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224 Cards in this Set
- Front
- Back
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Which lower body part and joint has the highest incidence of injury? |
The feet and ankles |
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What types of exercises are key to help recover ankle/foot strength? |
Balance exercise |
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Which metatarsal bone is the weakest? |
The fifth metatarsal bone |
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List the 4 arches of the foot and their locations |
Inner Longitudinal Arch (from posterior medial portion of the foot to the big toe); Outer Longitudinal Arch (from the posterior lateral portion of the foot to the little toe); Proximal metatarsal transverse arch; Metatarsal-phalangeal joint transverse arch |
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Which muscles are utilized when you dorsiflex your foot? |
Tibialis Anterior, Extensor digitorum longus, Extensor hallicus longus, and Peroneus tertius |
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Which muscles are utilized when you plantarflex your foot? |
Gastronemeus, Soleus, Peroneus Longus/Brevis, and Tibialis Posterior |
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At what point does movement of the ankle take place? |
Subtalar joint |
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Which two muscles pull the foot laterally? What is this action called? |
Eversion; Peroneals (Brevis and Longus) |
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Why will a bad eversion sprain result in damage to the fibula? |
Because the fibula is longer than the tibia and will impact the ankle bones (primarily the calcaneous) |
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Which muscles pull the foot medially and what is this action called? |
Inversion; Posterior Tibialis and Anterior Tibialis |
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What excessiveness is Varus and what is happening to the Subtalar Joint? |
Excessive Supination; Subtalar joint is over-Pronated |
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What excessiveness is Valgus and what is happening to the Subtalar Joint? |
Excessive Pronation; Subtalar joint is over-Supination |
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What results from varus of the foot and from valgus of the foot? |
Varus - weakening of the medial ligaments in the ankle Valgus - weakening to the lateral ligaments of the ankle |
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What generally will result from excessive or prolonged pronation or supination? |
Overuse injuries can occur |
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What do we do to compensate for structural deformities? |
Excessive motion |
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Excessive Pronation can result in ligaments and structures on which side of the ankle to become loose (and what side will become tight)? And what types of injuries (8) can occur (and where) from this? |
Structures on the lateral side of the ankle to become loose (medial ligaments will become tight); stress injuries in the first metatarsal as well as the attachment of the peroneus longus; 2nd metatarsal stress fracture, plantar fasciitis, posterior tibialis tendinitis, achilles tendinitis, tibial stress syndrome and medial knee pain can happen |
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Which plane(s) of movement is pronation in? What movements make up each individual plane? |
Pronation affects all 3 planes of motion; Eversion (frontal plane), Dorsiflexion (Sagittal Plane), and Abduction (Horizontal Plane) |
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Which plane(s) of movement is supination in? What movements make up each individual plane? |
Supination affects all 3 planes of motion; Inversion (frontal plane), Adduction (Horizontal Plane), and Plantarflexion (Sagittal Plane) |
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When and where can we look at excessive pronation of the foot? |
We can look at the posterior side of the foot during the weight bearing phase of the gait |
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Excessive ________ results in "loose foot" or hypermobility |
Pronation |
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Excessive ______________ results in "rigid foot" or a foot that gets "stuck" as well as limiting rotation of what? |
Supination; limits rotation of the tibia |
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What injuries can occur from Excessive Supination of the foot? (5) |
Inversion sprains, Tibial stress syndrome, peroneal tendinitis, IT-Band friction syndrome and Trochanteric Bursitis |
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Quickly describe a walking gait with valgus |
When foot leaves the ground, foot rolls outward and forefoot remains everted |
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How can some athletes walk on broken fibulas or some ankle bones? How then can you tell that these are broken? |
because they are not all load bearing; Comparing deformities with bilateral examination between the feet and looking for discoloration (poor blood supply) |
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What should you look for during an examination of any foot/ankle injuries? (6) |
Patient is favoring one foot, limping or unable to bear weight; Deformities; Swelling; Discoloration; Foot changing color on weight bearing; and Foot alignment |
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What Four things are important to do to maintain proper foot hygiene? |
Trying to keep feet dry and clean; toenails are cut; shaving down callouses; and wearing clean/correctly fitting socks and shoes |
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What general 5 things can foot problems be attributed to? |
- Improper footwear - Poor foot hygiene - Anatomical structural deviations - Faulty postural alignments - Abnormal stresses |
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What type of shoe (with medical term as well) and shape is ideal for persons with excessive pronation? Why? |
A rigid shoe (board last) straight-lasted with good rearfoot control is recommended; they need stability and firmness to reduce excess movement |
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What type of shoe (with medical term as well) is ideal for persons with excessive supination? Why? |
A more flexible (slip last) curved-lasted shoe (moccassin style) with increased cushioning is recommended; Allows a rigid foot to flex more and loosen up |
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What does a combination Slip-lasted and Board-Lasted shoe provide and where? |
Provides rearfoot stability with forefoot mobility |
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What is used in orthodics to control the motion of the rear foot? |
Heel Counters |
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What does TOP stand for? |
Tender on Palpation |
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How would you manage Plantar Fasciitis? |
Use a soft orthotic (dr sholls) and different types of socks that pull foot into correct position |
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What does it mean when something has a High Non-Union Rate? Why would this happen? |
It means that the two pieces have a hard time to come together and form back into one bone because of poor blood supply |
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What negative effects would happen to taping and bracing a distal joint to something more proximal? |
May cause an injury to the more proximal joint (taping ankle too much could result in a knee sprain) |
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Fracture of the Talus: Etiology, S&S, and Management (5) |
- Landing after a jump or fall OR avulsion of Calcanealnavicular or Tibial Collateral Ligaments - Immediate swelling & pain; unable to weight bear - RICE immediately; X-ray; immobilization; may need to be pinned because of poor blood supply; crutches |
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Calcaneal Stress Fracture: Etiology, S&S, and Management |
- Repetitive impact during heel strike - Weight bearing increases pain; pain continues after activity stops (has become chronic) - Conservative 2-3 weeks; non-weight bearing CV exercises |
