ACE 05 Injury & Emergency Flashcards

1
Q

Which of the following would be contraindicated for a client who has an acute hamstring strain?

A. Educate client about using RICE as early intervention strategy
B. Modifying the workout focusing on the non-injured points of the body
C. Stretching the hamstrings for up to 60s per stretch
D.
Recommend client to see a physician if pain persists

A

C.

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2
Q

Where is the scapular plane?

A

30 degress anterior to the frontal plane

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3
Q

An infolamation of the wrist extensors near their origin is commonly referred to as ____

A

Tennis elbow

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4
Q

Which nerve is commonly compressed due to carpal tunnel syndrome?

A

Median nerve

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5
Q

Clients returning to exercise following greater trochanteric bursitis should generally avoid ____.

A

Side-lying exercise positions that compress the lateral hip

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6
Q

When working with a client who has a history of IT band syndrome, which uscle group acting on the hip joint is MOST likely to be weak?

A

Hip abductors

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7
Q

Tightness in whcih of the following structures can be a cause of patellofemoral pain syndrome due to its lateral fascial connections to the patella?

A

IT band complex

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8
Q

Stretching which muscles has been show to help relieve symptoms associated with medial tibial stress syndrome (MTSS) and/or anterior shin splints?

A

Soleus and anterior compartment of the lower leg

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9
Q

Which exercise would be most important to include for a client who has recovered from Achilles teninitis and wants to prevent it from returning?

A

Eccentric strengthening for the calf complex through controlled dorsiflexion against gravity and stretching the calf muscles

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10
Q

When working with a client who has a history of plantar fascitis, it would be most important to include stretching exercise for the _____.

A

Gastrocnemius, soleus, and plantar fascia

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11
Q

For proper shoe fit, how musch space should be given between the shoe and the end of the longest toe?

A

width of index finger

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12
Q

Signs of overtraining include…

A
  1. decline in physical performance with continued training
  2. eleated heart rate and blood lactate levels at fixed submaximal work rate
  3. change in appetite
  4. weight loss
  5. sleep disturbances
  6. multiple colds or sore throats
  7. irritability, restlessness, excitability, and or anxiousness
  8. loss of motivation and vigor
  9. lack of mental concentration and focus
  10. lack of appreciation for things that are normally enjoyable
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13
Q

Cause of delayed onset muscle soreness (DOMS)

A

present evidence suggests it is caused by tissue injury from excessive mechnical force, particularly eccentric force, exerted on muscle and connective tissue

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14
Q

DOMS definition

A

muscle soreness generally appears 24 to 48 hours after strenuous exercise.

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15
Q

Lateral epicondylitis, also known as ______

A

“Tennis Elbow”

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16
Q

What is Greater Trochanteric bursitis?

A

Trochanteric bursitis is inflammation (swelling) of the bursa (fluid-filled sac near a joint) at the outside (lateral) point of the hip known as the greater trochanter. When this bursa becomes irritated or inflamed, it causes pain in the hip. This is a common cause of hip pain.

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17
Q

What is lateral ankle sprain?

A

Most sprained ankles occur in the lateral ligaments on the outside of the ankle. Sprains can range from tiny tears in the fibers that make up the ligament to complete tears through the tissue. If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes.

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18
Q

The most commonly reported knee injury involves damage to the __________.

A

Menisci

Why?

The most commonly reported knee injury is damage to the menisci. The menisci have an important role within the knee due to their multiple functions-shock absorption, stability, joint congruency, lubrication, and proprioception.

ACE Personal Trainer Manual, 5th ed., p. 575

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19
Q

What type of injury can be classified as longitudinal, oblique, transverse, or compression?

A

Stress fractures

Why?

Longitudinal, oblique, transverse, and compression are the four types of stress fractures, which often occur in distance runners, track athletes, and court sport athletes (e.g., volleyball, basketball).

ACE Personal Trainer Manual, 5th ed., p. 576

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20
Q

What is the first phase of healing after an injury occurs?

A

Inflammation phase

Why?

