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116 Cards in this Set
- Front
- Back
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what are the flexor muscles for the elbow
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biceps bracchi
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what are the muscles for extension for the elbow
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triceps brachi
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history assessment of elbow
what is injuries attributed to? |
moi
acute vs chronic -causes sudden overextension and repeated overuse of throwing type motion. feelings- locking of elbow and grating |
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obervations for elbow
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what movements can they do
circulation- pulse color of nailbeds |
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what is the carrying angle for elbow?
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cubitus valgus- angle more than 15 degrees
cubitus varus- less than 5 degree angle cubitus recurvatum- hyperextension |
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what to assess in the joint of the elbow?
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epicondyles, olecranon, distal aspect of humerus and proximal aspect of ulna.
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Contusion:
Moi? Signs and symtpoms? What to consider? |
MOI- vulnerable area due to lack of padding.
- result of direct blow or repetitve blows Signs: -Pain, swelling, point tenderness -swelling will appear almost spontaneously after irritation of bursa, without pain and heat. Possibilities: olecranon bursitis, and myositis ossifcans. |
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care for elbow contusion?
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treat with price
if acute=ice if severe, refer for query of bone fracture chronic requires protective therapy if swelling doesnt fade aspiration may be necessary pad it for competition |
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Elbow sprain?
how to treat and fix |
MOI- common along the medical aspect- mcl
due to elbow hyperflexion pain along medial aspect of elbow, inability to grasp objects care- RICE, and sling gradually regain elbow full ROM athlete modify activity |
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Lateral epicondylitis (tennis elboow)
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when any extensor muslce came off epicondyle
MOI- repetitive wrist extension microtrauma to insertion of extensor muscles Signs: -aching pain at lateral epicondyle -pain worsens and weakness in wrist and hand develop -elbow has decreased RO,M; pain w/ resistive wrist extension |
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medial epicondylitis (golfers elbow)
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MOI- repetiive microtruama to insertion of flexors muscles to medial epciondyle. repetitive flexion of wrist and extreme valgus turque of elbow
signs and symptoms: pain with forceful wrist flexion -point tenderness and mild swelling -passive movement of wrist seldom elicits pain, but active movement does care- sling, price, meds, sling, ROM exercises, teach proper mechanics and equipment instruction |
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Ulnar nerve injuries
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MOI-pronounced cubital valgus
ulnar nerve dislocation impingement or compression on nerve. signs- respond with paresthesia in 4th and 5th fingers care- avoid aggrevating it, may need surgery. |
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dislocation of elbow
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MOI- elbow extended -
displaced forwardly, backwards or laterally symptoms- swelling, severe pain, disability rupture of ligamnets will usually accompany injury olecranon displaced backwards. immobilize and refer to a physician elbow remain splinted in flexion for 3 weeks |
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Forearm fractures
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due to falls and direct blows
usually ulna and radius signs- audible crack or pop. moderate to severe pain, swelling, and disability -edema, ecchymosis care- rice, splint, go to hospital out 8 weeks |
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fractures to elbow
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cuase- direct blow, foosh.
s/s-may be visual deformity hemorrhaging, swelling muscle spasm care- ice, splint, refer to physician. |
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colles fracture
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snap distal end of radius and ulna
fall on outstretched hand, forcing radius and ulna into hyperextension. s/s- obvious deformity -extensive bleeding and swelling -tendons may be torn/ may be median nerve damage care- cold compress, splint wrist xray out 1-2 months prevent by- limit reps, utilize proper mechanics, use proper equipment, focus on proper strenght, flexibility, anbd endurance for activity. |
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what controls stability in the knee
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primarily ligaments, joint capsule, and muscles surrounding joint.
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what is the knee designed for
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1. stability with weight bearing
2. moblity in locomotion |
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where does hmastring attach?
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to the hip and somewhere on tibia
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if someone heard or felt anything happen to the knee what most likely was damaged
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ligament
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what is the knee locks, whats affected
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meniscus injury
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what is swelling in knee linked to?