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What is Sever's Disease? Etiology, S&S, and Management |
Apophysitis of the Calcaneus - Traction injury at apophysis of calcaneus (where achilles attaches) - Pain at posterior heel of child or adolescent - Rest, ice, stretching (Achilles tendon), heel lift (both shoes) |
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Retrocalcaneal Bursitis: Etiology, S&S, Management |
- Inflammation of the bursa that lies between the Achilles tendon and Calcaneus, swelling around both sides of achilles like it is being squished out the sides - Pain by palpating bursa; swelling on both sides of Achilles - RICE; NSAIDs; Stretching Achilles; donut pad on heel |
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What is Exostosis? What can it all be called? (Lamen's terms) |
it is a benign bony outgrowth or callus that protrudes from the surface of a bone; usually capped in cartilage; Also called Pump Bump |
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Heel Contusion: Etiology, S&S, Management |
- Activities that demand a sudden stop-and-go response or a sudden jumping movement - Sever pain in heel; unable to weight bear; warmth & redness - No weight bear for 24 hours; RICE; NSAIDs; squeeze fat pad back on the bottom of the foot to help heal; gel heel cup |
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Cuboid Subluxation: Etiology (where is the pain referred?), S&S, Management |
- Pronation and Traume - Pain along 4th and 5th metatarsals & cuboid; refers pain to heel; can cause the foot to lock up - Manipulation (chiropractor); orthodics; pad under bottom of foot (to hold cuboid in place) |
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What does the Tarsal Tunnel contain (5) and where is it located? |
it contains the Tibialis posterior, flexor hallucis longus tendon, flexor digitorum longus tendon, tibial nerve and artery Located behind the medial malleolus of tibia and calcaneus |
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Tarsal Tunnel Syndrome: Etiology, S&S, Management |
- Condition that compromises tarsal tunnel structures (ex. tenosynovitis) - Pain and Paresthesia, + Tinel's sign (too much pressure on a nerve) - Conservative; NSAIDs; Orthotic; Surgery |
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What would a positive + Tinel's sign indicate and how is it found? |
Indicates that there is too much pressure on a nerve; tapping a nerve and feeling a zinging would show a + sign |
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Tarsometatarsal Fracture and Dislocation: Etiology (long!), S&S, Management |
- Ankle is PFed with rear foot locked and sudden forceful hyperPF of forefoot. = dorsal displacement of proximal end of metatarsals OR landing on toes so that the metatarsals will slide back and fracture/dislocate - Pain and inability to bear weight; swelling and tenderness - Open reduction with internal fixation (surgically opening foot, putting bones back into place and then pinning them) |
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What 4 things can cause a Foot Strain? And what are 3 symptoms? Is it acute or chronic or both? |
- Insufficient conditioning - Structural imbalance - Incorrect mechanics - Longitudinal Arch Strain - May appear suddenly or over a period of time - Pain on running - below medial malleolus - Swelling and tenderness - Flexor hallicus longus often becomes tender |
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Pes Planus Foot: Lamen's Term, Etiology (4), S&S, Management |
- Flatfoot - Excessive foot pronation (arch may just collapse); structural forefoot varus deformity; wearing shoes too tight OR trauma that weakens support structures - Pain and weakness in arch, calcaneal Eversion; bulging navicular bone; DF with splaying 1st metatarsal - Orthotics - medial wedge |
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Pes Cavus: Lamen's Term, Etiology, S&S (6), Management |
- High Arch - Excessive supination; may be congenital - Poor shock absorption = foot pain; metatarsalgia; claw toes; forefoot valgus; shortened Achilles tendon; calluses on ball and heel of foot - Orthotics - lateral wedge (forces more pressure on inner arch pushing it down); stretching Achilles and Plantar Fascia |
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Morton's Toe: Etiology, S&S, Management |
- Abnormally short 1st metatarsal, making 2nd toe look longer - May cause stress fracture on 2nd metatarsal - If forefoot varus deformity - orthotic with medial wedge |
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Longitudinal Arch Strain: Etiology, S&S, Management |
- Repetitive contact with hard surfaces - pain during running and jumping; pain below TB tendon with swelling & tenderness - RICE, reduce weight bearing; taping |
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What is the 6 things of Etiology for Plantar Fasciitis? What is it? |
It is the inflammation of the plantar aponeurosis on the underside of the foot - Running puts a lot of force on structure - Longitudinal arch is depressed - Pushing off doubles body weight - Broad insertion, narrow attachment on calcaneus - Tight Achilles tendon - Pes Cavus (high arch) |
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Where when and how is pain caused by Plantar Fasciitis? |
Pain on plantar medial tuberosity, intensified in the morning then resolves (tightens while you sleep), Pain on dorsiflexion of toes and forefoot |
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What are the 6 things you can do to manage Plantar Fasciitis? |
- Soft orthotic - Heel cup to compress fat pad and cushion - Taping - Night splint (helps stretch foot and achilles tendon at night!) - Achilles tendon stretching - Increase dorsiflexion of great toe |
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Jones Fracture: Where is it most common? Etiology, S&S, Management; what is NOT good to do with it? |
- Inversion and Plantarflexion of foot; direct force or reptitive stress - Immediate swelling and pain (high non-union rate) - JUST crutches, NOT immobilization with cast (blood supply); surgery and pinning - Most common to the base of the 5th metatarsal |
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Metatarsal Stress Fracture: Where is it most common? Etiology, S&S, Management |
- Runner changes patterns of training or atypical condition (forefoot varus, hallux valgus) - Focal tenderness that does NOT show on x-ray - Bone scan, return to running gradually - Most common in 2nd metatarsal "march fracture" |
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Hallux Valgus Deformity: Lamen's Term: Etiology, S&S, Management, What kind of shoes would cause this? |
Bunion - Big toe points inwards with swelling of 1st metatarsal joint; forefoot varus (1st ray splays outward = pressure on 1st metatarsal); Calcification of bursa of the joint - Tenderness; swelling & enlargement of metatarsal phalangeal joint - Shoes with wide toe box; orthotics; doughnut pad; splint; strengthen ext & flex muscles of big toe - Shoes that are pointed and too narrow would cause this |
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Sesamoiditis: Etiology, S&S, Management |
- Repetitive Hyperextension of great toe (sesamoids sit in flexor and adductor tendons) - Pain under great toe at push off - Orthotics, metatarsal bar (prevents irritation and inflammation) |
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Metatarsalgia: Etiology, S&S, Management |
- Pain in ball of foot (2nd and 3rd metatarsal heads); heavy callus underneath is painful - Transverse arch becomes flattened, heads of 1st, 2nd, 3rd, 4th metatarsal heads depressed - Padding, static stretching |
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Metatarsal Arch Strain: Etiology, S&S, Management |
- Fallen metatarsal arch or pes cavus (more pressure now on metatarsal arch); rolling onto the medial side of the foot causes it - pain or cramping; point tenderness/weakness - Pad |
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Morton's Neuroma: Etiology, S&S, Management |
- Thickening of nerve sheath (common plantar nerve) between 3rd and 4th metatarsal heads - Burning paresthesia (pins and needles); severe intermittent (comes and goes) pain - Bone scan (rules out stress fracture); tear-drop shaped pad |
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Sprained Toes: Etiology, S&S, Management |
- Kicking a non-yielding object - Pain immediate & intense but short lived; swelling; discoloration; stiffness - RICE; buddy taping; soaking |
