Physical Therapy Functional Anatomy

INSTRUCTIONAL PACKAGE

PTH 205

Effective Term Fall /2014

1 INSTRUCTIONAL PACKAGE

Effective Term: 201410

COURSE PREFIX: PTH 205 COURSE TITLE: Physical Therapy Functional Anatomy Contact Hours: 6 Credit Hours: 4

RATIONALE FOR THE COURSE: This course introduces the student to performing manual muscle testing and goniometric patient assessments, correctly identifying musculoskeletal anatomy on written patient situations, accurately analyzing human movement and discussing the pertinent musculoskeletal components involved.

COURSE DESCRIPTION: This course introduces the basic concepts and principles of muscles, joints, and motion, including traditional testing procedures. Physical Therapy functional anatomy involves the principles of physics, anatomy and physiology as applied to the human body for the study of normal and abnormal movements.

PREREQUISITES: Admission into the Physical Therapy Program.

REQUIRED MATERIALS:

(1) Paul Jackson Mansfield, MPT, Donald A. Neumann, PhD, PT, Essentials of Kinesiology for the Physical Therapist Assistant,. First Edition. Mosby – Elsevier 2009 St. Louis, Missouri (2) Nancy Berryman Reese and William D. Bandy Joint Range of Motion and Muscle Length Testing Second Edition. Saunders Elsevier 2010 St. Louis, Missouri (3) Florence P. Kendall, Elizabeth K. McCreary, Patricia G. Provance, Mary Rodgers, and William Romany Muscles: Testing and Function, with Posture and Pain Fifth Edition. Wolters Kluwer Lippincott Williams & Wilkins 2005 (4) Frank Pierson and Sheryl Fairchild Principles and Techniques of Patient Care 4th Ed. Saunders Elsevier 2008 (5) First Hand Student Kit American Physical Therapy Association (6) Lab Coat

ADDITIONAL REQUIREMENTS: None.

TECHNICAL REQUIREMENTS: None.

2 PROGRAM LEARNING OUTCOMES

After successful completion of the Horry-Georgetown Technical College Physical Therapist Assistant Program the graduate will be able to achieve the program learning outcomes. The student is advised to view the program learning outcomes in the student clinical handbook. Reviewing the outcomes will assist the student in understanding how the terminal course objectives achieve the program learning outcomes.

STUDENT TERMINAL LEARNING OUTCOMES After successful completion of this course, the student will be able to meet the following terminal behavior outcomes:

1. Communicate an understanding of the plan of care developed by the Physical Therapist to achieve short and long term goals and intended outcomes. 2. Review the medical record and physical therapy documentation to accurately identify and palpate specific musculoskeletal structures along with muscular origins, insertions and innervations within the human body. 3. Describe basic principles of kinesiology including kinematics and kinetics for human movement. 4. Describe in complete detail the components of normal and abnormal human posture in varying positions including pregnancy related postural changes. 5. Demonstrate appropriate data collection techniques to perform competently goniometric measurements of the neck, trunk and extremities on a mock patient scenario. 6. Demonstrate appropriate data collection techniques to perform competently manual muscle testing of the neck, trunk and extremities on a mock patient scenario. 7. Demonstrate appropriate data collection techniques to perform competently muscle length testing of the upper and lower extremities on a mock patient scenario. 8. Review the medical record and physical therapy documentation to identify and discuss the functional significance of supportive connective tissues within the human body (i.e. ligaments, bursa, capsules, and etc.) 9. Review the medical record and physical therapy documentation and be able to differentiate structures in the central and peripheral nervous systems and discuss the functional significance of each (ie. Brain, spinal cord, brachial plexus, lumbosacral plexus and peripheral nerves). 10. Identify indications, contraindications and precautions for data collection procedures and be able to adjust interventions within the plan of care established by the physical therapist. 11. Describe using correct terminology components of a gait cycle and explain in detail the primary muscle and joint actions during each phase of a gait cycle. 12. Demonstrate proficiency in educating and teaching different populations a home exercise or self-care program for mobility and prevention strategies to achieve patient outcomes based on the physical therapist plan of care.

3 13. Participate in the discharge planning and follow up care in patient treatment as recommended by the Physical Therapist. 14. Communicate adequately and appropriately, both verbally and non-verbally, in a manner that fosters confidence, and reflects an understanding of socioeconomic, cultural, and psychological differences during data collection procedures on a mock patient scenario. 15. Comply with policy and procedures, safety and risk management strategies for self, patient, and facility. 16. Demonstrate compliance with the scope of practice of a Physical Therapist Assistant in both legal and ethical dimensions, by demonstrating professional behaviors by behaving honestly, tactfully, dependably, enthusiastically, cooperatively and industriously. 17. Accurately and timely documents components of data collection in SOAP note format, including specific treatment parameters, application techniques, and treatment outcomes with correct billing for reimbursement. 18. Be proficient in CPR and emergency response, and recognize the need for referral for other emotional and psychological conditions beyond the scope of practice of physical therapy.

