PhysicalAssessment
TrainerHeart Auscultation / Percussion / Palpation

LM-084
Instruction Manual
Thank you for purchasing the LM-084 Physical Assessment Trainer.
Please read this instruction manual carefully to ensure correct use of the product,and store it in a safe place for easy access.

KOKEN CO., LTD.
1-4-14 Koraku, Bunkyo-ku, Tokyo 112-0004 JAPANURL:http://www.kokenmpc.co.jp
E-mail:customer@kokenmpc.co.jp© 2008-2020 KOKEN CO., LTD. C-1-960-1-02-03

Handling and Safety Precautions
These precautions should be strictly observed in order to ensure safe,long-term use of the product.
The following precautions should be observed particularly strictly:
The default voltage setting for the heart and breathing sound source included with thisproduct is 110 V. When using the product outside of Japan, before use, be sure to confirm thevoltage of the region in which it will be used and change the voltage setting of the heart andbreathing sound source to 220 V if necessary.
(See page 8 for instructions for switching the voltage.)
1. This model is made to have the same feeling as living body. It may cause damage if and when youhandle it with force.
2. Please do not put objects on the main body of this model. That may lead to transformation of thisskin. Please do not use nor store the model at the place with high temperature. The skeleton may be
deformed.
3. Please store the model in the attached case while it is not used.
4. Please wipe stains of the model, with wet gauze etc. Using water or a neutral detergent diluting withwater. Please do not use thinner, benzine which damages the model.
5. Please do not use oily ink and painting, if they soak into the model, they never be removed.
6. Please store this model solvents such as in the place where no direct rays of the sun and/or ultraviolet
rays are.
7. Always remove the power cord from the unit before switching the AC voltage of the heart andbreathing sound source.

1. The contents of this instruction manual are subject to change without notice.
2. This instruction manual may not be reproduced in part or in its entirety without permission.
3. Please contact the manufacturer in the event that any errors or omissions are found in the contents ofthis instruction manual.
4. This product should be used only as described in this instruction manual. In particular, the productshould not be used in any way that contravenes the precautions noted in the instruction manual.

1

Table of Contents
1. Outline & Characteristics
2. Composition and Name
3. How to Handle Model
Disposition of speaker
Case Data
4. How to Perform Percussion
5. Physical Assessment
6. Others
7. Specification2

1. Outline & Characteristics
OutlineThis is a Torso model to acquire four basic techniques for physical assessment(inspection / palpation / percussion / auscultation).

Characteristics
The following four basic skills regarding physical assessment can be exercised.
1. Inspection: Inspection of cervix and chest
2. Palpation：Palpation of lymph node on upper clavicle, palpation of thyroid gland
3. Percussion：Percussion of thorax
By injecting air into simulation lungs, you can adjust the air and set the normality /abnormality of each simulation lung.
4. Auscultation: Auscultation of heart and breathing
Breathing sounds:		12 kinds of breathing sounds (Normal - 1, Abnormal - 11)			Auscultation region (Two for each of right and left lung. One for 				bronchus)			After auscultation, abnormal breathing sound can be adjusted which		is corresponding the status you set for the abnormality to each of right		and left lung.
Heart sounds:

20 kinds of heart sounds (Normal - 2, Abnormal - 18)			Auscultation region (Heart base, Apex cordis - 4)3

2. Composition and nameComposition

Torso

Name

Skin
Main body
Model base
Bolt for ﬁxing model base
Pump for inﬂating simulation lungs
Sound source
Heart and breathing sound source
Cord for connecting model and heart /breathing sound source

Qty
111
1
1
1
1

Power supply cord for heart /breathing sound source

1PouchHexagonal wrench (8mm)
Syringe (20ml)
Hard case

1111Others4

Name※ HS：HEART SOUND※ BS：BREATHING SOUND

Thyroid gland
Speaker：BS※−TLymph node

Speaker：HS※−AMain body sponge
Simulation lungs (Right, Left)
Speaker：HS※−P

Speaker：HS※−M

Speaker：HS※−T
Connector for heart/
breathing sound source

Speaker cableBase plate for speaker

Sponge pant for lumbus
Silicone part for lumbus

Model base

Speaker：BS※−RL

Speaker：BS −LL※

Zipper (both side)

Inﬂating connector for lungs
Insertion for connector

Inﬂation connector for lymph node53. How to Handle Model
3-1. Preparation for Torso Part
① Get through the female connector of the cord for connecting the model with the heart andbreathing sound source into the hole on the right back side of main body.

② After connecting the female connector with the connector inside the main body connector,
fix with the screw.

＊ A screwdriver of minus is NOT accompanied.

