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Level IB (First Year – Spring Semester) (Based on KIN 352K – Therapeutic Modalities in Athletic Training) Therapeutic Modalities Teaching Objective 1: The student will relate the findings of a physical examination to determine the appropriate course of treatment. Specific Outcomes 1. The student will perform a physical examination to identify the current inflammatory stage. ATS will assess an injured athlete for the presence of inflammation, through history, inspection or observation, and / or palpation 2. The student will perform a physical examination and interview to identify the indications, contraindications, and precautions to various treatment protocols. ATS will take a history and perform an assessment using observation or inspection of the injured body part. The ATS will use this information to determine indications, contraindications and precautions of the treatments Teaching Objective 2: The student will demonstrate the ability to apply therapeutic modalities. Specific Outcomes Cryotherapy 1.The student will demonstrate the ability to select the appropriate parameters for and then prepare and apply the following: a. cold whirlpool treatment b. controlled cold therapy unit c. ice pack d. vapo-coolant spray e. ice immersion f. ice massage g. cryokinetics Farr 9/30/2005 Level 1B 1 Thermotherapy 1. The student will demonstrate the ability to select the appropriate parameters for and then prepare and apply the following: a. moist heat pack b. paraffin treatment c. contrast bath d. warm whirlpool treatment Electrotherapy 1. The student will demonstrate the ability to select the appropriate parameters for and then prepare and apply the following: a. sensory-level pain control treatment b. noxious-level pain control treatment c. motor-level pain control treatment d. muscle re-education treatment e. muscle pumping treatment f. muscle atrophy retardation treatment g. acute edema treatment h. muscle splinting/spasm treatment i. iontophoresis treatment 2. The student will set-up and apply the following types of electrical stimulation units: a. monophasic stimulator (e.g., high volt stimulation) b. biphasic stimulator (e.g., Transcutaneous Electrical Nerve Stimulation [TENS], Neuromuscular Electrical Stimulation [NMES]) c. direct current (e.g., iontophoresis) d. alternating current (e.g., interferential, NMES) e. multifunction electrical stimulation devices Ultrasound 1. The student will demonstrate the ability to select the appropriate parameters for and then prepare and apply the following: a. thermal ultrasound treatment b. non-thermal ultrasound treatment c. combination electrical-stimulation/ultrasound treatment d. phonophoresis treatment e. indirect application of ultrasound treatment (underwater, bladder) Farr 9/30/2005 Level 1B 2 Traction 1. The student will demonstrate the ability to select the appropriate parameters for and then prepare and apply the following: a. mechanical traction b. manual traction c. positional traction Intermittent Compression 1.The student will demonstrate the ability to select the appropriate parameters for and then prepare and apply intermittent compression to the upper and lower extremities. Therapeutic Massage 1. The student will demonstrate the ability to prepare and apply a massage treatment. 