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Great Toe Hyperextension: Lamen's Term, Etiology, Management |
Turf Toe - Sprain in the metatarsal phalangeal joint - Significant pain and swelling - Stiffer shoes; tape into dorsiflexion |
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Fractures and Dislocations of the Phalanges; Etiology, S&S, Management, What NOT to do? |
- Kicking object, stubbing toe, stepped on - Immediate intense pain; deformity; swelling; discoloration - Reduction by physician; buddy taping - Do NOT cast toes |
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Hallux Rigidis: Etiology, S&S, Management |
- Bony spurs on dorsal aspect of 1st MTP joint; degenerative arthritic process - Unable to toe-off on 1st metatarsal, uses 2nd, 3rd, 4th, and 5th instead - Stiffer shoe with wide toe box; osteotomy |
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What is Hammer Toe? |
It is a flexible deformity that becomes fixed (flexion contracture of PIP joint) |
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What is Mallet Toe? |
Flexion contracture at DIP joint of FDL tendon |
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What is Claw Toe? |
Flexion contracture at DIP joint with hyperextension at MTP joint |
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Overlapping Toes: Etiology, S&S, Management |
- Congenital or improper footwear - Outward projection of 1st toe OR drop in arch - Surgery |
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Subungual Hematoma: Etiology, S&S, Management |
- Stepped on OR repetitive shearing forces (long-distance runner) - Considerable pain; blood under nail (black toenails) - Drain it (use surgical needle to drill through the nail to release pressure) |
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What NINE things should you focus on during Foot Rehabilitation?* |
- General body conditioning - Weight bearing - Joint mobilization (regain ROM) - Flexibility - Muscular strength - Neuromuscular control - Foot orthotics & taping - Functional progressions - Strength training in sport specific settings |
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What type of joint is the ankle? |
Hinge joint |
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In what position is the ankle most stable? Most unstable? |
Most stable during dorsiflexion, most unstable during plantarflexion |
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What types of movement are prevented by the malleoli? |
Medial and lateral displacement as well as excessive inversion or eversion (with help of deltoid ligament) |
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What degree of motion can the ankle move during dorsiflexion and during plantarflexion? |
10 degrees of dorsiflexion to 50 degrees of plantar flexion |
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Name the 3 Lateral Collateral Ligaments and their basic functions |
Anterior Talo-Fibular Ligament (restrains anterior displacement of talus), Calcaneofibular ligament (Restrains inversion of calcaneus), and Posterior Talofibular ligament (Restrains posterior displacement of talus) |
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Name the 3 main medial ligaments of the ankle (one has 3 sub-ligaments, name those) |
Deltoid ligament (Posterior tibiotalar portion, tibiocalcaneal portion, anterior tibiotalar portion), Tibialis anterior and posterior tendons |
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What does the deltoid ligament help prevent on the ankle? |
Abduction and eversion of ankle and subtalar joint, also eversion, pronation and anterior displacement of talus |
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What do the tibialis anterior and posterior tendons help do on the foot? |
They help maintain the arch of the foot |
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What 5 things can you do to help prevent an injury in the lower leg and ankle? |
Achilles tendon stretching, Strength training (help maintain stabilizers), Neuromuscular control training (bosu balls, mini trampolines), Footwear, Preventive taping/orthotics |
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What percentage of sprains are caused by plantarflexion and internal rotation of the ankle? Which 3 ligaments are most likely sprained here? What is one of the symptoms of this? How could you manage it |
90-95% of sprains are to the lateral ligaments (anterior and posterior talofibular ligaments and the fibulocalcaneal ligament) - Lots of swelling to lateral side of foot - RICE (horseshoe pad), limit weight bearing, early functional rehabilitation (ROM), taping with closed basket weave technique |
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What percentage of ankle sprains are caused by traumatic Eversion? Why is this percentage the way it is? What can also be injured from this event? How can we manage it? |
5-10% of all ankle sprains are eversion sprains, It is so low because there is more bony protection as well as much stronger ligament strength on the medial side, A fracture of the fibula can also occur from this - X-ray to rule out avulsion fracture; RICE; no weight bearing; same program as inversion injury |
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What is another name for a Syndesmotic Sprain? What gets injured? Etiology, S&S, Management |
High Ankle Sprain - Injury to the distal tibiofemoral joint (anterior/posterior tibiofibular ligament) - Usually caused by torqueing on a planted foot or falling backward with foot trapped under body, torn with increased external rotation or dorsiflexion - Severe pain, loss of function, passive external rotation and dorsiflexion which causes pain - 2-3 times longer to heal than normal ankle tendon injuries |
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Ankle Sprains and Fractures: Name each degree and what the symptoms are; name the symptoms for a fracture |
1st Degree - weight bearing, little pain 2nd Degree (moderate) - weight bearing but some more pain 2nd Degree (severe) - NO weight bearing 3rd Degree - no weight bearing, ankle is unstable Fracture - no weight bearing, pain is acute, swelling MINIMAL |
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Ankle Fracture/Dislocation: Etiology, S&S, Management |
- Forcibly abducted = transverse fracture to tib/fib; planted with internal rotation = fracture to tib/fib - Extreme swelling & pain - RICE; immobilization; tape the way you find it |
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Osteochondritis Dissecans: Etiology, S&S, Management; Why is there so much pain? |
- Fragments of articular cartilage & underlying subchondral bone in talar dome - Very painful (very little space inside ankle compartment) and effusion; locking and giving away - x-ray; immobilization; surgery (must be managed properly!) |
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Achilles Tendon Strain: Etiology, S&S, Management |
- Sudden excessive dorsiflexion - Acute pain and weakness on pF - RICE; conservative; heel lift |
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Achilles Tendinosis: Etiology, S&S, Management |
- Inflammation of the tendon or tendon sheath; usually caused by repeated eccentric loading; achilles tendon is usually 'tight'; microtears lead to degeneration and chronic inflammation - Pain and Swelling; crepitation; erythemia (redness); weakness and restricted motion - Reduce stress on tendon, cast in a plantar-flexion position for 6 months; shoes/orthotics; flexibility (gastroc and soleus); RICE; Cross-friction massage (breaks up scar tissue) |
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Where is the Achilles Tendon usually injured and why? |
Usually injured in the lower 2/3rds part because it is the smallest part and just before it connects to bone |
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Achilles Tendon Rupture: Etiology, S&S, Management |
- Sudden push off action of forefoot with knee forced into extension - Sudden snap, feels like something 'kicked' them; toe raise impossible - Surgical repair |
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Peroneal Tendon Subluxation/Dislocation: Where does it occur? Etiology, S&S, Management |
Located posterior to fibula but lateral side of foot - Dynamic forces or direct blow - Complain of snapping in and out of groove with activity - Horseshoe pad; RICE; conservative 5-6 weeks |
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Anterior Tibialis Tendinitis: Etiology, S&S, Management |
