Athlete Care, Spinal, and Visceral Injuries Flashcards Preview

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Flashcards in Athlete Care, Spinal, and Visceral Injuries Deck (42)
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1

Quais são as regras e considerações na avaliação?

Be calm, do not panic; Eye to eye contact with athlete; Airway, Breathing, Circulation – Level of Consciousness ; Mechanism of injury; Position of athlete; Be thorough: Do no harm; Expect the worst; Calm the conscious athlete; Pain location, type, severity; Previous injury; Stabilization; Removal from the field.

2

Qual a informação que devemos procurar na avaliação objetiva?

Visual inspection: deformity, edema, discoloration;
Palpation: DOTS (Deformity, Open wound, Temperature, Swelling);
Neurological check;
Circulatory check;
Stability;
Removal from the field (decision).

3

Quais são os sintomas de lesão do plexo braquial?

Burning or stinging sensation between neck and shoulder radiating into the arm and hand; Arm feels “dead” - numb and weak; Tingling from neck to hand or anywhere in between; Transient paralysis or weakness; Last few seconds to a few minutes; Repeated trauma takes longer to heal; In rare cases the damage can be permanent.

4

Quais as causas e mecanismos de lesão do plexo braquial?

Result of compressive or traction forces on the brachial
plexus;
Force applied in a downward direction to the shoulder at the same time a force is applied to the head in the opposite direction - result is a stretch to the brachial plexus;
Downward force directly to clavicle.

5

O que avaliar em caso de suspeita de lesão no plexo braquial?

History and physical exam;
On the field: dead arm, numb and weak - comes off the field shaking hand as though asleep or arm hanging as if dead;
Nerve function and reflexes evaluated;
Rule out cervical spine injury;
X-rays, MRI, EMG in severe cases.

6

Como lidar com uma lesão no plexo braquial?

Remove from game until full strength and ROM regained in neck, shoulder, and upper extremity (UE).
If down on the field, consider treating as Spinal Cord Injury (SCI).
Subacute PT: modalities, manual therapy, strengthening exercise, posture correction.
Surgery: not a treatment option for true burners

7

Após lesão do plexo braquial, quando poderá haver regresso à atividade desportiva?

The lesion is self limiting: resolve over time.
Return To Play when symptoms resolve; Full ROM and strength; Full practice without limitation before returning to play; Repeated stingers should be evaluated by physician; Extra padding (Cowboy Collar) may be advised; Definitely avoid spearing (lançar).

8

Quais as suspeições quando ocorre fractura do crânio?

Suspect traumatic brain injury, subdural hematoma, epidural hematoma, intracerebral hematoma. It's Life Threatening!

9

Quais os tipos de fratura do crânio?

Comminuted: piece of the skull may be driven into
the brain (Risk of bacterial infection, meningitis).
Linear: Nasal fracture (Facial fracture can damage nerves as optic and olfactory).

10

Sinais e sintomas de fratura do crânio?

Mecanism of injury; Hit with ball or bat; Fall on to hard surface; Visible deformity; Deep laceration or severe bruise to scalp; Unequal pupils; Discoloration both eyes or behind ears; Bleeding or clear fluid from nose or ears; Loss of smell; Loss of sight or major visual disturbance; Lost Of Conscienceness (LOC) for more than 2 minutes after direct blow to head.

11

Como lidar com a suspeita de fratura do crânio?

Contact EMS - Provide necessary care, CPR/ AED - Clear area of all athletes - Contact parents - Send someone to meet EMS - Medical supplies and equipment - Assist EMS when they arrive, head and neck stabilization - Manage open wounds, light pressure - Treat for shock.

12

Qual o "slogan" da emergência?

"Expect the worst and hope for the best"

13

Como lidar com uma contusão nas costelas?

Mechanism of Injury: blow to the rib cage.
Signs and Symptoms: sharp pain with respiration, point tenderness, pain with compression.
Management: X-ray, RICE.

14

Quais as considerações em fratura de costela?

Mechanism of Injury: block or kick to ribcage, compression of ribcage.
Signs and Symptoms: sharp pain with respiration, crepitus with palpation, point tenderness, abnormality, positive tuning fork test.
Management: X-ray, RICE, brace.

15

E se ocorrer uma separação costo-condral?

Mechanism of Injury: direct blow to anteriorlateral thorax, sudden twist or fall.
Signs and Symptoms: pain localized in the junction of cartilage and ribs, sharp pain with sudden movements, difficulty breathing, rib deformity, crepitus.
Management: X-ray, RICE, immobilization.

16

Como lidar com fratura do esterno?

Mechanism of Injury: high impact blow to the chest.
Signs and Symptoms: point tenderness over the sternum at the site of the fracture, exacerbated by deep inspiration and forceful expiration.
Management: X-ray, monitor closely for signs of trauma to the heart.

17

E se ocorrerem lesões musculares no tórax?

Mechanism of Injury: direct blows or sudden torsions.
Signs and Symptoms: pain with active motion, pain with inspiration/expiration, laughing, coughing, or sneezing.
Management: application of cold for 1 hour, immobilization.

18

Quais as lesões pulmonares mais comuns no desporto?

Pneumothorax; Tension Pneumothorax; Hemothorax.

