Domain 2 - Assessment and Evaluation Skills

  The following table is a list of links to pages that describe how to perform these skills often with other background material.  Below that are objectives used to guide the inclusion of material in teaching.

Assessment and Evaluation Objectives

Teaching Objective 1:

The student will conduct static and postural evaluation and screening procedures.

Specific Outcomes

1.            The student will recognize the following postural deviations and predisposing conditions:

a.    kyphosis                                                                              g.    genu valgum, varum, and recurvatum

b.    lordosis                                                                                h.    rearfoot valgus and varus

c.     scoliosis                                                                               i.     forefoot valgus and varus

d.    pelvic obliquity                                                                j.     pes cavus and planus

e.    tibial torsion                                                                      k.    foot and toe posture

f.     hip anteversion and retroversion

2.            The student will perform a postural assessment of the following:

a.    cervical spine and head                                                d.    hip and pelvis

b.    shoulder                                                                              e.    knee

c.     lumbo-thoracic region                                                  f.     ankle, foot, and toes

3.            The student will identify and classify body types as

a. endomorph

b. ectomorph

c. mesomorph

Teaching Objective 2:

The student will perform record keeping skills while maintaining patient confidentiality.

Specific Outcomes

1.            The student will

a.       use standardized record keeping methods (e.g., SOAP, HIPS, HOPS)

b.                  select and use injury, rehabilitation, referral, and insurance documentation

c.                   use progress notes

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

b.    soft tissue structures of the head, trunk, spine, and extremities

c.     abdominal and thoracic structures

d.    primary neurological and circulatory structures

Teaching Objective 4:

The student will assess neurological responses.

Specific Outcomes

1.            The student will identify and assess the following:

a.    cranial nerves                                                                   d.    deep tendon reflexes

b.    dermatomes                                                                      e.    pathological reflexes

c.     myotomes

Teaching Objective 5:

The student will perform proper clinical evaluation techniques, including range-of-motion testing (active, passive, assisted).

Specific Outcomes

1.             The student will qualitatively assess active, passive, resistive range of motion for the following:

a.    temporomandibular joint                                            g.    hip

b.    cervical spine                                                                    h.    lumbar spine

c.     shoulder                                                                              i.     thoracic spine

d.    elbow                                                                                   j.     knee

e.    wrist and hand                                                                  k.    ankle

f.     thumb and fingers                                                          l.     foot and toes

Teaching Objective 6:

The student will perform clinical evaluations of major body areas to assess and interpret for injury and illness.

Head and Face Evaluation

The student will

1.            obtain the medical history of an ill or injured athlete or other physically active individual.

2.            observe and identify the clinical signs and symptoms associated with head injury:

a.    amnesia (retrograde or post-traumatic)                f.     pupil and eye movements

b.    levels of consciousness                                                g.    pulse

c.     orientation (person, time, place orientation)    h.    blood pressure

d.    intracranial hematoma                                                 i.     facial postures

e.    balance and coordination

3.             observe and identify the clinical signs and symptoms associated with eye injuries and illnesses:

a.    orbital blowout fracture                                               e.    detached retina

b.    conjunctivitis                                                                    f.     hyphema

c.     corneal abrasion                                                              g.    stye

d.    corneal laceration

4.                   observe and identify the clinical signs and symptoms associated with an ear injury or illness:

a.    pinna hematoma (“cauliflower ear”)                      c.     otitis externa

b.    impacted cerumen                                                         d.    otitis media

5.            observe and identify the clinical signs and symptoms associated with nose injury:

a.    deviated septum

b.    epistaxis

c.     nasal fracture

6.            observe and identify the clinical signs and symptoms associated with jaw, mouth, or tooth injury or illness:

a.    gingivitis                                                                             g.    tooth abscess

b.    mandibular fracture                                                       h.    tooth extrusion

c.     maxilla fracture                                                                i.     tooth fracture

d.    periodontitis                                                                     j.     tooth intrusion

e.    temporomandibular joint dislocation                    k.    tooth luxation

f.     temporomandibular joint dysfunction

7.            administer appropriate sensory, neurological, and circulatory tests