STUDENT UNIT LEARNING OUTCOMES After successful completion of the classroom activity, the student will be able to meet the following instructional objectives:

Unit 1: Chapter1 Basic Principles of Kinesiology

LECTURE OBJECTIVES

1. Define commonly used anatomic and kinesiologic terminology. 2. Describe the common movements of the body and explain the development of joint motions in the upper and lower extremities. 3. Differentiate between osteokinematic and arthrokinematic movement. 4. Describe the arthrokinematic principles of movement. 5. Analyze the planes of motion and axes of rotation for common motions. 6. Describe how force, torque, and levers affect biomechanical movement. 7. Describe the three biomechanical lever systems, and explain their advantages and disadvantages. 8. Analyze how muscular lines of pull produce specific biomechanical motions. 9. Explain how muscular force vectors are used to describe movement.

LAB OBJECTIVES Reese and Bandy Chapter 1 and Kendall Chapter 1

1. Explain the role of the physical therapist assistant in data collection procedures to meet the stated short and long term goals on the plan of care established by the physical therapist.

4 2. Explain the role of the physical therapist assistant to educate physical therapist assistant students in performing data collection procedures within the parameters of the plan of care. 3. Define joint range of motion and muscle length and discuss how positioning of a limb affects the outcome of a goniometric measurement. 4. Distinguish between arthrokinematic and osteokinematic movement. 5. Demonstrate the cardinal planes of movement and state the axis of movement for each degree of freedom associated with all joints in the human body. 6. Perform open chain and closed chain motions for the upper and lower extremities. 7. Appropriately position the axis, movable arm and stationary arm of a goniometer on a hinge joint following demonstration by the instructor. 8. Define terms used in description of muscle strength tests. 9. Distinguish between manual muscle testing grading scales for scoring muscle strength. 10. Review and acknowledge the HGTC PTA laboratory policy and procedures. 11. Review and acknowledge HGTC Campus Safety Policy and Procedure.

Unit 2: Chapter 2 Structure and Function of Joints

LECTURE OBJECTIVES

1. Describe the components of the axial versus appendicular skeleton. 2. Define the primary components found in bone. 3. Describe the five types of bones found in the human skeleton. 4. Describe the three primary classifications of joints and give an anatomic example of each. 5. Identify the components of a synovial joint. 6. Describe the seven different classifications of synovial joints in terms of mobility (degrees of freedom) and stability. 7. Provide an anatomic example of each of the seven different classifications of synovial joints. 8. Describe the three primary materials found in connective tissue. 9. Explain how tendons and ligaments support the structure of a joint. 10. Explain how muscles help to stabilize a joint. 11. Describe the effects of immobilization on the connective tissues.

LAB OBJECTIVES (Handout provided)

1. Accurately identify skeletal anatomy on a model and be able to palpate specified structures on your lab partner. 2. Provide an example for each classification of joints in the human body (Synarthrosis, Amphiarthrosis, and Diarthrosis). 3. Determine what type of synovial joint the shoulder, elbow, wrist, hip, knee and ankle are.

5 Unit 3: Chapter 3 Structure and Function of Skeletal Muscle

LECTURE OBJECTIVES

1. Describe concentric, eccentric, and isometric activation of muscle. 2. Identify the anatomic components that comprise a whole muscle. 3. Describe the sliding filament theory. 4. Describe how cross-sectional area, line of pull, and shape help determine the functional potential of a muscle. 5. Describe the active length-tension relationship of muscle. 6. Describe the passive length-tension relationship of muscle. 7. Explain why the force production of a multi-articular muscle is particularly affected by its operational length. 8. Describe the principles of stretching muscular tissue. 9. Describe the basic principles of strengthening muscular tissue.

LAB OBJECTIVES (Lab handout and Kendall Chapter 1)

1. Distinguish between concentric, eccentric and isometric contractions for muscles in the human body. 2. Demonstrate the force velocity relationship by performing muscle contractions as various speeds. 3. Demonstrate the length tension relationship by performing muscle contractions at varying degrees of available joint motion. 4. Discuss the significance of active and passive insufficiency for muscles of the upper and lower extremities.

Unit 4: Chapter 4 Structure and Function of the Shoulder Complex

LECTURE OBJECTIVES

1. Identify the bones and primary bony features relevant to the shoulder complex. 2. Describe the location and primary function of the ligaments that support the joints of the shoulder complex. 3. Cite the normal ranges of motion for shoulder flexion and extension, abduction and adduction, and internal and external rotation. 4. Describe the planes of motion and axes of rotation for the primary motions of the shoulder. 5. Cite the proximal and distal attachments, actions, and innervation of the muscles of the shoulder complex. 6. Describe the muscular interactions involved with active shoulder abduction. 7. Describe the scapulohumeral rhythm. 8. Explain the force-couple that occurs to produce upward rotation of the scapula.

6 9. Identify the primary muscles involved with dynamic stabilization of the glenohumeral joint. 10. Explain how the shoulder depressor muscles can be used to elevate the thorax. 11. Describe the interaction between the internal and external rotators of the shoulder during a throwing motion.