The first phase of healing is the inflammatory phase, which can typically last for up to six days, depending on the severity of the injury. The focus of this phase is to immobilize the injured area and begin the healing process. Increased blood flow occurs to bring in oxygen and nutrients to rebuild the damaged tissue.

ACE Personal Trainer Manual, 5th ed., p. 576

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21
Q

Which of the following is a contraindication to stretching ?

A

Joint hypermobility

Why?

The contraindications to stretching are as follows:

A fracture site that is healingAcute soft-tissue injuryPost-surgical conditionsJoint hypermobilityAn area of infectionA hematoma or other indication of traumaPain in the affected areaRestrictions from the client’s doctorProlonged immobilization of muscles and connective tissueJoint swelling (effusion) from trauma or diseasePresence of oseoporosis or rheumatoid arthritisA history of prolonged corticosteroid use
The other three choices are all relative contraindications.

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22
Q

A client complains of pain in the wrist during sleep and numbness and loss of grip strength during exercise. What injury is the MOST likely cause of these symptoms?

A

Carpal tunnel syndrome

Why?

The symptoms of carpal tunnel syndrome include:

Night or early-morning pain or burningLoss of grip strength and dropping of objectsNumbness or tingling in the palm, thumb, index, and middle fingers
ACE Personal Trainer Manual, 5th ed., p. 582-583

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23
Q

A client comes to you with recommendations from her doctor regarding exercise with greater trochanteric bursitis. One of the focuses or her training should be strengthening which of the following muscle groups?

A

Gluteals

Why?

When working with a client with greater trochanteric bursitis, strengthening the gluteals and deeper hip rotator muscles is important to maintain adequate strength. Stretching of the iliotibial band complex, hamstrings, and quadriceps should be the focus to ensure proper lower-extremity mobility.

ACE Personal Trainer Manual, 5th ed., p. 585

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24
Q

Which of the following injuries is primarily caused by training errors among athletes?

A

Iliotibial band syndrome

Why?

ITBS is common among active individuals 15 to 50 years of age and is primarily caused by training errors in runners, cyclists, volleyball players, and weight lifters.

ACE Personal Trainer Manual, 5th ed., p. 586-587

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25
Q

A client reports feeling terrible pain in the heel during his first few steps each morning, which then dissipates as he walks around the house. What is the MOST likely cause of this pain?

A

Plantar fasciitis

Why?

Typically, individuals with plantar fasciitis report pain on the plantar, medial heel at its calcaneal attachment that worsens after rest but improves after 10 to 15 minutes of activity. In particular, clients will commonly report excessive pain during the first few steps in the morning.

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26
Q

When programming exercise for a client who is recovering from a lateral ankle sprain, it is important to begin with side-to-side motions before progressing to straight-plane and then multidirectional motions.

A

FALSE

Why?

It is recommended that personal trainers progress individuals with this injury first with straight-plane motions such as forward running, then side-to-side motions such as sidestepping, and then multidirectional motions such as carioca.

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27
Q

What is joint hypermobility syndrome?

A

The joint hypermobility syndrome is a condition that features joints that easily move beyond the normal range expected for that particular joint. Symptoms of the joint hypermobility syndrome include pain in the knees, fingers, hips, and elbows. Often joint hypermobility causes no symptoms and requires no treatment.

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28
Q

Heat syndromes

A

Heat edema - temp swelling of extremities affecting hands, feet, and ankles, only for a few days. No treatment required.

Heat cramps - spasms that affect arms, legs, and abdominal muscles due to loss of fluid and electrolytes, causing cell size to decrease and affecting cell metabolism. could cause nausea and vomiting.
Treatment: rest, direct pressure to cramp and release, gentle massage, replacing fluids and electrolytes, passive stretching of the affected areas.

Heat cramps can lead to more serious problems, such as heat exhaustion and heat stroke.

Heat Exhaustion - fatigue, headache, dizziness, general weakness, profuse (lots of) sweating. elevated body temp.
Treatment: stop exercising, cool well-ventilated area. lay down and elevate feet 12-18 inches. give fluids.