19

Quais são os sinais e sintomas do pneumotorax? E a fisiopatologia? O que fazer de imediato

Pain, Difficulty breathing, Anoxia.

Pleural cavity becomes filled with air that has entered
through an opening in the chest. As the cavity fills with air, the lung on that side collapses.

Stop the air from going to the cavity! Por exemplo, com umas luvas. Quando a pessoa inspira, a luva penetra impedindo que mais ar entre. A luva pode ser segurada com tape, mas devemos deixar uma porção se fechar para que, quando o atleta expirar, saia algum ar da cavidade.

20

Quais são os sinais e sintomas do tension pneumothorax? E a fisiopatologia?

Shortness of breath and chest pain on the side of the injury; Absence of breath sounds, cyanosis and distention of neck veins; Trachea may deviate away from the side of the injury.

Pleural sac on one side fills with air and displaces the heart and lung toward the opposite side, compressing the opposite lung. Total collapse of the opposite lung is possible.

21

Quais são os sinais e sintomas do hemothorax? E a fisiopatologia?

Pain, Difficulty breathing, Cyanosis, Coughing up frothy blood (lung hemorrhage).

Presence of blood within the pleural cavity; results from tearing or puncturing of the lung or pleural tissue (involving blood vessels in the area). Violent blow or compression to the chest may cause a lung hemorrhage.

22

Quais as considerações acerca de heart contusion?

Mechanism of Injury: Heart is compressed between the sternum and the spine by a strong outside force (hit by a pitched ball; bounces a barbell off the chest in a bench press).
Signs and Symptoms: Severe shock and chest pain; Arrhythmias that cause a decrease in cardiac output.
Management: Transported to the hospital immediately; Be prepared to administer CPR.

23

Quais as lesões que podem ocorrer na zona abdominal?

Abdominal: Muscle strains; Solar Plexus contusion; Stitch in the side; Hernia.

Intra-abdominal: Kidney contusions; Bladder contusions; Liver contusions; Appendicitis; Splenic ruptures.

24

Que considerações em caso de Solar Plexus Contusion?

Mechanism of Injury: Blow to the sympathetic celiac plexus (solar plexus) produces a transitory paralysis of the diaphragm (“wind knocked out”).

Signs and Symptoms: Paralysis of the diaphragm stops respiration and leads to anoxia (usually unable to inhale).

Management: Have the athlete bend their knees; Take short inspirations and long expirations.

25

Quais as considerações clínicas de uma hernia?

Mechanism of Injury: A natural weakness of the of the muscles is aggravated by a strain or direct blow - Inguinal hernias (occur more in men), Femoral hernias (occur more in women).

Signs and Symptoms: Pain or prolonged discomfort from a previous blow or strain to the groin; Superficial protrusion that is increased by coughing or reported feeling of weakness and pulling sensation in the groin.

Management: Surgical management.

26

Quais as considerações clínicas de contusão no rim?

Mechanism of Injury: External force applied (usually to the back of the athlete).

Signs and Symptoms: May display signs of shock, nausea, vomiting, rigidity of the back muscles, and hematuria; May have referred pain - costovertebral angle posteriorly, around the trunk into abdominal region.

Management: Instruct athlete to urinate 2-3 times and note appearance of any blood; Usually a 24-hour hospital stay; gradual increase in fluids.

27

Que considerações clínicas acerca de bladder contusion?

Mechanism of Injury: Blunt force to lower abdominal region (injury occurs only if bladder is distended by urine); Intra-abdominal pressure during long distance running (runners bladder).

Signs and Symptoms: Pain and discomfort in lower abdominal region; May display signs of shock, nausea, vomiting, abdominal rigidity, and hematuria; If bladder is ruptured, athlete won’t be able to urinate; Refers pain to lower trunk and upper thigh anteriorly.

Management: Instruct athlete to urinate 2-3 times and note appearance of any blood; To prevent irritation - empty the bladder before sporting activity.

28

Descreve as considerações clínicas em caso de contusão do fígado.

Mechanism of Injury: Results from blunt trauma; Hard blow to the right side of the rib cage.

Signs and Symptoms: Hemorrhage and shock; Referred pain just below right scapula, right shoulder and substernal area.

Management: Immediate medical attention for diagnosis and treatment.

29

Considerações clínicas da apendicite?

Etiology: High incidence in males (ages 15-25); Caused by a variety of conditions: fecal obstruction, lymph swelling, carcinoid tumor.

Signs and Symptoms: Mild to severe pain in abdomen in lower right abdomen; Associated with nausea, vomiting, and low grade fever; Rigidity and tenderness upon palpation - McBurney’s point (between ASIS and 1-2 inches above the umbilicus).

Management: Surgical management.

30

What considerations about Splenic Ruptures?

Etiology: Fall or direct blow to upper left quadrant of the abdomen when some other condition has caused splenomegaly; Mononucleosis is most likely cause of spleen enlargement.

Signs and Symptoms: Possibly signs of shock, abdominal rigidity, nausea and vomiting; Reflex pain may occur 30 minutes after injury (Kehr’s sign) which radiates to left shoulder and 1/3rd down the left arm.

Management: Conservative non-op treatment; Return to play 3-4 weeks post-injury if asymptomatic.