, and in reading assignments on written examinations.
Athletic Training Competencies
Orthopedic Clinical Examination and Diagnosis (DI)
In order to demonstrate knowledge of the practice of athletic training, to think critically about the practices involved in athletic training, including the ability to integrate knowledge, skill, and behavior, and to assume professional responsibility, the entry-level certified athletic trainer must possess the ability to clinically examine and diagnose a patient for the purpose of identifying (a) common acquired or congenital risk factors that would predispose the patient to injury and (b) musculoskeletal orthopedic injuries to determine proper care including the referral of the patient to other health care providers when appropriate.
The Cognitive and Psychomotor Competencies and Clinical Proficiency in this section should encompass the following body areas:
a. foot and toes
b. ankle
c. lower leg
d. knee (tibiofemoral and patellofemoral)
e. thigh
f. hip/pelvis/sacroiliac joint
g. lumbar spine
h. thoracic spine
i. ribs
The use of learning objectives and outcomes in orthopedic clinical examination and diagnosis ensures that the student is able to:
Cognitive Competencies
1. Demonstrate knowledge of the systems of the human body
2. Describe the anatomical and physiological growth and development characteristics as well as gender differences across the lifespan.
3. Describe the physiological and psychological effects of physical activity and their impact on performance.
4. Explain directional terms and cardinal planes used to describe the body and the relationship of its parts.
5. Describe the principles and concepts of body movements including functional classification of joints, arthrokinematics, normal ranges of joint motion, joint action terminology, and muscle groups responsible for joint actions (prime movers, synergists), skeletal muscle contraction and kinesthesis/proprioception.
6. Describe common techniques and procedures for evaluating common injuries including taking a history, inspection/observation, palpation, functional testing, special evaluation techniques, and neurological and circulatory tests.
7. Explain the relationship of injury assessment to the systematic observation of the person as a whole.
8. Describe the nature of diagnostic tests of the neurological function of cranial nerves, spinal nerves, and peripheral nerves using myotomes, dermatomes, and reflexes.
9. Assess neurological status, including cranial nerve function, myotomes, dermatomes and reflexes, and circulatory status.
10. Explain the roles of special tests in injury assessment.
11. Explain the role of postural examination in jury assessment including gait analysis.
12. Describe strength assessment using resistive range of motion, break tests, and manual muscle testing.
13. Describe the use of diagnostic tests and imaging techniques based on their applicability in the assessment of an injury when prescribed by a physician.
14. Describe the clinical signs and symptoms of environmental stress.
15. Describe and identify postural deformities.
16. Explain medical terminology and abbreviations necessary to communicate with physicians and other health professionals.
17. Describe the components of medical documentation (e.g. SOAP, HIPS, and HOPS).
Psychomotor Competencies
1. Obtain a medical history of the patient that includes a pervious history and a history of the present injury.
2. Perform inspection/observation of the clinical signs associated with common injuries including deformity, posturing and guarding, edema/swelling, hemarthrosis, and discoloration.
3. Perform inspection/observation of postural, structural, and biomechanical abnormalities.
4. Palpate the bones and soft tissues to determine normal or pathological characteristics.
5. Measure the active and passive joint range of motion using commonly accepted techniques, including the use of a goniometer and inclinometer.
6. Grade the resisted joint range of motion/manual muscle testing and break tests.
7. Apply appropriate stress tests for ligamentous or capsular stability, soft tissue and muscle, and fractures.
8. Apply appropriate special tests for injuries to specific areas of the body as listed above.
9. Assess neurological status, including cranial nerve function, myotomes, dermatomes, and reflexes, and circulatory status.
10. Document the results of the assessment including the diagnosis.
Clinical Proficiency
Demonstrate a musculoskeletal assessment of upper extremity, lower extremity, head/face, and spine (including the ribs) for the purpose of identifying (a) common acquired or congenital risk factors that would predispose the patient to injury and (b) a musculoskeletal injury. This will include identification and recommendations for the correction of acquired or congenital risk factors for injury. At the conclusion of the assessment, the student will diagnose the patient’s condition and determine and apply immediate treatment and/or referral in the management of the condition. Effective lines of communication should be established to elicit and convey information about the patient’s status. While maintaining patient confidentiality, all aspects of the assessment should be documented using standardized record-keeping methods.
Acute care of Injuries and Illnesses (AC)
In order to demonstrate knowledge of the practice of athletic training, to think critically about the practices involved in athletic training, including the ability to integrate knowledge, skill and behavior, and to assume professional responsibility, the entry-level certified athletic trainer must recognize, assess, and treat patients with acute injuries and illnesses and provide appropriate medical referral. The use of learning objectives and outcome in acute care of injuries and illnesses ensures that the student is able to:
Cognitive Competencies
22. Identify the signs and symptoms of trauma to cervical, thoracic and lumbar spines, the spinal cord, and spinal nerve roots, including neurological signs, referred symptoms, and other symptoms that indicate underlying trauma and pathology.