- Commonly occurs after extensive downhill running - Point tenderness; pain with stretch or contract - Avoid hills; focused strengthening program |
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Posterior Tibialis Tendinitis: Etiology, S&S, Management |
- Overuse condition in runners with foot hypermobility or over pronation - Pain & swelling by medial malleoli - RICE; NSAIDs; non-weight bearing cast; correct pronation |
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Peroneal Tendinitis: Etiology, S&S, Management |
- Pes Cavus and Supination (with foot turning inwards and with a high arch, peroneal tendon will have a lot more friction on it - Pain behind lateral malleoli - RICE; NSAIDs; taping; warm-up; flexibility |
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Shin Contusion: Etiology, S&S, Management |
- Blows and bumps, absence of muscular or adipose tissue - Intense pain; hematoma - Pedal pulse; RICE; NSAIDs; ROM; Padding |
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Leg Cramps and Spasms: Name the two types, Etiology, S&S, Management |
Clonic (intermitten contractions), and Tonic (constant) - Fatigue, dehydration - Cramping and pain - Mild gradual stretch; ice pack (decreases nerve impulses) |
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Gastrocnemius Strain: Etiology, S&S, Management |
- Medial head susceptible; quick starts and stops - Edema (swelling from excess trapped fluid), point tenderness, strength loss - RICE, NSAIDs, heel wedge, taping |
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Medial Tibial Stress Syndrome: Lamen's Term, Etiology (7), S&S (where), Management |
Shin Splints - Faulty postural alignment, Fallen arches, muscle fatigue, overuse stress, chemical imbalances, overfatness, lack of reciprocal muscle coordination - Pain manifesting in antero-lateral aspect of leg & postero-medial aspect of leg, 4 grades of pain - Conservative, Ice, Tape, Stretching, NSAIDs, ultrasound |
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What is a catch-all term for non-specific pain in the leg? How much of all running injuries does it account for and what percentage of lower leg pain does it account for? |
Shin Splints (MTSS) - Accounts for 10-15% of all running injuries and 60% of all lower leg pain |
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List and describe the Grades of Pain for Shin Splints (MTSS) |
Grade 1 - pain after physical activity Grade2 - During and after activity (does not affect performance) Grade 3 - Pain before, during and after activity (AFFECTS performance) Grade 4 - Performance is impossible |
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Compartment Syndromes: List and describe the two types; Describe the pathology and the surgical management |
Acute: requires immediate decompression if swelling is uncontrolled by ice application, area is painful to touch, skin is shiny and red, loss of dorsal pedal pulse Chronic: internal pressure rises during activity, pain increases as activity progresses, pain gradually disappears after cessation of activity, eventually MAY need surgery - Caused by tight fascia around muscle; tissue fluid pressure increases and compresses blood vessels and nerves - Fasciotomy procedure: incision in skin and fascia to release pressure |
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List the 9 Rehabilitation Techniques for the Lower Leg and Ankle before returning an athlete back to activity |
- General body conditioning - Weight bearing - Flexibility - Neuromuscular control - Strengthening - Taping & Bracing - Functional progressions |
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What type of joint is the Knee joint? |
It is a Hinge joint |
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Which location of the knee joint contains the strongest ligaments? Why? |
The medial side are the strongest (MCL is very fan based); Because most blows come from the outside and try to cave knee medially) |
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If MCL is injured, it will most likely come with a ________ _________ Injury |
Medial Meniscus |
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Which 3 muscle groups provide strength to the knee? |
The quads, hamstrings and Gastrocnemius |
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Which plane of movement is the knee exceptionally weak in? |
The horizontal plane |
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4 Things to do for Assessing the Knee |
- Determine the mechanism of the injury (critical) - Check if joint is locked (or if it could move immediately after the injury) - Is there immediate swelling? (ligament/menisci injury) - Has there been an injury similar to this one? |
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What does the femur do during Anteversion and what does it do during Retroversion? |
The femur rotates forward and inward during Anteversion and rotates backwards and outward during Retroversion |
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6 Things to Observe for in the knee/leg |
- Walking, half squatting, going up/down stairs - Leg alignment - Tibial torsion - Femoral anteversion and retroversion - Knee symmetry or asymmetry - Leg length discrepancy |
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What increases as the grade of a sprain increases? |
Instability |
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What is a test done to measure ACL laxity or tear (grade 3 sprain)? What do you do for the test? |
Drawer Test - place thumb on top of femur and push inwards |
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What test is done to check for PCL damage? What do you do for the test? |
Posterior Sag Test/Godfrey's Test - Look for femur sliding forward on tibia |
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Which test looks for menisci damage in the knee? What do you do for the test? When would you conduct this test? |
McMurray Test - Grind and rotate tibia on femur (internal and external rotation); Would conduct on the field before swelling sets in |
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What does the Lachman Test look for? What do you do for this test? |
Tests for Cruciate Instability - torsioning tibia and femur opposite to each other to test tension of ligaments |
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What test assesses menisci damage? What do you do for this test? |
Aplyey Compression/Distraction Test - Press Tibia down to assess damage (have knee bent at 90 degrees with butt and heel facing upwards and then press down or pull upward) |
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What would you see at the knee joint if the Posterior Cruciate Ligament was torn? |
Tibia would sag downwards and femur would push upwards |
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List 5 Patellar Exams |
Palpation, grinding tests, compression, apprehension (relocating patella), Q angle |
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What would be done during a Valgus and Varus stress test of the knee? |
Femur would be manually turned so that only one of the heads would be against the menisci of the tibia |
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What is the Q Angle? |
It is the angle formed from a line which bisects the patella relative to the ASIS (very side of hip) AND the tibial tubercle |
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What is the A Angle? |
It is the angle created from the Patellar Orientation to the tibial tubercle |
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List 4 Things to help prevent Knee Injuries? What should you NOT do to a knee to try and return it to play? |
- Physical Conditioning and rehabilitation - ACL prevention programs - Shoe type - Functional knee braces Do NOT tape to return to play
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Braces are good to prevent _______ injuries, but they don't help against ________injuries |
Impact injuries; Rotational injuries |
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MCL Sprain: Etiology, S&S (list the grades), Management |
- Direct blow from lateral side (valgus force) - Grade 1: Fibers stretch; joint stable - Grade 2: Partial tear of deep capsular ligament and superficial layer; no instability - Grade 3: Complete loss of medial stability Management: RICE, bracing, stress test at end of rehab; no surgery (unless bad blood supply) |