2. The student will demonstrate the ability to properly perform the following therapeutic massage strokes: a. effleurage b. petrissage c. friction (circular, transverse) d. tapotement e. vibration f. myofascial release techniques Injury Evaluation and Physical Examination Skills Teaching Objective 3: The student will demonstrate the ability to palpate anatomical structures. Specific Outcomes 1. The student will identify and palpate the following: a. bony landmarks of the head, trunk, spine, scapula, and extremities 1. head a. frontal bone b. sphenoid bone c. nasal bone d. zygomatic bone i. zygomatic arch e. maxilla bone f. mandible bone i. angle of mandible Farr 9/30/2005 Level 1B 3 ii. ramus iii. condylar process iv. temporomandibular joint g. parietal bone h. temporal bone i. mastoid process i. occipital bone i. external occipital protuberance j. hyoid bone 2. trunk a. sternum i. sternal notch ii. manubrium iii. body iv. xyphoid process v. sternoclavicular joint b. ribs i. shaft / body of ribs 1-12 c. clavicle i. sternal border ii. sternoclavicular joint iii. acromion border iv. acromioclavicular joint d. spine i. Cervical 1. spinous processes 1-7 2. transverse processes 1-7 ii. Thoracic 1. spinous processes 1-12 2. transverse processes 1-12 iii. Lumbar 1. spinours processes 1-5 2. transverse processes 1-5 iv. Sacrum 1. sacro-iliac joint 2. level of S1 3. level of S2 4. inferior lateral angle 5. sacral base 6. sacral hiatus v. Coccyx 3. scapula a. inferior angle b. superior angle c. lateral angle d. vertebral border e. axillary border f. spine of scapula g. supraspinous fossa Farr 9/30/2005 Level 1B 4 h. infraspinous fossa i. acromion process i. acromioclavicular joint j. coracoid process 4. upper extremity a. humerus i. head ii. anatomical neck iii. greater tubercle iv. lesser tubercle v. bicipital groove vi. surgical neck vii. shaft viii. lateral epicondyle ix. lateral supracondylar ridge x. medial epicondyle xi. medial supracondylar ridge xii. capitulum xiii. trochlea xiv. olecranon fossa b. radius i. head ii. neck iii. shaft iv. styloid process c. ulna i. olecranon process ii. styloid process iii. head iv. shaft d. carpals i. scaphoid ii. lunate iii. triquetral iv. pisiform v. trapezium vi. trapezoid vii. capitate viii. hamate 1. hook of hamate ix. carpal-metacarpal joints e. metacarpals i. heads ii. shafts iii. bases iv. metacarpal-phalangeal joints v. carpal-metacarpal joints f. phalanges i. proximal ii. middle Farr 9/30/2005 Level 1B 5 iii. iv. v. vi. distal metacarpal-phalangeal joints proximal interphalangeal joints distal interphalangeal joints 5. pelvis a. ilium i. posterior superior iliac spine ii. anterior superior iliac spine iii. anterior inferior iliac spine iv. iliac crest v. iliac fossa vi. sacral iliac joint b. ischium i. ischial tuberosity c. pubis i. pubic tubercle ii. body of pubis iii. pubic sympysis 6. lower extremity a. femur i. head ii. neck iii. shaft iv. greater trochanter v. lateral condyle / epicondyle vi. medial condyle / epicondyle vii. adductor tubercle viii. trochlear notch / patellar notch b. patella i. apex ii. base iii. medial facet iv. lateral facet c. tibia i. lateral condyle / plateau ii. medial condyle / plateau iii. tibial tuberosity / tubercle iv. shaft v. proximal tibiofibular joint vi. medial malleolus vii. distal tibiofibular joint d. fibula i. head ii. shaft iii. proximal tibiofibular joint iv. distal tibiofibular joint v. lateral malleolus e. tarsals i. calcaneus Farr 9/30/2005 Level 1B 6 1. sustentaculum tali 2. medial tuberosity (plantar) ii. talus 1. neck 2. sinus tarsi iii. navicular iv. medial cuneiform v. intermediate cuneiform vi. lateral cuneiform vii. cuboid f. Metatarsals i. 1-5 ii. Base iii. Shaft iv. head v. Metatarsal-phalangeal joints vi. Base / tuberosity of 5th metatarsal vii. Sesamoid bones g. phalanges i. distal ii. middle iii. proximal iv. proximal interphalangeal joints v. distal interphalangeal joints vi. metatarsal-phalangeal joints b. soft tissue structures of the head, trunk, spine, and extremities 1. head a. temporal m. b. masseter m. c. sternocleidomastoid m. d. scalenus m. e. nasal cartilage f. platysma m. g. anterior cervical lymph nodes h. frontal sinus i. maxillary sinus j. thyroid cartilage k. tracheal cartilage / trachea l. ear i. auricle ii. scaphoid fossa iii. triangular fossa iv. concha v. lobule vi. helix vii. antihelix viii. tragus ix. external acoustic meatus 2. trunk Farr 9/30/2005 Level 1B 7 