LAB OBJECTIVES Reese and Bandy Chapter 3 and Chapter 6

1. Accurately identify the bony landmarks used for goniometric alignment and be able to perform active and passive range of motion for the shoulder using a goniometer on your lab partner following demonstration by the instructor. 2. Accurately identify shoulder and scapular musculature by palpation and place your lab partner in the correct position to perform manual muscle testing of the shoulder and scapula following demonstration by the instructor. 3. Accurately perform muscle length testing for the shoulder on your lab partner following demonstration by the instructor. 4. Recognize when data collection procedures should not be provided due to a change in the patient’s status and report to the supervising Physical Therapist. 5. Recognize when a mobility or strength intervention is not further indicated based upon data collection with assistance from the instructor. 6. State the proximal and distal attachments and the innervation of muscles for the shoulder and scapula complex. 7. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 8. Appropriately respond to a peer’s privacy by performing appropriate draping during data collection techniques. 9. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

Unit 5: Chapter 5 Structure and Function of the Elbow and Forearm Complex

LECTURE OBJECTIVES

1. Identify the primary bones and bony features relevant to the elbow and forearm complex. 2. Describe the supporting structures of the elbow and forearm complex. 3. Describe the structure and function of the four main joints within the elbow and forearm complex. 4. Cite the normal range of motion for elbow flexion and extension and forearm supination and pronation. 5. Describe the planes of motion and axes of rotation for the joints of the elbow and forearm complex.

7 6. Cite the proximal and distal attachments and innervation of the muscles of the elbow and forearm complex. 7. Justify the primary actions of the muscles of the elbow and forearm complex. 8. Cite innervation of the muscles of the elbow and forearm complex. 9. Explain the primary muscular interactions involved in performing a pushing and pulling motion. 10. Explain the primary muscular interactions involved in tightening a screw with a screwdriver.

1. Accurately identify the bony landmarks used for goniometric alignment and be able to perform active and passive range of motion for the elbow and forearm using a goniometer on your lab partner following demonstration by the instructor. 2. Accurately identify elbow and forearm musculature by palpation and place your lab partner in the correct position to perform manual muscle testing of the elbow and forearm following demonstration by the instructor. 3. Accurately perform muscle length testing for the elbow and forearm complex on your lab partner following demonstration by the instructor. 4. Recognize when data collection procedures should not be provided due to a change in the patient’s status and report to the supervising Physical Therapist. 5. Recognize when a mobility or strength intervention is not further indicated based upon data collection with assistance from the instructor. 6. Cite the proximal and distal attachments and the innervation of each muscle in the elbow and forearm. 7. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 8. Appropriately respond to a peer’s privacy by performing appropriate draping during data collection techniques. 9. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

Unit 6: Chapter 6 Structure and Function of the Wrist

LECTURE OBJECTIVES

1. Identify the bones and primary bony features relevant to the wrist complex. 2. Describe the supporting structures of the wrist. 3. Cite the normal ranges of motion for wrist flexion and extension and radial and ulnar deviation. 4. Describe the planes of motion and axes of rotation for the joints of the wrist. 5. Cite the proximal and distal attachments and innervation of the primary muscles of the wrist.

8 6. Justify the primary actions of the muscles of the wrist. 7. Describe how compressive forces are transferred from the hand through the wrist. 8. Explain the function of the wrist extensor muscles when grasping. 9. List the structures that travel within the carpal tunnel. 10. Explain the synergistic action between the muscles of the wrist when performing flexion-extension and radial and ulnar deviation.

1. Accurately identify the bony landmarks used for goniometric alignment and be able to perform active and passive range of motion for the wrist using a goniometer on your lab partner following demonstration by the instructor. 2. Accurately identify wrist musculature by palpation and place your lab partner in the correct position to perform manual muscle testing following demonstration by the instructor. 3. Accurately perform muscle length testing for the wrist on your lab partner following demonstration by the instructor. 4. Recognize when data collection procedures should not be provided due to a change in the patient’s status and report to the supervising Physical Therapist. 5. Recognize when a mobility or strength intervention is not further indicated based upon data collection with assistance from the instructor. 6. Cite the proximal and distal attachments and the innervation of each muscle in the wrist. 7. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 8. Appropriately respond to a peer’s privacy by performing appropriate draping during data collection techniques. 9. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

Unit 7: Chapter 7 Structure and Function of the Hand

LECTURE OBJECTIVES

1. Identify the bones and primary bony features of the hand. 2. Identify the carpometacarpal, metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints of the hand. 3. Describe the supporting structures of the hand. 4. Describe the planes of motion and axes of rotation for the motions of the hand. 5. Cite the proximal and distal attachments, as well as the innervation of the muscles of the hand. 6. Justify the primary actions of the muscles of the hand. 7. Identify the two types of prehension (grasps).

9 8. Recognize fine motor milestones for hand function. 9. Describe the primary mechanism that causes an ulnar drift deformity. 10. Describe the mechanics of a “tenodesis” grasp action of the wrist. 11. Explain the interaction between the intrinsic and extrinsic muscles when opening and closing the hand. 12. Explain why the fourth and fifth digits cannot be fully extended across all interphalangeal joints following a severance of the ulnar nerve. 13. Identify which active motions are lost (or severely weakened) following a cut of the median nerve at the level of the wrist. 14. Explain why an injury to the radial nerve would reduce the effectiveness and strength of one's grasp.

