Physical Assessmemt Model
Physiko
Instruction ManualPhysical Assessment Simulator

IndexRead meP.1

Features

P.2

System configuration

P.2

How to connect each device

P.3〜P.5

How to use software
Start‑Up PC 〜 Top Menu

P.7

System configuration（Volume set）

P.8

System configuration (Pupils sensor & Listening volume)

P.9

Patient cases (Mode 1)

P.10

Patient cases editor (Mode 2)・Creating patient case

P.11

・How to save / delete the file

P.12

・Open data / Execution

P.13
P.14・P.15

・Continual execution
Basic operation in learning course

P.16〜P.20

Basic operation in Skills training

P.21

How to quit software

P.22

Ｑ＆Ａ

P.23・P.24

DOs and DONʼTs

P.25

Read
me
必ずお読みください
This product is designed for training in medical education.
Do not use it for other purposes.
Do not use the system in a way other than hereinafter prescribed.
Manufacturer shall not be liable for damages or problems caused bynoncompliance with the written instruction.
Read

Note in use

before use of model.

Handle the model carefully. Excessive force or physical impact may
damage the product or result in problems.
If you have any questions, contact Kyoto Kagaku.
(Contact address is printed on back cover)1Features① Physiko facilitates learning of the basic procedure for physical assessment
comprehensively interfacing with PC.
② Physiko facilitates practice for Pupil reflex, BP measurement(Right Arm), Pulsation(Carotid artery, Radical artery), Auscultation (Lung and Heart sound) and ECG.
③ Physiko provides many cases for each procedure, which facilitates learning of thefeatures for each case.

System Configuration

Physiko consists of following internal functions■Mannequin
Pupils light sensors

Speakers(Heart sounds, Lung sounds)
ECG Sensors
Speaker(Bowel sound)

Pulse generator

Blood pressure sensor（Right arm）

Pulse generator

ECG Sensors■Terminal Box & Peripheral Device

ECG electrocord& leadTerminal Box
Sphygmomanometer

PC

Mouse
Cables to connect※ Specification and shape of devices are subject to change without notice.

2How to connect each device ①
Connect each device according to the following instruction and diagram.
・Connect the power cable of Terminal box to the outlet (AC 115V).
・Connect PC to Terminal box by USB cable.
・Connect the cable from Mannequin (96‑pin terminal cable) to Terminal box.
・Connect the cable from the Sphygmomanometer to the Terminal box.
（Use the Sphygmomanometer provided in kit）
・Connect power cable from PC to outlet in Terminal box.
※It is possible to connect the cable "to ECG" to the Electrocardiographic Monitor you have.
Pay attention not to make an impact on the PC or the Terminal box.
※Electrocardiographic monitor may not be able to connect to the Terminal box.

■Figure to connect each device
Outlet
AC115V

Sphygmomanometer provided in kit
TerminalBox

96‑pin teminal cableUSB

PC
ECG lead
Mouse
AC115V
to ECG

Mannequin3

How to connect each device ②■Back Side of Terminal Box

RA

LA

RL

LL

V1

V2

V3

V4

V5

血圧計/Cuff

V6

AC100V OUT

AC100V IN

電極/Electrode
心電計/EGG

to ECG leadto ECG Monitor you haveto powerof PC

to outlet

to Sphygmomanometer

Connect each cable to suitable terminal carefully according to the figure of the back sideof Terminal Box.
※Do not use the outlet in Terminal Box for another electric device since it is designed
for the PC provided in kit.

■Side of Terminal Box

USB

モデル/Model

to USB teminal of PC

to Mannequin

Connect each cable to suitable terminal carefully according to the figure on sideof Terminal Box.

4

How to connect each device ③■Terminal side of PC

to Terminal Box（USB）

to Mouse（USB）

You may connect to any USB connectors of the Terminal side of PC.

※The layout of terminal is subject to change according to the model of PC.
However the way of connection is not changed.

