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269 Cards in this Set
- Front
- Back
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when coming upon an injury you must make sure to assess the whole situation. this is because __
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more than one injury is possible
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what are the 2 kinds of evaluations?
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-on field
-of field |
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the primary survey is made of __
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ABC's (airway, breathing, conciousness) and vitals
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what does HOPS stand for?
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History
Observation Palpation Special Tests |
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the part of HOPS where you gain as much information about the athlete and the inury as possible
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history
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the part of HOPS where you look at the injured area and compare bilaterally
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observation
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in the observation part of hopes, you compare __
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bilaterally
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the part of HOPS where you feel the injury
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palpatation
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the part of HOPS where you check range of motions, neruologic exams, stress test, and functional tests
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special tests
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evaluation where you check for stability and to see if they can be moved
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on field
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sudden onset, short duration (resolves quickly) serves biological function
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acute pain
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slow onset, long duration
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chronic pain
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pain in the skin, ligaments, muscles, and joints.
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somatic pain
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results from disease or organ injur, deep, nagging, nausea
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visceral pain
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referred pain is an example of __
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visceral pain
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two types of somatic pain
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deep, superficial
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a pain that is nagging, indicating significant tissue damage
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deep somatic pain
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a pain that is brief, intense, and sharp
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superficial somatic pain
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what should you ask in during the history portion of HOPS
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-mechanism of injury (MOI)
-PMHx -where and what kind of pain |
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What should you look for during observation?
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-watch the athlete
-posture -compare bilaterally -ecchymosis and effusion |
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joint swelling
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effusion
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soft tissue swelling
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edema
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black and blue discoloration
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eccymosis
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grinding/grating sensation
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crepitus
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what does goiniometry measure?
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range of motion
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a measurement of girth that uses water displaced by a hand or foot
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volumetric movement
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in palpation you should start __ from the injury site and work __ the area
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away, toward
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you should first palpatate __ then __
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bone, soft tissue
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when testing ROM, do __ first, the __
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active, passive
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an end feel is the __
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feeling at the end of motion
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what characterizes bone to bone end feels
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hard, painless sensations
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what characterizes soft tissue end feels?
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compression stops further movment
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types of end feel over pressure qualities:
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1. bone to bone (hard)
2. soft tissue 3 firm |
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what characterizes firm end feels
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tissue stretch
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what are two types of stength tests you can do in special tests part of HOPS?
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static or dyanmic
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stress tests are done on __ and __
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ligaments, muscles
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types of neurological assesments
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dermatomes, myotomes, reflexes
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proprioception, genreral movements, and sport specific tests are __
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functional tests
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walking, jogging, running, figure 8s, and cutting are all forms of __
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functional tests
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area of skin supplied by cutaneous nerves
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dermatome
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group of muscles innervated by single nerve group
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myotomes
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if a test is true, it is done __
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correctly
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if a test is false it is done __
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incorrectly
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there are __ cerviacl vertabrae
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8
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there are __ thoracic vertabra
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12
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there are __ lumbar vertabrae
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5
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lowest cost of all the the imaging techniques
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radiographs
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radiographs have limitations like __
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scaphoid fractures
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radiographs work because bones are more __ and absorb more __
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dense, radiation
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when taking a radiograph, you must protect the __
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reproductive organs
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the 4 ways to interpret radiographs
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A-alignment
B-bones C-cartilage S-soft tissue |
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when interpreting radiographs in terms of alignment, there should be __ of the bones and joint surfaces
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continuity
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when interpreting radiographs in terms of bones the should be uniform __. areas of decreased density will appear __
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color, darkened
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when interpreting radiographs in terms of cartilage joint spaces should be __
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smooth
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when interpreting radiographs in terms of soft tissue __ and bones can be seen
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swelling within or between soft tissue
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a stress radiograph is taken when stress is applied to the joint to maximize __
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joint laxity
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when X-ray source and detectors rotate around the body, computer determines the density of the tissue, creates 2 dimensional image (slice)
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computed tomography (CT) scan
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pathologies identified by MRI
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-sprains
-fluid -nerve entrapment |
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the MRI tube produces a __
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magnetic field
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in an MRI hydrogen nuclei align with the __
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magnetic axis
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in an MRI electromagnetic waves cause nuclei to resonate as they absorb __
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energy
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an MRI has no __
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harmful effects
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in an MRI contrast can be __
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"weighted"
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MRI's setbacks are __ and __
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claustrophobia
types of metal implants (pacemaker) |
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studies blood vessels:
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magnetic resonance angiography (MRA)
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uses radionuclide Tc-99m that is absorbed by remodeling bone creating a "hot spot"
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bone scan
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what kind of pathologies are identified by a bone scan?
