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KNPE 331 > Final Exam > Flashcards

Final Exam Flashcards

1
Q

plica

A
  1. fibrous tissue extending from joint capsule that is supposed to reabsorb during growth and development
  2. can get in the way of the joint
    ***mimick meniscus injury
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2
Q

structures of hip and pelvis

A
  1. iliac crest
  2. ASIS (origin of sartorius)
  3. AIIS (origin of rectus femoris)
  4. PSIS
  5. ischial tuberosity (origin of hammies)
  6. pubic symphysis
  7. hip joint and articular cartilage
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3
Q

ORIGIN of EO

A

outer surface of ribs 5-12

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4
Q

INSERTION of EO

A
  1. inferiorly onto anterior 1/2 of iliac crest
  2. medially into linea alba
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5
Q

ACTIONS of EO

A
  1. trunk rotation
  2. flexion
  3. side bending
  4. compresses abdominAl VISCERA
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6
Q

hip flexors

A
  1. psoas
  2. iliacus
  3. sartorius
  4. rectus femoris
  5. pectineus
  6. TFL (assists)
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7
Q

quadriceps muscle

A
  1. rectus femoris (origin AIIS)- hip flexion
  2. vastus lateralis
  3. vastus intermedius
  4. vastus medialis
  5. common insertion via quad tendon into patella
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8
Q

medial hamstrings

A
  1. semimembranosus
  2. semitendinosus
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9
Q

lateral hamstrings

A

biceps femoris

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10
Q

adductors

A
  1. pectineus
  2. adductor longus
  3. adductor magnus
  4. adductor brevis
  5. gracillis
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11
Q

ORIGIN of sartorius

A

ASIS

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12
Q

INSERTION of sartorius

A

medial aspect of proximal tibia

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13
Q

acetabular labrum

A
  1. fibrous cartilage
  2. ribs acetabulum
  3. deepens socket
  4. increases stability
  5. base of labrum heals well (blood supply) but free edge labrum doesn’t heal well (bad supply)
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14
Q

hip pointer

A

contusion of iliac crest (periosteum has lots of sensory nerves)

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15
Q

MOI of hip pointer

A

blunt trauma to iliac crest

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16
Q

S&S of hip pointer

A
  1. pain (often severe) with trunk flexion
  2. pain with rotation
  3. pain with side bending or hip flexion
  4. bruising and swelling over iliac crest
  5. muscle spasm of surrounding muscles
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17
Q

other structures affected with a hip pointer

A
  1. external obliques
  2. TFL
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18
Q

pain pattern with hip pointer

A
  1. pain with forced exhalation
  2. pain with bowel movements
  3. pain with all functions of external obliques
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19
Q

acute management with a hip pointer

A
  1. PIER (sometimes cannot tolerate pressure pad)
  2. lymph drainage to settle spasm
  3. donut pad with cover for RTP - with hip flexor wrap if hip flexion affected
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20
Q

MOI of acetabular labral tears

A
  1. acute plant and twist
  2. hyperabduction (splits)
  3. overuse degeneration
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21
Q

S&S of acetabular labral tears

A
  1. pain
  2. clicking/catching in hip or groin
  3. decreased hip ROM
  4. audible pop/sensation at time of injury
    “C” sign is a common descriptor of pain
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22
Q

special test for acetabular labral tears

A

scouring test

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23
Q

acute management of acetabular labral tears

A
  1. ice
  2. rest
  3. pain management
  4. correct mechanics (stable base, core and hip stability)
  5. increase proprioception
  6. refer - surgery if needed
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24
Q

scouring test

A
  1. highly sensitive, but lacks specificity
  2. good indicator of pathology in jint itself
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25
Q

what does the scouring test test for

A
  1. hip labrum tears
  2. capsulitis - inflamm of capsule leading to scar tissue
  3. osteochondral defects - bone & cartilage
  4. acetabular defects
  5. osteoarthritis
  6. avascular necrosis - bone death from decreases blood supply
  7. femoral acetabular impingement syndrome
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26
Q

MOI of ITB friction syndrome

A
  1. ITB friction over lateral femoral condyle 2 degree to biomech causes
  2. overuse condition from friction over lateral femoral condyle
  3. glut medius weakness
  4. winter books/ walking in snow
    ***common in sports with continuous knee flex and ext like running or cycling
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27
Q

acute management of ITB friction syndrome

A
  1. check type of footwear and wear patterns
  2. biomech assessment
  3. PIER
  4. lymph drainage
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28
Q

MOI of hip flexor tendonitis

A
  1. overuse
  2. repetitive flexion
    ***common in cyclists, dancers, gymnasts (repetitive motions)
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29
Q

S&S of hip flexor tendonitis

A
  1. pain with active & resisted hip flexion
  2. stretch pain with passive hip extension
  3. TOP affected tendon
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30
Q

acute management of hip flexor tendonitis

A
  1. ice
  2. rest/altered activity
  3. hip flexor wrap
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31
Q

MOI of hip flexor strain

A
  1. forceful hip flexion
  2. leg caught in hip extension (or combo)
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32
Q

MOI of quad strain

A
  1. forceful quad contraction
  2. hip extension with knee flexion (or combo)
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33
Q

MOI of hamstring strain

A
  1. excessive hip flexion with extended knee in sprinting
  2. eccentric hams contraction in late stance phase
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34
Q

MOI of adductors strain

A
  1. quick cutting (overstretch with forceful contraction)
  2. splits type motion (contact, slippery surface)
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35
Q

S&S of hip and thigh strain

A
  1. “pull” or “pop” sensation
  2. weakness (Gr 2&3)
  3. bruising (Gr 2&3) due to high blood pressure
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36
Q

acute management of hip and thigh strain

A
  1. PIER (pressure pad)
  2. educate
  3. NWB (crutches)
  4. hip flexor wrap of adductor wrap for daily wear as needed
  5. effleurage/lymph drainage to help with bruising
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37
Q

MOI of thigh contusions

A

blunt trauma

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38
Q

S&S of thigh contusions

A
  1. discolouration
  2. muscle weakness possible
  3. risk of myositis ossificans
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39
Q

acute management of thigh contusions

A
  1. care for contusion to prevent secondary complications
  2. effleurage/lymph drainage
  3. ice
  4. no deep tissue massage
  5. protective passing - donut pad with cover pad
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40
Q

spine features

A
  1. facet (zygapophyseal joints)
  2. vertebral body
  3. disc/disk
  4. nerve roots
  5. spinous processes
  6. transverse processes
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41
Q

right upper quadrant

A
  1. liver
  2. gallbladder
  3. duodenum
  4. head of pancreas
  5. right kidney + adrenal gland
  6. hepatic flexure of colon
  7. part of transverse + ascending colon
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42
Q

left upper quadrant

A
  1. stomach
  2. spleen
  3. left lobe of liver
  4. body of pancreas
  5. left kidney + adrenal gland
  6. splenic flexure of colon
  7. parts of transverse + descending colon
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43
Q

right lower quadrant

A
  1. caecum
  2. appendix
  3. right ovary and tube
  4. right ureter
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44
Q

left upper quadrant

A
  1. part of descending colon
  2. sigmoid colon
  3. left ovary and tube
  4. left ureter
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45
Q

palpation of abdomen

A
  1. palpate 4 quadrants
  2. start superficial and gradually increase pressure
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46
Q

sports hernias (athletic pubalgia)

