SYLLABUS QUARTER: NAME OF COURSE: LENGTH OF COURSE: FALL 2011 Palpation I (Bony Spinal Palpation) TECH - 116 1 unit,

22 hours (2 hours lab-demo/week)

COURSE DESCRIPTION: In this course the student learns to identify bony landmarks, count vertebrae, and locate each vertebra of the spine. The student also begins to develop awareness and skills in the areas of the doctor-patient relationship, communication, and ergonomics. PREREQUISITES: COURSE OFFERED BY: NONE Technique/Analysis Department Bruce Chester, D.C., Dept. Chair

DEPARTMENT OBJECTIVE: To give to our students, freely and out of abundance, the best of our knowledge and skills. To develop the most talented of chiropractors that they may with skill, both find and correct the vertebral subluxation. To do this for the overall betterment, health, and well-being of their patients and the world. COURSE INSTRUCTORS: Bruce Chester, D.C. Email: bchester@lifewest.edu Phone: 780-4500 x1250 Room: 125 Dr. Wayne Coleman, D.C. wcoleman@lifewest.edu 780-4500 x 1589 Office: 151 See faculty schedule board or faculty webpage None Textbook of Clinical Chiropractic, Plaugher, D.C. 1993 Spinal Palpation, D. Gates, D.C. 5th Ed. 1995 Trail Guide to the body, Biel, A. 3rd Ed. 2005

Dr. Vu Phan vphan@lifewest.edu 780-4500 x 1946 Office: 148 OFFICE HOURS: REQUIRED TEXT: RECOMMENDED TEXTS:

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REFERENCE TEXTS:

Clinical Biomechanics of the Spine-White AA 2nd ed. 1990 Anatomy: a Regional Atlas of the Human Body. 5th ed. 2007 - Clemente

MATERIALS: Marking pencil, dry spine, gown or open back top for women ACADEMIC GRADE (A - F): College policy will apply. A - 4.0 Superior Work B - 3.0 Above Average Work C - 2.0 Average Work F 0.0 The student must repeat the entire course. METHOD OF GRADING: Midterm Practical 45% of class grade Final Practical 50% of class grade Copy of X-rays Copy of Radiology Report Copy of Current CMR review from the clinic all are 5% of your grade.

In order to maintain satisfactory Academic Progress, a student must maintain a 2.0 or better in each and every course. Any grade less than a C must be remedied by repeating the class. Grades are based on classroom participation, attendance and proficiency. Both lecture and lab sections must be passed to pass the course. METHOD OF INSTRUCTION: Handouts, Videos, X-ray, Dry Spine, Guest Speakers, Lab and Lecture

EXTRA CREDIT: There will be no extra credit work accepted in this class. ATTENDANCE: Instructors are required to record student attendance. Roll can be taken at any time during the class period. The instructor may call names, pass a roll sheet, use submitted classroom assignments, or observe the students. If the instructor calls roll, a student who is not present when his or her name is called is absent. If the instructor uses a roll sheet, students have 15 minutes to sign in. If a student arrives after attendance has been taken but within the first 15 minutes of the start of the class session, the student must see the instructor at the end of the class hour to request that his or her absence be changed to a tardy. Three tardies attendance constitute one hour of absence. Failure to notify the instructor will result in the absence mark remaining on the attendance sheet. This cannot be changed later. No additional assignments can be used to compensate for absences except as outlined in the college course overlap policy.