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degenerative disease
bone tumors stress fractures |
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sonograms are relativlely __ and __
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easy, inexpensive
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diagnostic ultrasound identifies __
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soft tissue defects
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to see internal organs with diagnostic ultrasound, a frequency of __ is used
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1-6 MHz
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to see superficial structures with diagnostic ultrasound, a frequency of __ is used
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7-15 MHz
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the tip of the ultrasound device is called a __
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piezoelectric transducer
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detect pathology in nerves and the muscles they innervate
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nerve conduction studies (NCS) and electromyography (EMC
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pathologies identified by NCS or EMG
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peripheral nerve entrapments
nerve root injury muscle disease |
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senses when peripheral nerve is stimulated and muscle activity is detected
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NCS
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time it takes for the impulse to travel to the muscle
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latency
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magnitude of the nerves response
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amplitude
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an emg is __
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invasive
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an electrode needle is inserted into the muscle and electrical activity within muscle is noted
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emg
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normal muscle is __ in an EMG
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electrically inactive
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pathological muscle is __ in an EMG
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spontaneous activity or depolarization at rest
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Why do we use evidence based practice (EBP) in the diagnsotic process?
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-rising medical costs
-insurance companies |
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the ability of a protocol to produce the intended effects
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efficacy
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methods or procedures that through research and experience have demonstrated the optimal, most expedient results
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best practice
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what is the hierarchy of research?
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-meta-analysis
-randomized clinical trials -cohort studies -case control studies -case series report -case report -expert opinon |
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clinical exam components should be supported by __
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evidence
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how often the same results are obtained
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reliablility
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the extent to which the same examiner produces the same results, how consistently will the SAME examiner get the same results
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intraraterer reliability
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the extent to which different examiners produces the same results, how consistently DIFFERENT examiners get the same results
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interrater reliability
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how often do the results correctly identify whether or not the pathology is present
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diagnostic accuracy
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the measure of how well a certain test does what it is supposed to do
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validity
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steps to assessing diagnostic accuracy
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-identify a population to test
-compare results to diagnostic gold standard |
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the extent to which a condition is present in a population; can change depending on a group
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prevalence
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the likelihood that a specific condition is present before the diagnostic test results are known
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pretest probability
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the highest diagnostic accuracy, generally more expensive, less accessible, slower, invasive, requires more personnel
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diagnostic gold standard
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best diagnostic accuracy=__
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high rate of true +'s and -'s
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formula for a positive predictor value
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true positive/true positive+false positive
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formula for a negative predictor value
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true negative/true negative+false negative
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sensitivity=__
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true positive rate
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a tests ability to detect those patients who actually have the disorder relative to the gold standard
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sensitivity
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specificity=__
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true negative rate
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a tests ability to detect those patients who don't have the disorder relative to the gold standard
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specificity
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formula for sensitivity
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true positive/true positive+false negative
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formula for specificity
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true negative/true negative+false positive
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quick sumary of how positive and negative finding determine a tests diagnostic usefulness
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likelihood ratios
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__ explains the shift in the pretest probability that a patient has a condition after obtaining a test result
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likelihood ratios
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the probability that a condition exisits decreases if the likelihood ratio is __ 1
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<
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the probability that a condition exisits increases if the likelihood ratio is __ 1
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>
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__ express the change in our confidence that a condition is present when the test is positive
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+ likelihood ratio
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what is the formula for LR+?
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sensitivity/(1-specificity)
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expresses the probability that the pathology is still present even though the test was negative
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- likelihood ratio
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what is the formula for a - LR?
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(1-sensitivity)/specificity
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a group of findings taht improve decision making, decrease costs, and improve patient outcomes
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clinical decision rules
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the disposition of teh body at any one moment
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posture
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a straight line that passes through the ear lobe, the bodies of the cervical vertebrae, the tip of the shoulder, midway throguht the throax, through the bodies of the lumbar vertebrae, slightly posterior to the hip joint, slightly anterior to the axis of the knee joint, and just anterior to the lateral malleolus
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ideal alignment
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teh position in which minimum stress is applied to each joint. upright posture is the normal standing posture. if it is correct, minimal muscle activity is needed to maintain that position
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correct posture
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correct posture can __
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-improve performance
-decrease abnormal stresses -reduce development of pathological conditions |
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any position that increases the stress to the joints
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faulty posture
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waht is a normal pelvic angle
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30 degres
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waht is the most common cause of poor posture?