1. Accurately identify the bony landmarks used for goniometric alignment and be able to perform active and passive range of motion for the hand using a goniometer on your lab partner following demonstration by the instructor. 2. Accurately identify hand musculature by palpation and place your lab partner in the correct position to perform manual muscle testing following demonstration by the instructor. 3. Accurately perform muscle length testing for the hand on your lab partner following demonstration by the instructor. 4. Recognize when data collection procedures should not be provided due to a change in the patient’s status and report to the supervising Physical Therapist. 5. Recognize when a mobility or strength intervention is not further indicated based upon data collection with assistance from the instructor. 6. Cite the proximal and distal attachments and the innervation of each muscle. 7. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 8. Appropriately respond to a peer’s privacy by performing appropriate draping during data collection techniques. 9. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

Unit 8: Chapter 9 Structure and Function of the Hip

LECTURE OBJECTIVES

1. Identify the bones and bony features of the hip and pelvis. 2. Describe the supporting structures of the hip joint. 3. Cite the normal ranges of motion for hip flexion and extension, abduction and adduction, and internal and external rotation.

10 4. Describe the three kinematic strategies used to produce different functional motions at the hip. 5. Describe the planes of motion and axes of rotation for all motions of the hip. 6. Justify the actions of the hip muscles through knowledge of the muscle's proximal and distal attachments. 7. Describe the force-couple involved in producing an anterior pelvic tilt and a posterior pelvic tilt. 8. Explain the biomechanical consequences of a hip flexion contracture. 9. Explain how the position of the hip and knee affect the length and ultimate function of the multi-articular muscles of the hip. 10. Explain the function of the hip abductor muscles during the single-limb support phase of walking. 11. Describe why a cane is most effective when used in the hand opposite the weakened or painful hip.

1. Accurately identify the bony landmarks used for goniometric alignment and be able to perform active and passive range of motion for the hip using a goniometer on your lab partner following demonstration by the instructor. 2. Accurately identify hip musculature by palpation and place your lab partner in the correct position to perform manual muscle testing following demonstration by the instructor. 3. Accurately perform muscle length testing for the hip on your lab partner following demonstration by the instructor. 4. Recognize when data collection procedures should not be provided due to a change in the patient’s status and report to the supervising Physical Therapist. 5. Recognize when a mobility or strength intervention is not further indicated based upon data collection with assistance from the instructor. 6. Cite the proximal and distal attachments and the innervation of each muscle in the hip. 7. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 8. Appropriately respond to a peer’s privacy by performing appropriate draping during data collection techniques. 9. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

Unit 9: Chapter 10 Structure and Function of the Knee

LECTURE OBJECTIVES

1. Identify the bones and primary bony features of the knee. 2. Describe the primary supporting structures of the knee.

11 3. Describe the planes of motion and axes of rotation for the motions of the knee. 4. Cite the proximal and distal attachments of the muscles of the knee. 5. List the innervation of the muscles of the knee. 6. Justify the primary actions of the muscles of the knee. 7. Describe the factors that contribute to excessive lateral tracking of the patella. 8. Explain how patellofemoral joint compression force is increased or decreased relative to the depth of a squatting position. 9. Describe one biomechanical consequence associated with hamstring tightness. 10. Explain the principles of active and passive insufficiency in regard to the multi-articular muscles of the knee. 11. Describe the combined movements at the hip and knee that promote the most effective force production in the hamstrings and rectus femoris. 12. Cite the functional range of motion of the knee required for functional activities such as stair climbing.

1. Accurately identify the bony landmarks used for goniometric alignment and be able to perform active and passive range of motion for the knee using a goniometer on your lab partner following demonstration by the instructor. 2. Accurately identify knee musculature by palpation and place your lab partner in the correct position to perform manual muscle testing following demonstration by the instructor. 3. Accurately perform muscle length testing for the knee on your lab partner following demonstration by the instructor. 4. Recognize when data collection procedures should not be provided due to a change in the patient’s status and report to the supervising Physical Therapist. 5. Recognize when a mobility or strength intervention is not further indicated based upon data collection with assistance from the instructor. 6. Cite the proximal and distal attachments and the innervation of each muscle. 7. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 8. Appropriately respond to a peer’s privacy by performing appropriate draping during data collection techniques. 9. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

Unit 10: Chapter 11 Structure and Function of the Ankle and Foot

LECTURE OBJECTIVES

1. Identify the primary bones and bony features of the ankle and foot. 2. Describe the connective tissues of the ankle and foot.

12 3. Describe the primary motions that occur at the talocrural, subtalar, and transverse tarsal joints. 4. Describe the most stable position of the talocrural joint. 5. Describe the planes of motion and axes of rotation for dorsiflexion/plantar flexion, inversion/eversion, and adduction/abduction of the ankle and foot. 6. Cite the components of the motions of pronation and supination. 7. Explain the function of the medial longitudinal arch. 8. Explain why the lateral ligaments of the ankle are injured far more often than the medial ligaments. 9. Justify the actions of the muscles of the ankle and foot through knowledge of their proximal and distal attachments. 10. Cite the innervation of the muscles of the ankle and foot. 11. Explain the primary muscular interactions involved with rising up on tip-toes. 12. Describe the common abnormal gait patterns involved with weakness of the dorsiflexor muscles. 13. Explain how the interaction among the talocrural, subtalar, and transverse tarsal joints allows the foot to adapt to uneven ground while standing and walking.