A
  1. fascial weakness in abdominal wall where the abdominals and adductors attach into pubic bone
  2. common in hockey, football, soccer, sprinters/hurdlers, rugby
  3. easily re-irritated so sequential RTP
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47
Q

MOI of sports hernias

A

repetitive strain to the area

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48
Q

S&S of sports hernias

A
  1. pain with sitting up
  2. pain with quick cutting
  3. pain with sprinting and coughing
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49
Q

special test for sports hernias

A

resisted sit-up

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50
Q

acute management of sports hernias

A
  1. PIER
  2. adductor wrap
  3. conservative treatment 4-6 wks
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51
Q

visceral structures potentially affected in sport

A
  1. kidney contusions
  2. spleen rupture = mono
  3. lungs = pneumothorax
  4. bladder rupture= empty bladder
  5. testicles - must stop spasm to control hemorrage
  6. heart
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52
Q

MOI of abdominal injuries

A
  1. direct blow
  2. fall from height
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53
Q

S&S of abdominal injuries

A
  1. pain
  2. rigidity in abdomen
  3. feeling unwell
  4. shock
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54
Q

signs of internal hemorrhage

A
  1. cullen sign (umbilicus discoloration)
  2. grey turner sign (flank discoloration)
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55
Q

acute management of abdominal injuries

A
  1. quadrant palpation
  2. call 911
  3. rest comfortably
  4. treat for shock
  5. reassure
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56
Q

MOI of kidney injuries

A

blow to the back

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57
Q

S&S of kidney injuries

A
  1. pain in lower back
  2. peeing blood
  3. feeling unwell
  4. shock
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58
Q

treatment to kidney injuries

A

refer

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59
Q

causes of sudden death in athletes

A

usually due to cardiac disease
1. congenital abnormalities of coronary arteries
2. hypertrophic cardiomyopathy

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60
Q

hypertrophic cardiomyopathy

A

genetic condition causing thickening of heart muscle

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61
Q

warning signs of hypertrophic cardiomyopathy

A
  1. fainting or seizure
  2. dizziness or light-headedness
  3. chest pain (even at rest)
  4. palpiatations - quick fluttering/irregular/pounding heart beats
  5. shortness or breath
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62
Q

emerging causes of acquired heart disease in young athletes

A
  1. anabolic steroids
  2. peptide hormones (growth hormone)
  3. stimulants (energy drinks)
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63
Q

blow to the solar plexus

A

spasm to the diaphragm muscle
“wind knocked out of you”

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64
Q

MOI of blow to the solar plexus

A
  1. blow to abdomen of chest
  2. fall on buttocks or back
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65
Q

S&S of blow to the solar plexus

A
  1. pain
  2. difficulty breathing
  3. panicky
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66
Q

acute management of blow to the solar plexus

A
  1. bring athletes knees gently towards chest
  2. guided breathing
  3. diaphragmatic breathing
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67
Q

RTP for blow to the solar plexus

A

able to RTP one symptoms resolve pending no other kind of injury

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68
Q

MOI of facet joint sprain

A

forced rotation

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69
Q

S&S of facet joint sprain

A
  1. hear/feel pop
  2. sharp localized pain
  3. pain with motions that open the joint
  4. muscle guarding
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70
Q

facet joint sprain

A
  1. common in contact sports - unexpected hit
  2. common in c-spine due to large ROM - lig taken beyond available length
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71
Q

special test for a facet joint sprain

A

quadrant test
- positive if pain on opposite side

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72
Q

acute management of a facet joint sprain

A
  1. PIER
  2. refer for treatment
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73
Q

facet joint effusion

A

irritation of the facet joint

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74
Q

MOI of facet joint effusion

A
  1. sudden episode of extreme ROM
  2. felt a click of sharp pain
  3. localized pain
  4. spasm around inflamed joint
  5. nerve root becomes irritated
  6. closing joint will be painful
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75
Q

special test for a facet joint effusion

A

quadrant test
- positive if pain on same side

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76
Q

acute management of a facet joint effusion

A
  1. PIER
  2. refer for treatment
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77
Q

MOI of disc protrusions

A

acute or chronic compression through disc often in flexed position
- results in a bulge in the disc (usually posterolateral) resulting to changes to myotomes and dermatomes

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78
Q

S&S of disc protrusions

A
  1. pain with repeat forward bending (for posterior protrusion)
  2. relief with extension
  3. pain with cough/sneeze
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79
Q

acute management of disc protrusions

A

refer for treatment

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80
Q

dermatomes

A
  1. sensory areas of the skin innervated by specific nerve roots (afferent nerve fibres)
  2. sensations can include pain, tingling, numbness, pressure
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81
Q

C1 nerve root resisted motion

A

cervical flexion

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82
Q

C2 nerve root resisted motion

A

cervical rotation

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83
Q

C3 nerve root resisted motion

A

cervical side bending

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84
Q

C4 nerve root resisted motion

A

shoulder elevation (shrug)

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85
Q

C5 nerve root resisted motion

A

shoulder abduction

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86
Q

C6 nerve root resisted motion

A

elbow flexion

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87
Q

C7 nerve root resisted motion

A

elbow extension

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88
Q

C8 nerve root resisted motion

A

thumb extension

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89
Q

T1 nerve root resisted motion

A

hand intrinsics (spread fingers)

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90
Q

cervical nerve root involvement for testing myotomes

A

resisted tests are performed 5x bilaterally to look for weakening

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91
Q

lumbosacral nerve root involvement for testing myotomes

A

resisted tests are performed 5x bilaterally to look for weakening

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92
Q

L1, L2 nerve root resisted motion

A

hip flexion (in high sitting)

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93
Q

L3 nerve root resisted motion

A

knee extension

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94
Q

L4 nerve root resisted motion

A

foor dorsiflexion + inversion

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95
Q

L5 nerve root resisted motion

A

hallux extension

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96
Q

S1, S2 nerve root resisted motion

A

plantarflexion in standing (toe raises)

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97
Q

S1 nerve root resisted motion

A

knee flexion

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98
Q

S2 nerve root resisted motion

A

hallux flexion

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99
Q

pressure on C5 nerve root

A

biceps reflex will be damaged

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100
Q

pressure on C6 nerve root

A

brachioradialis reflex will be damaged

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101
Q

pressure on C7 nerve root

A

triceps reflex will be damaged

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102
Q

pressure on L3, L4 nerve roots

A

patellar tendon reflex will be damaged

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103
Q

pressure on S1 nerve root

A

achilles tendon reflex will be damaged

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104
Q

patellar tendon reflex

A

quads contract, hamstrings inhibited

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105
Q

MOI of muscle strains of the neck and back

A
  1. overstretch of eccentric load (loading muscle while forward bending)
  2. rotation at high velocity
  3. external force
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106
Q

muscle strains of neck and back

A

common in tennis, gold, baseball
- even minor strains become quite limiting

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107
Q

S&S of muscle strains of neck and back

A
  1. abrupt “pull”
  2. pain
  3. protective spasm
  4. divot (large strains)
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108
Q

acute management of muscle strains of neck and back

A
  1. PIER (but never to anterior neck)
  2. altered activity
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109
Q

pain-spasm cycle

A

must break it
- find the cause and treat it

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110
Q

MOI of rib and scapula fracture

A
  1. direct blow
  2. compression (ribs)
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111
Q

