Chapter 12

Question 1

femoral fracture

Answer 1

=occur to the femoral shaft due to a substantial amount of force
=signs/symps: excruciating pain, shock, inability to put pressure or stand on the leg, deformity, crooked appearance, and the leg appearing shorter than the uninjured leg
=stress fractures can occur from repetitive motion and forces applied to femur during constant wt bearing.
=signs/symps: groin/hip pain that increases with activity, swelling, point tenderness, inability to bear weight fully on the leg, thigh muscles weakness, loss of hip function, and an abnormal gait

Question 2

hip dislocation

Answer 2

=femoral head displaces from acetabulum due to substantial, traumatic, direct blow to hip; to flexed knee w/ force placed upward thru femur; or to foot.
=experiences shock, cant sit up or move hip that’s in an adducted, internally rotated position, and injured leg appears shorter than uninjured leg

Question 3

hip bursitis

Answer 3

=trochanteric, iliopsoas, and ischial bursitis are typically chronic overuse injuries
=signs/symps: severe, dull, diffuse pain, stiffness, point tenderness, and snapping.
=RICE, avoid all activities that aggravate injury, and see physician if pain lasts for over a week

Question 4

Legg-Calvé-Perthes Disease

Answer 4

=femoral head becomes necrotic and breaks
=usually occurs to prepubescent boys
=unknown mechanism of injury, but for undetermined reasons head of femur is deprived of blood and dies
=signs/symps: hip pain and/or pain that refers down into groin and knee

Question 5

Slipped Capital Femoral Epiphysis

Answer 5

=femoral head slips backward out of acetabulum
=in children, especially pubescent and adolescent boys who are overweight for their height
=unknown causes; not preventable
=hip and knee pain, and affected leg appears shorter and turned outward

Question 6

Adductor “Groin” Strain

Answer 6

=1 or both of legs are forced into abduction w/ or w/out lower extremity rotation
=signs/symps: loss of motion, ecchymosis, swelling, etc
=rest, ice, elastic compression wrap, and anti-inflammatory meds

Question 7

hip strain

Answer 7

+caused by forceful stretch of ligaments due to excessive, involuntary hip joint ROM during activity
+hip pain, inflexible muscles, joint stiffness, limp, swelling, and point tenderness exist.
+RICE, crutches/cane, and anti-inflammatory meds

Question 8

Quadriceps Strain

Answer 8

+occurs w/ a concentric or eccentric muscle contraction
+pain, muscle spasm, loss of function, point tenderness
+Grade 3 strain, a bulge and/or divot may be present
+RICE, crutches, anti-inflammatory meds

Question 9

Quadriceps Contusion

Answer 9

+direct blow by an object
+signs/symps: pain, loss of motion, point tenderness, spasm, increase temp, and ecchymosis
+RICE and NSAIDs

Question 10

Myositis Ossificans

Answer 10

+ectopic bony growth that occurs in muscle groups, particularly quads and bis; no definitive cause
+pain w/ motion exists, bony formation that may be palpated
+RICE, then increasing ROM and strength

Question 11

Iliotibial Band Syndrome

Answer 11

+repetitive, constant friction of ITB over lateral femoral condyle causes ITB inflammation.
+pain and popping sensation or sound that occurs over the lateral femoral condyle or greater trochanter exists, tightness, rigidity, and point tenderness.
+heat, stretch b4 exercise, ice pack or ice massage after exercise

Question 12

knee dislocation

Answer 12

+rare injury occurring due to direct trauma
+signs/symps: shock, deformity, and loss of sensation and circulation
+call 911 immediately, treat for shock, stabilize and splint lower extremity, place ice pack on knee

Question 13

Anterior Cruciate Ligament Sprain

Answer 13

+patient will hear audible pop, which indicates the ligament rupture, and will feel immediate, severe pain and joint instability when attempting to weight bear on the leg.
Usually not a medical emergency, so treat with RICE and refer to a physician

