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159 Cards in this Set
- Front
- Back
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what are the functions of the rotator cuff? |
Abduction-Supraspinatus • IR-Subscapularis • ER-Infraspinatus +Teres Minor
As weell as stabilizes the head of the humerus |
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What are the differences between signs, symptoms and MOI's of rotator cuff sprains and tears in younger athletes |
Younger Athlete: Sudden onset |
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What are the differences between signs, symptoms and MOI's of rotator cuff sprains and tears in older athletes? |
Older Athlete >35-49 YO • Shoulder pain during activity above shoulder • Usually slower onset • +ve impingement signs Really a tendinosis! |
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What might be occuring here? What caused it? |
humerus is pulled too far and pinches the Supraspinatus or sub-acromial bursa = shoulder impingement -Weakness of Rotator cuff (too strong deltoid or weak supra) and reduces the effectiveness of centralization of the humeral head
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what are SYMPTOMS of rotator cuff impingement? |
-painful during ROM between 70-120 degrees once past 120 = feel better! -pain around acromion and over deltoid • Overhead activities increase pain • Feels OK below shoulder height |
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what is a drop test? what can it be used for? |
physio passively abducts patient's arm, patient slowly adducts it. +ve if they can't do it slowly -this test emphasizes the rotator cuff stability (particularly supraspinatus) |
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what are SIGNS of rotator cuff impinemgent? |
Painful arc (70-1200 ) OK below 90 degrees Weak external rotators with scapula stabilized *Poor scapulohumeral rhythm Poor joint stability (Usually anterior humeral head Positive Hawkins-Kennedy, Neer and possibly Speed’s |
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What is a Hawkins Kennedy test? what is it signifciant for? |
get arm to 90 degrees and then internally rotate it with the elbow bent also tests for rotator cuff impingement |
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What is a Neer's TEst what is it significant for? |
abduct arm slightly and then flex it, the supraspinatus should be pinched under the coracoacromial arch if positive! |
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What is the Treatment for shoulder impingement? |
1.Palliate Pain (POLICE IF ACUTE) 2.Maintain ROM 3.Strengthen Scapular Stabilizers 4.Strengthen RC 5.Reinforce proper movement patterns |
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a patient complains about "dead arm" what exactly may that be from?/ what is causing it? |
the person probably has a shoulder that is born loose. dead arm is Traction/impingement of neurovascular structures causing transient weakness/numbness |
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what is the cross flexion test? What is its signficance? |
you flex your arm across your body and touch your hand to your shoulder!. Check to see if there is postive pain when the patient flexes their arm. (AC joint injury or dislocation) |
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what is the fowler reduction test? what is its signficance? |
placing pressure anteriorily and posteriorrily on the GH jt if it feels better that is a positive sign bc there is obviously a lot of pressure on the anterior capsule of the shoudler. Now the humeral head is centralized and stable! |
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What key landmarks on the body identify a Sagittal plane alignment for posture? |
you face their side..... middle of shoulder back of ear middle of greater trochanter back patella front of malleolus |
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What are things to look for in a coronal assesment? |
first of all you see the backside or front of a patient. -check to see if head is tilted, -if the eyes are lvl -if the shoulders are uneulae arqual -and if the trunk is flexed on one side -unequal distance from body to arm -hips. knees
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what is kyphosis vs lordosis? |
k: = ^ t-curve, protracted scapula, usually forward head posture (^ spine extension, done usually to keep eyes lvl) l: = ^ L-spine, anterior pelvic tilt, and will have short hip flexors! (due to not stretching them far enough! |
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what is swayback vs flatback? |
s:= anterior shift of entire pelvis, results in hip extension! thoracic segment shifts posteriorily which causes flexion of thorax! net = lwr lordosis and ^ ky. f: = lwr lordosis, ^ posterior pelvic tilt, ^ hip flxion length patient appears stooped forward, difficutly standing up |
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Define Scoliosis. what are the 2 different types? |
-one or more lateral curves of the spine greater than 10 degrees, may be thoracic spine alone, thoracolumbar or lumbar spine alone -can be structural or non-structural
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how prevalent is scoliosis? are there any differences of scoliosis among different demographics? |
present in 2-4% of children btwn 10 and 16 yrs of age -ratio of girls to boys with small curves of 10 degrees is =. but ^ to a ratio of 10 girls for evry one boy with curves greater than 30 degrees. Therefore girls will need treatment more often!
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What method is used to measure scoliosis? What signs do we have to identify scoliosis? |
Cobb method (standing x-ray) -angle of the most tilted vertebrae above and below apex of curve! Cobb angle = where lines of top of superior vertebrae and bottom of inferior vertebrae meet! -rib hump is a hallmark sign of curves grter than 10 degrees! |
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name the curve on the right |
double major curve with right thoracic and left lumbar |
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are there any significant factors to directions for which scoliosis takes place? |
90% of thoraciccurves are to right, left = a red flag and should be more extensive! it could be due to a spinal cord tumor, chiari malformation (brainstem dropping), or a neuromuscular disorder! |
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what is non-structural scoliosis? how is it caused? |
= no bony deformity!, usually dissapears on forward flxn, can be treated, not progressive! -postural problem,s, leg length discrepancy, hip contracture, muscle spasm, too tight rotator cuff muscles etc. |
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what is structural scoliosis? how is it caused?