■Front side of Terminal Box

感度/Sensitivity
POWER

Phisycal Assessment Model

The pilot lamp lights up
when every connection ismade correctly and thepower of PC is turned on.

瞳孔収縮感度/Contracted pupil

瞳孔散大感度/Dilated pupil

高
/High

高
/High

聞き取り感度/Hearing

M55

低
/Low

低
/Low

高
/High

低
/Low

Refer to page 9 regarding
how to adjust these adjusters.

5How to use the software
Physical Assessment Model Physiko

6How to use software【Start‑Up PC 〜 Top Menu】

Start‑Up PC
Turn on PC power button after finishing connection for devices.
←This icon shows the main power button for PC.

The software is started up automatically when the power is turned on, and Top Menu is shown.
If the message "The USB‑BOX is not connected！"shows on the display, check theconnection of each device.

Top Menu

To Shut down the softwareand turn off PC→P.22
To the individual examination
skills training mode →P.21
To patient cases editor mode
→P.14〜20
To the patient cases mode
→P.10
To system configuration toadjust→P.8・97

How to use software【System Configuration】

System Configuration
Return to※This page is Top Manu.

Each volume for Heart sound, Pupils light sensors and Microphone can be adjusted on
this screen.
After adjusting each item, click the icon "Home" on the right top corneron the screen.

Volume Set
The window on left can be opened byclicking the "Volume Set" icon.
Adjust the volume suitably as you need.
1.Move the slider left to right to adjusteach volume. The volume becomes higher bymoving it to right. It becomes lower bymoving it to left.
2.Click "Adopt" icon after setting eachvolume.
3.Click "Reset" icon to make the status
before shipment.
4.Click "Cancel" icon to make the status
before "Adopt".
5.Click "Using" to work the microphone.

8How to use software【System Confiruration】

How to adjust the pupils light sensors
Adjust the pupils light sensors according to thebrightness in the room in order to make a normal
pupils reflex.
Adjust the Sensitivity knob on the front of theterminal box in order to locate the indicator in
the "Normal" range.

感度/Sensitivity
瞳孔収縮感度/Contracted pupil

瞳孔散大感度/Dilated pupil

高
/High

低
/Low

低
/Low

高
/High

感度/Sensitivity
聞き取り感度/Hearing

高
/High

低
/Low

■Sensitivity setting for contractionof the pupil
Normally the knob is set in acounterclockwise status. If the pupils
feels overreact to brightness, adjust
the knob clockwise.
Pupils become insensitive to the light.

瞳孔収縮感度/Contracted pupil

瞳孔散大感度/Dilated pupil

高
/High

低
/Low

低
/Low

高
/High

聞き取り感度/Hearing

高
/High

低
/Low

■Sensitivity setting for dilationof the pupil
Normally the knob is set in acounterclockwise status. If the pupils
feels underreact to darkness, adjust theknob clockwise.
Pupils become sensitive to the darkness.

If "！" logo is lighted, turn knobs again counterclockwise up to end and adjust themin order to locate the indicator in the "Normal" range.

How to adjust listening volume
感度/Sensitivity
瞳孔収縮感度/Contracted pupil

瞳孔散大感度/Dilated pupil

高
/High

低
/Low

低
/Low

高
/High

聞き取り感度/Hearing

高
/High

低
/Low

Adjust listening volume to make the mouth move when microphone is used.
Adjust the volume to light "Audible" sign when you speak into the microphone and"Inaudible" sign when you don't speak.
When turning knob counterclockwise, it becomes sensitive to even silent voice,and when turning clockwise, it becomes insensitive.

9

How to use software【Patient mode（Preset）】

Mode 1（Patient cases）
Mode 1 provides twelve pre‑set
patient cases which can bechosen to learn.
In this mode user cannot change
patient data arbitrarily.
Choose Mode 2 (Patient caseeditor) on Top menu when you
create new patient and learn
with that.

When you put cursor on the bar onleft side of the screen, the dataof its patient is shown on theright side of the screen.
When you click the bar of thepatient data, it changes to thescreen for the physicalassessment session.(It takes alittle time to change screen.)