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LCL Sprain: Etiology, S&S, Management; What can also be injured with this? |
- Varus force with tibia internally rotated - Pain and tenderness over LCL; laxity - RICE, Bracing - Peroneal Nerve may be injured (lateral side of foot can become numb) |
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ACL Sprain: Etiology, S&S, Management |
- Tibia externally rotated and knee in valgus position; occurs when bones of leg twist in opposite directions under full body weight - "pop" followed by immediate disability; feels like "shifting" - RICE, bracing, reconstructive surgery, work on abductors to help keep knees in position |
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What is the Unhappy Triad? |
It is when you are hit from behind and tear the Medial Meniscus, MCL and ACL |
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PCL Sprain: Etiology, S&S, Management |
- Knee flexed at 90 degrees, hard blow (pushes tibia backwards) - "pop" in back of knee, tenderness and swelling in popliteal fossa - PCL drawer check, RICE, quad/hamstring strengthening, surgery is difficult* |
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Meniscal Lesions: Etiology, S&S, Management |
- Valgus impact or rotary force with knee flexed or extended (tears may be longitudinal, oblique or transverse - Effusion, joint line pain, loss of motion, intermittent locking and giving away - RICE, ROM & strengthening, Arthroscopic surgery |
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Knee Plica: Etiology, S&S, Management |
- Knee of fetus fails to absorb the 3 synovial cavities before 4 months, non-yielding - no MOI, 15-20 degree flexion they feel a snap - Rest, heat, surgery |
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Osteochondral Knee Fractures: Etiology, S&S, Management |
- Fractures of cartilage and underlying bone varying in size and depth - Diffuse pain along joint line - CT or MRI scan; surgery, non-weight bearing recovery |
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Which joint in the body generally has the most traumatic injuries? |
The knee joint |
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Osteochondritis Dissecans: Most common locations (3), Etiology, S&S, Management |
- Mid inferior location of medial chondyle, lateral condyle, and inside of patellar surface - Chronic degeneration of articular cartilage in knee; chunks of cartilage in knee joint - Chronic knee pain, may be chronic swelling, may lock up, atrophy of quads, condyles of femur may be tender - Rest or surgery with pins in condyle |
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Joint Contusions: Etiology, S&S, Management |
- Blow against muscles crossing the knee joint; can bruise the bone in addition to muscle - Severe pain; loss of movement - RICE, ROM, conservative treatment, work on regaining ROM and flexibility of joint |
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Peroneal Nerve Contusion: Etiology, S&S, Management |
- Direct blow behind neck of fibula - Radiating pain; numbness; paresthesia, tingling, foot drop (lateral side of foot is innervated by this) - RTP when symptoms abate; padding |
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Bursitis (of the knee): Etiology, S&S, Management |
- Usually a blow to the patella, may also be from an infection, abrasion (if acute injury) - Swelling over patella, increased pressure, tenderness, aspiration, looks like a big lump - Eliminating cause, wraps, Ice and compression, Anti-inflammatories, surgical removal |
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Baker's Cyst: Etiology, S&S, Management |
- Problems in joint cause swelling (semimembranosus bursa), seen with ACL and PCL injuries - Painless and no disability unless flexed or extended far (prevents some ROM) - MRI helpful for revealing underlying pathology to figure out what to stop doing |
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Patellar Fracture: Etiology, S&S, Management |
- Direct trauma OR indirect trauma (strong pull from quads), severe pull of patellar tendon - Hemorrhage & joint effusion (swelling), bone fragments - x-ray, immobilized (surgery and screws) |
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Patellar Subluxation or Dislocation: Etiology, S&S, Management |
- Quick cutting motion to one side, patella may move laterally or medially, may be congenital, medial and lateral retinaculum is stretch/torn, may be pulled out from a tight IT band - Pain and abnormal movement, swelling, patella and knee tender - RICE, splint, medical referral |
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Injury to the Infrapatellar Fat Pad: Etiology, S&S, Management |
- Fat pad may become wedged between tibia and patella, chronic KNEELING, lots of bleeding due to good blood supply - Capillary hemorrhage, swelling of fatty tissue, pain below patellar ligament on extension - Rest and heel elevation (prevents patella from jamming into fat pad) |
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Patellofemoral Pain Syndrome: Etiology (and 3 stages), S&S, Management |
- Softening and deterioration of the articular cartilage on back of patella, most common cause is recurrent swelling, patella does not slide in the right "track" or notch - Stage 1: swelling and softening of cartilage - Stage 2: Fissure of softened cartilage - Stage 3: Deformation of cartilage surface - Knee joint hurts, pain in anterior of knee, swelling around patella, grating sensation - Isometric strengthening to prevent irritation, neoprene sleeve (centers patella), surgery |
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Patellofemoral Stress Syndrome: Etiology, S&S, Management |
- Lateral deviate of patella while tracking in femoral groove, tight structures, pronation, increased Q angle, insufficient medial musculature - Tenderness on lateral patella, swelling - Identify cause, McConnel taping |
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Osgood-Schlatter Disease: Lamen's Term, Etiology (be descriptive of anatomy), S&S, Management |
Jumper's Knee - Epiphyseal inflammation of tibial tubercle, patellar ligament is inflammed and tearing at distal point where it attaches to tibia) - Pain and tenderness, swelling, decreased jumping and running ability (acute traumas) - Decrease stressful activity, isometric strengthening, cast |
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Larson-Johansson Disease: Which other injury is it similar to? (same ligament affected), What does it look like? |
Similar to Osgood-Schlatter Disease because it affects the proximal attachment of the patellar ligament (pain over inferior pole of patella) - Seen as a lump in bottom of patella |
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Patellar Tendinitis: Lamen's Term (2), Etiology, S&S, Management |
Kicker's Knee/Jumper's Knee - Jumping or kicking, placing tremendous stress and strain on patellar or quadriceps tendon, sudden or repetitive extension - Pain and tenderness at inferior pole of patella - Conservative, stopping of certain exercises |
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3 Phases of pain for Extensor Mechanism Injuries; Management of these injuries |
Phase 1 - Pain after activity Phase 2 - Pain during and after activity Phase 3 - Pain during and after (possibly prolonged) and may become constant - Patellar tendon bracing (taping) |
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Patellar Tendon Rupture: Etiology, S&S, Management |
- Sudden, powerful quad contraction, chronic inflammatory condition - Palpable defect, lack of knee extension (all muscles that extend knee are detached) - Surgical repair is needed |
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Ilio-Tibial Band Syndrome: Etiology, S&S, Management |
- Running on crowned surface, Tight ITB, Increased Q-Angle, iliotibial tract glides back and forth over lateral femoral epicondyle (causing friction) - Pain on lateral aspect of knee - Correct foot alignment, warm-up, stretch, avoid inclines |
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Pes Anserinus Tendinitis or Bursitis: Etiology, S&S, Management |
- Excessive genu valgum (knock knee), weak vastus medialus - Pain on medial aspect of knee - Correct foot alignment, warm-up, stretch, avoid inclines |
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Describe the Q angle |
It is the angle formed by a line drawn from the ASIS (the lateral hip bone) to the central patella and a second line drawn from the central patella to the tibial tubercle (creates a measurable degree a little ways up the thigh) |