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-a bony defomrity where vertebral bodies rotate to the convexity of the curve, may be progressive, and does not disapeear on forward flxn -genetics, congenital,idiopathic |
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what are some of the 4 biomechanical contributing factors for LE overuse injuries |
1. Lower chain aligment (a =static b =dynamic control [hip and knee]) 2. Foot (interface with ground) (a =Static [standing] b = dynamic [walking/running]) |
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Valgus vs Varus? where does the load bearing axis fall on each one? |
different lower chain alignments. valgus = knocking knees ( falls on the outside of knee and hip) varus = bow-legged (falls on inside of knee and hip) |
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What is the Q-angle? Why is this significant? |
-axis formed by the femur and tibia ^ Q = ^ lateral pull Q greater than 20 degrees ^ risk of instability of PF jt -can be a factor in patellofemoral syndrome, Osteoarthritis and ITB friction syndrome (varus) |
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what is the medial collapse mechanism? what is the result of this mechanism! |
-hip adduction (hip dropping, not pulling closer), femoral internal rotatoin, and knee valgus, -it changes the way we recruit muscles at the hip! - lower jt contact area and increased jt stress
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Where does normal knee flexion and extension and leg twisting motion take place? |
flxn extension takes place btwn bottom of femu and the top of the menisci! -twisting takes place btwn bottom of menisci and the tibia! |
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What is the screw home mechanism? Why is this important? |
- it is when rotattion occurs during the last few degrees of extension bc the medial femoral condyle is larger than the lateral. so when the foot is planted... femur is rotated medially and then if the femur is fixed the tibia rotates laterally This is then a locked joint! |
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how do you unlock the knee? why would you unlock the knee? |
popliteus must contract to externally rotate femur on the tibia! causing tibia to internally rotate! -to distribute forces when pronating during gait! Converting torque! |
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what structures support the medial longitudinal arches of the foot? How is the lateral logitudinal arch in comparison to the medial? |
tibialis posterior and the spring ligament
the lateral is typically a little lower and less flexible! |
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Pes Planus vs Pes Cavus? |
P: excessive pronation, flatfeet and low MLA C: excessive supination, high arch and high MLA |
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what are the transverse logitudinal arch and the metatarsal arch? |
TLA: extends across the tarsals, gives protection to soft tissue and ^ foot mobility! MTA: from 1st to 5th! |
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what is the plantar fascia? |
= central band that originates from the medial tubercle on the plantar surface of the calcaneus and travels to toes as a solid band of tissue dividing prior to MT heads into 5 slips.
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what are the fn's of the plantar fascia? |
-supports foot against downward forces -fn's like a muscle as it is dynamic (shortens during extended toes) -transferring the weight from the medial to the lateral side of the food during gait cycle! -shock absorption |
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What is the Windlass mechanism> |
when the foot has to arch and acts like a rigid lever! -from the feet flat, our toes dorsiflex (lateral weight transfer and shortening of plantar fascia which causes increase in arch height. (which helps with foot supination) -this all happens as our heel starts to lift |
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During Waling how often is a leg in stance phase vs swing phase? What type of kinetic chain is walking? Is there dbl contact during walking? is there single contact during walking where? |
60% stance, 40% swing -closed kinetic chain -dbl contact during initation and early loading after the terminal stance and b4 midstance -body supported only by 1 limb everywhere else |
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what does pronation allow for our bodies? pronation of the foot occurs on which axis? If you are an overpronator, how would that effect your gait? your stance? |
absorption, equilibrium balance and ground terrain changes! TRICK! pronation is simultaneously dorsiflexoin abduction and eversion! -you turn in too far which lwrs chance of supination which lwrs propulsion, and the foot will always be a bag of bones with an arch that is hard to maintain! tibia never can't ex rotate so femur internally rotates excessively causing pain. |
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what are the characterisitcs of supination of the foot? if you are a supinator, how would that effeect your gait? Stance? |
tibia externally rotates, mid tarsal jts are locked , the foot is a lot more stable for the toe and foot allowing large propelling forces. -however, decreased shock absorption bc no pronation which means fascia absorbs all of shock (causing plantar fascitis or shin splints) -also it over externally rotates the tibia causing damage. |
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what mscle aids supination of the foot? |
peroneus longus as it wraps around the cuboid pulley |
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explain this slide.. |
see pg 38 lec 13 |
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How is the gait cycle different for running from walking? |
-no simultaneous dbl foot plant -sprinters forefoot strike -shock absorption and surface adaption is still the same -80% of runners have a lateral heel strike!