6

3-2. Heart and Breathing Sound Source

Front
Breathing Sound Volume(Left and Right Lungs, Respiratory Tract)

Outside Speaker Volume, Select Switch
Heart Sound Volume (A, P, T, M)

LCD

Keys to InputCasesBackPower Switch

Fuse

Input cord terminal for connecting model with heartand breathing sound source.

Power Supply plug

Outside speaker terminal

Specification:
Output functions for cases: Heart sound cases - 20, breathing sound cases - 12Case selection:
Case sound can be selected with the switch on the operation panel.
Settings of heart rate:
Outside speaker output:		

Heart rate can be set with the switch on the operation panel.
One of the sounds chosen from 4 kinds of heart sound (A, P, T, M) and3 kinds of breathing sound (left and right lung, respiratory tract) can be		outputted by connecting outside speaker.

7本器は１１０１０又は２２０２切り替え方式になっており、使用場所の電圧に設定可能です。
本器は１又は２０ 切り替え方式になっており、使用場所の電圧に設定可能です。
Thevoltageofthisunit
canbeswitchedbetween110 V and 220 V to match the voltage（初期設定：１１０）（初期設定 ：１１０ ）ofthepower
sourcebeingused.
(Defaultsetting:110V)○ ○ 電圧切り替え方法
電圧切り替え方法※心音呼吸音発生器のＡＣ電圧を切り替える際は必ず本器から電源コードを外して行って下さい。
○ How to switch the ACvoltage※心音呼吸音発生器のＡＣ電圧を切り替える際は必ず本器から電源コードを外して行って下さい。
①心音呼吸音発生器を裏返します。
①心音呼吸音発生器を裏返します。
* Always remove the power cord from the unit before switching the AC voltage of the heart andbreathing sound source.
① Flip over the heart and breathing sound source.

②心音呼吸音発生器の左下にあるキャップを外します。
② Remove the cap on the lower left corner.
②心音呼吸音発生器の左下にあるキャップを外します。
キャップ
Cap
キャップ

③ The AC switching lever can be seen through the hole uncovered when the cap is removed. By

ラジオペンチ等を用いて使用場③キャップを外した窓から 電圧切り替えレバーが見えますので、using long-nose pliers and so on, switch to the voltage of the power source being used.
所の電圧に切り替えます。
（１１０、２２０の表示はキャップを外した窓から確認できます。）
電圧切り替えレバーが見えますので、ラジオペンチ等を用いて使用場③キャップを外した窓から（The label of 110V and 220V can be found through the hole when the cap is removed）
所の電圧に切り替えます。
（１１０、２２０の表示はキャップを外した窓から確認できます。）
切り替えレバーを手前（矢印方向）に引くとロック
1.
Point the switching lever towards you
1

１２ 2１が解除されます。
(in切り替えレバーを手前（矢印方向）に引くとロックthe direction of arrow) to unlock it.
ロックが解除された状態で電圧を切り替えることが解除されます。
2.ができます。
When
unlocked, switch the voltage.
ロックが解除された状態で電圧を切り替えることができます。

２④キャップを元に戻します。
④ Replace the cap.

④キャップを元に戻します。

8-7-

3-3. Preparation for Sound Source① After connecting the male connector of the cord for connecting the model with the heartand breathing sound source, with the heart and breathing sound source, fix with the screw.

② Connect the plug cord with the heart and breathing sound source.

③ Connect the plug code with the socket and turn on the power switch.

3-4. How to Operate Heart and Breathing Sound Source① When the liquid crystal display shows “Heart Sound No,” input a case number of heart sound(refer page 11 of this manual) and then press the “E” key.

“E” key9

② "Heart Rate" is displayed on the LCD display. Enter the heart rate (see page 11: “Case data”)
and press the "E" key.
* If a value outside the settable range is entered, the output will not be correct.
③ When the liquid crystal display shows “L-Breath Sound” input a case number of breathingsounds for the left lung and then press the “E” key. (refer page 11 of this manual)④ When the liquid crystal display shows “R-Breath Sound No,” input a case number of breathingsound for the right lung and then press the “E” key.
(refer page 11 of this manual)⑤ The liquid crystal display shows“H NO □HR □ 						

L-B

R-B □

□ST”

and then a case sound you set is outputted. Each case sound volume can be adjusted,corresponding to the volume switch of each region.

○ Cautions for the speaker volume＊ When turn up the volume too much, the sound may be distorted.
＊ When the speaker sound of other parts interfere while auscultation,please turn down the volume.
Each case sound chosen by the select switch can be heard from the speaker outside.
⑥ When you finish or output other cases, press the “R” key.
⑦ When you finish, turn off the power switch.