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ACL immediately
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what is most likely affected if you feel or hear grinding?
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there might be a malalignment of patella or could be meniscus
more superficial the pain the better off less serious injury |
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for physical examination how many movements are there for the hip and knee for testing
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knee: 4 flexion, extension, internal, and external rotation
Hip: 6 ab and adduction, flexion, extension, internal and external rotation. |
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palpation for knees
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bone structures- pain or tenderness
soft tissue- muscles, ligaments, cartilage deformity, pain and tenderness. |
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what is translation in the knee
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glide of tibial plateau on femoral condyles
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what is knee laxity
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straight and rotary instability
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what are some characteristics of grade 1 ligament injuries
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fiber tearing, stable stress tests, little effusion, decreased ROM, some pain.
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what are some characteristics of grade 2 ligament injuries
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partial ligament tearing, some laxity in stress tests, moderate swelling, decreased ROM, pain.
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what are some characteristics of grade 3 ligament injuries
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ligament tear, laxity on stress tests, swelling, loss of ROM and guarding, and pain.
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assessment for wrist and hand
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check posture from neck down
common signs of inflammation |
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what are the ROM for the wrist and hand
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flexion, extension, adduction, abduction, supination, and pronation.
thumb- saddle joint strain is due to overuse |
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what is the most common wrist and hand injury?
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SPRAINS AND STRAINS
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what is the MOI for sprains and strains in the wrist and hand?
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abnormal, forced movements
fallling on hyperextended wrist violent flexion or torsion overuse/ repetitive movements common MOI for strains. |
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what is the care for wrists and hands sprains and strains
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price
medical attention if severe strengthening |
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explain carpel tunnel syndrome
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MOI: compression of median nerve due to inflammation of tendons and sheaths of carpal tunnel.
result of repeated wrist flexion or direct trauma to anterior aspect of wrist. s/s- sensory and motor deficits, tingling, numbness, parasthesia, weakness in thumb care: conservation treatment, price nsaids, possible steriod injection of surgery required. |
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scaphoid fracture explain.
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MOI: foosh. the scaphoid compresses btwn radius and second row of carpal bones
S/S: swelling, severe pain in anatomical snuff box. CARE: spilinting and xray referral prior to casting immobilization- 6 weeks, followed by strengthening and tape/ brace. protection against impact loading for another 3 months. slow healing due to poor blood supply |
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Metacarpal fracture explain?
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MOI: direct axial force or compressive force. 4th of 5th most common.
common in boxers and martial arts. to diagnos flick fingers and then tap along the metacarpals to look for fraxcture. S/S: pain and swelling possible angular or rotational deformity -possible palpable defect CARE: price, xray, immobilization splint 2-4 weeks |
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Fracture of Hamate explain
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MOI: results from a fall on hand
-from contact while athlete is holding an implement S/S: pain in wrist, weakness in the 5th digit due to nerve compression, point tenderness. CARE: xray, cast. protect with doughnut pad. |
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Mallet finger
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MOI: sudden blow to tip of finger
extensor tendon to rip off of insertion -jammed finger S/S: pain at dip joint. -xray may show avulsed bone -unable to extend distal finger CARE: price, splinting in extension for 6-8 weeks surgery may be necessary |
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boutonniere deformity
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a finger condition that orevents being able to fully extend at PIP joint.