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what are the main differencees regarding foot fn, structure, and gait phase for pronation and supination? |
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why is it bad to excessively pronate? |
-internal rotation of tibia and delayed re-supination, which affects screw home mechanism as the tibia does not have ample time to externally rotate! -as a result the femur rotates internally more to get an extension which causes issues in the chain! |
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What is a concussion? What are the differences btwn the different types? what are the different types? |
-complex pathophysiological process affecting brain inculding biomechanical forces! -linear or rotational linear: injry at impact site or brain strikes skull at opp side rotational: worse than linear, brain strikes skull on other side or it rotates causing tears in vessels or B.S. |
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What are the symptoms of a concussion? which ones are most often? which ones are easy to see (black and white, and which ones are harder ? grey) |
somatic (BW) = visual, dizziness, balance, headaches, nausea, light sensitivity emotions (G) e.g. irritability, nervousness sleep disturbance (G) cognitive (G) = attention prob, memory dysfn, fatigue, cognitive slowing "fogginess" -headaches, concentrating and being slowed down are most common! |
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One is hit in the arm, there are no borken bones or seperations to the arm, however as the trainer, the athlete is generally confused what should you do? |
tell the coach that 40% of concussions can occur anywhere on body that isn't the head due to body transmitting "impulsive" forces to the head! |
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a football player just trips and falls on the ground, and asks you if they could have a concussion. What do you say? |
-force of impact does not factor in symptom severity, the largest hit doesn't even have to cause a concussion. more times than not, smaller forces cause concussion! |
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The parents of a hockey player say that they have bought the best helmet at sportcheck and that their kid is ready to go despite the rumour about him having a concussion. As their coach, what do you say? |
helmet will protect high impact injuries, but not so much those smaller or rotatoinal injuries since concussions are usually related to the latter it its best that the player still be cautious, the helmet isn't 100% efficient! |
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you overhear a parent saying that they don't want to enroll their kids in sport because concussions are getting worse? what do you tell the parent? |
they arent' getting worse, we are just getting better at identifying them, oncussion severity scales have been published but none are scientifically validated so a "graded" concussion can't exist! |
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You are playing rugby, and all of a sudden someone gets tackled and the head lands forefully on the grouhd, the player appears to be unconscious? is this any more reasn to panic in terms of a concussion? why? What would be a reason(s) to not panic? |
Not for sure, if they were blacked out for more than 1 minute then that would be worrisome, post-concussive symptoms are more important, loss of memory before the event isn't really a concern, and seizures (tonic convulsions) aren't a concern either! |
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what are potential modifiers for severity for anyone having a concussion ? |
Age, ppl with migrains, ADHD, learning disabilities, etc!, fqncy of previous concussoins, and a high risk of sport and dangerous behaviour. |
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regardless of age, or athletic abilities. How would you manage ppl with concussions? |
ABC's if unconscious, ambulance, load and go! -appropriate disposition of player must be determined quickly! -using SCAT2 are mor impnt than "how many fingers" -someone must monitor them over the next few hours and don't wake them! any worsening of symptoms is reason for the merg! |
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How would you treat chldren under 13 with a concussoin? Would/when can they return to play? |
-due to plastic brains, they may be mor evulnerable to injry! -NEVER RETURN TO PLAY ON SAME DAY! -don't return them unless they are sympom free |
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how would you treat high school athlettes with a concussion? Would/when can they return to play? |
less than 15 minutes of on field symptoms require at least 7 days bb4 symptom recovery -athletes should be removed from play during contest and do non-contact! |
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how would you treat athletes who are 13 or older? when would they be able to return to play? |
-30 days to return to baseline lvl of cognitive fn (high school) -college = 7-10 days -professonal athlete for 3-5 days, if less than 15 minutes then the sameday might even be possible! |
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What is second impact syndrome? Who does it affect most?> |
-athletes with prior concussoins having a second concusssoin -usually athlete returns to play b4 the resolutoin of the 1st concussoin symptoms! -results in a catastophic ^ in intracranial pressure -occurs most often in athletes less than 21 years old? |
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explain this graph and how it relates to concusssions |
demand for glucose does not match the blood flow any more concusssoins during this poitn could be fatal! |
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What are reasons for why kids don't want to report concussions? |
-don't want to leave -haven't realized it happened -they don't think it is severe enough -don't want to let teammates down |
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you are testing an athlete post-hit on the head for concussoin, you have them go on an exercise bike and do light aerobic exercise. What are you looking for? |
if they can talk while they do exercise they are fine! |
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when pulling ppl offf for concussoins? what shoud you never do? |
use the word concussins. 50% of pp; don't want to know they have one! |
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How many bands does the plantar aponeurosis consist of? What arch does the apop go through? |
lateral, medial, and central (plantar fascia), -apop goes through the medial logitudinal arch! |
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how prevlanet is plantar fascitis? What is it? Which structures cause the problem? |
-most common condition in the foot, 1 in 10 ppl will report that medial heel pain! -usually pain is in the medial tubercle of the calcaneus, due to trauma of plantar fascia or tightness in mscles invovled with the achilles tendon as their is an anatomical connection btwn the AT and the plantar fascia!