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poor habits
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__ casues other joints in the kinetic chain to compensate
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postural deviation
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when arthokinematic motions of teh GH joint are decreased
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adhesive capsulitis
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narrowing of the vertebral foramen through which the spinal cord or spinal nerve root pass
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stenosis
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an ecessive anteiror curvature of teh spine. an exaggeration of teh normal curves found in teh cervical and lumbar spine
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lordosis
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what are the two types of lordosis
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patholgical and exaggerated
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characterized by sagging shoulders, medial rotaion of the legs, and the head poking foward. deviation in one part of teh body often leads to deviation in another part of the body in an attempt to maitian the correct center of gravity
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pathological lordosis
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__ is the most common kind of lordosis
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pathological
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usually accompanied by tight hip flexors, tensor fasciae latae, and hip flexors, combined with weak abdominals
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exaggerated lumbar lordosis
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when there is an increased pelvic inclination to approximately 40 degrees, and the thoracolumbar spine exhibits a kyphosis
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swayback deformity
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an excessive posterior curvature of the spine, an exaggeration of the normal curve found in teh thoracic spine
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kyphosis
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long rounded curve with decreased pelvic inclination and thoraco-lumbar kyphosis, the trunk is flexed forward and has a decreased lumbar curve
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round back
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a localized sharp posterior angulation in the thoracic spine
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humpback
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a decreased pelvic inclination to 20 degrees and a mobile lumbar spine
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flat back
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a lateral curvature of the spine.
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scoliosis
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involves bony deformity which is either congenital or acquired
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structural scoliosis
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may be caused by postural problems, hysteria, nerve root irritatio, inflammation, or compensation caused by leg length descrepancy or contracture in the lumbar spine
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nonstructural scoliosis
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there is no __ with scoliosis
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bony deformity
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scoliosis is __ progressive
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not
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accounts for 75%-85% of all causes of structural scoliosis
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idiopathic scoliosis
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the scoliotic curve disappears on __
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forward flexion
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the imaginary line from the ear lobe to the acromion and iliac crest
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lateral line of reference
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when a plumb line would drop down the 7th cervical vertebrae
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posterior line of reference
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abd
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abduction
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act
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active
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A/A
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active/asistive
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add
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adduction
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ADL
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activities of daily living
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AG
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achieving goals
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A/P
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anterior posterior
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AROM
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active range of motion
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Ⓑ
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bilateral (both)
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BID
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twice a day
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BF
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biofeedback
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BP
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blood pressure
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C1
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first cervical
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c (with a line on top)
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with
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CC
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chief complaint
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CCP
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continue current program
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c/o
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complaint of
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cx
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cancelled
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D/C
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discontinue
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DOB
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date of birth
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Dx
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diagnosis
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ER
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external rotation
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ext
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extention
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f
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female
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flex
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flexion
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fx
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fracture
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FWB
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full weight bearing
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HEP
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home exercise program
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HP
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hot pack
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Hx
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history
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I (circled)
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independent
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IR
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internal rotation
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LE
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lower exteremity
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L1
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first lumbar
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L (circled)
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left
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LBP
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low back pain
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m
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male
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MMT
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manual muscle testing
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NC
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no change
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NWB
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non-weight bearing
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p (line over it)
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after
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post op
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post operation
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PMHx
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past medical history
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PNF
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proprioneuromuscluar facilitation
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PRE's
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progressive resistance exercises
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prn
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as needed
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PROM
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passive range of motion
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PT
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physical therapy
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pt.
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patient
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PWB
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partial weight bearing
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qd
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every day
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R/O
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rule out
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R (circled)
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right
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Rx
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treatment
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s
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without
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S1
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first sacral vertebrae
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SI
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sacroiliac
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SLR
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straight leg raises
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S/P
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status post
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STM
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soft tissue mobilization
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T1
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first thoracic vertebrae
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TE or Ther. Ex
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theraputic exercise
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TENS
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transcutaneous electrical nerve stimulation
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TID
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three times daily
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Tx
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traction
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US
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ultrasound
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WNL
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within normal limits
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WP
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whirlpool
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CWP
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cold whirlpool
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NSAID
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nonsteroidal anti-inflamatory drugs
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P
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pulse
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c
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continue
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what does SOAP stand for?