S&S of rib fractures

A
  1. pain with deep breath (shallow breathing)
  2. pain with compression
  3. TOP area of fracture
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112
Q

S&S of scapula fractures

A
  1. TOP
  2. pain with movement of shoulder
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113
Q

acute management of rib and scapula fracture

A
  1. stabilize the segment with padding and tensor if tolerated
  2. tube sling for scapula fracture
  3. send for imaging
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114
Q

4 spondys of spine

A
  1. pars interarticularis
  2. spondylolysis
  3. spondylolisthesis
  4. spondylitis
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115
Q

spondylolysis

A

stress fracture in pars interarticularis

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116
Q

spondylolisthesis

A

stress fracture and sliding of vertebra

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117
Q

spondylitis

A

inflammation in vertebra that could lead to fusion

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118
Q

MOI of spinal fractures

A
  1. axial load
  2. compression through spine
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119
Q

S&S of spinal fractures

A
  1. central pain
  2. tingling
  3. numbness
  4. unwillingness to move
  5. spasm
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120
Q

spinal fracture

A

displacement of segments can put pressure on spinal cord or nerve roots resulting in paralysis

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121
Q

c-spine spinal fracture

A

quadriplegia

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122
Q

t-spine + l-spine spinal fracture

A

paraplegia

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123
Q

acute management of a spinal fracture

A
  1. stabilize
  2. call 911
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124
Q

pharynx

A

throat

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125
Q

larynx

A

“voice box”
- connects throat and trachea preventing food from getting into trachea while breathing

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126
Q

trachea

A

brings air from throat to lungs

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127
Q

esophagus

A

brings food from throat to stomach

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128
Q

nerves and blood supply in the neck

A
  1. carotid artery
  2. jugular vein
  3. subclavian artery & vein
  4. vagus nerve
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129
Q

bones of the face

A
  1. frontal bone (forehead)
  2. orbital bones (around eyes, along eyebrows)
  3. nasal bone (nose)
  4. zygomatic bones (cheekbones)
  5. maxilla bones
  6. mandible (jaw)
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130
Q

bones of head and face

A
  1. frontal bone
  2. parietal bones
  3. temporal bones
  4. occipital bone
  5. temporomandibular joint (TMJ)
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131
Q

temporomandibular joint (TMJ)

A
  1. joint between temporal bone and mandible
  2. articular disc within joint
  3. hinge joint
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132
Q

muscles that act on TMJ

A
  1. temporalis
  2. pterygoids (med and lat)
  3. masseter
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133
Q

MOI of injuries to anterior neck

A

blunt force to anterior neck/throat by stick, puck, ball or opponent

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134
Q

injuries to anterior neck

A

common in field hockey, lacrosse, and hockey

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135
Q

S&S of injuries to anterior neck

A
  1. pressure
  2. difficulty swallowing
  3. “feels thick”
  4. difficulty breathing
  5. panicky
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136
Q

what do injuries to anterior neck cause risk of

A

risk of larynx fracture

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137
Q

MOI of common carotid artery laceration

A

skate to the neck causing a laceration to the common carotid artery

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138
Q

S&S of common carotid artery laceration

A
  1. pale
  2. sweating heavily
  3. tachycardiac
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139
Q

acute management of common carotid artery laceration

A
  1. pressure
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140
Q

why was CCA laceration a success story

A
  1. trained personnel
  2. rapid recognition
  3. emergently evacuate
  4. planned evacuation and communication
  5. very prepared
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141
Q

MOI of major bleeds

A
  1. skate
  2. stick
  3. contact with boards
  4. laceration of carotid artery, jugular vein and subclavian vein
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142
Q

major bleeds

A

common in hockey and figure skating

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143
Q

acute management of major bleeds

A
  1. pressure (lots)
  2. rapid call to EMS
  3. treat for shock
  4. requires vascular surgical team to repair damaged vessels
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144
Q

prevention of major bleeds

A

neck guards

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145
Q

facial injuries

A
  1. eye-poke injuries
  2. fractures
  3. auricular hematomas
  4. lacerations
  5. TMJ conditions
  6. dental injuries
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146
Q

eye-poke injuries

A

commonly results in subconjuctival hemmorrhage or corneal abrasion

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147
Q

subconjunctival hemorrhage

A

bright red bleeding/spot on white of eye from broken blood vessel

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148
Q

corneal abrasion

A

scratch on surface of eye

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149
Q

S&S of eye-poke injuries

A
  1. mild discomfort
  2. irritation
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150
Q

acute management of eye-poke injuries

A
  1. cold compress
  2. refer for eye exams
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151
Q

when should you refer for eye-poke injuries

A
  1. any vision changes
  2. shadows
  3. floaters
  4. pressure
  5. pain should be referred urgently due to risk of more serious conditions (retinal tears/detachment, deeper damage to eye and/or vessels)
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152
Q

MOI of facial fractures

A
  1. direct trauma via opponent (head-to-head, fist)
  2. puck
  3. ball
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153
Q

facial fractures

A

common in ice hockey, football (mandible), rugby, baseball

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154
Q

common facial fractures

A
  1. unilateral zygomatic-maxillary-orbital
  2. isolated mandibular
  3. nasal fractures
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155
Q

S&S of facial fractures

A
  1. TOP of fracture site
  2. racoon eyes
  3. swelling
  4. divots
  5. deformities
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156
Q

acute management of facial fractures

A
  1. PIER if tolerated
  2. refer
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157
Q

MOI of auricular hematoma

A
  1. blunt trauma
  2. repetitive friction
  3. resulting contusion to ear
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158
Q

S&S of auricular hematoma

A
  1. pain
  2. swelling
  3. bruising
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159
Q

auricular hematoma

A
  1. blood accumulates between connective tissue and cartilage of the ear
  2. results in pressure
  3. can lead to necrosis of the cartilage form blood supply being cut off
  4. if not drained the cartilage can become deformed resulting in “cauliflower ear” aka wrestlers ear
  5. common in wrestling, rugby, judo, boxing
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160
Q

acute management of auricular hematoma

A
  1. PIER
  2. add pressure by packing ear with folded gauze to prevent fluid accumulation
  3. magnets?
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161
Q

MOI of lacerations

A
  1. blunt trauma
  2. sharp object (including teeth)
    ***tend to open up
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162
Q

lacerations to the face

A

refer for stitches

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163
Q

acute management of lacerations

A
  1. pressure
  2. steri-strips
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164
Q

MOI of TMJ conditions

A
  1. direct trauma to mandible
  2. cumulative repeat impacts
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165
Q