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What scientififically causes plantar fascitis? (not what we can see) |
slow onset due to a change in structure without inflammaotry mediators helping out bc they aren't present! -continous plantar flexion or even sleeping (cause your foot points to end of bed) causes |
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what are the signs and symptoms of plantar fascitis? why? |
Signs: pain during first steps in the morning or long sitting -pain ^ as activity intensifies, but lessens during normal activity (these signs due to tearing contraction and tightness of what it tried it already tried to heal!) |
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If plantar fascitis has a slow onset, how could cetain athletes develop this injury? |
Well trained athletes changed their FiTT rather than overpronation and as a result caused excessive overload over time. Noob athltes: BMI causes overload |
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what is this? any problems associated with it? any relation to other injuries? |
NOT CAUSE OF PLANTAR FASCITIS PAIN, it could be caused by bleeding at the attachment site A heel spur is caused by the body being tired of re-injuring the plantar fascia, as a result the body starts calcification to fix the problem. |
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how do you treat people who have plantar fascitis? with each treatment when would it be appropriate and how long? |
Correct training Errors! •Manual Therapy/Soft tissue work (foot and tight post. msles) -in gerl trt like a tendinosus bc of its slow onset • foot and calf Stretching (2-4 months) -calcaneal taping (if <10 days) -orthoics (over counter and customized have same effect) for <1 year -night splints (symptoms >6months) for stretch |
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Which muscles do the following? Plantar flex and invert? Plantar flex and evert? dorsiflex and invert? dorsiflex and evert? |
PI: flex hallicus longus ,flx digitorum, tibialis post PE: peroneus longus, peroneus brevis DI: tibialis anterior DE:extensor hallicus longus, extensor digitorum longus, peroneus tertius |
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wearing high heels can do what to your foot? |
Morton's neuroma: squishes the Nerve between 3rd and 4th MT head as it is the thickest. this nerve receives branches from medial and lateral plantar nerve!
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explain what is happening here? |
flat feet (from high heels or high impact sports like basketball or running, over pronation) are causing the transverse arch to drop therefore allowing the bones to drop. the drop of the bones squishes the nerves and the transverse metatarsal ligament is under stretch! This causes sensory loss in the foot! |
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what is an easy way to tell that your transverse arch is dropping a lot? |
wear in the middle of the shoe |
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what are signs and symptoms for Morton's neroma or anhy other metarsal problem? |
Severe pain and loss of sense from the distal metatarsal heads to the tips of the toes. • Pain relieved when not bearing weight. • Hyperextension of toes worsens pain • Pain on palpation usually between 3rd and 4th toes |
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how would you treat one with morton's neroma? |
strengthen dynamic stabilizers of foot intrinsics! Spreading foot into increased transverse arch position Metatarsal Pad. Avoid high-heeled , pointed or narrow shoes. Select shoes with a wide toe box -surgical methods as a last resort |
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What is Sesamoiditis? First of all what are the sesamoids in your foot? why are they their? What would be the cause of sesamoiditis? (last bt pt)= how common is sesamoditis in comparison to other sesamoid injuries? |
beneath 1st MTP joint to protect hallicus longus from being crushed. in addition to transmitting forces from ground! -fractured, arthritic, but usually irritated sesmoid -caused by repetitive hyperextension of the great toe Most common in dancing and basketball -30% |
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what are some symptoms and signs of sesamoiditis? |
Toe Runners Swelling Pain under great toe during push-off Palpable tenderness under the 1st metatarsal head Warm to touch |
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how would you treat for sesamoiditis? |
POLICE Correct training errors Restrict activity to allow inflammation to subside -wear a dancer's (metatarsal) pad the pad doesn't cover 1st MT but spreads out all other focal forces of the foot! |
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How would you diagnose turf toe? what signs and symptoms help you indicate that? what is the cause? what could prevent turf toe? |
high energy trauma or repeated minor trauma where the great toe is hyperextended and the capsule is torn! Pain and swelling at the 1st MTP joint • Pain is exacerbated with push-off • Pain with PROM of MTP into dorsiflexion -better shoes with more support rather than ones that are so flimsy you have full ROM! |
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how would one manage and treat turf toe? |
POLICE Restrict activity to allow inflammation to subside Shoe sizing issues? Taping Steel insert in shoe? |
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you see someone who you may supsect has a C-spine injury what is the first thing you want to do to prevent the injury! |
apply appropriate tertiary protection (in this case, STABILIZING HEAD!) |
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when doing a primary survey for a person with a c-spine injury.... How should you posiition/ not position them? What should you do? |
-if they are unresponsive, then ABC's which involves them in a supine position (NEUTRAL position!) don't try to move their head too much if...... -there is a fracture it may rupture a vessel! -mvmnt causes ^ amnt of pain -resistance to mvnt is encountered -and patient expresses apprehension -try to get helmet and shoulder pads off! |
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when doing a secondary survey for a person? What do you have to ensure you have done before you do so? then what do you look for? |
1st: call EMS -get their opinion on what happened! do a general questions about where pain is felt numbness occuring, and brief history. bc if bi-lateral numbness is occuring all the more reason for EMS! |
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How can you tell if someone has a Stinger or a Burner? |
-rarely neck pain, unilateral symptoms, transient pain (occurs quickly), C5-C6 damage (numbness from head to fingers), not able to flex and extend elbow, or abduct shoulder! Generally they heal quickly as well! |
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What are the symptoms and signs of a C-spine injury? |