Head stroke - hot, dry skin (due to inability to sweat). Bright red skin color. Rapid, strong pulse. Change in mental status. Labored breathing. elevated body core temp (>= 41C).
Treatment: stop exercising. Removing clothing. Try to cool body (wet towels, ice packs/ fan), give fluids. Transport to emergency.

Heat syncope - fainting/ dizziness due to blood pooling in the legs and not enough blood reaching the brain.
Treatment: drink fluids. Rest with feet raised.

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29
Q

Whats the core temperature body can survive?

A

23.9 to 41C.

30
Q

How does body respond to cold environment?

A

Body decreases its circulation to slow heat loss.

Shivering to increase core body temperature.

31
Q

What is hypothermia?

A

Hypothermia is a medical emergency that occurs when your body loses heat faster than it can produce heat, causing a dangerously low body temperature (<35).

Symptoms: confusion, dysarthria (difficult speaking), fatigue, dizziness, amnesia (deficit in memory), and apathy (lack of interest, enthusiasm, or concern), lethargic (sluggish), hallucinate, unconscious.

Treatment: Move person to nearest warm shelter. Remove wet clothing. Pat the person dry. Dress him warm. Call for medical help. Keep the person lying down to prevent drop in blood pressure (orthostatic hypotension). Get AED ready (cardiac arrest/ VFis common)

32
Q

What’s Frostbite?

A

Frostbite occurs when parts of the body are exposed to extreme cold. Tissues on the hands, face (especially the nose), feet and ears may freeze and die. At first the areas become numb and painful. THe skin becomes grayish-white or yellow and has a waxy appearance that is hard to touch. Frostbite is worsened by altitude, wind, exposure for long periods, and contact with cold objects that serve as conductors (e.g sleeping on cold ground).

Diabetes and atherosclerosis (Atherosclerosis is a condition where the arteries become narrowed and hardened due to a buildup of plaque around the artery wall.) are at high risk for frostbite because circulation is already impaired.

24 hrs - blisters may form containing yellow or clear liquid.
1-2 weeks: eschars may form (scabs that give the appearance of having been burned).
3-6 weeks: skin may turn dark and eventually the scabs will fall off. The skin may be painful for weeks - red, throbbing (causing pain in a series of regular beats) and burning.

Treatment: warm the victim and remove any tight jewelry or clothing if there is no chance of refreezing (refreezing cause more damage). Avoid massaging the frostbitten area, warm with heating pad/ fire.

As frostbitten areas are warmed, there may be a throbbing pain and swelling in the affected areas.

33
Q

What is seizure?

A

A seizure occurs when there is abnormal and excessive electrical activity in the brain. 10% of the population may have a seizure at some point in their lives, only 1% of all seizures occur due to epilepsy. Some sizures are cuased by head injuries, low blood sugar, heat injuries, or poisons.

Seizures types: 1. general; 2. Partial.

Well-know type of seizure: tonic clonic seizure or grand mal seizure: start with an ‘aura’, person experience a smell or sound that indicates a seizure is about to occur. When seizure starts, the victim experiences a loss of consciousness and whole-body jerking movements, where the muscles contract and relax, the jaw is clenched, and bowel or bladder control might be lost. Theis could last one or more minutes, and is followed by a state of exxhaustion called the postictal state. The victim may still be unconscious in this state for 10 to 30 minutes.

Treatment:
During seizure:
1. Clear the area so victim will not hit his or her head on nearby furniture or objects.
2. Place a towel under the victim’s head to help protect it from injury.
3. Never restrain the victim or place anything in the victim’s mouth.
4. Have someone phone EMS.

After seizure:

  1. check if the victim is breathing, if not start CPR.
  2. roll victim to recovery position (on his or her side) to prevent vomit or mucus from obstructing the airway.
34
Q

What is hypoxia

A

deficiency in the amount of oxygen reaching the tissues.

35
Q

What is Epileptic seizure?

A

Chronic and have no known cause.
Less likely to occur during exercise than during rest.
Exercise is helpful in controlling them.
If associated with exercise, occur during prolonged exercise such as triathlons or marathons.

36
Q

Treatment for types of breaks that can occur in the skin (abrasion, incision, laceration, avulsion, puncture).