TMJ conditions

A

most common in contact sports

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166
Q

result of TMJ conditions

A
  1. dislocations
  2. sprains
  3. articular disc injuries
  4. muscle tension/strains
  5. clicking/altered joint mechanics
  6. headaches
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167
Q

MOI of dental injuries

A

direct blow

168
Q

common sports related dental injuries

A
  1. tooth (crown) fractures
  2. tooth intrusion
  3. tooth extrusion
  4. tooth avulsion
169
Q

tooth intrusion

A

tooth gets forced into the bone

170
Q

tooth extrusion

A

tooth gets forced out of the bone

171
Q

tooth avulsion

A

complete removal from socket (tooth knocked out)

172
Q

acute management of dental injuries

A
  1. ensure broken teeth removed from mouth (choking hazard)
  2. rule out concussion and C-spine
  3. refer to dentist
  4. ER (for severe cases)
  5. rolled gauze to control bleeding
  6. on-field Dr. can supply numbing agent
173
Q

prevention of dental injuries

A

mouthguards

174
Q

headache types in sport

A
  1. dehydration (approx 90% due to this)
  2. cervicogenic
    - muscle tension: referred pain patterns
    - joint dysfunction
  3. concussion
175
Q

MOI of concussions (mTBI)

A

direct blow or indirect blow
- land on bum or whiplash mechanism

176
Q

are concussions physical or functional injury

A

functional injury
- and a transient change of neurological function

177
Q

cause of a concussion

A

stretch and shearing of axons

178
Q

concussion

A

stretch, ion exchange, depolarization of action potentials
- results in an electrical storm

179
Q

signs of a concussion

A
  1. vomiting
  2. disorientation/confusion
  3. memory loss
  4. loss of consciousness (only in <10% of concussions)
180
Q

symptoms of concussions

A
  1. headache, pressure, migraines
  2. cognitive changes: reduced focus and though processing, difficulty following instruction
  3. vestibular system: dizziness, motion sensitivity, reduced balance and coordination
  4. nausea: due to vestibular dysfunction or migraines
  5. fatigue
  6. fogginess, detached from self
  7. mood changes: anxiety, depression, irritability
  8. c-spine injuries often get missed and can contribute to symptoms
181
Q

assessing a concussion

A
  1. interviews
  2. physical exams
  3. testing
182
Q

common assessment tools for assessing a concussion

A
  1. SCAT6
    - sideline/clinical
    - 10-15 min to be done correctly
  2. imPACT testing (immediate post-concussion assessment and cognitive testing)
    - clinical only
    - measures memory, attention span, visual and verbal problem solving
183
Q

component of SCAT6

A
  1. observable signs
  2. glasgow coma scale (LOC)
  3. cervical sign assessment
  4. coordination and ocular/motor screen (visual, vestibular)
  5. memory assessment maddocks question (cognitive)
184
Q

observable signs

A

athlete position/behaviour/MOI

185
Q

glasgow coma scale (LOC)

A

eye/verbal/motor responses

186
Q

cervical spine assessment

A
  1. pain at rest
  2. TOP
    3.AROM
  3. limbs
187
Q

coordination and ocular/motor screen

A

finger to nose, follow finger

188
Q

memory assessment maddocks questions

A
  1. questions re venue
  2. game
  3. past games
189
Q

on field assessment of SCAT6

A
  1. athlete background
  2. symptom evaluation
  3. cognitive screening
    - orientation
    - immediate memory
    - concentration
  4. coordination & balance examination
  5. delayed recall
  6. decision - summary of scores with decision
190
Q

post-concussion syndrome

A

timeframes vary as to what is considered post-concussion syndrome
- >3 months
- >4 weeks
- >7-10 days post-injury

191
Q

concussion testing and rehab tools

A
  1. helps to zero in on primary issues limiting recovery
  2. focuses on establishing functional neural pathways in the brain to support complete recovery
  3. complete rest with no stimulation is no longer the recommendation
192
Q

primary issues options limiting recovery

A
  1. visual
  2. vestibular
  3. physiologic
  4. cervicogenic
  5. psychological
193
Q

chronic traumatic encephalopathy (CTE)

A

progressive degenerative brain disorder caused by repeat head injuries

194
Q

S&S of CTE

A
  1. memory loss
  2. confusion
  3. headaches
  4. irritable mood
  5. aggression
  6. depression
  7. slurred speech
  8. unsteady/altered motor control
195
Q

concussion injury prevention

A
  1. mouthguards
  2. proper fitting helmet
  3. safe technique
    - no high tackles
    - no spearing
  4. concussion education
    - early identification
    - no RTP with even 1 symptom
    - safe and progressive RTP
    ***most at risk of injury immediately post-concussion
196
Q

shoulder girdle made up of 4 joints

A
  1. glenohumeral joint
  2. acromioclavicular joint
  3. sternoclavicual joint
  4. scapulothoracic joint
197
Q

glenoid labrum

A

made up of ligs to keep everything contained
- gives more support

198
Q

pectoral muscles

A
  1. pec major
  2. pec minor
    - brachial plexus and subclavian artery and vein under armpit
    ***if tight it can pinch brachial plexus
199
Q

muscles acting on the scapula

A
  1. levator scapulae
  2. rhomboid minor
  3. rhomboid major
  4. latissimus dorsi
  5. trapezius
200
Q

rotator cuff muscles

A
  1. supraspinatus
  2. infraspinatus
  3. teres minor
  4. subscapularis
201
Q

supraspinatus

A

major dynamic stabilizer of the shoulder

202
Q

GH joint dislocation

A

head of humerus translates completely out of the glenoid
- ball completely out of socket

203
Q

GH joint sublexation

A

a partial or incomplete dislocation of the GH joint
- ball out of socket then back in
***can recover easily

204
Q

anterior shoulder dislocation

A

most common
- head sits in front of socket

205
Q

posterior shoulder dislocation

A

head sits behind the socket

206
Q

inferior shoulder dislocation

A

head sits below the socket

207
Q

MOI of anterior shoulder dislocation

A
  1. 90 degrees abduction, 90 degrees elbow flexion and ER
  2. force to back of shoulder
208
Q

S&S of anterior shoulder dislocation

A
  1. uneven instability
  2. deformation
  3. tingling and numbness (brachial plexus)
  4. pain and unwillingness to move
  5. bruising/swelling
  6. limites ROM
209
Q

structures affected with a shoulder dislocation

A
  1. labrum
  2. scapula
  3. brachial plexus
  4. clavicle
  5. surrounding muscles
210
Q

acute management of anterior shoulder dislocation

A
  1. sling (stabilize)
  2. PIER
  3. immobilize
  4. refer for x-rays
  5. manage shock
211
Q

re-establishment of stability for a shoulder dislocation

A
  1. rest
  2. slow progression of muscle
  3. decrease second degree complication
  4. increase proprioception and slowly weight-bear
  5. support surrounding muscles
  6. sport specific movements
212
Q