LAB OBJECTIVES Reese and Bandy Chapter 13 and 14

1. Accurately identify the bony landmarks used for goniometric alignment and be able to perform active and passive range of motion for the ankle and foot using a goniometer on your lab partner following demonstration by the instructor. 2. Accurately identify ankle and foot musculature by palpation and place your lab partner in the correct position to perform manual muscle testing following demonstration by the instructor. 3. Accurately perform muscle length testing for the ankle and foot on your lab partner following demonstration by the instructor. 4. Recognize when data collection procedures should not be provided due to a change in the patient’s status and report to the supervising Physical Therapist. 5. Recognize when a mobility or strength intervention is not further indicated based upon data collection with assistance from the instructor. 6. Cite the proximal and distal attachments and the innervation of each muscle. 7. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 8. Appropriately respond to a peer’s privacy by performing appropriate draping during data collection techniques. 9. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

Unit 11: Chapter 8 Structure and Function of the Vertebral Column

LECTURE OBJECTIVES

13 1. Identify the normal curvatures of the vertebral column, and explain how these curves provide spinal stability. 2. Identify the bones and bony features of the vertebral column and cranium. 3. Describe the ligaments and soft tissues of the vertebral column and important features of an intervertebral disc. 4. Describe the unique features of the cervical, thoracic, lumbar, and sacral vertebrae. 5. Identify rib cage anatomy and discuss the kinematics of the chest wall. 6. Cite the normal ranges of motion allowed for flexion and extension, lateral flexion, and axial rotation at the craniocervical and thoracolumbar regions of the vertebral column. 7. Explain how the orientation of the facet joints helps determine the primary movements of the various regions of the vertebral column. 8. Describe the motions of the spine that decrease and increase the diameter of the intervertebral foramen. 9. Describe the effect of flexion, extension, and lateral flexion on the potential migration of the intervertebral disc. 10. Justify the actions of the muscles within the anterior and posterior craniocervical region of the vertebral column. 11. Justify the actions of the muscles within the anterior and posterior thoracolumbar region of the vertebral column. 12. Differentiate between segmental and gross stabilization of the vertebral column. 13. Describe the factors that contribute to safe and unsafe lifting techniques.

1. Accurately identify the bony landmarks used for goniometric alignment and be able to perform active and passive range of motion for the cervical, thoracic and lumbar spine using a goniometer, tape measure, and inclinometer on your lab partner following demonstration by the instructor. 2. Accurately identify spinal musculature by palpation and place your lab partner in the correct position to perform manual muscle testing of the spine following demonstration by the instructor. 3. Recognize when data collection procedures should not be provided due to a change in the patient’s status and report to the supervising Physical Therapist. 4. Recognize when a mobility or strength intervention is not further indicated based upon data collection with assistance from the instructor. 5. Cite the proximal and distal attachments and the innervation of each muscle in the spine. 6. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 7. Appropriately respond to a peer’s privacy by performing appropriate draping during data collection techniques. 8. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

14 Unit 12: Chapter 2 Posture (Kendall)

LECTURE OBJECTIVES

1. Define posture. 2. Discuss pain in relation to postural faults. 3. Define center of gravity. 4. Define line of gravity. 5. Explain the use of a plumb line in observing posture. 6. Identify the ideal plumb alignment from a lateral view, anterior view and posterior view. 7. Identify the four types of postural alignment. 8. Define handedness patterns. 9. Identify the muscle action that maintains normal postural alignment in a lateral, anterior and posterior view. 10. Identify elongated and weak and short and strong muscles in faulty postural alignment when observed from a lateral, anterior and posterior view. 11. Describe normal and abnormal sitting posture. 12. Discuss posture of children with regards to nutritional factors, defects, diseases, disabilities, environmental factors and developmental factors. 13. Define scoliosis and explain the etiology and effects of the postural faults.

LAB OBJECTIVES

1. Position your lab partner to prepare for postural assessment using a plumb line. 2. Observe and document posture from a lateral view, posterior view, and anterior view on your lab partner. 3. Recognize normal and abnormal postural alignment from a lateral view, posterior view and anterior view on your lab partner. 4. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 5. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

Unit 13: Chapter 12 Kinesiology of Human Gait

LECTURE OBJECTIVES

1. Describe the primary events of the gait cycle. 2. Define the common terms used to describe human gait. 3. Describe the muscular and joint interactions that occur during heel contact. 4. Describe the muscular and joint interactions that occur during foot flat. 5. Describe the muscular and joint interactions that occur during mid stance. 6. Describe the muscular and joint interactions that occur during heel off and toe off.

15 7. Describe the muscular and joint interactions that occur during early, mid, and terminal swing. 8. Define the common terms that are used to describe human gait. 9. Explain the role of the hip abductor muscles during the stance phase of gait. 10. Describe the common gait deviations, including impairments that may cause the deviations.