-neck pain, pain on spinous process palpitation, BILATERAL myotome or dermatome findings, upper and lower extremity findings, paralysis! |
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What do we do with an athlete once we have determined they have a stinger vs a c-spine injury? |
Stinger: bring player off and they can return if everything is fnlly ready! -c-spine: Board them, and then send them to EMS! |
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your athlete has just come off to the bench beause of a stinger, the coach asks you what is up with Johnny. What do you say? |
Tell them if they can play, and if not tell them when they would be available for the current game, what % they are at. Don't tell them what is injured quite yet, wait till after the Game! Fill them in on what the injury is and how long they are out! |
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What is a Stinger? what is the MOI? |
it could be....nerve compression due to .... 1.forced neck extsn and rotation on injured side 2.shoulder distracted down from head and neck 3.a blow to the supraclavicular fossa! |
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What is a C-spine injury? what is the MOI? |
2 mechanisms: 1.axial load vertical compression (tilting head down straightens the vertebrae) 2.any sort of compression flexion injury! (anterior compressing and posterior elongating) |
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know a select few of dermatomes.. (C5-C6) |
c5: lateral arm over deltoid c6:radial side of arm and entire thumb |
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KNOW ALL OF THE MYOTOMES! (tell me, this chart only has C2-T1) |
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How would you properly do a log roll for an athlete with a C-spine injury? |
-stable grip at head and use cross arm technique so the arms unwind! -leader needs to make sure evry1 moves as 1 unit -use at least 3 ppl, and always roll body towards yourself! |
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When regarding eqpmnt and taking them off for a player with C-spine injuries... What tool(s) should you be using to take eqpmnt off? In Hockey, what should happen with pads and helmet? What should happen in Football? |
cordless screwdrivers are most efficient! but a back-up is still rqd! hockey:^ in lordosis with helmet removal so no. Football: ^ in c-spine extsn for helmet or pads, but helmet is only 10 degrees! threfre if you remove helmet you must remove shoulder pads. BUT FOR C-spine both should be left on.
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What about Lacrosse helmets and shoulder pads.. should we keep them on if one has a c-spine injry? How is it different from football or hockey |
-both should be left on, but the effect of the helmet on the c-spine is actually flexion rather than extension like hockey or football |
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How should one remove shoulder pads? on an injured victim? |
1. partner 1 stabilizes head while leader cuts patients jersey on front across shoulders and out on arms 2.partner 1 stabilizes while leader cuts all staps on SPs. 3.leader does allligator grip while partner 1 releases head and takes SP off 3.partner 1 takes control of head again while leader applies cervical collar on! |
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How to transport injured athletes using the vertical lift! what are the rqmnts for this to happen? why would you use a vertical lift in comparison to a log roll? |
-8 ppl necessary -leader has head and neck, 1 person slides board underneath, and 3 people on either side at hips , knees and shoulders -^ axial rotatoin and lateral flxn when doing a log roll so whenever possible try to do a vertical lift! |
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What are the steps rqd to get an athlete secure on a board? |
strap the thorax area in 1st as it is the largest part of the body, and if the athlete needs to throw up or something, the athelte can be tilted to the side and the head and feet can move while the thorax is properly strapped in! |
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why is head trauma such a serious issue in sport? what kind of forces cause brain injuries? How can we minimize these forces? |
head trauma has the most fatalities than any injry in sport -compressive forces, tensile forces, and shearing -having stronger necks cause the neck to acceletarte less due to its larger mass! |
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How does cerebro spinal fluid affect the forces placed on the head? |
- it converts the focal force into compressive stress which dissipitates over the brains full surface! -CSF has minimal impact on shearing! |
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What are signs of a Skull fracture? |
-severe headache + nausea -defect in skull while palpating -blood in middle ear, ear canal, or nose -pre-oribtal ecchymosis -peri-auricular ecchymosis -a halo sign (CSF appearing in the ear and nose! that is seperate from blood!) -UodU pupils (unequal, unresponsive, one dilated)
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what is peri-orbital ecchymosis? when would this appear? |
if you have injured your skull, it is bruising around the eye, not oly that, but it is a late finding which may not be found till about 1 to 2 days later! |
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what is per-auricular ecchymosis? when would this appear? when would this appear? |
bruising behind the ear (also called Battle's Sign) -late finding that may not be found til labout 1-2 days later! |
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how do pupils normally respond? if pupils are equal, dilated, and unresponsive could have happened? if pupils are equal, constricted, and unresponsive, what could have happened? if pupils are unequal, one is dilated, and unresponsive what could have happened? |
-Pupils, equal, and Responsive to Light = normal -cardiac arrest of CNS injry -CNS injry or narcotic drug use -Cerebrovasc. accident, head injry, or direct trauma to eye |
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if you an athlete was over pronating and you wanted them to slow down their pronation... which muscles would you strengthen? what about supination? |
you would want to stregnthen your flex hallucis longus, tib post, and flex digit, bc they eccentrically contract during pronation of foot! supination = the lateral anterior muscles like extensor digit longus, and peroneus tertius! |
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What is the cause signs and care of an Epidural Hematoma? |
cause:skull fractures near middle meningeal artery causes bruise to occur sign: LOC followed by lucid interval, a gradual lwring of mental status, wknss, diated pupil on same side of injry, neck rigidity, depression of pulse + resp, mscle convulsion care: URGENT EMS to relieve pressure or death!