MOI of posterior shoulder dislocation

A
  1. force to front of shoulder
  2. fall on outstretched hand
213
Q

S&S of posterior shoulder dislocation

A
  1. uneven instability
  2. deformation
  3. tingling and numbness (brachial plexus)
  4. pain and unwillingness to move
  5. bruising/swelling
  6. limites ROM
214
Q

acute management of posterior shoulder dislocation

A
  1. sling (stabilize)
  2. PIER
  3. immobilize
  4. refer for x-rays
  5. manage shock
215
Q

MOI of inferior shoulder dislocation

A
  1. handstand
  2. hyperabduction or hyperflexion
216
Q

S&S of inferior shoulder dislocation

A
  1. uneven instability
  2. deformation
  3. tingling and numbness (brachial plexus)
  4. pain and unwillingness to move
  5. bruising/swelling
  6. limites ROM
217
Q

acute management of inferior shoulder dislocation

A
  1. sling (stabilize)
  2. PIER
  3. immobilize
  4. refer for x-rays
  5. manage shock
218
Q

special test for anterior GH dislocation

A

apprehension test

219
Q

SLAP lesions/tears (superior labrum anterior and posterior)

A
  1. injury to superior aspect of labrum from anterior to posterior
  2. may also injure biceps tendon due to pull
  3. 4 types
220
Q

MOI of a SLAP lesion

A
  1. repetitive overhead movements
  2. FOOSH (fall on outstretched hand)
  3. sudden traction to the arm
  4. dislocation of GH
221
Q

S&S of SLAP lesion

A
  1. clicking/catching/popping
  2. pain moving arm overhead
  3. pain lifting heavy objects
  4. pain deep in joint or in back of joint
  5. anterior shoulder pain if biceps involved
222
Q

bankart lesion

A

an injury to anterior-inferior glenoid labrum
- result of an anterior dislocation

223
Q

S&S of bankart lesion

A
  1. pain and limited ROM with most shoulder movements
    2.clicking/catching/grinding/popping/subluxation
224
Q

hills-sachs lesion

A
  1. a divot-type fracture of the head of humerus following a dislocation
  2. head of humerus gets compressed against rim of the glenoid
    ***compression fracture
225
Q

rotator cuff injuries

A
  1. impingement
  2. tendonitis and tendonosis
  3. rotator cuff tears
226
Q

MOI of rotator cuff impingement

A
  1. overuse
  2. poor mechanics
227
Q

MOI of tendonitis/osis

A
  1. overuse
  2. poor mechanics
228
Q

MOI of rotator cuff tears

A

acute or overuse

229
Q

MOI of acromioclavicular (AC) sprains

A
  1. FOOSH
  2. fall/tackle - landing on the side of shoulder
  3. checked into boards (compression)
230
Q

S&S of AC sprains

A
  1. pain
  2. step deformity at AC
  3. weakness in shoulder/arm
231
Q

acute management of AC sprain

A
  1. PIER
  2. sling
  3. swath
  4. severe deformities must be referred
  5. AC tape job to support healing and decrease pain
232
Q

Type I rockwood classification

A
  1. sprained AC ligaments
  2. normal CC ligaments
233
Q

Type II rockwood classification

A
  1. disruption of the AC ligaments
  2. sprained CC ligaments
234
Q

Type III rockwood classification

A

disruption of the AC and CC ligaments

235
Q

Type IV rockwood classification

A

posterior displacement into or through the trapezius muscle

236
Q

Type V rockword classification

A

rupture of the deltotrapezial fascia

237
Q

Type VI

A

inferior displacement of the distal clavicle under the conjoined tendon
***uncommon - clavicle rupture

238
Q

treatment for acute shoulder injuries

A
  1. PIER
  2. sling for support
  3. AC tape job to help approximate joint/any remaining lig to support healing
  4. rehab to promote tissue healing and regain mobility
239
Q

when is surgery considered for treatment of acute shoulder injuries

A
  1. middle third clavicle fractures
  2. type III AC sprains in active people
  3. types IV, V and VI AC sprains
  4. first-time GH dislocation in young athletes
  5. full-thickness rotator cuff tears
  6. displaced or unstable proximal humerus fractures
  7. urgent surgical referral for posterior sternoclavicular dislocations
240
Q

MOI of subacromial impingement syndrome/ shoulder impingement

A
  1. overuse
  2. biomechanical imbalances (compensation patterns)
241
Q

shoulder impingement

A

pinching and subsequent inflammation of structures under the coracoacromial ligament
- roll up and glide down doesn’t happen
***common in swimmers, overhead athletes (tennis, pitchers, quarterbacks)

242
Q

what structures are involved in a shoulder impingement

A
  1. supraspinatus tendon
  2. long head of biceps tendon
  3. subacromial bursa
243
Q

S&S of a shoulder impingement

A
  1. pain and weakness in painful arc of abduction (reaching especially with a weight)
  2. catching/clicking
  3. pain with sleeping on affected side
  4. pain putting jackets/sweaters on
244
Q

special test for shoulder impingement

A

painful arc

245
Q

positive test of shoulder impingement

A

pain during GH abduction between 60 degrees and 120 degrees (pinch area)
- pain clears beyond 120 degrees

246
Q

referred pain pattern for positive test for shoulder impingement

A

pain in supraspinatus pattern down middle deltoid

247
Q

MOI of a humerus fracture

A

high-energy direct blow

248
Q

S&S of a humerus fracture

A
  1. pain
  2. swelling
  3. bruising
  4. unable to move arm or grinding when they do
249
Q

what is the most common fracture site on humerus

A

surgical neck

250
Q

how many of humerus fractures are non-displaced

A

80 % are non-displaced and non-surgical

251
Q

acute management of a humerus fracture

A
  1. PIER
  2. sling
  3. treat for shock
  4. send to emerge if stable otherwise call EMS
252
Q

management of a humerus fracture

A
  1. sling
  2. pain management
  3. start treatment early to avoid frozen shoulder
    - encourage early movement
253
Q

MOI of scapula fractures

A
  1. high-energy blunt trauma
  2. fall from height
254
Q

S&S of scapula fractures

A
  1. extreme pain with arm movements
  2. localized swelling
  3. swelling/bruising/trauma to the areas
255
Q

management of scapula fracture

A

sling
- most cases are non-surgical

256
Q

surgery indicated for scapula fractures if…

A
  1. displaced fractures of the glenoid
  2. displaced fracture at neck of scapula
  3. acromion fractures causing impingement
257
Q

MOI of clavicle fractures

A
  1. force to lateral shoulder (tackle, check into boards)
  2. FOOSH
  3. direct trauma
258
Q

S&S of a clavicle fracture

A
  1. severe pain and swelling over sites
  2. deformity
  3. unwillingness to move the arm
259
Q

acute management of clavicle fractures

A
  1. tube sling (to avoid pressure on clavicle)
  2. PIER
260
Q

treatment of a clavicle fracture

A
  1. sling or figure 8 brace
  2. PIER
  3. pain management
  4. alleviate association spasms
261
Q

shoulder girdle

A
  1. 3 joints
  2. muscles spanning from multiple joints
262
Q

important considerations for treating shoulder girdle

A
  1. thoracic spine mobility
  2. scapular mobitlity
  3. scapular stability
  4. upper limb proprioception
    - needs stable base for upper limb (scapula)
263
Q

physiological ROM of the GH joint

A
  1. abduction/adduction
  2. flexion/extension
  3. IR (0-90 degree abduction)
  4. ER (0-90 degree abduction)
  5. horizontal adduction (cross-flexion)
  6. horizontal abduction (cross-extension)
264
Q

elbow joint (hinge)