LAB OBJECTIVES Pierson and Fairchild Chapter 9

1. Distinguish between Rancho Los Amigos and Standard terminology used to describe the phases of the gait cycle. 2. Accurately identify the muscle activity that occurs during the phases of gait and the normal range of motion values required for normal gait. 3. Use appropriate gait terminology to perform data collection for gait patterns on your lab partner and document accurately in a SOAP note. 4. Identify various types of ambulatory aids. 5. Explain the differences in the two-point, four-point, three-point, three-one-point, and modified gait patterns. 6. Replicate a gait pattern with an assistive device after demonstration from the instructor that is appropriate for the patient’s condition on level surfaces. 7. Replicate functional activities such as sit to stand and climbing stairs with an assistive device after demonstration from the instructor. 8. Describe the advantages and disadvantages of various types of ambulation aids. 9. Demonstrate weight bearing techniques with the use of an assistive device with your lab partner. 10. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 11. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

Unit 14: Chapter 13 Kinesiology of Mastication and Ventilation

LECTURE OBJECTIVES

1. Identify the bones and bony features relevant to the temporomandibular joint. 2. Describe the capsule and ligament that supports the temporomandibular joint. 3. Identify the motions that occur at the temporomandibular joint. 4. Describe the muscular and joint interactions involved in opening the mouth. 5. Describe the muscular and joint interactions involved in closing the mouth. 6. Justify the actions of the primary muscles of the temporomandibular joint through knowledge of the muscles' proximal and distal attachments. 7. Explain Boyle's law in reference to the process of inspiration and expiration. 8. Compare the mechanics of quiet expiration with forced expiration.

16 9. Cite the primary muscles of inspiration. 10. Cite the primary muscles of forced expiration. 11. Describe the muscular interactions involved in forced inspiration. 12. Describe the muscular interactions involved in forced expiration. 13. Explain why accessory muscles of inspiration are often used by an individual with chronic obstructive pulmonary disease.

LAB OBJECTIVES Reese and Bandy Chapter 9

1. Accurately identify the bony landmarks used for measuring range of motion of the temporomandibular joint on your lab partner following demonstration by the instructor. 2. Accurately identify muscles of mastication by palpation and place your lab partner in the correct position to perform manual muscle testing following demonstration by the instructor. 3. Recognize when data collection procedures should not be provided due to a change in the patient’s status and report to the supervising Physical Therapist. 4. Recognize when a mobility or strength intervention is not further indicated based upon data collection with assistance from the instructor. 5. Cite the proximal and distal attachments and the innervation of each muscle. 6. Explain the purpose and results of data collection procedures to your lab partner effectively in a clear and understandable manner and reinforce the importance of a home exercise program. 7. Accurately documents the objective findings of data collection procedures in the objective portion of the SOAP note.

Schedule

Date Lecture Monday Wed Lab 1 Lab 2 Lecture Lecture (Mon/Tues) (Wed/Thurs) Week 1 Basic No Class Chapter 1 No Class Terminology, August 21, Principles of Planes/Axes, 2013 Kinesiology Open and Closed Chain Intro to goniometry and MMT Week 2 Structure and Chapter Chapter 3 Bony Isometric, August 26, Function of 2 landmarks Concentric, 28, 2013 Joints/ Model and Eccentric; Force Skeletal Palpation, Velocity; Length Muscle Joint Tension; Active identification and Passive Insufficiency Week 3 Structure and Closed Chapter 4 MMT/ROM MMT/ROM

17 Sept 4, Function of Labor Shoulder and Shoulder and 2013 the Shoulder Day Scapula Scapula Complex (Tuesday only) Week 4 Structure and Chapter Test 1 Continue Skill Assessment Sept 9, 11, Function of 4 Chap Shoulder and 1 2013 the Shoulder 1, 2, 3, 4 Scapula MMT/ROM Complex Shoulder/ Test Scapula and Planes/Axes Week 5 Structure and Chapter Chapter 6 MMT/ROM MMT/ROM Sept 16, Function 5 Elbow and Wrist 18, 2013 Elbow/ Forearm Forearm Complex; Wrist Week 6 Structure and Chapter Test 2 MMT/ROM Skill Assessment Sept 23, Function of 7 Chapter 5, Hand 2 25, 2013 the Hand 6, 7 MMT/ROM elbow, forearm, wrist and hand Week 7 Structure and Chapter Chapter 10 MMT/ROM MMT/ROM Sept 30, Function of 9 Hip Knee Oct 2, the Hip; Knee 2013

Week 8 Structure and Chapter Chapter 11 MMT/ROM MMT/ROM Oct 7, 9, Function of 11 Ankle Foot 2013 Ankle/Foot

Week 9 Test Test 3 Chapter 8 Skill MMT/ROM Oct 14, 16, Structure & Chapter Cervical Assessment 3 Cervical 2013 Function of 9, 10, 11 MMT/ROM Vertebral hip, knee, Column ankle and foot Week 10 Structure & Chapter Thoracic MMT/ROM Continue Oct 21, 23, Function of 8 Ribs/Chest Thoracic Cervical and 2013 Vertebral Thoracic Wall Thoracic Column Week 11 Structure & Chapter Chapter 8 MMT/ROM Continue Lumbar Oct 28, 30, Function of 8 Sacrum/SI Lumbar 2013 Vertebral Lumbar joint

18 Column Week 12 Kendall Kendall Kendall Posture Posture Nov 4, 6, Posture Posture Posture 2013 Week 13 Test Test 4 Chapter 12 Skill Gait Lab Nov 11, Kinesiology of Chapter Gait Assessment 4 13, 2013 Human Gait 8 and MMT/ROM Posture Spine and Posture

Week 14 Kinesiology of Chapter Chapter 12 Gait Lab Gait Lab Nov 18, Human Gait 12 Gait 20, 2013 Gait Week 15 Kinesiology of Chapter Closed Gait Lab Closed Holiday Nov 25, Human Gait 12 Holiday 2013 CLOSED Nov 27 Week 16 Kinesiology of Chapter Test 5 MMT/ROM Skill Assessment Dec 2, 4, Mastication 13 Chapter TMJ 5 2013 and 12, 13 MMT/ROM TMJ Ventilation and Gait with AD Test

METHODS OF INSTRUCTION:

Concepts will be taught by lecture, laboratory, discussion, demonstration, and audio-visual materials. Memorization is no substitution for understanding and will not give you the results desired.