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Describe the True Angle (or A Angle) |
It is the angle formed from the ASIS to the medial malleolus of the ankle and then from the belly button to the medial malleolus of the ankle |
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What is Miserable Misalignment Syndrome? |
It is an increased femoral anteversion that produces increased internal rotation of the hip, high Q angle, tibia vara, external tibial torsion, and pronated flat feet |
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What are 8 focuses of Knee Joint Rehabilitation before returning to play? |
- General Body Conditioning - Weight bearing - Knee joint mobilization - Flexibility - Muscular Strength - Neuromuscular control - Bracing - Functional Progression |
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What is the only quadriceps muscle that crosses the hip? What are its 2 actions? |
The Rectus Femoris muscle, extends knee and flexes the hip |
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Which is the only hamstrings muscle that does NOT cross the hip? |
The short head of the biceps femoris muscle |
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_________ of the knee and hip during movement and MOI play important roles and provide information |
Position of the knee |
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List the 5 muscles in the medial compartment of the thigh |
Pectineus, adductor magnus, adductor brevis, adductor longus, gracilis |
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List the 5 muscles in the anterior compartment of the thigh |
Sartorius, Vastus intermedius, vastus lateralis, vastus medialis and rectus femoris |
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List the 4 main muscles in the posterior compartment of the thigh |
Biceps femoris long head, biceps femoris short head, semitendinosus and semimembranosus |
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Quadriceps Contusions: Etiology, S&S, Management |
- Compression of soft tissue against femur - Pain and loss of function - Knee flexed with ice pack, crutches, gentle stretching, surgery to aspirate hematoma |
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List and Describe the 3 degrees of a Quadriceps Contusion |
1st Degree - Intramuscular Bruise, produces little hemorrhage, NO restriction of ROM 2nd Degree - Deeper than grade 1, produces mild swelling, point tenderness, unable to flex the knee through 90 degrees 3rd degree - Major disability, may split the fascia, intramuscular hemorrhage, severe pain, unable to flex, may lead to further trauma |
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Myositis Ossificans Traumatica: Etiology, S&S, Management |
- Formation of ectopic bone (unusual position or form) following repeated blunt trauma (disruption of muscle fibers, capillaries, fibrous connective tissue and periosteum), may be the result of improper thigh contusion treatment - X-ray shows calcium deposit 2-6 weeks after - Conservative, let time heal it |
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Quadriceps Muscle Strain: Etiology, How many grades are there? Management |
- Sudden stretch, violent forceful contraction of hip and knee into flexion - 3 grades of injury - RICE, pain-free ROM, isometric exercises (pressing towel upward into bottom of table with knee), crutches |
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List and Describe (symptoms) the 3 grades of a Quadriceps Muscle Strain |
Grade 1 - Complain of tightness in front of thigh, near normal ambulation, swelling may be limited, mild discomfort during palpation Grade 2 - Abnormal gait cycle, may be splinted into extension, swelling may be noticeable with pain on palpation, possible defect in muscle, RESISTIVE knee extension will reproduce pain Grade 3 - Possibly unable to ambulate, pain with palpation, may be unable to extend knee, may produce defect or bulging in muscle belly |
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Hamstring Muscle Strain: Etiology, S&S (including each grade and the percentage of muscle fibers torn), Management |
- Hamstring and quad contract together, posture, leg length discrepancy, lack of flexibility, strength imbalances - Grade 1 (soreness during movement and point tenderness <20% torn), Grade 2 (partial tear, sharp snap or tear, severe pain, loss of function <70% torn), Grade 3 (rupturing of tissue, major hemorrhage and disability, edema, loss of function, ecchymosis, palpable mass or gap, >70% torn) - RICE, NSAIDs, activity reduced until soreness gone (no pain and no difference in strength than other leg), conservative (easy to tear again while healing), eccentric exercise |
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Acute Femoral Fractures: Etiology, S&S, Management |
- Generally involving shaft of femur and requiring great deal of force - occurs in middle third of shaft, muscle guarding, hip is adducted and externally rotated, extensive soft tissue damage (bones will displace) - Immoblize (splint knee and splint hip above and below), transport |
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Femoral Stress Fractures: Etiology (what percentage of all stress fractures does this make up?), S&S, Management |
- Overuse (10-25% of all stress fractures), excessive downhill running or jumping - Persistent pain in thigh/groin - x-ray or bone scan will reveal fracture, NO running |
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Compartment Syndrome: What is it and list (and describe) the 2 types |
It is increased pressure within the thigh causing compression of the musculature and neurovascular strucutres Acute - occurs secondary to direct trauma Chronic - systems arise consistently during activity (legs swell) |
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Where are thigh injuries the most common? (location) and where can Myositis Ossificans occur? |
Thigh injuries are most common on front side of body (quads) Myositis Ossificans can occur anywhere you get a severe contusion and continue to aggravate it |
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List the 5 structures that make up the Pelvis and what are their two functions? |
Ilium, Ischium, Pubis, Sacrum and Coccyx, serves as attachment for muscles of thigh and trunk and protects viscera and ograns of pelvis |
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What is Apophysitis? |
It is when abdominal oblique and tensor fascaie latae muscles pull on iliac apophysis as pelvis swings and tips, causing inflammation |
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What is Osteitic Pubis? |
It is a sheering action that happens on the symphysis pubis as the pelvis seesaws up and down |
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What are (basically) adductor tendonitis and a avulsion fractures of the hip caused by? |
They are caused by stress of the adductor tendons pulling on the pubic bone |
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What are 8 things to look/test for during an assessment of the hip? |
- Make sure there is symmetry of hips and pelvic tilt (Trendelenburg's Test) - Look for pelvic landmarks (ASIS, PSIS, Iliac Crest) - Leg length discrepancy - Muscle spasm or weakness - Lower limb Q angle (8 to 12 degrees), genu varum (bow legged) or valgum (knees knocked) - Pain from standing on one leg - Ambulation (abnormal walking gait or sitting) - Squat on one leg to test for muscle weakness - ROM, strength tests for different movements |
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What is the normal relationship angle between the neck and the shaft of the femur? |
15 degrees |
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What is anteversion of the femur? |
When the femoral neck is anterior to long axis of femur = feet toe in (toes pointed inward)
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What is retroversion of the femur? |
When the femoral neck is posterior to the long axis = feet toe out (toes pointed outward) |
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What is the Trendelenburg's Test/Sign? What would create a + sign (positive trendelenburg sign)? |
Patient is asked to stand on one leg, normal person would be able to keep pelvis level, test is positive (+) if hip drops and sags toward the affected side (ABductors are weak, ex. gluteus medius) |