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If a student leaves after attendance has been taken, the instructor can change the attendance record to indicate an absence for the class period. Any request to leave class early must be approved by the instructor before the class session. A student who misses more than 10% of the class hours will be over-cut from the class. If the student presents documentation to the dean verifying a documented emergency or other excusable reason that prevented attendance for 15% of the class hours, the dean may permit him or her to continue attending the class. In determining whether or not to permit a student to continue attending a class, the dean will consider the students overall attendance record and academic standing. Under no circumstances, regardless of any personal situation, will a student who misses 20% of the class hours receive course credit. Excused absences still count toward total absences, they only may entitle a student to make-up assignments and examinations. A student is responsible for keeping track of his or her own attendance and absences. Instructors may but are not required to provide courtesy notices indicating that a student is approaching or has reached over-cut status. Documented emergencies include hospitalization, accidents, or death in the family. Undocumented illness, not feeling well, weddings, events, extended vacations or school holidays, non-school scheduled seminars, etc., are not considered excusable reasons for missing class. MAKE-UPS: Students are expected to take all examinations and complete assignments as scheduled. Students who have missed an exam due to a documented emergency or other excusable reason must pick up a Request for Alternative Testing form in the Deans Office. At that time, they will explain the circumstances of their emergency and provide documentation to the Dean of the College. If the Dean authorizes the exam, the student must then present the form to his/her instructor to complete the necessary information. The student must then take the completed and signed request to the Student Services Office to schedule a time for the exam to be proctored. As indicated near the top of the form, Student Services requires a minimum of 5 working days to set up and schedule the approved exam. Documented emergencies include hospitalization, accidents, or death in the family. Undocumented illness, not feeling well, weddings, events, extended vacations or school holidays, non-school scheduled seminars, etc., are not excusable reasons for making-up an exam or assignment. CONDUCT AND RESPONSIBILITIES It is the students responsibility to maintain professional standards of behavior and attire while on campus. Students are expected to be prepared for instructional activities. They must bring

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required supplies/equipment and dress appropriately in accordance with the instructors directions. Failure to do so can result in the student being marked absent for the class session. Any disruptive activity (e.g. use of cell phones, side conversations) in the classroom is prohibited. If the instructor requires a disruptive student to leave the classroom, the student remains responsible for all information and will be marked absent for the class session. The dean will impose sanctions for unprofessional behavior. Any form of deceit, fraud, plagiarism, unauthorized collaboration, or theft will result in failure of the course and referral to the dean for disciplinary sanctions. Please refer to the handouts titled Ground Rules For Technique Classes and Respectful Touch for further tips and guidelines. The use of electronic devices (e.g. cell phones, labtops) for non-course activities is unprofessional behavior. Students will be penalized for such activities which can include loss of attendance credit for the course hour. Course related use of electronic devices during class time requires prior instructors approval. INDEPENDENT STUDENT WORK All assignments and exams must be the product of the individual students original efforts for this class. Collaboration is prohibited. PROCEDURES FOR REVIEWING EXAMS The instructor has not authorized distribution of old exams. Any possession of old exams is prohibited. The instructor may either conduct review sessions in class or may meet with a student to review his or her exam during office hours for two weeks following the exam (unless there is a shorter time period until the last scheduled office hour during the last week of classes.) Students may not review mid-term exams during final exam week. The possession of any exam other than during a review session constitutes unprofessional conduct. COURSE OBJECTIVES: * Knowing and being able to locate the spinal landmarks on any person. ** Being able to motion palpate the following segments: C-1, L5-S1 junction, and the vertebral prominence. * Counting vertebrae, being able to locate specific vertebrae by counting up or down from landmarks. * Blind Palpation. * Having a sense of variability of spines and body types. ** Appreciating the relationship in chiropractic of mind and hands, and of knowledge and intuition. * Being able to visualize the spinal structures while palpating. * Develop tactile sensitivity while gathering information in the palpatory process. Professionalism: * Being able to confidently be with a patient and communicate respect and concern for them, both through how you speak with them and how you touch them. * Being able to verbalize about what you're doing in a testing situation.