A

Clean area
Irrigate plenty of water
Apply a dry dressing
Apply direct pressure can help control bleeding

37
Q

Treatment for soft-tissue injures

A

RICE (Rest, ice, compression and elevation)

Ice: applied appx 20 mins to relieve swelling and pian.
Elevate: above level of the heart can help reduce swelling.

Secondary treatment: corticosteroid shots, physical therapy, brace the area, non-steroidal anti-inflammatory drugs - aspirin, ibuprofen etc.
Heat - increase blood flow to muscle tissue to increase temperature, elasticity, and healing. ultrasound is a deep heating to increase circulation to an area and decrease inflmmation.

38
Q

What is fracture?

A

Disruption or break in bone continuity.

Closed fracture - no break in the surface of the skin.
Open fracture - open wound that may or may not have the end of the broken bone protruding through it.

39
Q

Symptoms of fracture

A
  1. Deformity or angulation - difference in size or abnormal position
  2. Pain and tenderness
  3. Grating, crepitus - the sound of bone fragments grinding against each other
  4. Swelling
  5. Disfigurement
  6. Severe weakness and loss of function
  7. Bruising
  8. Exposed bone ends
  9. Joint locked in position

Non-weightbearing exercises such as swimming or stationary biking are recommended during the healing process.

40
Q

What is the 3 layers of protective covering for the brain called?

A

Meninges

41
Q

What is concussion?

A

Brain injury that causes a change in mental status. Can occur during contact sports, as a result of falls or blows to the head. May accompany with temp loss of consciousness.

Symptoms: confusion and disorientation. amnesia, memory loss, headache, drowsiness, impaired speech, tinnitus (ringing in the ear), nausea, unequal pupil size, vomiting, blurry or double vision, sensitivity to light or noise etc.

42
Q

What is Tinnitus?

A

Tinnitus is the perception of noise or ringing in the ears.

43
Q

Treatment for tooth avulsed (knocked out)

A

keep it clean and place it in milk or salt water. Have the victim keep the tooth in the cheek area and see a dentist immediately to re-implant it.

44
Q

Treatment for neck injury

A

Victim should not be moved and head must be immobilized until EMS arrive.
Check ABC.
Instruct victim to look straight ahead and not try to follow the trainer with his eyes when talking to ekep head still.

45
Q

What can cause burning pain, weakness, numbness, and tingling due to nerve compression on spine?

A

A herniated disk, or a bulging of the fibrocartilaginous sac between vertebrae. Commonly occur in the lumbar spine, most often between the 4th and 5th lumbar vertebrae or the fifth lumbar and first sacral vertebrae.

46
Q

Tight _________ can cause pelvis to tilt anteriorly and increase the lordotic curve of the lumbar spine?

A

Tight hip flexors

47
Q

Tight _________ can increase posterior pelvic tilt, flattening the lower back.

A

Tight hamstrings

48
Q

_______ can contribute to low-back pain.

A

Either anterior/ posterior pelvic tilt can contribute to low-back pain.

49
Q

Proper lifting technique to avoid low-back strains

A
  1. Keep objects close to the body
  2. bending at the knees while keeping the back straight, and contracting the abdominal and leg muscles to assist with the lift
  3. Avoid exhale during the lift
  4. Lifting with a slow, controlled motion
  5. good postures should be maintained when doing all activities of daily living - sitting, standing, and walking to avoid chronic strains or sprains.
50
Q

What is hypoperfusion?

A

a.k.a. Shock
occurs when blood is not adequately distributed in the body and tissues do not receive the oxygen and nutrients needed for proper function and survival.

Symptoms: restlessness, anxiety, altered mental status, pale, cool, clammy skin, fast and weak pulse, irregular breathing, nausea, and thirst.

Treatment: check ABC, control severe bleeding.
If no trauma to lower body, elevate legs 20-30cm.
Cover with blanket - shock decreases the ability to regulate body temperature.

51
Q

What are 4 types of shock?

A
  1. hypovolemic - when fluid (e.g. blood) is lost as a result of sever dehydration or severe internal or external bleeding.
  2. obstructive - blood clot or other obstructions does not allow blood to reach the heart.
  3. distributive - vessels are dilated and not allowing normal blood distribution.
  4. cardiogenic - inadequate function of the heart
52
Q

What is tendinitis?