MOI: rupture of extensor tendon dorsal to middle phalanx -forces dip joint into extension and PIP into flexion -will be able to passively extend that joint. S/S: severe pain obvious deformity -inability to extend DIP joint -swelling, point tenderness CARE: ice, then splint for 5-8 weeks -athlete is encouraged to flex distal phalanx |
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Jersey finger
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MOI: rupture of flexor digitorum profundus tendon from insertion on distal phalanx
-often occurs with ring finger when athlete tries to grab a jersey (on palmar side) opposite of mallet finger S/S: DIP can not be flexed, finger remains extended, pain and point tenderness over distal phalanx. CARE: keep finger splinted in a shortened position, may need surgery, 12 week rehab- poor gliding of tendon, and possibility of rerupture. |
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collateral ligament sprains
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axial force to tip of the fingers
my most common injury jammed finger S/S SEVERE Point tenderness at the joint -lateral or medial joint instability positive valgus or varus stress tests. CARE: xray to rule out fracture splint for support |
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gamekeepers thumb
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sprain of UCL or MCP joint of the thumb
forceful abduction of proximal phalanx combined with hyperextension skiiers thumb S/S: pain over ligaments weak and painful grip and pinch actions tenderness and swelling over medial aspect of thumb. CARE: splint and tape xray up to 12 weeks for recovery |
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dislocation of phalanges
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MOI: DIRECT BLOW TO TIP OF FINGER, possible rupture of flexor or extensor tendon
possibkle avulsion. S/S: deformity, pain and swelling, tender to touch around joint CARE: put in by physician xray splint tape special conditions for thumb. |
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phalanx fracture
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MOI: crushed, twisted
CARE: |
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VOLKMANS FRACTURE
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MOI: associated with humeral supracondylar fractures
-causes bone pressure on brachial artery -inhibits circulation to forearm S/S: pain in forearm- increased with passive extension of fingers CARE: surgey to release pressure doctor right away |
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subluxation/ dislocation of lunate bone.
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MOI; forceful hyperextension of wrist
S/S: difficulty with wrist and finger flexion. -numbness of flexor muscles due to pressure onmedian nerve lunate will dislocate volarly send to physician, if not noticed bone deterioration could occur, requiring surgery reovery 1-2 months |
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wrist ganglion
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MOI: synovial cyst
appears following wrsit pain or forced hyperextension S/S: lump, pain increases with use, might feel soft rubbery or hard. CARE: original: break down through distal pressure new approach: aspiration, cauterization, pressure pad surgical removal is most effective |
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subungual hematoma
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MOI: contusion of distal finger, blood accumulation in nail bed.
S/S: extreme pain due to presure CARE: price, drill nail within 12-24 hours to relieve pressure |
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how many head injuries to kids are related to sports
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nearly 50%
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are children at higher risk for summer or winter sports
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winter sports
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why are children at greater risk for injury than adults
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inability to assesss risk, less coordination, slower reaction time, and less accuracy.
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what are tanners stage of maturity
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stage 1- puberty is evident
stage 3- fastest bone growth and is crucial in terms of contact/collision sports (growth plate weakness) stage 5- full development |
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what are the 2 types of play
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organizing vs free flowingw
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what are some risk factors for psychological complications in the injured child
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stress in the family
-high achieving siblings -over and under involved parents -paradoxical lack of leisure in athletic activity -self esteem that is relient on athletic prowess -narrow range of interests outside of athletics |
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what are key things coahces should know about kids before coaching
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coaches should have good understanding of child development- physical, emotional, and psycholigical.
must be concerned about repeated microtrauma that become compounded |
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what are some injuries to be concerned about in a young athlete?
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1. growth plate fractures
2. apophysitis 3. avulsion fracture 4. spondylolysis |
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growth plate fractures
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determines length and shpae of bone.
could be caused by acute incident or chronic, overuse, stress related one leg could end up longer than the injured leg if serious |
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Apophysitis
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specialized area of cartilage within growth plate
-often point of large tendon insertion -if inflamed turns into osggod shlaters disease and severs disease\ begins at age 8-15 |
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avulsion fractures
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bone vs muscle development
common sites: -ASIS, AIIS, ischial spine, and 5th metatarsal more common in lower vs upper extremity |
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spondylolysis
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defect or fracture in bony structures of spine.
-genereally result of repetitive loading between ages of 5-10 around 4th and 5th vertebrae -children usually asymptomatic and realized later in skeletal development treatments: depend on severity brace or no brace flexibility becomes a major factor in rehab program |
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what are foot problems associated with?
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improper foowear
poor hygiene anatomical structural deviations abnormal stresses |
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what is the foot alignment related to the arch type: normal, high arch, and flatfoot
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normal arch-neutral foot alignment- stability shoe
high arch-supinator-cushioned shoe flatfoot-pronator-motion control shoe |
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how are foot injuries prevented?
