MSTA121 SN01 Lecture - … · alone do not explain all the palpation processes or give you all of the ... o Here are four very effective ... don’t study alone!

MSTA121

www.endeavour.edu.au

Session 1

Anatomical terminology

and introduction to

palpation

Department of Myotherapy

© Endeavour College of Natural Health www.endeavour.edu.au 2

Introduction

o Understanding the role of and learning to palpate

muscles, bones and other structures is a vital part of

being an effective therapist.

• Assessment and treatment both require the practitioner to have

a knowledge of what underlies the skin, how it moves and how

it may respond to pressure, stretch etc.

o The slides frequently ask you to palpate a structure with

a partner

• Try to alternate partners frequently with a variety of different

students, so that you become comfortable and skilful working

with various body sizes and shapes

• Compare structures in different students, so that you become

familiar with some possible anatomical variations

Image: © Microsoft


Preparation for Class

o Each week, come prepared with:

• Appropriate clothing for the region being

palpated (check in advance each week)

• One towel (either bath towel or bath sheet)

• Lecture notes

• The Trail Guide textbook: This must be

brought to each class. This unit is designed

for you to have your textbook beside you

from week 3 onwards. The PowerPoints

alone do not explain all the palpation

processes or give you all of the answers.

o Prepare for each session by completing the prescribed

workbook pages.

Image: (CollegeDegrees360, 2012a)


Important Note:

Qld Myotherapy StudentsAdvance notice

o All Myotherapy students undertake MSTA212 (typically

in the following semester).

o Wet lab (cadaver lab) attendance is an assessable

component of MSTA212; students cannot pass the unit

without attending the wet lab.

o Queensland Health now requires that Qld students be

immunised for Hep A&B, MMR, tetanus and

whooping cough prior to attendance at the wetlab and

to provide proof of immunity.

• Hepatitis B immunisation occurs in several parts across a

period of months. PLEASE START NOW. (See SL for queries)

Image: © Microsoft


How can I learn anatomy

successfully?

o Musculoskeletal anatomy is full of terminology; It’s

like learning a new language!

• How do I know what I’ve actually learnt?

• What if I forget everything in my

practical exams??

• How do I make the best of my

study time?

o Discuss ideas as a class

Image: (geckoam, 2010)


Big bang for your study bucks

o Here are four very

effective

techniques to give

you the most ‘bang

for your buck’ in

study time….

Image: (wombatarama, 2011)


1. Quiz quiz quiz yourself

o We learn quicker if we’re studying to answer a

question. So either start with a study question for

yourself,

or quiz yourself

to find your

knowledge gaps

Image: (brewbooks, 2014)


2. Suit yourself

o Find out what type of learner you are:

• If you’re a social learner, don’t study alone!

Find a study friend today and make a time

to study with them from day one.

• If you’re a kinaesthetic (“doing”) learner, don’t sit in front of a

textbook! Kinaesthetic learners will take in more knowledge

by touching, moving, singing and interacting. You are never

too old to do the Anatomy Macarena.

Image: (CollegeDegrees360, 2012b)


3. Be all talk and action

o If you read quietly, you take in

knowledge through sight alone.

BUT…

o If you read out loud while

palpating, you learn by sight,

touch and hearing

Image: (MarquetteUniversity, 2012)


4. Neurons that fire together..

o Students sometimes blank out in a practical exam.

You can prevent this by developing ‘autopilot’ mode:

• If 2 pieces of information are always together, your brain will

recall one when it is given the other.

• Always connect words with

movements: Say it, then do it.

This means, when you are

examined, your hands will

already be headed there.

Image: (MarquetteUniversity, 2008)


Bony Anatomy

o It doesn’t matter how much you know today- but you

must be clear on where you’re starting.

o Without looking anything up, write on a piece of paper

every bone that you know – it’s ok if that’s nothing at all!

• If you don’t know the anatomical name, write the laymen’s term

o Now, turn to a partner and see how many bones you

can name together

• Join your partnership with another

pair and see if, between the four

of you, you can “fill in any gaps”

for each other.

Image: © Microsoft


Naming the Bones

o Stand up and follow your lecturer’s lead as they name

each bone (except for individual carpals, tarsals and

skull bones)

o Now play

‘Speed Anatomy’,

touching each

bone as it’s

called out

Image: (Beth Scupham, 2011)


Bony Anatomy Quiz

o Form 4 teams

o Your lecturer will point to

a bone on this diagram

o Teams will “buzz” if they

know the name of the

bone

Image: (Tortora & Derrickson, 2009)


Bony Anatomy:

The Hip and Sternum

o With a partner, name

the three bones of the

hip

o Where can you palpate

them on yourself?

o Name the three bones of

the sternum



Bony Anatomy: The Spine

o With a partner,

name each section

of the spine

o Find them on

yourself

o Try to name the

inner ear bones



Bony Anatomy: Simon Says

o Students form a circle

o Lecturer names a bone

o Students point to the

indicated bone

o Students sit if they are

wrong

o Last standing wins



Introduction to Assessment Skills

Image: © Microsoft



o In this class, your palpation partner is your client.

This means:

• Always asking for consent prior to touching

• Always talking your client through what you are doing, and

explaining as you go

• Always treating your client with respect and care

• Maintaining privacy and dignity at all times

• Keeping confidentiality: The bodies in this classroom are

real! You see may signs of disorder, disease and/or

abnormality. This is not to be discussed outside of the

classroom environment.

• Palpate slowly and avoid excessive pressure: Check for

discomfort or pain and avoid this



o Musculoskeletal assessment usually involves

gathering information in four primary ways:

• Inspection/observation

• Palpation

• Range of motion testing and special testing

o Inspection should always come first.