Regarding how to learn the patient
cases, refer to page 16 to 20.

10How to use software【Patient cases editor】

Creating patient case
Click " N " on the left whencreating patient case newly.

When you clickof each case, thepulldown selection is shown.
Choose the item you like.
Regarding the blood pressure, clickor,or click the number you
change and input by keyboard.

※You cannot input greater number to S4
than S5's.

■How to input letter by keyboard (In the case of Japanese version of PC)
Alphabet input mode is set usually. If it is not, switch to alphabet modeby following instruction.

Shift

半角／
全角
漢字

to Alphabet input mode

11

How to use software【Patient cases editor】

How to save the file
When you save the created file, click"Save" icon.
When the window is shown on the left,
input filename to ① by keyboard and click"Save" icon ② .

※If you named existing filename, the dialogue
is shown. You may change the filename to resave
or overwrite.

①②

How to delete the file①

When you delete created file, click "Save" or"Call data".
After the window is shown like the left, click
the filename you delete like ① , and click"Delete" icon ②.

②

12How to use software【Patient cases editor】

Call data
When you open the saved file,click "Call data" bar.
The window below is then shown.

Click the filename you choose in the window opened ① .
Next click "Open" icon to open the file you chose ② .
If there is unsaved file, the window below will beshown.

①

Click "Yes" if you don't save the file,and open another one.
Click "No" if you save the file.
Next, open the another one.
②

※Regarding how to save the file, refer to page 12.

Execution
Click the "Execution" bar on the left, when you execute "Created file" or "Opened file".

If you execute "Unsaved file", the window below will be shown.

Click "Yes" if you don't save the file, and execute another one.
Click "No" if you save the file, and click "Execution" after saving the file.
※Regarding how to save the file, refer to page 12.

13How to use software【Patient cases editor】

Continuous execution ①
When you execute files continuously,
click "Continuous execution" bar.

※When you execute this mode,it isrequired that more than two files
are saved.
You can execute up to three files
continuously.

■Choice of file to execute

Click the file to execute on the window opened ① .
Next click "Choice" icon to transfer the file to"Continuous execution pattern" box ② .
Repeat task ① ② to choose up to three files.

①②■Choice of the executing time

Choose the executing time according to following order.
Click the file in "Continuous execution pattern" box
you choose the executing time for ③ .
Next you click "Executing time"④ , and choose one fromfive options of "executing time" you needin pull‑down menu.
Repeat task ③ ④ to choose proper "Executing time" forevery file you chose.

③④※If you don't choose "Executing time" for a file,
it will be one minute automatically.

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How to use software【Patient cases editor】

Continuous execution②■Changing the order of files to execute

Click the file for which you change the order
to execute ⑤ .
Next, you change the order of files by clicking"Up" or "Down" ⑥ .

⑥⑤■Unlocking the chosen file

Click the file to unlock the choice ⑦ .
Next when you click "Unlock",the file is unlockedfrom the choice ⑧ .

⑧⑦■Execution

Click "Execution" after finishing configuration ⑨ .

※It takes a time for this system to transfer the data
to the terminal box from PC when you choose next filein the continuous execution.
⑨

15

How to use software【Patient cases】

Learning course
When you go into Learning course, the screen below is shown first.
Choose skill you would like to learn and click it.
You can choose skill andgo to each course.
You can return to previous menu.
You can retrun to Top Menu

Basic operation for learning course ①
There are "The patient overview" and "Details of the findings" screens in eachlearning course. You can switch the screen by clicking the icon on top‑leftin the screen.

16How to use software【Patient cases】

Basic operation for learning course ②
There is "Interpretation of findings" icon on bottom‑right ineach "Details of findings" screen. You can check what finding is bypressing this icon.
The example screen is for Pupil reflex. The figure of icon isdifferent in each skill.