REQUIRED COURSE MEASURES/ARTIFACTS:

Departmental Exams and Comprehensive Final Skill Assessments Homework Assignments Written/Oral Comprehensive Lab Competency Examination

 Your assignment will be reviewed by your own department faculty, but also faculty from multiple disciplines. Please make sure you use appropriate sentence structure, proper grammar, correct spelling and punctuation in your assignments. It is important your work make sense and makes a good impression to everyone reviewing it. An important component of your education at Horry-Georgetown Technical College is acceptable communication skills. With this in mind, please revise accordingly.

19  Grades earned in courses impact academic progression and financial aid status. Before withdrawing from a course, be sure to talk with your instructor and financial aid counselor about the implications of that course of action. Ds, Fs, Ws, WFs and Is also negatively impact academic progression and financial aid status.

EVALUATION OF REQUIRED COURSE MEASURES/ARTIFACTS

Evaluation Points Percentage Assigned of Weighted Grade Departmental Exams: 100 points 60% Exams will cover the objectives outlined in the instructional each (Five package tests)

Comprehensive Final: 100 points 20% Exam will cover the objectives outlined in the instructional package Skill Assessments: 100 points for 15% The skill assessment rubrics are uploaded on D2L under Final content. Intervention or data collection skill assessment is Comprehensive performed at the end of each lab unit after the instructor has Lab Practical provided the student with didactic material, demonstration Examination and hands on application. The student is required to successfully complete each skill assessment below for this course prior to the final comprehensive lab competency examination. The skill assessment may be attempted up until the date of the scheduled lab competency examination. Failure to complete a skill check off will not allow the student to complete the lab competency examination, which will result in failure of the course. See schedule for skill assessment for this course bellow.

Skill Assessments 1. MMT/ROM shoulder and scapula and Planes/Axes 2. MMT/ROM elbow, forearm, wrist and hand 3. MMT/ROM hip, knee, ankle and foot 4. MMT/ROM spine (cervical, thoracic and lumbar) 5. MMT/ROM TMJ and Gait with Assistive Device

Comprehensive Laboratory Practical Examination The laboratory practical examination grading rubric is uploaded on D2L under content. A minimum of 75% and all critical elements must be achieved to pass the laboratory practical examination. Three attempts will be given for the

20 competency. Repeat competency will be awarded a maximum of 75 points. Students will only be allowed to try competency check off one time per day.

Homework: Homework and 5% Homework is uploaded on D2L and will have specific due date number of for each assignment. points to be determined for each assignment GRADING SYSTEM: 100-91 %= A 90-82 %= B 81-75 %= C 74-69 %= D 68 - 0 %= F Grades earned in courses impact academic progression and financial aid status. Before withdrawing from a course, be sure to talk with your instructor and financial aid counselor about the implications of that course of action. Ds, Fs, Ws, WFs and Is also negatively impact academic progression and financial aid status.

The Add/Drop Period is the first 5 days of the semester for full term classes. Add/Drop periods are shorter for accelerated format courses. The following week of the semester is Financial Aid Attendance Verification period. You must attend at least one meeting of all of your classes during that period. If you do not, you will be dropped from the course(s) and your Financial Aid will be reduced accordingly.

Physical Therapist Assistant Grading Policy : Your grade for this course will be determined solely on the basis of the criteria outlined in this syllabus. Students will not be allowed to substitute other activities (reports, homework, etc.) to count in place of any of the stated criteria. (This means there will be NO extra credit offered.) Also, since the tests/exams given in this course are designed to measure the extent to which you have mastered course materials, students should not expect there to be any “curving” of grades. Missed exams may be made up at the discretion of the professor.

Make Up Examinations: 1. A maximum of one (1) scheduled exam may be made up at the discretion of the course instructor. Any subsequently missed exams will receive a grade of 0.

2. Makeup examinations will be taken in the testing center on campus or a location designated by the instructor.

3. A 10% deduction will be applied to the makeup examination score.

Academic Dishonesty:

21 All forms of academic dishonesty, as outlined in the Student Code in the HGTC catalog, will NOT be tolerated and will result in disciplinary action. Anyone caught cheating or committing plagiarism (Defined in the code as: “The appropriation of any other person’s work and the unacknowledged incorporation of that work in one’s own work offered for credit”) will be given a grade of a zero for that assignment. A second offense will result in charges being filed with the Chief Student Services Officer.

The Student Success and Tutoring Center (SSTC) The SSTC offers to all students the following free resources: 1. Academic coaches for most subject areas, Writing Center Support, and college success skills

2. On-line student success and academic support resources

a. 24/7 online academic tutoring assistance (access in WaveNet)

b. 24/7 Online Resource Center (ORC)

c. Campus2Campus Virtual Appointments

d. Tips and tricks for college life, studying, and learning (Facebook: hgtcsstc)

3. Other student resources and academic support

a. Resource guides to improve college success skills

b. Science models & other supplemental tools and textbooks

c. Workshops on college success skills and citation styles

d. Study Skills, Test Anxiety, Time Management, etc.

e. APA, MLA, and Preventing Plagiarism

f. Check the EVENTS calendar in WaveNet for more information!