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footwear selesction
correcting biomechanical structural deficiencies -foot adapts to training surface over time |
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where do you check for ciculation in the foot?
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dorsal pedal pulse
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retrocalcaneal bursitis
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MOI: inflammation of bursa beneath calcaneus
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jones fracture
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fracture of metatarsal
-high velocity rotational forces -base of 5th metatarsal S/S- immediate swellin may feel a pop CARE: 6-8 weeks in air cast surgical repair may be required |
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metatarsal stress fracture
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MOI: change in: running pattern, mileage, hills, hard surface
-often a result of structuaral deformities of the foot or training erros S/S: continues pain and aching while non weight bearing more common in female athletes CARE: modifies rest with training modifications for 2-4 weeks gradual RTP OVER 2-3 WEEKS with right shoes xray proper diet |
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metatarsal arch strain
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MOI: hypermobility of metatarsals
-poor footwear selection S/S: pain or cramping over metatarsal heads -heae callus over area of pain -numbness, tingling |
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longitudianl arch strain
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tibialis posterior tendon plays a major role in the support of the longitudinal arch.
MOI: increased stress on arch- limited arch support -mechanics during mid stance step S/S: pain with activity swelling may be present CARE: price and limit weight bearing arch support or arch tape address the cause -footwear -training- -congenital |
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Hallux Valgus deformity "bunion"
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MOI: exotosis of 1st metatarsal head
-forefoot varus -narrow pointed or short footwear bursa become inflamed and thickens -causes lateral malalignment of great toe S/S: TENDERNESS, swellomng and enlargement of joint -as time goes on angulation increases CARE: correct fitting orthotics or pad over 1st MT headsurgery may be required |
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Mortons neuroma
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MOI: thickening nerve sheath
-most common btwn 3rd and 4th MT HEADS -commonly associated with MT arch dysfunction S/S: BURNING parasthesia and pain in forefoot -toe hyperextension increases symptoms CARE: teardrop pad -increase space -decreases pressure on neuroma shoes with wider box |
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Turf toe
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MOI: hyperextension sprain of 1st MTP joint
S/S: PAIN with push off in walking, running and jumping CARE: increase rigitty in toe box of shoe -turf toe tape job discourage activity until pain free |
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Ingrown toe nailMOI
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moi: tight footwear, poor nail trimming
S/S: redness, swellling, puss at site CARE: Treat for infection address footwear soak and pack toenail with cotton to lift nail away from soft tissue may need to surgically remove |
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athletes foot:
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MOI: fungal infection
webs of toes S/S; itching on soles of feet appearamnce of dry scaling patch inflmmatory scaling red papules may develop secondary infection from itching nad bacteria in foot. CARE: topical ati fungal agents and good foot hygiene. |
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what is menarche
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onset of menses that occurs normally between the ages of 10-17 in females
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what is dysmenorrhea
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painful menstruation prevalent in active women
most common menstrual disorder S/S: cramps, nausea, lower ab pain, headache, -continue activty as long as performance levels do not drop |
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what is the female triad?
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the rleationship btwn disordered eating , amenorrhea, and osteoporosis
-driven to meet standards of sport or to meet a specific image to attain goals S/S: disordrered eating osteoporosis- premature bone loss in young women, inadequate bone development care- prevention is key, identify and educate |
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contraceptives
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do not use to delay menstraution during competition
may result in nausea, vomitng, fluid retention, amneorrhea, hypertension, double vision, and thromboplebitis low dose |
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pregnancy
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can go hard up to 3 months
may even be able to go to 7 months extreme exercise might result in low birth weight |
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what muscles are included in movement and stablization of the shoulder complex
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rotator cuff muscles, joint capsule, scapula stabilizing muscles.
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glenohumeral joint
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135 degrees of motion
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what can pain in shoulder mean to other parts of the body
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it could be nerve related, could mean heart atttack, ruptured spleen.