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What is the cause, signs, and care of a Subdural Hematoma? |
cu: damaged venous ciculation that bridge from brain to dura, bleeding that may damage cortex.torn by acceleration of brain s: unconscious, UodU, general wkness care: needs EMS as it is leading cause of traumatic death! |
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What could have been the cause, signs, and care of a SCalp injury? |
cu: blunt or penetrating head s:LOTS of bleeding c: clean with antiseptic soap and water, cut away hair, apply pressure, wounds larger than1/2 inch in length should be referred, smaller wound can be covered with gauze |
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as an AT you are assessing ronny who got hit in the face and you are looking at the opening and closing functions of his mouth. During this process what would be signs that might indicate a specific face injury. |
difficulty opening or pain on lateral cheek = mandible or zygomatic fracture
difficulty closing = maxilla or palate fracture |
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what would be th signs and care of a mandible fracture? |
pain with occlusion (can't put teeth togheter) -deformity -bleding around teeth -lower lip numbness Care: emerg. and temp immobilization with elastic wrap! |
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what would be the signs and care of a zygomatic complex fracture? |
signs: put rulers on each isde of face, if both angles aren't the same = deformity -numbness due to injry of infra orbital nerve -nosebleed (on injured side of sinus) -dbl vision -periorbital ecchymosis (50% of patients Care: emerg. and immobilization b4 swelling |
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what would be the signs and care of a facial laceration? |
sign: lots of bleeding care:pressure, you need to determine if it isn't brain or skull trauma! (check bruising or UodU) -get it stiched in a merg. put gauze on for now |
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What are the signs and care needed for tooth fractures? What are the different type of fractures? |
Uncomp = missing parts but no bleeding in the upper tooth comp = bleeding, and a lot of pain in the upper part of tooth root= bottom part of tooth care: comp and un don't need immediate attention, root should get an x-ray! Do not put any teeth in ice, put them in milk, gauze. |
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what are the signs and care for a tooth sublux, lux and avulsion? |
s: sublux: tooth loose w/o pain lux: no fracture, but displacment avul: knocked out tooth care: for all, referall should be for 1st 48 hrs lux:try to put tooth back in, even backwards is better than not at all! avul: within 30 min, clean, put in milk, put back in , but use gum to spint it!
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What ae the signs and care for nasal fractures? |
s: deviation of tip of nose, palpate for creptius (cracking), breathing through 1 nostril is difficult c: secure airway if needed, pressure for bleeding, see physician for x-ray |
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what are the signs and care for a deviated septum? |
bleeding and sometimes bruising in septa -pain Care: -compression at site of hematoma -a wick is needed for further drainage! and packing will prevent bruising (put stuff in nose), neglecting bruises will form an abscess, deformity, and cartilage loss.
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what are the causes signs, and care for an epistaxis? |
(nose bleed) cu: direct blow, sinus infectin, high humidity, allergies, foreign body, etc. signs: bleeding from anterior septum, resolves quickly generally care: sit upright, ice on back of head only to force neck forward, compress affected nostril, gauze nose, and in btwn upper lip and gum |
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what are some of the WORST THINGS that can happen/could do with an epistaxis? |
(nose bleed) -You can't blow the nose! it has to do its own thing for 2 hours! -if bleeding does not stop in 5 min, you need an antistingent compound, in addition to gauze! |
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what are the causes signs and care required for an auricular hematoma? |
-called cauliflower ear! -compression or shear of the ear. -signs: subcutaneous bleeding if the person keeps rubbing it, some1 who wrestles or plays rugby. tearing of overlying tissue away from cartilage, bruising and fluid accumulation, and clots if unattended care: Ice, ear protection, pressure, and doctor care |
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what are the causes, signs, and care required for a rupture of the tympanic mmb? |
cu: fall or slap to the unprotected ear, or underwater incidents s: complaint of loud pop and pain, "sickness", and hearing loss ca: small to moderate perforations usually heal spontaneously in 1-2 weeks, infection can occur and must be monitered, shouldn't do air travel!
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what are the causes, signs, and care required for Otitis Media? |
cu: - accumulation of fluid to the M.E. caused by infection s: pain,fluid drainage from ear canal, and hearing loss, fever, headaches, irritability, loss of appetite, and nausea ca: fluid withdrawal for antibiotics, generally goes away in 24 hrs while pain lasts for 72 hrs! |
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how many eye injureis occur each year? How can we fully prevent these eye injuries? Why are eye injuries so scary? why is vision so imporatnat? |
over 100 k occur each year, they are so scary bc high ^ of being severe injuries where saving remaining vision is an impnt priority! wearing a FULL facemask can prevent these injuries! vision is about 70% of all our sensory receptors and 40% of our cerebral cortex! |
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you are going to do a typical eye assesment with your athelte.. how are you going to do this? (assume person was in an injured state) |
-flush out the eye for 30 minutes to eliminate chemicals 1. get a history of injury 2. check vision b4 any manipulation! 3. examine pupil/cornea/ by checking PEARL, seeing if there are foreign bodies, or a hazy iris 4.check eye mvmnts (dbl vision?) |
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what are the signs and care for an orbital fracture? |
s: dbl vision, restricted mvmnt, downward displacement of eye, tissue welling and bruising, peri-orbital ecchymosis, and bleeding in the under part of eye (hyphema), unilaterla epistaxis, and numbness fron infraorbital n. damage C: ice, no blowing nose, x-ray and surgery.