A

made up pf 3 joints:
1. ulnohumeral joint
2. radiohumeral joint
3. proximal radioulnar joint

265
Q

elbow ligaments

A
  1. ulnar (medial) collateral ligament
  2. radial (lateral) collateral ligament
266
Q

collateral ligaments of wrist

A
  1. ulnar (medial) collateral lig
  2. radial (lateral) collateral lig
267
Q

ligaments of fingers

A
  1. collateral ligaments
  2. intercarpal ligaments (dorsal and palmar)
  3. triangular fibrocartilage complex (TFCC)
268
Q

triangular fibrocartilage complex (TFCC) aka triangular disc

A
  1. complex made up of load-bearing triangular fibrocartilage articular disc and ligaments on medial aspect of wrist
  2. disperses axial load from carpals to ulna
  3. thickened by the UCL medially
269
Q

what is the TFCC a major stabilizer of

A
  1. ulnocarpal joint
  2. distal radioulnar joint
270
Q

function of the TFCC

A

facilitates articulations at the wrist joint

271
Q

nerves at the elbow and wrist

A
  1. ulnar nerve both at elbow and wrist
  2. median nerve under flexor retinaculum
272
Q

elbow flexors

A
  1. biceps brachii (long and short head)
  2. brachialis
  3. brachioradialis
273
Q

elbow extensors

A
  1. triceps brachii
  2. anconeus
274
Q

common flexor tendon origin for muscles

A

medial epicondyle

275
Q

common extensor tendon origin for muscles

A

lateral epicondyle

276
Q

carpal tunnel

A

median nerve is compressed

277
Q

elbow physiological ROM

A
  1. flexion/extension
  2. pronation/supination
278
Q

wrist physiological ROM

A
  1. flexion/extension
  2. radial/ulnar deviation
279
Q

digits physiological ROM

A
  1. flexion/extension
  2. abduction/adduction
  3. 1st-5th opposition/reposition
280
Q

lateral epicondylitis aka tennis elbow

A

most common in tennis, squash, badminton

281
Q

MOI of tennis elbow (LE)

A

overuse of forearm extensors

282
Q

most common extensors affected in tennis elbow (LE)

A
  1. extensor carpi radialis longus
  2. extensor carpi radialis brevis
283
Q

S&S of tennis elbow (LE)

A
  1. TOP common extensor origin (lateral epicondyle)
  2. pain and weakness with wrist extension
284
Q

acute management of tennis elbow (LE)

A
  1. stretch wrist extensors in elbow extension and flexion
  2. PIER (if itis)
  3. tennis elbow brace
  4. eccentric strengthening program for forearm extensors
285
Q

MOI of medial epicondylitis aka golfers elbow

A

overuse of wrist flexors

286
Q

medial epicondylitis aka golfers elbow

A

common in golfers and pitchers

287
Q

most common flexors affected in golfers elbow (ME)

A
  1. flexor capri radialis (FCR)
  2. pronator teres (PT)
288
Q

S&S of golfers elbow (ME)

A
  1. TOP of common flexor origin (medial epicondyle)
  2. pain and weakness with wrist flexion
289
Q

acute care of golfers elbow (ME)

A
  1. PIER
  2. stretch forearm flexors
290
Q

MOI of ruptured biceps

A
  1. sudden lengthening of contracting muscle (eccentric)
    ex. sudden load when lifting or catching a heavy load
291
Q

what biceps are most commonly affected in a ruptured biceps

A

distal biceps tendon

292
Q

S&S of ruptured biceps

A
  1. “popeye muscle”/muscle balled up
  2. bruising
  3. pain near insertion of biceps into radial tuberosity
  4. pain and weakness with elbow flexion and supination
    ***complete ruptures might be painless
293
Q

acute management of ruptured biceps

A
  1. PIER
  2. pressure pad to approximate any remaining fibres
  3. shorten biceps in sling to remove tension
  4. surgical repair within first couple weeks for active people
294
Q

MOI of dequervain’s syndrome aka tenosynovitis

A

overuse of thumb due to gripping/wringling

295
Q

dequervains syndrome aka tenosynovitis

A

inflammation of tendons and sheath around the thumb tendons
1. extensor pollicis brevis
2. abductor pollicis longus
***common in golf

296
Q

S&S of dequervains syndrome aka tenosynovitis

A
  1. pain over tendons of thumb
  2. weakness with thumb abduction or extension
  3. pain with gripping
297
Q

special test for dequervains syndrome aka tenosynovitis

A

finklestein test

298
Q

acute management of dequervains syndrome aka tenosynovitis

A
  1. PIER
  2. thumb spica brace
  3. if left untreated can progress to thickening/scarring and reduced ROM
299
Q

MOI of elbow hyperextension injuries

A

FOOSH

300
Q

S&S of elbow hyperextension injuries

A
  1. anterior elbow pain and swelling from ligament/capsule sprain and/or muscle strain
  2. posterior elbow pain from osteochondral lesion
301
Q

what must be ruled out for an elbow hyperextension injuries

A

olecranon fracture - may see deformity

302
Q

acute management of elbow hyperextension injuries

A
  1. PIER
  2. shorten injured tissues (elbow flexion) by a sling
  3. tape job is very effective
303
Q

MOI of UCL sprains of elbow

A
  1. FOOSH
  2. overuse by repeat valgus force on elbow
304
Q

S&S of UCL sprains of elbow

A
  1. pain and laxity (instability) in medial elbow joint
  2. ulnar nerve symptoms
305
Q

UCL sprains of the elbow

A

common in pitchers due to repeat high velocity force

306
Q

tommy john surgery

A

reconstructs UCL using a graft tendon- palmaris longus, semitendinosus or gracilis

307
Q

MOI of collateral ligament sprains of wrist

A
  1. FOOSH
  2. forced forearm rotation
308
Q

MOI of UCL sprain in wrist

A

valgus force

309
Q

MOI of RCL sprain in wrist

A

varus force

310
Q

S&S of collateral ligament sprains of the wrist

A
  1. pain
  2. swelling and instability on medial (UCL) or lateral (RCL) aspect wrist
311
Q

special test for UCL (MCL)

A

valgus stress test

312
Q

special test for RCL (LCL)

A

varus stress test

313
Q

acute management of collateral ligament sprains of the wrist

A
  1. PIER
  2. wrist wrap
  3. wrist tape job for RTP
314
Q

MOI of UCL sprain of thumb aka skiers thumb or gamekeepers thumb

A

traumatic or overuse hyperabduction of the thumb (1st metacarpophalangeal joint)