8.            administer functional tests and activity-specific tests

9.            identify, palpate, and assess the integrity of bony landmarks

10.          identify, palpate, and assess the integrity of soft tissue

11.          administer commonly used special tests to make a differential assessment of the following:

a.    cranial nerves (e.g., eye motion, facial muscles)

b.    cognitive tests (e.g., recall, serial 7s, digit span)

c.     cerebellar function (e.g., Romberg's test, finger-to-nose test, heel-toe walking, heel-to-knee standing)

d.      spinal nerve roots (e.g., upper quarter screen)

Cervical Spine Evaluation

The student will

1.            obtain the medical history of an ill or injured athlete or other physically active individual

2.             observe and identify the clinical signs and symptoms associated with common injuries, illnesses, and predisposing conditions:

a.    atrophy                                                                                e.    intervertebral disc herniation

b.    dislocation or subluxation                                           f.     nerve root compression or stretch

c.     vertebral fracture                                                            g.    ischemia

d.    head and neck posture                                                 h.    torticollis

3.             administer active and passive range-of-motion tests using quantifiable techniques (e.g., tape measure, goniometer, and inclinometer)

4.            use manual muscle-testing techniques

5.            administer appropriate sensory, circulatory, and neurological tests

6.            administer functional tests and activity-specific tests

7.            identify, palpate, and assess the integrity of bony landmarks

8.            identify, palpate, and assess the integrity of soft tissue

9.            administer commonly used special tests to make a differential assessment of the following:

a.    nerve root compression (e.g., distraction/compression test, Spurling's test, shoulder depression test)

b.    brachial plexus neuropathy (e.g., brachial tension test, Tinel's sign)

c.     cervical disc herniation (e.g., Valsalva’s maneuver)

d.    neurovascular dysfunction (e.g., vertebral artery test)

Shoulder Evaluation

The student will

1.            obtain the medical history of an ill or injured athlete or other physically active individual

2.             observe and identify the clinical signs and symptoms associated with common injuries, illnesses, and predisposing conditions:

a.    atrophy                                                                                h.    positioning (Sprengel’s deformity)

b.    bursitis                                                                                 i.     strain

c.     dislocation or subluxation                                           j.     scapulohumeral rhythm

d.    efficiency of movement                                               k.    scapular winging

e.    fracture                                                                                l.     step deformity

f.     sprain                                                                                   m.   symmetry

g.    nerve injury                                                                       n.    tenosynovitis and tendonitis

3.            administer active and passive range-of-motion tests using standard goniometric techniques

4.            use manual muscle-testing techniques

5.            administer appropriate sensory, neurological, and circulatory tests

6.            administer functional tests and activity-specific tests

7.            identify and palpate bony landmarks

8.            identify and palpate soft tissue landmarks

9.            administer commonly used special tests to make a differential assessment of the following

a.    glenohumeral instability (e.g., anterior drawer test, posterior drawer test, relocation test, apprehension test, clunk test, sulcus sign)

b.    acromioclavicular instability (e.g., shear test, compression test)

c.     rotator cuff impingement/inflammation (e.g., Speed's test, drop arm test, empty can test, impingement test, Hawkins-Kennedy impingement test, Neer impingement test, pectoralis major contracture test)

d.    biceps and biceps tendon pathology (e.g., Yergason's test, Ludington's test)

e.    thoracic outlet syndrome (e.g., Adson’smaneuver, Allen test, military brace position)

Elbow Evaluation

The student will

1.            obtain the medical history of an ill or injured athlete or other physically active individual

2.             observe and identify the clinical signs and symptoms associated with common injuries, illnesses, and predisposing conditions:

a.    symmetry                                                                           h.    epicondylitis

b.    carrying angle (cubital valgus and varus)              i.     tenosynovitis and tendonitis

c.     dislocation or subluxation                                           j.     osteochondritis dissecans

d.    fracture                                                                                k.    sprain

e.    atrophy                                                                                l.     strain

f.     efficiency of movement                                               m.   nerve injury

g.    bursitis                                                                                

3.            administer active and passive range-of-motion tests using standard goniometric techniques

4.            use manual muscle-testing techniques

5.            administer appropriate sensory, neurological, and circulatory tests