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What are the signs and care for an orbital Hematoma? |
(black eye) s: bleeding under the eye, swelling and discoloration ca: - cold application for at least 30 minutes, 24 hrs of rest if discoloration, and DO NOT BLOW NOSE |
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what are the causes, signs, and care needed for a corneal abrasion? |
cau: attempting to remove objects from eye signs: mild to severe pain, watering of eye, sensitivity to light, pain with blinking, lwrd focus ability, spams of orbicular mscls care: Patch eye and go to the DOC! |
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what are the causes, signs, and care needed for Hyphema? |
cau: any injry leading to problems with lens of retina si: collection of blood in anterior chamber of eye, visibile reddish tinge in anterior chamber of blood, blocked vision care: IMMEDIATE MERG, elevation 30-40 degrees on an incline, both eyes patched , sedation, and medication to reduce ant. chamber pressure otherwise vision loss will occur. |
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what are the signs and care for retinal detachment? |
si: painless, flash of light, curtain falling over eye, may report specks, or blurred vision care: immediate referral to opth! bed rest, and patches for both eyes! |
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what are the cause, signs, and care for acute conjunctivis? |
cau: allergies or bacteria/viral infection si: swelling eyelid with pus!, burning or itiching care: highly infectious, so one should refer to physician for treatment! |
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what is so important about airway injuries? what are their signs and care? |
-most dangerous of maxillofacial injuries, bc they can worsen! signs: hoarseness, loss of prominence in ant. neck, difficulty with swallowing, and tenderness, subcutaneous emphysema (air in and out from neck), hematoma, coughing up blood care: have them calm down, even if they pass out, then EMERG! |
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what is cause, signs, and care about subungual hematoma? |
cause: common in running and squash, due to toe hitting end of toe box and injures nail, or something dropping on it. signs: bleeding underneath toe nail care: heat a paper clip and hold it with pliers, press into nail and release blood, then put manual pressure to release all blood!, may need to do it again tomorrow with an unheated clean paperclip! |
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how can we prevent subungual hemotoma? |
get a pad on the forefoot, this causes toes to hold back and stop banging on the edge, do not put a pad at the end of the shoes bc you are just shortening it! |
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how does an ingrown toenail happen? what are signs? |
sign: tissue being pushed over nail growing in a lateral direction (occurs on big toe often), smelly, and pussy infection as a result of bacteria from nail. cau: results from repeated trauma, improper trimming, or really poor fitted shoes applying lateral pressure
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How can we treat an ingrown toenail? |
-1.soak in warm water, then tease tissue back away from nail with manicure stick, 2.take cotton ball, wet it and roll until cylindrical 3.tuck cotton along border of nail blot out excessive moisture and trim 4.may need to be done 2x a day until inflammation settles 5. Cut nails just so they are long enough and make it a "V" shape,
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what is the last resort that one might do to treat an ingrown toenail? |
cut a wedge, and then put a stitch in there.
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how common are ankle sprains in sports? in general pop.? what kind is most common? how much time away from game do they cause? |
-most common injry in sports -37/1000 ppl per year in general pop. -23% of all sports injry's -85% lateral, 10% syndesmmosis (AITFL) 5% medial (deltoid) -1/4 of lost time in bball and football |
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how and where does the ankle joint get its strength from? |
1. Shape of Bones (Mortise) 2.Capsule and ligaments 3. ACtive muscle strength |
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What is the relationship between the medial and lateral malleolus of the ankle? why is this important? what is the relationship btwn the talus and the malleoli? why is this sig? |
lat gives lots of stability as it helps the medial structures from stopping the ankle from swinging out! -with dorsiflxn, wider portion of talus lies within malleoli (so wider = more stable since dorsiflxn is more stable) |
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any other special properties of the talus bone that are important? the Capsule of the weak anteriorily and posteriorily, why? |
trochlear surface is wider anteriorily than posteorily -no muscles attatch to it! -very extensive articular capsule! (which makes it look like a dome) ***the capsule is weak bc it has to allow mvmnt! |
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ATFL vs CFL vs PTFL |
ATFL: -weakest of 3, strain ^ with PF/inversion, part of capsule (it will swell quickly as blood supply is good, will heal quickly) CFL: extra capsular (harder to heal due to blood supply from ends), stabilizes subtalar jt, limits adduction/medial tilt, tight in neutral to dorsiflxn PTFL: strongest of 3 (won't tighten till full dorsiflxn) |
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why do ankle sprains usually occur when we are landing on our ankles or when we leave the ground? Which ligament is the first line of defense? |
that usually occurs when our ankle is loaded or unloaded, during those times, the ankle is more stablie in the mortise ***depends on position of ankle, usually the most verticle lig = first line of defense |
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What is the Anterior drawer test? why is it useful? what is the talar tilt test? why is it useful? |
-determines damage to ATFL primariliy, +ve when foot lides forward and or makes clunking sound as it reaches the end point -performed to determine the extent of injry to the CFL or delotid lig, with foot at 90 degrees, excessive motion on inversion or eversion will indicate which lig is injured |
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When is each part of the deltoid lig tight? why is an eversion sprain so bad? |