315
Q

traumatic MOI of UCL sprain of thumb

A

skiers thumb: thumb gets caught, FOOSH, catching ball

316
Q

overuse MOI of UCL sprain of thumb

A

gamekeepers thumb: repeat gripping/twisting

317
Q

what can a UCL sprain of thumb result in

A

avulsion fracture

318
Q

S&S of UCL sprain of the thumb

A
  1. pain
  2. swelling
  3. instability at 1st MCP joint
319
Q

is surgery recommended for UCL sprain of thumb

A

yes due to instability so it can stabilize the joint and prevent osteoarthritis longer term

320
Q

acute management of thumb UCL spain

A
  1. PIER
  2. possible x-ray to rule out avulsion
  3. brace for healing
  4. thumb tape job/brace for RTP
321
Q

MOI of an acute TFCC tear

A
  1. FOOSH
  2. forced forearm rotation
322
Q

S&S of an overuse TFCC tear

A
  1. medial wrist pain
  2. pain with ulnar deviation and loading through wrist
  3. popping/clicking
  4. wrist weakness
323
Q

special test for a TFCC tear

A

TFCC compression test (passive ulnar deviation with axial compression - loads through discs)

324
Q

acute management of TFCC tear

A
  1. PIER
  2. brace as heals
  3. anti-inflammatory injections if needed, surgery for the persistent instability
325
Q

elbow dislocations

A

elbow joint bony structure provides a lot of stability - but enough force can cause dislocations

326
Q

MOI of the elbow dislocations

A

FOOSH

327
Q

S&S of the elbow dislocations

A
  1. deformity
  2. lots of pain
  3. holding elbow
  4. tingling /numbness
  5. shock
328
Q

acute management of an elbow dislocation

A
  1. stabilize
  2. splint
  3. monitor/treat for shock
  4. ER/EMS
  5. reduction under sedation
329
Q

MOI of elbow fractures

A

direct trauma/fall

330
Q

S&S of elbow fractures

A
  1. lots of pain
  2. unable or unwilling to move elbow
331
Q

acute management of elbow fractures

A
  1. splint
  2. monitor for shock
  3. ER for x-rays/surgical referral
  4. ORIF = open reduction internal fixation
332
Q

MOI of colles’ fracture - distal radius fracture

A

FOOSH

333
Q

colles’ fracture - distal radius fracture

A

distal radius gets displaced posteriorly

334
Q

S&S of colles’ fracture - distal radius fracture

A
  1. “dinner fork deformity”
  2. lots of pain
  3. numbness
    ***don’t need to test, cause deformity is very obvious
335
Q

acute management of colles’ fracture - distal radius fracture

A
  1. splint
  2. monitor for shock
  3. emerge for x-rays
  4. surgery if unable to align
336
Q

MOI of scaphoid fractures

A

FOOSH

337
Q

S&S of scaphoid fractures

A

TOP of anatomical snuffbox

338
Q

scaphoid healing

A

scaphoid has poor blood supply so it has a decreased ability to heal

339
Q

acute management of a scaphoid fracture

A

identify early and immobilize with a cast or brace

340
Q

MOI of metacarpal (MC) and finger fractures

A
  1. axial compression (jammed) finger
  2. direct trauma
  3. being stepped on
341
Q

S&S of MC and finger fractures

A
  1. localized pain
  2. swelling
  3. unable to grip
342
Q

acute management of hand (MC)

A

SAM splint

343
Q

acute management of fingers

A

buddy tape to stabilize

344
Q

what can happen with MC and finger fractures

A

avulsion fractures - tendon pulls of piece of bone
- immobilization or surgical repair

345
Q

MOI of cyclist palsy

A

compression from handlebars

346
Q

S&S of cyclist palsy

A
  1. tingling/numbness/nerve pain
  2. decreased muscle strength of 5th digit
  3. hand cramping
347
Q

cyclist palsy

A

common in new cyclists and distance cyclists

348
Q

prevention of cyclist palsy

A
  1. avoid hyperextension of wrist on handlebars
  2. proper bike fit
349
Q

acute management of cyclist palsy

A
  1. PIER
  2. splint
  3. may require NSAIDs
350
Q

MOI of carpal tunnel syndrome

A

overuse of wrist flexor tendons causing pressure on median nerve within carpal tunnel

351
Q

S&S of carpal tunnel syndrome

A
  1. burning/tingling/numbness in anterior wrist and hand (along median nerve distribution - digits 1-3 and 1/3 of digit 4)
  2. decreased grip strength
352
Q

acute management of carpal tunnel syndrome

A
  1. bracing
  2. PIER
  3. anti-inflammatory treatment
  4. proper ergonomic set up
  5. steroid injection
  6. surgery to open up tunnel if conservative treatment unsuccessful
353
Q

growth plates

A
  1. area of new bone growth in kids and teens
  2. located at the end of long bones
  3. made of cartilaginous tissue
354
Q

when do growth plates close

A
  1. 14-15 years old for females
  2. 16-17 years old for males
355
Q

pediatric medial conditions/considerations

A
  1. juvenile diabetes (type 1 - insulin dependent)
  2. juvenile arthritis
  3. asthma
  4. epilepsy
  5. allergies (anaphylaxis)
  6. water safety/CPR for drowning
  7. choking
356
Q

pediatric sized emergency supplies

A
  1. oropharyngeal airway (OPA)
  2. neck collar
  3. splints
  4. epipen jr
  5. child SCAT6 (ages 8-12)
357
Q

injury prevention in youth sports

A
  1. proper warm up
  2. properly fitted protective equipment
  3. diversifying their activities
  4. playing time limits for training and competition
  5. max games/day for tournaments
  6. minimum hours between games
  7. rotating positions
  8. proper nutrition and hydration
  9. avoid overtraining
  10. baseline concussion testing
  11. psychological wellness
  12. pre-season screenings
  13. pitch count limits - mandated rest days
358
Q

pre-season screenings

A
  1. identify current pain/injuries
  2. review medical conditions
  3. assess functional movement patterns
  4. concussion baseline testing
  5. discuss important topics (concussions, nutrition, hydration, overtraining, communicating injuries easily)
    KEEP SPORTS FUN
359
Q

psychological wellness

A
  1. support following injury - parents, coach, team
  2. healthy competition
  3. healthy eating habits
  4. inclusivity
  5. motivational talks
  6. encouraging cheers
  7. promoting homework
360
Q

growth plate injuries/fractures

A
  1. excessive repeat stress on growth plate of the bone which causes a widening of the growth plate
  2. growth plate becomes inflamed
  3. if not addressed it can affect growth - deformities and bone stops growing prematurely
361
Q

management of growth plate injuries/fractures

A
  1. altered activity is essential
  2. may require 2-3 months of rest from aggravating sport skill
362
Q

little league shoulder - proximal humeral epiphysitis

A
  1. irritation of the growth plate in proximal humerus
  2. may lead to stress fractures through growth plate
  3. most common in pitchers and baseball players, tennis, volleyball
363
Q

MOI of proximal humeral epiphysitis (LLS)

A

overuse in overhand motions causing excessive strain on growth plate

364
Q

S&S of proximal humeral epiphysitis (LLS)

A

progressive increase in pain in proximal humerus or shoulder

365
Q

prevention of proximal humeral epiphysitis (LLS)

A
  1. limiting pitch counts
  2. proper throwing mechanics
  3. train kinetic link
366
Q