6.            administer functional tests and activity-specific tests

7.            identify, palpate, and interpret the integrity of bony landmarks

8.            identify, palpate, and interpret the integrity of soft tissue

9.            administer commonly used special tests to make a differential assessment of the following

a.    joint instability (e.g., valgus stress test, varus stress test)

b.    inflammatory conditions (e.g., tests for lateral epicondylitis, tests for medial epicondylitis)

c.     neuropathy (e.g., Tinel's sign, pronator teres syndrome, pinch grip test)

Forearm, Wrist, and Hand Evaluation

The student will

1.            obtain the medical history of an ill or injured athlete or other physically active individual

2.            observe and identify the clinical signs and symptoms associated with the following

a.    fracture (Colles’ fracture, Bennett's fracture, carpal fracture [“boxer's fracture”], metacarpal fracture, phalanges fracture)

b.      dislocation or subluxation

c.       disease states (e.g., clubbed nails, spoon-shaped nails)      

d.    soft tissue pathology (e.g., sprain, flexor tendon avulsion [jersey finger sign], extensor tendon avulsion [mallet finger], extensor tendon rupture [boutonniere deformity], volar plate rupture [pseudo-boutonniere deformity], Dupuytren’s contracture, ganglion, swan neck deformity, trigger finger)

e.    neurovascular involvement (e.g., carpal tunnel syndrome, bishop’s or benediction deformity, ape hand, claw fingers, drop-wrist deformity, Volkmann's contracture)

3.            administer active and passive range-of-motion tests using standard goniometric techniques

4.            use manual muscle-testing techniques

5.            administer appropriate sensory, neurological, and circulatory tests

6.            administer functional tests and activity-specific tests

7.            identify, palpate, and interpret the integrity of bony landmarks

8.            identify, palpate, and interpret the integrity of soft tissue

9.            administer commonly used special tests to make a differential assessment of the following:

a.    inflammatory conditions (e.g., Finkelstein test)

b.    joint instability (e.g., valgus stress test, varus stress test, glide tests)

c.     neurovascular pathology (e.g., Tinel's sign, Phalen’s test)

Thoracic/Lumbar Spine Evaluation

The student will

1.            obtain the medical history of an ill or injured athlete or other physically active individual

2.             observe and identify the clinical signs and symptoms associated with common injuries, illnesses, and predisposing conditions:

a.    café au lait macules (spots)

b.    dislocation or subluxation

c.     spina bifida occulta               

d.    facet syndrome       

e.    intervertebral disc pathology           

f.     spinal posture (kyphosis/ lordosis)

g.    leg length discrepancies     

h.    nerve root compression      

i.     sacroiliac dysfunction

j.     scoliosis

k.    vertebral pathology (e.g., spondylitis, spondylolysis, spondylolisthesis)

l.     sprain

m.   stenosis

n.    step deformity

o.    strain

3.             administer active and passive range-of-motion tests using standard qualitative and quantitative techniques

4.            use manual muscle-testing techniques

5.            administer appropriate sensory and neurological tests

6.            administer functional tests and activity-specific tests

7.            identify, palpate, and interpret the integrity of bony landmarks

8.            identify, palpate, and interpret the integrity of soft tissue

9.            administer commonly used special tests to make a differential assessment of the following:

a.    intervertebral disc herniation (e.g., Valsalva’s maneuver)

b.    neuropathy (e.g., straight leg raise test, well straight leg test, Babinski’s reflex test, Oppenheim’s gait test, Kernig’s sign, Brudzinski sign test, bowstring test, Hoover sign test)

c.     vertebral defects (e.g., stork standing test/spondylolisthesis test)

d.    joint instability (e.g., spring test)

Hip/Pelvis Evaluation

The student will

1.            obtain the medical history of an ill or injured athlete or other physically active individual

2.             observe and identify the clinical signs and symptoms associated with common injuries, illnesses, and predisposing conditions:

a.    leg length discrepancies                                              j.     osteitis pubis

b.    hip retroversion                                                               k.    athletic pubalgia

c.     hip anteversion                                                                l.     bursitis

d.    Legg-CalvJ-Perthes disease                                       m.   piriformis syndrome

e.    apophysitis                                                                        n.    iliotibial band syndrome

f.     slipped capital femoral epiphysis                            o.    contusion

g.    dislocation or subluxation                                           p.    sprain

h.    fracture                                                                                q.    strain

i.     stress fracture                                                                   r.     tendonitis

3.            administer active and passive range-of-motion tests using standard goniometric techniques and/or a tape measure