Course Outline:
I. Lumbar/sacral plexus & Nuerology
II. Dermatomes/Myotomes/Reflexes
III. Lumbar Spine & Pelvis
a. anatomy
b. injury S/S review & Tx
c. Posture Evaluation/observation
d. Palpation
e. AROM/PROM
f. Nuero Testing
g. Special Testing
h. MMT
i. Functional Testing
j. Clinical Practice Scenarios
k. Mock Injury Evaluation and Presentation
l. Oral/practical Exam
m. Written Exam
IV. Hip
a. anatomy
b. injury S/S review & Tx
c. Posture Evaluation/observation
d. Palpation
e. AROM/PROM
f. Nuero Testing
g. Special Testing
h. MMT
i. Functional Testing
j. Clinical Practice Scenarios
k. Mock Injury Evaluation and Presentation
l. Oral/practical Exam
m. Written Exam
V. Knee
a. anatomy
b. injury S/S review & Tx
c. Posture Evaluation/observation
d. Palpation
e. AROM/PROM
f. Nuero Testing
g. Special Testing
h. MMT
i. Functional Testing
j. Clinical Practice Scenarios
k. Mock Injury Evaluation and Presentation
l. Oral/practical Exam
m. Written Exam
VI. Ankle
a. anatomy
b. injury S/S review & Tx
c. Posture Evaluation/observation
d. Palpation
e. AROM/PROM
f. Nuero Testing
g. Special Testing
h. MMT
i. Functional Testing
j. Clinical Practice Scenarios
k. Mock Injury Evaluation and Presentation
l. Oral/practical Exam
m. Written Exam
VII. Gait Evaluation
a. terminology
b. biomechanics
c. mechanical analysis of different gaits
d. podiatric correction options
VIII. Cumulative Oral/Practical Examination
COURSE REQUIREMENTS:
Instructional Plans and Methods: Lectures will be supplemented with outside information, video disc, computer simulations and interactive programs, as well as clinical examination demonstrations and laboratory practice. Testing will be consistent with BOC Examination Format with a majority of multiple-choice questions in the written examinations and oral/practical examinations. The Oral Exams will be digitally recorded and then reviewed by the students.
Course Requirement: Written and Digitally recorded Oral/Practical Examinations will be given at the conclusion of each section. Clinical Evaluation Scripts will be completed at the end of each section. Students will also watch their Oral/Practical Exams and complete a self-evaluation of their skills.
Attendance is major portion of this class. Each student will be given two unexcused absences from this course. Each additional absence will result in a 2% deduction in your final grade.
Assignments
Four Written Exams @ 75 points each = 300 Points
Four Oral/Practical Exams @ 35-50 points each = 200 Points
Final Exam – Comprehensive Oral/Practical = 150 Points
Self-Evaluation of Oral/Practical Exams
@ 10 points each = 40 Points
Evaluation Scripts @ 50 points each = 200 Points
Neurological Diagram = 50 Points
Total Points = 835 Points
GRADING SCALE:
A= 95%, B= 85%, C= 75% of the top score attained in the class.
Academic Honesty: “At WSU, academic integrity is based on honesty. The University community requires that work produced by students represents their personal efforts and requires that they properly acknowledge the intellectual contributions of others” (Undergraduate Catalog, Winona State University). All ideas other than the students must be properly quoted, summarized, or paraphrased and cited accordingly. Ideas without citation are assumed to be the ideas of the student. Examples of academic integrity violations include, but are not limited to: cheating, deception and misrepresentation, enabling academic dishonesty, fabrication, multiple submission, and plagiarism (Undergraduate Catalog, Winona State University).
Due Process: Students that violate the Academic Integrity policy of the University will be dismissed from this course following Due Process. Due Process is delineated in the Undergraduate Catalog, Winona State University.
Equal Access and Equal Opportunity: The Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973 and the Minnesota Statute concern the rights and responsibilities of qualified persons with disabilities. You have the right to equal access and equal opportunity, which includes the right to access Winona State University's academic programs.
The Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973 and the Minnesota Statute concern the rights and responsibilities of qualified persons with disabilities. You have the right to equal access and equal opportunity, which includes the right to access Winona State University's academic programs. Requests regarding academic accommodations should be directed to Nancy Dumke, Maxwell Hall, 457-5600.
WINONA STATE UNIVERSITY
PROPOSAL FOR UNIVERSITY STUDIES COURSES
DIRECTIONS FOR THE DEPARTMENT
This form, Proposal for University Studies Courses, is to be used to submit course proposals for inclusion in the University Studies Program. Read the directions below for information on providing course descriptions. The department must include the University Studies Approval Form with this proposal. Copies of each of these forms are attached. Refer to Regulation 3-4, Policy for Changing the Curriculum and the University Studies Program and Policies Document for complete information on submitting University Studies courses.
The following points are contained in the University Studies Program and Policies Document (Section IV. Course Approval Process).
Material to be submitted for course approval for Course Requirements:
1. Course proposals must address all specified outcomes.
2. The course proposal must include documentation of Course Requirements and learning activities designed to meet the course outcomes specifies for the area.
3. The course proposal must include a course description (e.g., a syllabus or course outline for distribution to students) that clearly identifies (to the student) the course as a University Studies Course.
4. The course description (e.g., a syllabus or course outline for distribution to students) should also include information directed to the student that clearly identifies course activities and assignments that address the course outcomes.
5. Sequences of courses may be submitted to satisfy area requirements. In this case the requested material or documentation in items 1-4 must be submitted for all of the courses in the sequence.
6. The USS may request other material (e.g., textbooks) for review in evaluation course proposal.
7. The USS may request additional information for re-approval.
Material to be submitted for course review of Flagged Courses:
1. The USS recognizes that decisions as to which courses meet department flag requirements reside with the department offering the courses. Nevertheless, departments are required to demonstrate how flagged courses address the relevant outcomes for each flag.
2. Departments should submit course descriptions for flagged courses to the USS and the syllabus should clearly identify the course as a course that satisfies a flag requirement within the University Program.
3. The course descriptions for flagged courses should include information directed to the students which clearly identifies activities and assignments that address the outcomes.