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assessment and special tests fo gh joint
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active, passive, and ROM
-flexion, extension -abduction and adduction -internal and external rotation muscle testing- muscles of the shoulder and those that serve as scapula stabilizers neurovascular testing |
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clavicular fracture
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fall on outstretched arm
fall on tip of hsoulder, direct impact primary in middle third signs of injury: generally presents w/ supporting of arm, head tilted towards injued side w/chin turned away clavicle may appear lower palpation: pain, swelling, deformity, point tenderness CARE: closed reduction- sling and swathe immobilize for 3 weeks 6-8 weeks for full recovery followed by joint movement exercises -ROM -Strengthening occasioanlly requires operative management |
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sternoclavicular sprain
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indirect force; blunt trama
S/S: grade1- slight disability, pain grade 2- subluxation with deformity, decreased ROM, pain swelling grade 3- gross deformity, decreased ROM, pain swelling possible life threatening if dislocates posteriorly care- price, immobilization for 3-5 weeks |
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acromioclavicular joint
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result of direct blow; upward force from humerus; foosh
grade 1- no disruption of AC joint, pain with movement grade 2- tear of rupture of AC ligament partial displacement of lateral end of clavicle; decreased ROM (ABDUCTION, adduction) grade 3: Rupture of AC, and CC ligaments--- dislocation of clavicle; gross deformity; loss of function; instability CARE- ICE, REFERRAL\-grade 1- 3-4 days grade 3- weeks of immobilization aggressive rehab is required with all grades flexibility, strengthening, padding and protection may be needed |
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glenohumeral dislocations
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head of humerus is forced out of the joint
anterior dislocation in the result of an anterior force on the shoulder -forced abduction, extension, and external rotation occasionally other planes signs of injuries- flattened deltoid, prominent humeral head head in axilla -arm carried in slight abduction and external rotation; moderate pain and disability care- rice, immobilization reduction by a physician use of sling -begin muscle re-conditioning |
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what test is used for anterior glenohumeral instability?
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apprehension test
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shoulder impingement syndrome
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mechanical compression due to decreased space under coracoacromial arch
-suprspinatus tendon, subacromial bursa, long head of biceps tendon seen in overhead repetitive activities signs of injuries- diffuse pain, decreased strength or external rotators compared to internal rotators positive impingement tests CARE-restore normal biomechanics in order to maintain space strengthening of joint capsule modify activty |
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rotator cuff strain
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includes supra and infra spinatous muscles, teres minor, and subscapularous
occurs at greater tuberosity full thickness tears usually in athletes over 40 primarily due to acute trauma signs of injuries- pain with muscle contraction -loss of function-loss of strength due to pain -tenderness to palpate, swelling -impingement and empty can test positive for high grade strains |
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shoulder bursitis
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chronic inflammatory condition due to trauma or overuse
may develop from direct impact or fall on tip of shoulder signs of injury- pain with motion, tenderness during palpation in subacromial space; positive impingement tests. price- nsaid's to reduce inflammation - remove mechanisms -maintain full ROM- TO REDUCE chances of adhesions from forming |
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bicipital tendonitis
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repetitive overhead athlete- due to repeated stretching of the biceps tendon causing irritation to the tendon and the sheath
signs: tenderness over bicipital groove, swelling, crepitus -pain when performing overhead activities CARE- rest, ice, nsaids gradual program of strngthening and stretching |
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contusion of the upper armdirect blow- could cause myositis ossificans
signs of injuries pain and tenderness, increased warmth, discoloration and limited elbow flexion and extension |
direct blow- could cause myositis ossificans
signs of injuries pain and tenderness, increased warmth, discoloration and limited elbow flexion and extension CARE: price for 24 hours provide protection to contused area maintain ROM |
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why do you incorporate scapula stablizing muscles
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enhances base of function for glenohumeral joint
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which meniscus has more support and which one gets injured more in the knee
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medial meniscus has more support but gets injured more.
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what is the difference btwn semimembranosis and semitendinosis
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semimembranosis is medial muscle of thigh
semitendonosis- is lateral muscle of the thigh |
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what are the 4 ROM for the knee
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flexion, extension, internal or external rotation.