a. b. c. d. e. f. g. h. i. j. k. l. m. n. latissimus dorsi m. external oblique m. rectus abdominus m. quadratus lumborum m. pectoralis major m. intercostals m trapezius m. i. superior segment ii. middle segment iii. inferior segment rhomboid major m. rhomboid minor m. teres major m. teres minor m. supraspinatus m. infraspinatus m. levator scapulae m. 3. spine a. splenius i. capitis ii. cervicis b. iliocostalis m. i. cervicis ii. thoracis iii. lumborum c. longissimus m. i. capitis ii. cervicis iii. thoracis d. spinalis i. thoracis ii. cervicis iii. capitis (semispinalis) e. thoracolumbar fascia f. multifidus 4. pelvis / hip a. inguinal ligament b. iliopsoas muscle c. tensor fascia latae m. d. gluteus maximus e. gluteus medius f. piriformis g. inguinal lymph nodes 5. upper extremity a. deltoid m. i. anterior ii. middle iii. posterior Farr 9/30/2005 Level 1B 8 b. triceps brachii m. c. biceps brachii m. i. tendon of long head ii. tendon of short head d. brachialis m. e. brachioradialis m. f. flexor carpi radialis m. g. flexor digitorum m. h. palmaris longus m. i. flexor carpi ulnaris m. j. abductor pollicis brevis m. k. abductor pollicis longus m. l. flexor pollicis brevis m. m. abductor digiti minimi m. n. flexor digiti minimi m. o. flexor digiti minimi tendons p. extensor carpi ulnaris m. q. extensor carpi radialis longus m. r. extensor carpi radialis brevis m. s. extensor digitorum m. t. extensor digitorum tendons u. extensor digiti minimi m. v. extensor digiti minimi tendon w. extensor pollicis brevis m. x. extensor pollicis longus m. y. axillary lymph nodes z. ulnar collateral ligament (elbow) aa. annular ligament (elbow) bb. radial collateral ligament (elbow) cc. radial collateral ligament (wrist) dd. ulnar collateral ligament (wrist) ee. volar plates (phalanges) ff. collateral ligaments (phalanges) 6. lower extremity a. thigh i. sartorius m. ii. rectus femoris m. iii. iliotibial tract iv. vastus lateralis m. v. vastus medialis m. vi. vastus intermedius m. vii. patellar tendon viii. quadriceps tendon ix. pectineus m. x. adductor longus m. xi. adductor minimus m. xii. adductor brevis m. xiii. adductor magnus m. xiv. gracilis m. xv. pes anserine Farr 9/30/2005 Level 1B 9 xvi. semitendinosus m. xvii. semimembranosus m. xviii. biceps femoris xix. plantaris xx. popliteal fossa b. knee i. medial collateral ligament ii. lateral collateral ligament iii. medial joint space / joint line iv. lateral joint space / joint line c. leg & foot i. gastrocnemius m. ii. soleus m. iii. peroneus longus m. iv. peroneus longus tendon v. peroneus brevis m. vi. peroneus brevis tendon vii. peroneus tertius m. viii. Achilles tendon ix. Tibialis posterior tendon (ankle) x. Flexor digitorum longus tendon (ankle) xi. Flexor digitorum longus / brevis tendons (plantar foot) xii. Flexor hallucis longus tendon (ankle) xiii. Flexor hallucis longus tendon (plantar foot) xiv. Anterior tibialis m. xv. Anterior tibialis tendon xvi. Extensor hallucis longus tendon xvii. Extensor digitorum brevis m. xviii. extensor digitorum longus m. xix. extensor digitorum longus tendons xx. plantar aponeurosis / plantar fascia xxi. anterior talofibular ligament xxii. calcaneofibular ligament xxiii. posterior talofibular ligament xxiv. anterior tibiofibular ligament xxv. deltoid ligament complex 7. abdominal and thoracic structures a. rectus abdominus b. external oblique c. costal cartilages d. upper right quadrant i. liver e. upper left quadrant i. spleen f. lower right quadrant i. appendix g. lower left quadrant h. kidneys 8. primary neurological and circulatory structures Farr 9/30/2005 Level 1B 10 a. b. c. d. e. f. g. h. i. j. k. l. Farr 9/30/2005 common carotid artery brachial artery radial artery femoral artery posterior tibial artery (ankle) dorsalis pedis artery ulnar n. (elbow) median n. (wrist) sciatic n. (hip) common peroneal n. (knee) tibial n. (popliteal fossa) tibial n. (ankle) Level 1B 11