There is "Case explanation" icon on bottom‑right in each
"Details of the findings" screen. You can check what case is bypressing this icon.
(It is blank in "Patient case editor".)17

How to use software【Patient cases】

Basic Operation in learning course ③
You can adjust volume by click by "Volume Setting" icon in some cases.
→P.8

Refer to Volume setting■Operation in ECG learning

You can choose "Indicate" or "Hide" inElectrode status on ECG detail screen.

Electrode Status "Indicate"Electrode Status "Hide"

In ECG pasient screen, you can choose
ECG wave by clicking ECG display
surrounded inline on left figure.

18How to use software【Patient cases】

Basic operation in learning course ④■How to use speaker in PC.

In each screen of Heart sound, Lungsound and Bowel sound, if you put yourcursor on the sound wave, it will bechanged to stethoscope icon.
Make a sound from speakers in PC byclicking that icon.
When you stop making a sound, click
the other area except the soundwave.

EX. In Heart sound, the cursor will be changed in the areas surround by red line.

※If the quality of sound from PC speaker is not good enough, we recommend you use
the external speaker with built‑in amplifier.
■How to auscultate posterior in Lung sound mode
You can change to anterior or posterior by clicking the icon encircled by red dash line.

19How to use software【Patient cases】

Basic operation for learning course ⑤■Notes in Blood pressure measurement

During cuff application for BP
measurement, if "The cuff is not
appropriately applied" message
appears (see left), refer to thediagram below to insure that it iscorrectly done.

右腕Right arm
※Measure BP on the right arm.
Don't do on the left.

20How to use software【Skills Training】

Basic operation for Skills training
When you put the cursor on theskills bars of the left side,
the corresponding picture forskill will appear.
When you click the skills bar
you will go to each skill's
trainig section.

■Choice of case

There is "Select findings" icon on
the top of the screen except "Bloodpressure case".
When you click this icon, the pull‑
down cases appear. Choose a case topractice.

■Setting for Blood pressure

You can set the value of S1,S2,S5 in
Blood Pressure Measurement.
When you click "BP measurement" icon
under the screen, Dialogue is shownand you can set each value by clicking
andicon beside numbers.

※その他の操作方法につき

21How to use software【How to quit】

How to quit software
Click "Home" icon on top‑right ineach screen to go to Top Menu.
Next when you click "Quit"
on bottom‑right, the window below
is shown. Click "Yes" to quit.
The program ends and PC shut down
automatically.

22

Preparation

Pulse Strength Setting

Pulse Strength Adjustment
Strength of carotid and radial arteries is controllable.
・Take oﬀ the cover pad located at the lower right waist of manikin.

・Adjust the pulse by turning knob clockwise or counter-clockwise.

Mark (Recommended
setting)

Weak

Turn clockwise to raise pulse strength and turncounter-clockwise to lower pulse strength.
Turning the knob fully left will make the pulse
barely palpable.

Strong※ Strong pulse may result in louder device
noise and interrupt auscultation.
When it occurs, lower the pulse while listening.
As a safety measure, Physiko will automatically enter cooling mode when used with strong pulse fora prolonged period of time. When this happens, it is advised to switch oﬀ power, or weaken the pulse
setting to cool the device.
Recommend setting of the pulse strength is marked as shown in above photo.

8

Ｑ＆Ａ

Q
The message "Please confirm the connection with the device" has appeared.

A
Please confirm it since there are the following possibilities.
1.Terminal BOX is not connected to a PC with a USB cable.
2.The power (AC 115V) is not supplied to Terminal BOX.
※The message doesn't disappear even if the state of 1 and 2 is solved.
Click "OK" to delete the message when a correct connection is completed.

Q
The message "It is within ○○ minutes to run out of battery" has appearedon the screen.

A
PC is driven by battery without connecting to the power(115V).
Connect PC power cable to outlet of Terminal Box.
The outlet of Terminal Box is for attached PC. Don't use it for others.

Q
The screen was changed to OS mode,or the application program was frozen.