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what are the 6 ROM FOR THE HIP
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ab and adduction, flexion, extension, internal and external rotation.
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what is a special test for knees
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knee stability vs instability
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what are the 2 classification of joint instability?
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knee laxity- straight and rotary instability
translation- glide of tibial plateau on femoral condyles. |
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what are characteristics of grade 1 ligament injury to knee
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fiber tearing/ stretching
stable stress tests little effesion decreased ROM some pain |
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characteristics of grade 2 ligament injury to knee
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partial ligament tearing
some laxity moderate swelling decreased ROM pain |
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characteristics of grade 3 tear in ligament of knee
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ligament tear
laxity on stress tests swelling loss of ROM and guarding pain |
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MCL
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MOI- severe lateral blow or outward twist
valgus stress CARE- price, during inflammatory phase crutches and knee immobilizer functional progressions- isometrics-stlr exercises- bicycle riding- isokinetics full RTP ONCE ALL AREAS have returned to normal important to focus on balance and coordination |
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LCL sprain
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MOI; varus force with tibia internally rotated
direct blow is rare S/S: joint laxity with varus stress CARE: same care protocol as MCL sprains typically non contact |
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ACL
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MOI- rapid decelaration of knee joint
most injuries occur through non contact mechanisms tibia is externally rotatede, knee slightly flexed and tunred in rotation and valgus force at the knee contact and non contact |
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how much more common is it for women to damage acl
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4-6 more likely to occur
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why are females more likely to suffer an ACL SPRAIN?
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hormonal differences- estrogen causes relaxation of muscles which doesnt allow for protection of impact
estrogen found to decrease motor skills duting menstrual cycle changes in elasticity 2. anatomical differences women have wider pelvis which leads to a greater q angle which puts more pressure on inside of knees- causes a tendency to turn knees in when jumping forward slope of the pelvis contributes to a tendency to hyperextend the knees females have statistically smaller acls than males, smaller intercondylar notch width may inpinge on the acl 3. Neuromuscular/ biomechanical differences landing from a jump females tend to land with a much straighter knee, putting much more load on their knees females are ligament dominant for stabilization of the knee women are more quad dominant which pulls on tibia causing more strain |
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ACL sprain
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S/S: audible pop, followed by a sensation of ripping
swelling occurs within a few hours pain and disability knee is reported to give way TREATMENT: neglect of treatment will result in degeneration of knee joint- arthritis which would result in reoccurences of stiffness and inflammation. unhappy triad: ACL, MCL, and medial meniscus. special tests: anterior drawer test make sure hamstring is relaxed before test CARE: xray for complete rupture surgery reconstruction-arthroscopy age and activity level a factor to consider requires 4-8 months |
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PCL
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MOI: dashboard injuries
-fall on bent knee (90 degrees of flexion most common) S/S: pop in back of knee laxity in posterior drawer tests and posterior sag tests. non operative rehab focus on quad strength |
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Meniscus
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MOI: most common: rotary force with knee flexed or extended while weight bearing
medial meniscus more commonly injured effusion develops over 48-72 hour period apleys compression test CARE: PRICE treatment similar to mcl injury if locking occurs surgery may be required |
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patellar bursitis
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MOI: can be acute or chronic
prepatellar= continued kneeling/ landing infrapatellar=overuse of patellar tendon S/S; SIGNS OF INFLAMMATION CARE: eliminate cause price, referral for nsaids |
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ILIOTIBIAL band friction syndrome (runners knee)
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MOI; REPEtitive/overuse conditions
S/S: irritation at bands insertion tenderness, warmth, swelling, redness over lateral femoral condyle. CARE; correction of mal alignments ice avoidance of aggravating activities |
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Patellar fracture:
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MOI: direct trauma
indirect trauma; severe pull of tendon----due to forcible contraction S/S: hemorrhaging and joint effusion-swelling CARE: xray PRICE refer to physician immobilize 2-3 months |