A

inflammation of the tendon - usually shoulders, elbows, knees, and ankles.

53
Q

What is bursitis?

A

inflammation of the bursa sac due to acute trauma, repetitive stress, muscle imbalance, or muscle tightness on otop of the bursa.

usually affects shoulders, hips, and knees.

54
Q

What is fascitis?

A

inflmmation of connective tissue called fascia. commonly occurs in the bottom and back of the foot.

55
Q

What is menisci cartilage for?

A

act as shock absorbers on the knee. commonly injured with hyaline cartilage (covers the bone).

56
Q

What is the most commonly reported knee injury?

A

Damage to the menisci.

57
Q

What is chondromalacia?

A

Damage of the cartilage under the patella (i.e. the knee cap).

58
Q

What are the 4 types of stress fracture (minor fracture)?

A
  1. longitudinal
  2. oblique
  3. transverse
  4. compression

stress fractures symptoms:

  1. progressive pain that is worse with weightbearing activity
  2. focal pain
  3. pain at rest in some cases
  4. local swelling
59
Q

Healing process phases

A
  1. inflammatory phase (6 days) - focus: immobilize the injured area and begin healing process. Incrased blood flow occurs to bring in oxygen and nutrients to rebuild the damaged tissue.
  2. fibroblastic/ proliferation phase (day 3-21). This phase begins with the wound filing with collagen and other cells, which will eventually form a scar.
    2-3 weeks - wound can resist normal stresses but would strength continues to build for several months.
  3. maturation/ removeling phase (day 21 - last up to 2 years). Remodeling of the scar, rebuilding of bone, and /or restrengthening of tissue into a more organized structure.
60
Q

What is carpal tunnel syndrome?

A

compression syndrome of the wrist. Repetitive wrist and finger flexion when the flexor tendons are strained results in a narrowing of the carpal tunnel due to infoammation, eventually compresses the median nerve.

avoid movements that involve full wrist flexion or extension. further compress the carpal tunnel can increase symptoms.

61
Q

Most frequently cited causes of low-back pain are?

A
  1. Mechanical back pain
  2. Degenerative disc disease (DDD)
  3. sciatica
62
Q

What is PFPS (paterllofemoral pain syndrome)

A

anterior knee pain/ runner’s knee.
often confused with chondromalacia

Tymptoms: pain with running, ascending or descendign stairs, squatting, prolonged sitting. gradual archy pain that occurs behind or underneath the patella. knee stiffness, giving way, clicking, or a popping sensation during movement.

63
Q

What is infrapatellar tendinitis?

A

aka jumper’s knee.
symptoms: pain at the distal kneecap into the infrapatellar tendor. Pain with running, walking stairs, squatting, or prolonged sitting.

64
Q

Most common ankle sprains is _____

A

lateral/ inversion ankle sprains are the most common.

Medial/ eversion, ankle sprains are relatively rare and result from forced dorsiflexion and eversion of the ankle.

65
Q

What is transient ischemic attack (TIA)?

A

A transient ischemic attack (TIA) is a stroke that lasts only a few minutes. It happens when the blood supply to part of the brain is briefly blocked. Symptoms of a TIA are like other stroke symptoms, but do not last as long. They happen suddenly, and include. Numbness or weakness, especially on one side of the body.

66
Q

What’s the most important step a fitness facility can take to minimize risks of cardiovascular events?

A

Having each member complete a medical history form

67
Q

What does health insurance portability and accountability act (HIPAA) of 1996 require?

A

ensures individual privacy by requiring confidentiality of health documents

68
Q

How is a transient ischemic attack (TIA) different from a stroke?

A

a transient ischemic attack can mimic the symptoms of a stroke but causes only temp disability. Symptoms usually last less than one hour and may be relieved within 10/15 mins.

69
Q

What is a critical indicator that someone is suffering from heat stroke and in need of emergency treatment?

A

altered mental status

70
Q

what region of the spine is most prone to catastrophic injury?

A

Cervical