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Subjective
Objective Assessment Plan |
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part of SOAP where you take down everything the patient says
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subjective
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part of SOAP where you write down everything you see and do
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objective
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8 categories of objective (SOAP)
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A/PROM
grith strength sensation gait special tests swelling soft tissue restrictions |
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in the assessment part of SOAP, what 2 things are recorded?
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long and short term goals, status of player progress
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part of soap that describes what the AT is going to do with the patient
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plan
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the process of determining the priority of treatment
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triage
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an observable condition that indicates of a disease or injury
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sign
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the immediate and long-term managment of an injury or illness
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disposition
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finite measures that are readily reproducible regardless of the indiviual collecting the information
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objective data
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valuntarily or involuntarily assuming a posture to protect an injured body area, often through muscular spasm
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muscle gaurding
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an injury that casuses permenant disability or death
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catastrophic
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a condition existing before birth
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congenital
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fainting caused by a ransient loss of oxygen supply to the brain
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syncope
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unexpected and instantaneous death occuring within 1 hour of the onset of symptoms; most often used to describe death cuased secondarily to cardiac failure
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sudden death
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a hereditary condition of the connectibe tissue, bones, muscles, and ligmaments. over time, this condition results in degeneration of brain functin, cardiac failure, and other visceral problems
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marfan syndrome
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the presence of multiple unrelated disorders in teh same person at the same time
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comorbidity
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of gradual onset; with respect to symptoms of an injury or disease having no apparent cause
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insidious
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injury casued by accumulated microtraumatic stress placed on a structure or body area
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overuse syndrome
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the gradual and progressive deformation of tissues to adapt to postural changes including immobilization or pathomechanics
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tissue creep
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the sensation of numbess or tingling often described as a "pins and needles" sensation, caused by compression of or a lesion to a peripheral nerve
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parethesia
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faking or exaggerating the symptoms of an injury or illness
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malingering
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fusion of a joint as the result of pathology or surgical design
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ankylosed
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a research technique that combines the results of multiple studies that have a similar research hypothesis
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meta-analysis
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a condition not visually apparent to the examiner, indicating the existance of a disease or injury; usually obtainned during the history taking process
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symptom
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an inflammatory condition involving a bones growth plate (aka osgood schlatter)
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apophysitis
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inflammation of the bursae, common on patella and olecranon process
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bursitis
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inflammation of a joints capsule
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capsulitis
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a bony growth which develops within a muscle following a contusion or strain
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myositis/myositis ossificans
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inflammation of one or more nerves
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neuritis
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inflammation of the periosteum
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periostitis
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describes tendon pathology (3 degrees)
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tendinopathy
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an inflammation of the synovial sheath surrounding a tendon, more common in hand and feet bcasue small tendos
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tenosynovitis
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the inflammation of a joints capsule that occurs secondary to prescence of existing inflamation in or around a joint that spereads to synovial membrane
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synovitis
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when a bony fragment is stable withing the joint or free floating within the joint space
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osteochondritis dissecans
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the degeneration of a joints articualr surface
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arthritis
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growth of exraneous bones due to irrecular forces
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exstosis
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injurying any part of the epiphyseal plate/a direct blow to joint area
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epiphyseal injury
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caused by a stress that forces the joint beyond its normal anatomical limits
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dislocation
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a fracture that results from stress that takes the joint beyond its normal anatomical limits
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subluxation
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a fracture that result of extremly high velocity impact forces thats causes the bone to shatter into multiple pieces
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comminuted fracture
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a fracture that results form compressive forces applied throught the ling axis of the bone
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compacted/compression fracture
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a fracture that generally specific to pediatric and adolescent population
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greenstick fracture
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a fracture in which the line of break occurs obliquly to the axis of teh bone
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oblique fracture
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fracture that is the result of a rotational force placed on teh shaft of a long bone
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spiral fracture
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a fracture caused by a direct blow, shear force, or tensile force being applied to the short of a long bone and results in a fracter that crosses the bones axis
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transverse fracture
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the tearing away of a ligaments or tends body
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avulsion
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when a bone is subjected to abnormally high levels of streses
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stress fractures
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having no sensation
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anesthesia
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skin sensation such as burining, pickling, itching, with no apparent physical cause
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hyperthesia
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the mildest form of peripheral nerve stretch injury
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neurapraxia
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a growth of a tumor of nerve tissue
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neuroma
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body type: slender, thin build, relatively low BMI
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ectomorph
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body type: medium athletic build, relatively average BMI
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mesomorph
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stocky build; relatively high BMI
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endomorph
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