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Groin Strain: Etiology, S&S, Management |
- Over extension of the adductor muscle group, tearing of the adductor tendon attaching to the pubis bone - Pain (especially on full extension), weakness on adduction, compromised gait, may be bruising (gravity may pull down swelling to middle of thigh) - Very hard to rehab, RICE, NSAIDs, AROM, PROM, RROM (to determine extent of damage, gradual stretching, spica bandage |
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Trochanter Bursitis: Etiology (usually seen in runners with an increased ___________), S&S, Management |
- Inflammation of the bursa under gluteus medius or ITB, usually seen in runners with an increased Q angle, running on inclined surfaces - Pain in lateral hip, limping - Find the cause, RICE, NSAIDs, Padding if in collision sport |
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Sprains of the Hip Joint: Etiology, S&S (what movement of leg is disabled?), Management |
- Any unusual movement exceeding normal ROM may result in damage, violent twist - Inability to circumduct hip - x-rays or MRI to rule out fracture, crutches may be required |
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Dislocation of the Hip: Etiology,S&S, Management |
- Direct trauma to the long axis of the femur (knee is bent), most common displacement is posteriorly - Thigh is flexed, internally rotated and adducted, causes serious damage to the ligamentous tissue, could lead to disruption of blood supply - Splint - FMS - treatment by an orthopedic surgeon |
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Avascular Necrosis: Etiology, S&S, Management |
- Result of temporary or permanent loss of blood supply to bone or ligaments, can be a traumatic condition (hip dislocation) or a non-traumatic condition (steroids, blood coagulation disorder) - Joint pain with weight bearing progressing to pain at times of rest - Most cases will ultimately require surgery |
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Leg-Perthe Disease: Etiology (who does it effect?), S&S, Management |
- Usually seen in children 3-12 years old, necrosis of the femoral head (congenital defect) *smaller femur head than normal - Pain in groin (may be referred to abdomen and knee), limping, may have rapid or slow onset - Non-weight bearing or braces (forrest gump) |
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Slipped Capital Femoral Epiphysis: Etiology (who does it effect?), S&S, Management |
- Found in boys 10-17 years old (characteristically tall, thin or overweight), idiopathic (related to GH) - May come on gradually or suddenly with trauma, limitation on abduction, flexion, medial rotation *pain on circumduction - Non-weight bearing, surgery, look for absence of solid white lines that show strong bone growth |
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The Snapping Hip Phenomenon: Etiology (who does it effect?), S&S, Management, Name 3 examples (using correct anatomical terms) |
- Common to young female dancers, gymnasts and goalies, muscles around hip become imbalanced, hip is laterally rotated and leg is flexed as part of the activity, related to narrow structural pelvic width - Athlete complains of snapping (especially when on one leg), should be examined if accompanied by pain or inflammation (can see while palpating) - ITB moving over greater trochanter (resulting in trochanteric bursitis), iliofemoral ligament moving over femoral head, long head of biceps femoris moving over ischial tuberosity - Stretch tight musculature and strengthen weak musculature |
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Contusion of the Hip Pointer (superior and anterior aspect of iliac crest): Etiology, S&S, Management |
- Direct blow to the area (take a helmet to hip) - Swelling, pain, may walk with slight limp on affected side, increase in intra-abdominal pressure (uncomfortable) - RICE (get them on bike or pool to keep them moving), protection for the injured part, may require crutches, keep abrasion clean |
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Osteitis Pubis: Etiology, S&S, Management |
- Stress and degeneration of the symphysis pubis (runners, basketball, gymnasts, rodeo = shear connection between the two hip bones) - Pain in groin area, TOP on pubic tubercle - Medical referral, anti-inflammatories and rest |
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On an x-ray, what do you want to see and what will indicate damage and irritation of the bone? |
You want to see nice white edges, but damage and irritation will make it look fuzzy and darker |
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Dislocated Symphysis Pubis: What is it? What is it composed of? Etiology, S&S, Management |
- It is the nonsynovial joint that holds the two hips together at the anterior part, very strong - It is composed of Fibrocartilage - Legs abducted widely - Severe pain and disability - Relocation (getting athlete to force legs to adduct until it pops back into place) |
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Stress Fractures (in thigh): Etiology (name 3 anatomical locations it could happen), S&S, Management |
- Repetitive cyclical forces from ground reaction force, common site include inferior pubic ramus, femoral neck and subtrochanteric area of femur - Groin pain, with aching sensation in thigh that increases with activity and decreases with rest, standing on one leg may be impossible - Rest (non weight bearing), bone scan |
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Avulsion Fracture and Apophysitis: Etiology (3 common sites), S&S, Management |
- Seen in sports with sudden accelerations and decelerations, Ischial tuberosity, AIIS, ASIS - Sudden localized pain, swelling, point tenderness - X-ray, RICE, Crutches |
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Sciatica: Etiology, S&S, Management |
- Impingement of the sciatic nerve, can be chronic or acute, trapped by piriformis muscle - Burning or tingling down the back of the leg, will get worse if not treated properly - Refer to a physician (only if not able to release muscle with physical force/elbow) |
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FIA (Femoralacetabular Impingement): Etiology, S&S, Management |
- A condition of too much friction in the hip joint, femoral head and acetabulum rub abnormally creating damage to the hip joint, damage can occur to the articular cartilage or the labral cartilage (can affect either head of femur or the edge of the acetabulum) - Hip pain (front, side or back), loss of hip motion - Eliminate other causes of hip pain, x-ray to determine the shape of the ball and socket and amount of joint space in hip, non-operative = lifestyle change, arthroscopic or open surgery |
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List 6 Thigh and Hip Rehabilitation Techniques before returning to activity |
- General body conditioning - Flexibility - Mobilization - Strength - Neuromuscular control - Functional progressions
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What are 2 possible results of having trouble taking a deep breathe in? |
Could be possible rib injuries or it could be an intercostal strain |
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Athletic Therapist's evaluation should focus on _______ and _______ that indicate potentially ____________________ conditions |
Signs and symptoms, Life-threatening |
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What are 5 observations to make for someone who has an injury to their thorax? |
- Is the athlete breathing? are they having difficulty breathing? does breathing cause pain? - Body position (curled in to avoid intercostals or abdominal injury or stretched out to avoid breathing force muscles) - Check for DCAP-BLS - Are the abdominal muscles tight and guarding? - Cyanosis - respiratory difficulty (blueness of lips) |
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List the areas of referred pain for: The heart, Liver/gallbladder, Kidney, Ureter, and Pancreas |
Heart - left pectoralis and down inside of left arm Liver/Gallbladder - right should and right ribs (front and back) Kidney - V lines on hip down to pubis - Ureter - Higher V lines just above hip down to pubis Pancreas - small spot on left ribs (front and back) |
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What referred pain is transferred to the Right Upper (which is most common?) and the Right Lower (which is most common?) quadrants of the Abdomen? |