4.                   use manual muscle-testing techniques

5.            administer appropriate sensory, neurological, and circulatory tests

6.            administer functional tests and activity-specific tests

7.            identify, palpate, and interpret the integrity of bony landmarks

8.            identify, palpate, and interpret the integrity of soft tissue

9.            administer commonly used special tests to make a differential assessment of the following:

a.    sacroiliac dysfunction (e.g., Patrick's/FABER, Gaenslen’s test, pelvic compression/distraction test)

b.      neuropathy (e.g., femoral nerve traction test)

c.       neuromuscular pathology (e.g., Trendelenburg test, Thomas test, rectus femoris contracture test, Ober test, Noble’s test, piriformis test)

Knee Evaluation

The student will

1.            obtain the medical history of an ill or injured athlete or other physically active individual

2.             observe and identify the clinical signs and symptoms associated with common injuries, illnesses, and predisposing conditions:

a.    bursitis

b.    chondromalacia patella

c.     dislocation and subluxation

d.    fat pad contusion

e.    fracture

f.     leg length

g.    meniscal tear

h.    Osgood-Schlatter disease

i.     osteochondritis dissecans

j.     patellar alignment (e.g., patella alta, patella baja, squinting patella, Q angle)

k.    patellar tendon rupture

l.     peroneal nerve contusion or palsy

m.   popliteal cyst

n.    sprain

o.    strain

p.    tendonitis

q.      tibial torsion

r.     tibiofemoral alignment (e.g., genu recurvatum, genu valgum, genu varum)

3.            administer active and passive range-of-motion tests using standard goniometric techniques

4.            use manual muscle-testing techniques

5.            administer appropriate sensory, neurological, and circulatory tests

6.            administer functional tests and activity-specific tests

7.            identify, palpate, and interpret the integrity of bony landmarks

8.            identify, palpate, and interpret the integrity of soft tissue

9.            administer commonly used special tests to make a differential assessment of the following:

a.    uniplanar stress tests (e.g., valgus stress test, varus stress test, Lachman test, anterior drawer test, posterior drawer test, posterior sag sign)

b.    multiplanar (rotational) stress tests (e.g., Slocum test, Hughston's test, lateral pivot shift maneuver)

c.     meniscal tears (e.g., McMurray’s test, Apley’s test)

d.    patellofemoral dysfunction (e.g., grind test, apprehension test)

e.    intra-extracapsular swelling (e.g., sweep test, ballottable patella)

Leg, Ankle and Foot Evaluation

The student will

1.            obtain the medical history of an ill or injured athlete or other physically active individual

2.             observe and identify the clinical signs and symptoms associated with the following common injuries, illnesses, and predisposing conditions:

a.    overuse injures (e.g., bursitis, exostosis, fasciitis, stress fracture, tarsal tunnel syndrome, tendonitis and/or tenosynovitis, tibial stress syndrome)

b.    Achilles tendon rupture

c.     compartment syndromes

d.    apophysitis

e.    dislocation or subluxation

f.     foot type/structure (e.g., forefoot varus/valgus, equinus deformity, pes cavus/planus, plantar flexed first ray, rearfoot [hindfoot] varus/valgus)

g.    fracture

h.    deep vein thrombosis (e.g., Homans’ sign)

i.     neuroma

j.     osteochondritis dissecans

k.    sprain

l.     strain

m.   toe structure/alignment (e.g., bunion, claw toes, hallux rigidus, hallux valgus, hammer toes, mallet toe, Morton’s foot syndrome)

n.      weight-bearing versus non-weight-bearing alignment

o.    gait

3.            administer active and passive range-of-motion tests using standard goniometric techniques

4.            use manual muscle-testing techniques

5.            administer appropriate sensory, neurological, and circulatory tests

6.            administer functional tests and activity-specific tests

7.            identify, palpate, and interpret the integrity of bony landmarks

8.            identify, palpate, and interpret the integrity of soft tissue

9.            administer the following commonly used special tests to make a differential assessment:

a.    compression test (e.g., Pott’s fracture)                 e.    talar tilt test

b.    percussion test                                                                 f.     Thompson test

c.     anterior drawer test                                                       g.    Tinel's sign

d.    Kleiger’s test                                                                     h.    Homans’ sign