Question 14

Anterior Cruciate Ligament Sprain

Answer 14

+patient hears audible pop, immediate, severe pain and joint instability when attempting to weight bear on leg
+RICE and refer to physician
+noncontact ACL sprain → weight-bearing position w/ foot planted on ground
+contact ACL sprains → lower leg hit by another player/person
+fall on foot or land from height and sprain ACL

Question 15

Posterior Cruciate Ligament Sprain

Answer 15

+direct force to anterior tibia while knee is in approximately 90-degrees flexion
+Grade 3 sprains cause audible pop and severe pain, swelling, point tenderness, and immediate loss of ROM
+same treatment as ACL

Question 16

Collateral Ligament Sprain

Answer 16

+MCL injured by valgus force or direct blow to lateral side of knee
+LCL injured by varus force or blow to medial side of knee
+Pain, point tenderness, swelling, ecchymosis, and instability exist
+same treatment as ACL

Question 17

Meniscal Injury

Answer 17

+medial and lateral menisci injured when knee is in some degree of flexion and then rotates while weight bearing
+signs/symps are mild to severe and include pain catching.
+RICE, crutches, and physician

Question 18

Patellar Fractures

Answer 18

+caused by a direct blow
+signs/symps: pain, knee appears flexed, inability to extend knee, swelling, deformity, ecchymosis, and point tenderness.
+splint leg in position its found in, apply ice pack on area, treat athlete for shock, and call 911

Question 19

Patellar dislocation

Answer 19

+females prone due to Q angle
+cause pain, deformity, swelling, point tenderness, and inability to move the knee
+treat like other dislocations

Question 20

Patellar subluxation

Answer 20

+females prone due to Q angle
+signs/symps: pain, swelling, point tenderness, feeling of patella moving out and then back into place at time of injury, normal ambulation, and minimal to no swelling
+apply ice, compression wrap; rest and anti-inflammatory medications

Question 21

Patellofemoral Pain Syndrome

Answer 21

+general term used to describe pain at anterior knee and around patella, which has no definitive cause
+pain btwn anterior knee and posterior surface of patella
+grinding, grating, and point tenderness around and behind patella

Question 22

Chondromalacia Patella

Answer 22

+type of PFPS; occurs when cartilage on lateral posterior portion of patella softens and degenerates over time
+occurs from same mechanisms and same care as PFPS
+dull, aching pain, especially with knee flexion, crepitus, grating, or grinding

Question 23

Osteochondritis Dessicans

Answer 23

+occurs at patellofemoral joint
+posterior patella and/or the femoral condyles become necrotic due to lack of blood flow to the area
+cartilage degrades and begins to fragment and fracture along with attached bone
+pain, grating, catching, edema, and tenderness

Question 24

Patellar Tendon Rupture

Answer 24

+forceful, sudden quadriceps muscle contraction or from a fall when the athlete lands on the area
+shock, immediate severe pain, felt or heard a pop, ecchymosis, swelling, and point tenderness
+treat for shock, apply ice, splint, and call 911

Question 25

Patellar Tendinitis (Jumper’s Knee)

Answer 25

+repetitive knee flexion concurrent w/ quadriceps muscle overload +pain at beginning and after activity +rest and discontinue activities that cause pain, apply ice, elevate area, wear a patellar compression strap, and take anti-inflammatory medication +stretching and strengthening of quadriceps help prevent

Question 26

*Osgood-Schlatter disease

Answer 26

+occurring primarily with adolescents | +inflammation of the athlete’s tibial tubercle apophysis where it attaches to the patellar tendon

Question 27

*Sinding-Larsen-Johansson disease

Answer 27

+occurring primarily with adolescents | +inflammation of the patella’s inferior pole at its growth plate, where it attaches to the patellar tendon

Question 28

Lower Leg Fractures

Answer 28

+overuse tibial stress fractures vs acute tibial and fibular fractures +Acute: fall, direct blow, or twist of the lower extremity; pain, inability to move the body part, point tenderness, swelling, bruising, and deformity +Stress: constant, repetitive bounding; → gradual onset of localized tibia pain, which increases during activity and decreases at rest

Question 29

Medial Tibia Stress Syndrome

Answer 29

+shin splints; overload of medial musculature that lies over the tibia +pain and point tenderness on the middle portion of the tibia, which decreases or goes away during activity, but then returns at rest. +immediate care includes ice to the area, taking NSAIDs, and limiting activities