Right upper - Liver, gallbladder, kidney (liver is most common) Right lower - Appendix, ovary (appendix most common) |
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What referred pain is transferred to the Left Upper (which is most common?) and the Left Lower (which is most common?) quadrants of the Abdomen? |
Left Upper - Pancreas, stomach, spleen, kidney (spleen most common) Left Lower - Ovary (most common and only) |
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Rib Contusions: Etiology, S&S, Management |
- Direct blow to ribcage - Severe pain (athlete may have heard pop or snap), point tenderness, increase in intrathoracic pressure can be unbearable (short breathes) - Ice (to reduce swelling), medical referral (x-ray), rib belt or wrap |
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What is a flail chest? How can that pose a problem for breathing |
It is where 3+ consecutive ribs are fractured and that section will move opposite to the other sections of the ribs being expanded or contracted, pressing against the lungs |
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Costochondral Separation: Etiology, S&S, Management |
- More common than a rib fracture, separation of the bone from the cartilage connecting the ribs to the sternum, from direct blow - Sharp pain on movement, difficulty breathing deeply - Rest, rib brace |
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Pneumothorax: What is it? What are the symptoms and how can you confirm it? |
When the pleural cavity fills with air (that can NOT escape) increasing lung cavity pressure - Pain and cyanosis - Will see another black outline on x-ray that does not match the lung cavity |
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Hemothorax: What is it? What are the symptoms, how can you confirm it and how can you treat it? |
When the pleural cavity fills with blood - Pain and increasing cyanosis - Bright red frothy blood from mouth - Chest tube is necessary to drain blood from lungs |
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Traumatic Asphyxia: What causes it and how can you treat it? |
Blow that causes cessation of breathing - requires rescue breathing |
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Heart Contusion: What causes it and what can result from it? |
Direct blow can cause it - Hematoma may form in the pericardium (cardiac tamponade) |
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Intercostal Muscle Injuries: Etiology, S&S, Management |
- Direct blow to the ribs or sudden torsion of trunk - Pain occurs on active motions or with inspiration and expiration, coughing, sneezing, and laughing - Immediate pressure & application of cold |
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Breast Injuries: Etiology, S&S, Management |
- Direct blow, lack of support (no sports bra), abrasion of the nipple - Pain and swelling, distention of the breast (Cooper's Droop), abrading of the areola - Proper support, ice (for contusion), band-aid or tape over nipple, padding for the breast |
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Commotio Cordis: Etiology (what two sports pose the highest risk for this?), S&S, Management |
- Direct blow to the chest, impact as little as 20mph, hockey and baseball highest risk - Ventricular fibrillation (throws heart into irregular rhythm), timing is critical (upslope of T wave/repolarization) - Resuscitation |
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Kidney Contusion: Etiology, S&S, Management |
- Direct blow to the back - Shock (nausea = NOT a normal reaction for just a muscle strain or contusion), rigidity of the back muscles, pain in the costo-vertebral angle (where the ribs touch the spine), hematuria (blood in the urine within 24 hours) - Medical referral |
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Liver Contusion: Etiology, S&S, Management |
- Blunt trauma - right side of rib cage - Hemorrhaging and shock may be present, referred pain in right scapula, shoulder and sub-sternal area, hurts to take deep breathe - May require immediate surgery |
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Irritable Bowel Syndrome: Where is the pain caused and what is it from? What are 3 symptoms? |
Pain caused in abdomen - Abdominal bloating, pain and distension - From irregularities and alterations in stool frequency, form and passage |
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Appendicitis: What is it and what is it resulting from? What are some early stage symptoms? |
- Inflammation of the vermiform appendix (chronic or acute) - Result of blockage, lymph swelling or carcinoid tumor - Early stages present a gastric complaint of uncomfortableness |
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Testicular Trauma: Etiology, S&S, Management |
- Direct blow to the genitalia - Extreme pain and point tenderness, may curl up in fetal position and grasp testicle, abdominal and crotch swelling - Allow athlete to recover, apply ice if necessary (do NOT leave on for very long), refer to physician if stays for very long |
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Spermatic Cord Torsion: Etiology, S&S, Management, poor management may lead to ______ of the testicle |
- Direct blow (not wearing a jock) - Acute testicular pain and inflammation, nausea and vomiting, appearance of swollen veins, dragging feeling in scrotum - Refer to physician, poor management may lead to atrophy of testicle |
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Contusion to the female genitalia: Etiology, S&S, Management |
- Direct blow to external structure, fluid forced into vagina (water skiing) - Athlete reports direct blow, swelling of vulva or mons pubis, hematoma, fallopian tubes may be infected - External contusion = ice ; internal = medical referral |
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Injury of the Spleen: Etiology, S&S, Management, How does "mono" have do to with increasing risk of this? What does a positive Kehr's sign mean? |
- Direct blow to organ - blunt trauma - spearing, athlete may have previously had "mono" (because spleen becomes enlarged and swollen when it's fighting off an infection) - Gradually increasing shock (cool and clammy skin), athlete reports being hit, abnormal rigidity, pain in the left arm (Kehr's sign) - Medical referral - may require surgery |
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Abdominal Muscle Strain: Etiology, S&S, Management, What anatomical structure is generally involved in these? |
- Sudden twisting or reaching of trunk, tearing abdominal musculature (hard to rest) - Severe pain and hematoma formation, generally involves rectus abdominus - No way to completely splint (hard to wrap all the way around abdominal), rest |
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Hernia: Etiology (what is an inguinal hernia, an umbilical hernia?), S&S, Management |
- Protrusion of the abdominal viscera through the abdominal wall, danger of becoming strangulated - Inguinal are just the intestine pushing through anywhere in the abdominal cavity, umbilical is where it pushes out through your belly button - Pain in abdomen, abdominal content may be felt when coughing or sneezing - Surgery is the best treatment (put a mesh in their to hold the tissue back inside) |
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What 3 anatomical structures make a triangle where Inguinal hernias can push out from? Why is it a risky location to perform surgery on? |
Superior by the Inguinal Ligament, Medially by medial border of adductor longus muscle, and laterally by medial border of Sartorius - Lymph nodes, arteries and nerves are very prevalent at this location? |
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Blow to the Solar Plexus ("winding"): Etiology, S&S, Management |
- Landing on the ball, knee to the abdominal area, taking the butt end of a stick - Athlete gasps for air (air hunger), quite distressed, may curl up in fetal position - Have athlete try to take deep breathes (calm him/her down), if breathing is not restored, do rescue breathing |
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Stitch in the side: Etiology (8 basic), S&S, Management |
- Constipation, intestinal gas, overeating, diaphragmatic spasms, poor conditioning, weak abdominals, poor breathing techniques or ischemia (lack of oxygen) to diaphram or intercostal muscles - Cramp like pain at L or R costal angles - Relaxation of spasm, stretch arm on affect side, flex trunk forward while tightening abs |