10

Disposition of speaker

Heart Sounds① HEART SOUND : A② HEART SOUND : P③ HEART SOUND : T④ HEART SOUND : M

Breathing Sounds⑤ BREATHING SOUND : LL ※⑥ BREATHING SOUND : T⑦ BREATHING SOUND : RL ※※ BREATHING SOUND : RL and LL position is back side11

Case data
NoHeart sounds

Case data

Settable heart rate range

Normal ( without splitting of S2 )Normal (splitting of S2 )Abnormal splitting of S2Hypertension increased intensity of S2 at apex
S4 apex
Innocent murmur
Ejection sound aortic site
Midsystolic click soundMidsystolic click murmur
Tricuspid regurgitation
Mitral stenosis
Mitral regurgitation
Aortic stenosis
Aortic regurgitation
Subaortic stenosis
Atria septal defectVentricular septal
Pulmonic stenosis
Pulmonic steno-regurgitation
Patent ductus arteriosus

60-25560-14660-10660-11860-13660-84
60-15160-11060-129
60-75
60-89
60-68
60-75
60
60-70
60-64
60-79
60-12060-72
60Breathingsounds

Normal vesicular sounds
Discontinuous sounds-ﬁne crackles
Discontinuous sounds-coarse crackles
RhonchiWheezes
Mixed sounds(rhonchi and wheezes)
Nervous dyspeneic respiration
Dyspeneic respiration at rest
Cardiac asthma
Dyspeneic respiration in asthma
Cheyne-stokes respiration
Biotʼs respiration

12

4. How to Perform Percussion
Percussion can be performed by injecting air into simulation lungs.

4-1. About Settings① Abnormal / normal percussion can be set, corresponding the breathing sound cases chosen.
② The normality and abnormality of left and right lungs are set by connecting the simulation
lung pump with the air-inflating connector.

Example・ Right: Abnormal breathing sound - Open (empty, lack of air in simulation lung)Left: Normal breathing sound - Inflated (filled with air in simulation lung)・ Both (left and right) normal sound: After inflating air into the one-side simulation lung,take off the connector and then inflate air into the other simulation lung.
・ Both (left and right) abnormal sound: Remove the air in the simulation lungs, using the pumpfor inflating the simulation lungs.

○ Cautions for inflation
Please be sure to make the simulation lung inflated around 40mmHg,
measuring with manometer.
Excessive inflation can break the simulation lungs.

134-2. Setting Procedure○ For Normal① Put the pump for inflating the simulation lungs with the connector for inflating, which is on
the side of lung you set for normal.
Connector for inflating

Pump for inflating
simulation lungs② Grasp the rubber ball of the pump for inflating simulation lungs and then put air into thesimulation lungs to be inflated around 40mmHg, measuring with manometer.

14

③ Pushing the button, remove the pump for inflating the simulation lungs.
ButtonBefore inflating the left lung(For abnormal breathing sound）

After inflating the left lung(For normal breathing sound)○ For Abnormal① Connect the pump for inflating the simulation lungs with the connector for injecting air into
the lung you choose as abnormal.
② Turning the knob of the rubber ball connecting to the pump for inflating the simulation
lungs, remove the air until the manometer shows 0mmHg.
Knob

15

5. Physical
5. Physical
Assessment
Assessment

5. Physical Assessment

5-1.5-1.
Palpation
Palpationof Chestof ChestFrame
Frame
5-1. Palpation of Chest Frame

TheTheaboveabove
frameframe
is installedisisinstalledinsideinsidethethethemodel.
model.
Theaboveframe
installed
insidemodel.

5-2.5-2.
Palpation
Palpationof Thyroidof Thyroid
Gland
Gland
5-2.
of Thyroid
Gland
InjectInjectairwithairPalpation
withthe thesyringe
syringefrom
fromthethetip oftiptheof thetubetubecomingcomingout outof theof thelower
lower
partpartof theof themodel.
model.
Inject air with the syringe from the tip of the tube coming out of the lower part of the model.

Before injection the air

after injection the air

Beforeinjectionthetheairair
Beforeinjection

afterinjection
thetheairairafterinjection＊ Please take off the syringe from tube after using.

PleasePleasetaketakeoff offthethe
syringesyringefromfromtube
tube
afterafterusing.
using.

1614 14

Palpation of Lymph Node on Upper Clavicle
It is possible to palpate Lymph Node on Upper Clavicle
Lymph node on upper Darcie

6. Others
If you would like to use the model with lying position, the base can be disconnected using
attached hexagonal wrench.

7. Specification
LengthWidth

HeightWeightApprox. 21 cm

Approx. 38 cm

Approx.54 cm

Approx. 7 kg

Approx. 30 cm

Approx. 30 cm

Approx.1.5 cm

Approx. 2 kg

Approx. 19 cm

Approx. 32 cm

Approx. 9 cm

Approx. 3.3 kg

Torso

Main Body
Model BaseeSound Source
PartHeart andBreathing
Sound Source17