Question 30

Compartment Syndrome

Answer 30

pressure in lower leg compartments increases and begins to compromise the nerve and vascular structures

Question 31

Acute compartment syndrome

Answer 31

+caused by a direct blow or severe trauma to the lower leg; call 911 +persistent pain that develops over hours and progressively gets intense, swelling, redness, and decreased sensation and muscular weakness down the leg and into the foot

Question 32

Exertional compartment syndrome

Answer 32

+caused by muscular contraction during exercise activity +gradual pain during exercise that continues to increase until exercise is stopped +athlete should stretch, wear orthotics, make biomechanical changes, utilize massage, and rest from activities

Question 33

Gastrocnemius and the Achilles tendon strains

Answer 33

+due to a forceful muscle contraction, a sudden stretch, or repetitive loading +Grade 1 and 2: exhibit typical signs and symptoms for strains; RICE, and if crutches +Grade 3: create a snap or pop at time of injury, muscles roll up and create a bulge in calf area, which appears deformed; treat for shock and call EMS

Question 34

Ankle Dislocation

Answer 34

+caused by a severe force on the joint +same signs/symps exist as with a knee dislocation +call 911, treat for shock, stabilizing and splinting ankle, applying ice to the area

Question 35

Ankle Sprain

Answer 35

+1 of most common lower-extremity injuries; joint is forced beyond its normal ROM +signs/symps like other ligamentous sprains, and depend on the grade +RICE and crutches +Prevention: stretching gastrocnemius and Achilles tendon, strengthening the muscles, improving lower body coordination, balance, and agility, and wearing proper shoes

Question 36

foot fractures/dislocations (acute)

Answer 36

+fractures occur to phalanges, metatarsals, and calcaneus; metatarsals and phalanges usually dislocated +caused by direct trauma to the area +call 911 immediately, treat for shock, splint the foot and ankle, apply ice

Question 37

foot fractures/dislocations (stress)

Answer 37

+fractures occur to phalanges, metatarsals, and calcaneus; metatarsals and phalanges usually dislocated

Question 38

Plantar Fasciitis

Answer 38

+excessive tension placed on plantar fascia over a period of time, tissue begins to fail and inflammation results +sharp pain at underside of foot upon waking in morning and stepping down. +care includes NSAIDs, stretching plantar fascia and Achilles’ tendon, and ankle muscle strengthening

Question 39

Pes Planus

Answer 39

+flat medial longitudinal arch called flat foot +structural: occurs in athletes typically from birth +flat arch when weight bearing and nonweight bearing +functional: caused by loose soft tissue structures, bone malformations in the foot, or nerve problems +arch visible while nonweight bearing and flat when weight bearing

Question 40

Pes Cavus

Answer 40

+high arch; caused over time when an athlete continually wears shoes that have a too-small toe box +painful and rigid arch

Question 41

bunion

Answer 41

+bony outgrowth occurring at base of medial 1st metatarsal, which forms when an athlete wears shoes w/ tight, pointed toe box; also due to heredity +great toe angulated toward 2nd toe, a large bump exists at medial first metatarsal head, and signs of inflammation present

Question 42

sprains (turf toe)

Answer 42

+hitting the end of toe on a nonyielding object, or when the toe is forced into a valgus, varus, or hyperextended position +same signs/symps as any Grade 1, 2, or 3 sprain +RICE, buddy taping, anti-inflammatory medications, and crutches if he or she cannot weight bear without pain

Question 43

Hammer, Claw, and Mallet Toe

Answer 43

+Toe deformities from tendon contractures caused by wearing shoes that have a tight toe box +Deformed, contracted, and callused toes +wear shoes w/ larger toe box, and perform ROM and flexibility exercises

Question 44

Subungual Hematoma

Answer 44

+blood underneath the toenail caused by a direct blow to the nail +Pain increases as blood accumulates under point tender nail due to pressure created by blood, which is red at 1st and later turns dark purple to black +ice, and then physician to drain blood from toe