MOI of patellar tendonitis aka jumpers knee

A

excessive traction on patellar tendon
- often associated with growth spurts

367
Q

S&S on patellar tendonitis aka jumpers knee

A
  1. pain
  2. swelling and heat over patellar tendon
  3. pain with jumping, running, quick change in direction or strong quad contraction
  4. pain with flexion and extension
  5. can train and compete through the pain
368
Q

special tests for patellar tendonitis aka jumpers knee

A

thomas test - resisted quads

369
Q

acute management of patellar tendonitis aka jumpers knee

A
  1. PIER
  2. roll/soft tissue mobility for quads
  3. lower extremity mechanics
  4. important to train hammies to prevent anterior translation of tibia on femur and stability at hip and knee
  5. tendinopathy rehab = eccentric, x-training
370
Q

RTP for patellar tendonitis aka jumpers knee

A

a patellar tendonitis tape job

371
Q

osgoode schlatter’s disease

A

irritation of growth plate at tibial tuberosity (attachment patellar tendon)

372
Q

MOI of osgoode schlatters disease

A

overuse - excessive traction of quads via patellar tendon

373
Q

S&S of osgoode schlatters disease

A
  1. pain over tibial tuberosity
  2. visual bump over tibial tuberosity
  3. pain with contraction and stretch of quads
  4. jumping especially painful
374
Q

special test of osgoode schlatters disease

A

thomas test with resisted quads

375
Q

acute management of osgoode schlatters disease

A
  1. PIER
  2. roll/soft tissue mobility for quads
  3. lower extremity mechanics
376
Q

prevention of osgoode schlatters disease

A

diversify activity
- important to train hammies to prevent anterior translation of tibia on femur and stability at hip and knee

377
Q

sever’s disease

A

irritation of the calcaneal tuberosity growth plate (attachment achilles tendon)

378
Q

S&S of sever’s disease

A
  1. pain over achilles insertion into calcaneus
  2. pain with forceful achilles contraction (jumping, sprinting, starts/stops)
379
Q

special test for sever’s disease

A

single leg calf raise

380
Q

acute management of sever’s disease

A
  1. stretch gastrocnemius and soleus
  2. NSAIDs
  3. heel lift
381
Q

MOI of little league elbow

A

chronic valgus overload to medial elbow from throwing

382
Q

where does injury occur during a little league elbow injury

A
  1. medial epicondylitis
  2. medial epicondylar apophysitis (growth plate injury)
  3. avulsion fracture
  4. MCL sprain (older kids tho)
383
Q

S&S of little league elbow

A
  1. pain and inflammation over medial elbow
  2. pain and weakness with throwing
  3. medial instability
384
Q

special test for little league elbow

A
  1. wrist flexor muscle testing
  2. valgus stress
  3. x-rays
385
Q

acute management of little league elbow

A
  1. PIER
  2. alter activity and rest
386
Q

prevention of little league elbow

A
  1. limited pitch counts
  2. proper throwing mechanics
387
Q

growth plate irritation sites for gymnastics

A

distal radius -from repeat load

388
Q

growth plate irritation sites for tumbling sports

A

AIIS - rectus femoris contracts strongly while on stretch

389
Q

growth plate fractures

A
  1. rest, cast or splint
  2. surgical repair
390
Q

principles of splinting

A
  1. include the joint above and below injury
  2. pad splint for comfort and added support
  3. check distal pulse before and after splinting
391
Q

heat illness

A

heat cramps>heat exhaustion>heat stroke

392
Q

heat cramps

A

muscle cramping during/after activity in heat
- thought to be caused by fluid and salt loss form sweating
- common in long distance runners
***should be seen as warning to about more severe heat illness

393
Q

S&S of heat cramps

A
  1. pain
  2. spasm (usually legs or abdomen)
394
Q

acute management of heat cramps

A
  1. rest in cool area
  2. water/sports drink
  3. gentle stretching or massage
395
Q

prevention of heat cramps

A
  1. sufficient hydration and electrolytes (more than usual)
  2. avoid/minimize activity in high temperatures
396
Q

heat exhaustion

A
  1. results from activity in hot temperatures
  2. body’s ability to regulate temperature becomes stressed
397
Q

S&S of heat exhaustion

A
  1. normal or slightly elevated body temperature
  2. cool, moist, pale skin (red initially)
  3. headache
  4. nauseau (vomiting, dizziness)
  5. weakness
  6. exhaustion
  7. level of consciousness starts to decline in later stages
398
Q

acute management of heat exhaustion

A
  1. rest in a cool place
  2. cold cloths in armpits, groin, back of neck
  3. drink cool water - early stages it is very treatable
    ***if left untreated it can progress to heat stroke (emergency)
399
Q

heat stroke

A
  1. results from untreated heat exhaustion
  2. body becomes unable to cool itself
  3. life threatening emergency
400
Q

S&S of heat stroke

A
  1. dry
  2. red
  3. hot skin
  4. progressive loss of consciousness
  5. rapid and weak pulse
  6. rapid and shallow breathing
  7. high body temperature
401
Q

acute management of heat stroke

A
  1. cool the body
  2. give fluids
  3. minimize shock
  4. call EMS
402
Q

cold-related emergencies

A

frostbite>hypothermia

403
Q

frostbite

A
  1. when body tissues freeze following prolonged exposure to cold
  2. water within and surrounding cells freeze and swell which damage the cells
  3. can result in loss of digits or limbs
404
Q

superficial frostbite

A

skin only

405
Q

deep frostbite

A

skin and underlying tissues freeze

406
Q

S&S of frostbite

A
  1. decreased sensations
  2. skin is cold and waxy
  3. discolouration (flushed, white, yellow, blue, black)
  4. tingling
  5. swelling
  6. pain with rewarming
  7. blisters within 24 hours
407
Q

acute management of frostbite

A
  1. gentle rewarming by soaking in warm water
  2. apply dry sterile dressing
  3. gauze between fingers/toes
  4. warm drink
  5. blanket
    *** DO NOT RUB THE AREA - FURTHER DAMAGE TISSUES
408
Q

when do you refer frostbite

A
  1. infection
  2. red streaks
  3. blisters
  4. drainage
  5. no return of sensation or normal skin tone
409
Q

prevention of frostbite

A
  1. dressing in layers
  2. removing wet clothing/gear
  3. avoid extended time during extreme cold weather
410
Q

hypothermia

A
  1. a dangerous drop in body temperature below 95 degree F and 35 degree C following extended exposure to cold
411
Q

S&S of hypothermia

A
  1. shivering (stops in later stages)
  2. slow irregular pulse
  3. slow breathing rate
  4. numbness
  5. confusion
  6. drowsiness
  7. pale cold skin
  8. loss of coordination
412
Q

what can hypothermia lead to

A
  1. shock
  2. coma
  3. cardiac arrest
413
Q

acute management of hypothermia

A
  1. ABCs
  2. gradual rewarming with dry clothes
  3. blankets
  4. warm environment
  5. heating pads
  6. warm drinks if alert
414
Q
A
415
Q
A

KNPE 331 (2 decks)

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