• Look before you touch! Effective inspection/observation will

provide you with a great deal of information. You cannot be a

skilled (or even safe) practitioner without thoroughly

developing these skills

• Sometimes you will want to watch the client perform a

specific action. Practice giving clear instructions (which can

include demonstration) to your client.


Inspection

o Inspect your partner’s hand. What can you see?

• Check all surfaces of the hand, observing the skin and the

underlying muscle, bone and joints

• Are there signs of:

– Disease/disorder

– Ageing

– Dehydration

– Inflammation

– Something else?

• Now palpate the hand and see if you can confirm your

findings or learn anything new.

• Check your conclusions with your partner: Do they agree?


Palpation

o “To examine or explore by touching with intention”

o Palpation Hints

• Move slowly and avoid excessive pressure

• Relaxed hands will gather more information

• Try closing your eyes to increase sensation

and awareness

• For deep palpation: Lay one hand on top

of the other

• For small structures: Use finger pads

• For pulses: Use finger tips

• For large structures: Use your whole hand

• The deeper you go, the gentler you must be

Image: (Biel, 2010)

(Biel, 2010)


Palpation

o Hints to optimise your learning:

• Where possible, try self-palpation first. You’ll better

understand what you’re looking for, and you’ll know how your

client feels!

• When you palpate, say out loud what you’re palpating. It’s

easier to learn a muscle action or a landmark name when

you say it, hear it and think it all at once. Don’t stay quiet.

• When you are the client, help your partner and work

together. Let them know if you feel uncomfortable (they need

to learn this too!) or if you think they are

in the wrong spot. Help to problem-solve

together.

• Palpate all the bodies in the class!

Image: (Biel, 2010)

(Biel, 2010)


Palpation

o Rolling and strumming

• To outline the shape or edge of a bone or muscle, roll your

fingers across it, not along it. This helps you to determine

tension, fibre direction and size

o Movement and stillness

• To palpate a moving structure (such as a pulse, contracting

muscle or moving joint), keep your hands still

• To palpate a non-moving structure (such as a muscle or

bone), move your fingers/hands across it

Image: (Biel, 2010)

(Biel, 2010)


Palpation

o Palpation through movement

• Movements will often help you to locate (or double check the

location of) structures and notice tissue changes

o There are 3 types of movement you may be asked to

create:

• Active: The client moves their body part without assistance

• Passive: The client is relaxed/“floppy” while you move them

• Active resisted: The client pushes against you, while you

resist their movement

Image: (Biel, 2010)

(Biel, 2010)


Palpation Practice

o Palpation stages:

• Locate the structure

• Become aware of its characteristics

• Assess its quality or condition

o Palpate your dominant and

non-dominant forearm and feel the skin, fascia

(underlying connective tissue), muscle and bone

• Describe the quality of each layer. Is each side the same?

• Try to find 3 people in the class with very visually different

forearms. What qualities do you notice? Are they physically

different to touch?

Image: © iCLIPART


Palpation Practice

o In groups of 3:

• Follow the “Exploring the Skin and Fascia” activity on p47 of

Trail Guide. Your lecturer will demonstrate first.

– Discuss your results as a class

• With lecturer guidance, follow Trail 1 and 2 “Along the

Edges” and “In the Trenches” on p52-56 of Trail Guide.

– Can you find the bony landmarks?

– Are certain arm positions

easier to access certain

parts of the scapula?

– If yes, what positions?

Image: © Microsoft

© Endeavour College of Natural Health www.endeavour.edu.au 27Image: (Biel, 2010)


Review and Preparation

o Complete these pages in the Trail Guide Workbook:

• 1-2

• 14-15

• 28-29

Image: © Fotolia


References

o Biel, A. (2010). Trail guide to the body (4th ed.). Colorado: Books of Discovery.


Image References

o Beth Scupham. (2011). 333180-

2114398775274_1104813812_31925130_2145473485_o [Image]. Retrieved

February 6, 2017, from https://flic.kr/p/b42Nj6

o Brewbooks. (2014). New desk in use [Image]. Retrieved February 6, 2017, from

https://flic.kr/p/pGak5s

o Biel, A. (2010). Trail guide to the body, 4th edn, Books of Discovery, Colorado.

o CollegeDegrees260. (2012a). Backpack [Image]. Retrieved February 6, 2017, from

https://flic.kr/p/cEJSSb

o CollegeDegrees360. (2012b). College girls in the park [Image]. Retrieved February

6, 2017, from https://flic.kr/p/cEJgcq

o Geckoam. (2010). Professor Levi [Image]. Retrieved February 6, 2017, from

https://flic.kr/p/8dD7z3

o MarquetteUniversity. (2008). 08_06 Nursing graduate simulation lab 0012 [Image].

Retrieved February 6, 2017, from https://flic.kr/p/9WqLTu

o MarquetteUniversity. (2012). 08_09-Gross-Anatomy-Lab—0031 [Image]. Retrieved

February 6, 2017, from https://flic.kr/p/dgpED9


Image References

o Tortora, G. J., & Derrickson, B. (2009). Principles of Anatomy and Physiology (12th

ed.). Danvers: John Wiley & Sons.

o Wombatarama. (2011). book royalties = cookies! [Image]. Retrieved February 6,

2017, from https://flic.kr/p/9pmUf4


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Documents

MSTA121 SN01 Lecture - … · alone do not explain all the palpation processes or give you all of the ... o Here are four very effective ... don’t study alone!