A
PC needs to be restarted.
【The screen was changed to OS mode】

Click "Menu (A)" icon at the bottom of screen.
Choose "Restart PC" bar on the opened menu and click "OK".
【The application program was frozen】

Press "Ctrl" key + "Alt" key + "Back space" key at a time.
If the screen was changed to OS mode, restart PC according toabove【The screen was changed to OS mode】.
To be continued on next page →

23

Ｑ＆Ａ

A
If you pressed "Ctrl" + "Alt" + "Back space" keys together but thescreen did not change to OS mode, press the power switch for more
※１than five seconds after confirming PC was silent.
Pressing for more than five seconds makes PC shut down.
Press the power switch again to start PC.
※１

As the hard disk is working while PC is making small sound, wait for PC
to be silent and press the power switch.

Caution! Don't shut down the PC in this manner on a regular basis or
it may possibly break.
This is the only way to shut down the PC when the application software isfrozen abnormally.

Q
ECG sensor is malfunctioning.

A
When Mannequin is stored under 50 degree F, ECG sensor might malfunction
occasionally.
In this case, keep Mannequin at over 50 degree F for awhile and operate
the system after it returns to room temperature.

24DOs and DONʼTs
DOs and DONʼTs
DOs●Operate the system under the designatedcircumstances
Power input: AC100V～230V plus or minus 10％, 50Hz/60Hz
Temperature range: between 0 degrees C and 40 degrees C(no congelation)
Relative humidity; between 0％to 80％ (no condensation)*Connecting to power source outside of the designatedrange may lead to fire.

●Safe disposition
To avoid shoｒt circuit, do not run the simulator set above a
power receptacle.

●Handle the power plug and cord observing
following precautions
1. Clean the head of the plug periodically.
2. Plug in the plug to the outlet firmly to the end.
3. Always hold the plug when unplugging. Do not pull the cable.
4. Do not force to bend, twist the cable and avoid scratchingor cutting on it.
Failing to follow the above precautions can result in damage inthe plug and the cable, constituting risk of fire or shock.

●When the electric parts get warm or produce
smoke, immediately turn off the power andunplug from the power source

Risk of fire. Contact your distributor or the manufacturer for
repair.

●Handle with care
Handle the model carefully, like an actual patient. Excessive
force or impact may damage the product or result inproblems.
The materials for the models are special compositions of soft
resin. Please handle them with utmost care at all times.
For cleaning, wipe the model with water or soap water. If stain
persists, wipe with alcohol and place talcum powder on thebreast skin after dried.

●Storage
Store the simulator at room temperature, away from heat,moisture and direct sunlight.
Storage under the temperature above 50 degrees C may
reduce the performance quality of the simulator.

DONʼTs●Do not disassemble or open electric or
precision components
Do not open up or disassemble the housing for electric partsor precision components.
Refrain from opening up any lids, caps or covers for sucharea, and never run the system while any of such covers are
open.
*Never disassembling the electric components, power plugand cable as it may create a risk of fire, shock or injury.
Contact your distributor or the manufacturer for repair.

●Never wipe the product and components
with thinner or organic solvant●Ink marks on the soft surface wonʼt be
removable

Donʼt mark on the product and components with pen or
leave any printed materials in contact with their surface.

●Do not give shocks

The electric components are precision instruments.
Strong shocks or continuous vibration may cause breakagesof its internal structure.

●Do not run the system continuously over
2 hours

Take at least 30 minutes shutdown, turning oﬀ the power,
every 2 hours.
When you use this model continually for a long time, it might
malfunction occasionally due to heat in some circumstance.
In this case, shut down the model for about 30 minutes andrestart.

●Do not wet the electric components

Do not pour or spill water or liquid detergent over theelectric components, power cable and power plug.
Running the system while the electric components are wet
may create a shock hazard or a risk of ﬁre.

●Do not handle the power plug with wet hands
Risk of shock.

●No fire

Do not put the product close to ﬁre. It may lead to discoloration or deformation of the product as well as short circuit,creating a risk of ﬁre.

25