anterior = tight in PF and eversion middle = tight in neutral post = tight in dorsiflxn ** bc fractures usually occur too, its not that common fracture of fibula as it really helps prevent eversion |
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if one had an eversion sprain why would increased pronation occur? |
bc the delotid attatches superiorily to the navicular, and if the navicular didn't have anything to attach to it would fall down causing pronation! |
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What are the ottawa ankle rules? why is this useful? |
this rule applies for broken ankles. 1. pain on posterior 6 cm of medial malleolus? 2."" lateral malleolus? 3. press on base of the 5th MT 4. press navicualr bone 5.in ability to take 4 steps any of these 5 things are present = need x-ray |
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how would your ankle stability change without your deltoid lig? without your fibula? When you do eversion and external rotation what is the order of how structures can be torn/broken? |
without deltoid = still relatively good without fibula = very poor **1. Deltoid 2.AITFL 3. Fracture |
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how is it possible to to fracture your tibia/fibula? w/o rupturing your deltoid lig? what would the symptoms be still at this point> |
you still would not be able to bear weight! +ve squeeze test in the lower leg +ve excessive extenal rotatoin MOI: skate or a boot |
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Who developed the theory of STTT? what is STTT? What does pain before the end of a motion mean for a passive test? During a Isometric resistance test, what other structure information can we gather/manipulate aside from muscles and inert tissues? |
Dr. James Cyriax , he applied tension to structures hoping to find pain to figure out a certain lesion//injury ** usually means a red flag! $$$ = nerve info! |
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when doing isometric resisted movments w. patient how should you position yourself? why should you hold the position for 5 seconds? What is included in special tests? WHAT does SOAP stand for during STTT's |
above them maybe so you can have mechanical advantage (comes in handy with heavy ppl) ** if they cant hold it for less than that = a nerve issue $$ manual muscle testing!! and other tests && subjective, objective, (after all tests form an assesment, |
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about how many injuries occur at the upper extremity? Define a shoulder seperation, dislocation, and which jts these can happen in? Where does most of the stability from the SC joint come from? |
70%! **Seperation = AC jt and possibly the CC jt ligaments!, *dislocatoin = GH and SC jt $$mostly from ligaments bc only 25% of clavicle is actually in contact with the sternum! |
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what are the primary purposes of the SC jt? whhich ligaments prevent the SC jt from going to far in a certain direction? |
-acts as a shock absorber bc of the discs in btwn the surfaces! -impnt for abduction and flxn as clavicle retracts, elevates and rotates posteriorily on its own! -sc lig = no forward, cc ligh = no up, inter-clavicular = also not up! |
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fns of clavicle? which ligs provide stabliity to AC jt? if an injury were to occur, how would stability be affected? Lux vs Sublux? |
-protect B.P, mscle attachment, **CC lig AC lig and capsule = stability $$saggital and A-P stability, but A-P usually goes first && sub: partial dislocatoin, lux: full dislocation |
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how does the shoulder complex affect the GH jt? how much bigger is the humerus in comparison to the glenoid? |
it works w. rotator cuff maintain the instantaneous center of motion (ICOM) of the jt. if any of them were to be disrupted, it would alter ICOM. (think of the seal and ball analogy) 3 times!!
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how does shoulder support differ/similar in a static vs dynamic fn? how does shoulder support in a posterior vs anterior direction? why? |
static = labrum ,capsule, and GH ligaments dynamic = RC and other scapula mscles *posterior = lots, thick capsule, lots of RC, ligaments, majority of bones anterior = minimal, only Subscap, bicpes, capsule is smaller, minimal bony support, and a few ligaments ALLOWS US TO MOVE FORWARD WITh ease, but also allows a lot to pop out forward!
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when in abduction how does the IGL support the humerus? |
(hammock fn) it rotates anteriorily and superiorily to cushion it and prevent subluxation of shoulder! |
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how many shoulder dislocations are ant, int, and post? |
85% ant, 5% inferior, and 10% posterior |
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Achilles is a combined tendon of which mscles? How is the achilles tendon strength with respect to the body? what is the tendon surrounded/not surrounded by? and what would that mean? what are the chances that a runner can risk rupturing or having tendinosus of that tendon? |
-gastroc + soleus -strongest and thickest in body -not synovial sheath but by a paratendon ***paratendons are vascular meaning that this muscle requires a lot of o2 (slow twitch fiber) -15 x greater risk of rupture, 30x greater risk of tendinosus |
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running down a hill will more frequently cause what kind of tendinitis? rub from hockey laces......? hyper dorsiflexion......? what kind of factors are the above 3 regarding tendinitis? what are internal factors for tendinitis? |
Tib ant. (bc it is controlling your feet from flapping) -tib ant -achilles *external $$rub over the bone, cavus or flat/pronating feet |
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what sort of injury do the vast majority of ppl have when they complain about Achilles tendon pain? why? |
-tendinosus!, occurs usually in the midportion! -usually ppl have tedninitis but just ignore it so it turns into tendinosus!so as such it worsens without recovery and increased FITT.
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what kind of pressure is the result of the medial aspect of PF jt syndrome? What is the result? -same q for the lateral aspect? |
-hypopressure (catilage degeneration from the inside out) -hyperpressure (cartilage rub and fibrillation) |