Visit the SSTC website: www.hgtc.edu/sstc and visit the student services tab in your WaveNet account to schedule appointments using TutorTrac. For more information, call: SSTC Conway, 349-7872; SSTC Grand Strand, 477-2113; and SSTC Georgetown, 520-1455. Room locations and Live Chat is available on the SSTC website.

Student Information Center: WaveNet Central (WNC) WNC offers to all students the following free resources: 1. Getting around HGTC: General information and guidance for enrollment! 2. Use the Online Resource Center (ORC) for COMPASS support, technology education, and online tools 3. Drop-in technology support or scheduled training in the Center or in class

22 4. In-person workshops and online tutorials are available for: 1. D2L & WaveNet, 2. Microsoft Office Word, PowerPoint and Excel, 3. Basic Computer Skills, 4. Budgeting your Money, and more. 5. Check the EVENTS calendar or the WNC Online Resource Center for more information! 5. Additional services such as reviewing Degree Works, scheduling tutoring, or scheduling testing center appointments, scanning and uploading documents, etc. Visit the WNC website: www.hgtc.edu/wavenetcentral. Live Chat and Center locations are posted on the website. Or please call one of the following locations: WNC Conway, 349-5182; WNC Grand Strand, 477-2076; and WNC Georgetown, 520-1473. View tips and tricks for college life, personal development and technology learning on their Facebook page (Facebook: hgtcwnc).

“True genius resides in the capacity for evaluation of uncertain, hazardous and conflicting information.” W. Churchill

HGTC ATTENDANCE REQUIREMENTS: Students are expected to attend a minimum of 80% of all classes, but a program or an instructor may make the attendance policy stricter if he/she so desires.

After the allowed number of misses, the student will be dropped automatically from the course with a W or a WF. Remember an absence is an absence, no matter if it is excused or not!

Physical Therapist Assistant Program Classroom Attendance Policy:

For a 15 week course (Fall and Spring) the allowed number of misses is as follows:

For MWF classes: 9 absences are allowed for lecture and 9 absences from lab, regardless of the reason.

For MW classes: 6 absences are allowed for lecture and 6 absences from lab, regardless of the reason

For TTh classes: 6 absences are allowed for lecture and 6 absences from lab, regardless of the reason

For Classes meeting once a week for lecture: 3 absences are allowed for lecture and 3 absences from lab, regardless of the reason.

For a 10 week course (Fall and Spring) the allowed number of misses is as follows:

For MWF classes: 6 absences are allowed for lecture and 6 absences from lab, regardless of the reason.

23 For MW classes: 4 absences are allowed for lecture and 4 absences from lab, regardless of the reason

For TTh classes: 4 absences are allowed for lecture and 4 absences from lab, regardless of the reason

For Classes meeting once a week for lecture: 2 absences are allowed for lecture and 2 absences from lab, regardless of the reason.

For a 6 week course the allowed number of misses is as follows:

MTWTH 4 absences for lecture and 4 absences from lab are allowed, regardless of the reason.

MW or TTH 2 absences for lecture and 2 absences from lab are allowed, regardless of the reason

After the allowed number of absences, the student will be dropped automatically from the course with a W or a WF. Remember an absence is an absence, there are no excused absences.

Classroom Tardy

A tardy is defined as missing up to 10 minutes of classroom time.

Three tardy, of ten- minutes, will be counted as one class absence.

Six tardy of less than 10 minutes will be counted as a one-class absence

An absence is defined as missing greater than 10 minutes of classroom time or leaving class early with more than 10 minutes remaining.

HGTC WITHDRAWAL POLICY: Students needing to withdrawal from a course or courses must complete and submit a Drop/Add/Withdrawal Form. This form may be received from Student Services. Withdrawal through the fifth day of the term is considered a “drop” and will not show on the official transcript. Withdrawal from the sixth day of the term through the two-thirds point of the term results in a grade of “W”. Students who withdraw after the two-thirds point will receive a grade of a “W” if passing the course at the time of withdrawal or the course instructor will assign a grade of “WF”. Students should discuss their withdrawal plans and the grade they will receive with their instructor prior to withdrawal. Counselors are also available to assist with personal concerns. Grades earned in courses impact academic progression and financial status. Before withdrawing from a course, be sure to talk with your instructor and financial aid counselor

24 about implications of that course of action. D’s, F’s, W’s, WF’s, And I’s also negatively impact academic progression and financial aid status. MAKE-UP WORK:

CLASSROOM BEHAVIOR: You are expected to treat your fellow students with respect. This means you should limit talking to your neighbor during lecture and do not start to pack up your materials before class is over. Finally, cell phones MUST be turned off or put on the vibration mode during class.

During an exam all electronic devices (cell phones, pagers, etc.) must be turned off and stored in a purse or backpack, they may not be visible to the student. The only exception to this policy will be on-call emergency personnel. For those individuals in this situation, please contact your professor on how to handle electronic devices during exams.