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* Being able to communicate with patients to get compliance, in things such as how they prepare themselves for palpation (e.g., remove earrings), and in their cooperation with the exam (e.g., how they move when being motion palpated) * Giving feedback to each other in learning chiropractic skills together. * Learning habits of taking care of the room and equipment. Body Awareness: * Being aware of your own body position and comfortable balance while working on patients. * Developing sensitivity in your hands. * Being aware of being centered in yourself and relaxed while being with a patient. REQUEST FOR SPECIAL TESTING The student must notify the instructor of any authorized special testing at least one week prior to the exam. Once arrangements have been made, they cannot be changed without approval from the instructor and the office of student services. The student must notify the instructor of any schedule conflicts during final exam week at least one week prior to the beginning of final exams. Appropriate paperwork must be completed and submitted to the office of student services. Once arrangements have been made, they cannot be changed without approval from the instructor and the office of student services. ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES If you have approved accommodations, please make an appointment to meet with your instructor as soon as possible. If you believe you require an accommodation, but do not have an approved accommodation letter, please see the Academic Counselor Lori Pino in the Deans Office. Contact info: Lpino@lifewest.edu or 510-780-4500 ext 2061 COURSE OUTLINE: Palpation 1 Week 1 Hour 1 Introduction to Palpation The lighter the touch, the more you feel. The hand, fingers and the patient Professional ethics Intention: information & Data Communication: Connect & Deliver Information The ethics of touch Person to person Boundaries The VSC The 5 components of the VSC

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Application to Practice Application to patient communications Hour 2 5 Basic landmarks C-2 SP & Posterior arch Inferior angle of scapula-T-7 down Iliac Crest: L-4 SP Pelvis: Sacrum & PSIS Counting SPs Show full spine x-ray Week 2 The Upper Cervical Spine Hour 1 Occiput, C-1 & C-2 Show APOM, BP & Lateral Cervical X-rays The EOP Mastoid groove Nuchal ridge C-2 SP & Lamina C-3 SP Hour 2 Posterior arch of C-1 C-1 TP & Mastoid & Mandible Review of VSC- Quiz possible Week 3 Thoracic spine & Scapula Hour 1 Inferior angle of scapula T-7 down / 8 up Spine of scapula T-3 Ribs Rib Head, Rib Angle Anterior ribs, Angle of Louis & Sternum Rib #1 & Scapula & Pulmonary Dynamics Floating ribs & Diaphragm Show Rib X-Ray set Hour 2 Counting SPs C-2 to T-7 / 8 Review VSC Quiz Individual Skills assessment Landmarks & Counting SPs

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Week 4 The lower spine Hour 1 Iliac Crest L-4 Counting L-1 to L-5 Sacrum & PSIS Hour 2 Review for midterm Individual Skills assessment - Hot seat Landmarks & Counting SPs Week 5 Midterm Practical & Written (VSC & Ethics of touch) Exam Week 6 Pelvis, Sacrum & Ilium Hour 1 PSIS & PIIS Iliac Crest Lumbar Counting Acetabula ridge SP MP Sacral Notch Coccyx Hour 2 Variations of the human body X-Ray review Palpation drills Week 7 Thoracic SP-TPs Cervical Lamina & Articular pillars Thoracic X-Rays Counting Whole spine Review of major landmarks VSC Review Week 8 Hour 1 Intro to SOAP

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Hour 2 Skills practice Week 9 Hour 1 Finding VSC Hour 2 Skills practice & assessment Final Exam Written & Practical Exam Post Test Student Review of Skills & Knowledge Time to be posted

SPINAL LANDMARKS EOP - External occipital protuberance C1 - Transverse processes slightly inferior to and anterior to the mastoid process(it may be necessary to push the SCM forward) C2 - First large bifid spinous palpable below occiput. C6 - Last freely movable spinous in cervical region with flexion- extension. C7 - Vertebral Prominens, (VP) 60-70% of time. T1 - Vertebral Prominens, 30-40% of time. T3 - At level of medial aspect of scapular spine. T4 - Most prominent spinous of upper dorsal region. T6 - At level of tip of scapula - patient prone. T7 - At level of tip of scapula - patient sitting. T9 & T10- Spinouses are close together. L1 - First large blade-like spinous.

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L4 - Generally, inferior tip of spinous process at level of iliac crest. L5 - Short spinous - last movable segment in spine (difficult to palpate). S2 - Second sacral tubercle at the level of the PSIS's Sacral Hiatus - Last palpable depression on sacrum.
Coccyx - Last segment of spine

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