Lecture 9 Flashcards by Emma Crawford

Peritoneal folds of the abdomen and thorax

-parietal
-visceral

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3 regions of the spine

-cervical
-thoracic
-lumbar

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Viscera of the abdomen and thorax

-liver
-stomach
-small intestine
-large intesine
-bladder

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What is a fascial chain

-muscles in lower limb come up to insert into lumbar spine
-often share fascial wall with other structures so if muscles are tight it may effect other structures

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What are the cervical vertebrae

-C1-C7

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What are the thoracic vertebrae

-T1-T12

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What are the lumbar vertebrae

-L1-L5

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What are the structures included in the spine

-facet joint
-vertebral body
-disc
-nerve roots
-spinous process
-transverse process

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What are the 4 regions of the abdomen

-right upper
-left upper
-right lower
-left lower

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What is included in the right upper quadrant

-liver
-gallbladder
-duodenum
-head of pancreas
-right kidney and adrenal gland
-hepatic flexure of colon
-part of transverse and ascending colon

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What is included in the left upper quadrant

-stomach
-spleen
-left lobe of liver
-body of pancreas
-left kidney and adrenal gland
-splenic flexure of colon
-parts of transverse and descending colon

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What is included in the right lower quadrant

-caecum
-appendix
-right ovary and tube
-right ureter

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What is included in the left lower quadrant

-part of descending colon
-sigmoid colon
-left ovary and tube
-left ureter

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What to remember when palpating the abdomen

-start superficial
-gradually increase pressure

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What is a sports hernia

-fascial weakness in abdominal wall, where abdominals and adductors attach into pubic bone

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What is medical term for sports hernia

-athletic pubalgia

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MOI sports hernia

-repetitive strain to area

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What are sports are hernias common in

-hockey
-football
-soccer
-sprinters/hurdlers
-rugby

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Signs and symptoms of sports hernia

-pain with sitting up, quick cutting, sprinting and coughing

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What is special about sports hernias

-they do not usually protrude like traditionally hernias

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Special test for sports hernia

-resisted sit-up

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Acute management of sports hernia

-PIER
-adductor wrap
-conservative treatment 4-6 wees

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Why do sports hernias have sequential RTP

-easily re-irritated

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Visceral structures potentially affected in sport

-kidney contusions
-spleen rupture
-lungs
-bladder rupture
-testicular contusions
-heart

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What can a spleen rupture chance be increased from

-mono

What can happen to the lungs

-pneumothorax

MOI of abdominal injuries

-direct blow -fall from height

Signs and symptoms of abdominal injuries

-pain -rigidity in abdomen -feeling unwell -shock

What is the cullen sign

-umbilicus discolouration

What is the grey turner sign

-flank discolouration

Acute management of abdominal injuries

-quadrant palpation -call 911 -rest comfortably -treat for shock -reassure

MOI kidney injuries

-blow to the back

Signs and symptoms of kidney injuries

-pain in low back -peeing blood -feeling unwell -shock

Acute management of kidney injuries

-refer

Causes of sudden death in athletes

-usually due to cardiac disease

Types of cardiac disease

-congenital abnormalities of coronary arteries -hypertrophic cardiomyopathy

What is hypertrophic cardiomyopathy

-genetic condition causing thickening of heart muscle -leading cause of sudden death in athletes

What is the incidence of hypertrophic cardiomyopathy

-1 in every 200 000

What does hypertrophic cardiomyopathy cause

-altered rhythm -reduced blocked blood flow

Warning signs of hypertrophic cardiomyopathy

-fainting or seizure -dizziness or light headedness -chest pain -palpitations -shortness of breath

What are emerging causes of acquired heart disease in young athletes

-anabolic steroids -peptide hormones -stimulants (energy drinks, high doses of caffeine)

What is a blow to the solar plexus

-wind knocked out of you -spasm of the diaphragm muscle

MOI of blow to solar plexus

-blow to abdomen or chest -fall on butt or back

Signs and symptoms of blow to solar plexus

-pain -difficulty breathing -panicky

Acute management of blow to solar plexus

-bring athletes knees gently towards chest -guided breathing -diaphragmatic breathing -able to RTP once symptoms resolve

MOI facet joint sprains

-forced rotation

Signs and symptoms of facet joint sprains

-hear/feel pop -sharp localized pain -pain with motions that open joint -muscle guarding

What causes facet joint sprains

-unexpected hit -common in c spine due to large ROM

Special test for facet joint sprains

-quadrant test -positive if pain on opposite side

Acute management of facet joint sprains

-PIER -refer

What is facet joint effusion

-irritation of facet joint

MOI and signs and symptoms of facet joint effusion

-sudden episode of extreme ROM -may have felt a click or sharp pain -localized pain -spasm around irritated joint -closing joint will be painful

Special test for facet joint effusion

-quadrant test -positive if pain on same side

Acute management of facet joint effusion

-PIER -refer

MOI disc protrusions

-acute or chronic compression through disc, often in flexed position

What does disc protrusion result in

-bulge of disc resulting in changes to myotomes and dermatomes

Signs and symptoms of disc protrusion

-pain with repeat forward bending -relief with extension -pain with cough/sneeze

Acute management of disc protrusion

-refer

What are dermatomes

-sensory areas of the skin that are innervated by specific nerve roots

Sensations of the dermatomes

-pain -tingling -numbness -pressure

What is a special test for myotome testing

-cervical nerve root involvement -lumbosacral nerve root involvement

How are cervical nerve root involvement tests performed

-resisted tests are performed 5x bilaterally -look for weakening

Nerve root C1 test

-cervical flexion

Nerve root C2 test

-cervical rotation

Nerve root C3 test

-cervical side bending

Nerve root C4 test

-shoulder elevation (shrug)

Nerve root C5 test

-shoulder abduction

Nerve root C6 test

-elbow flexion

Nerve root C7 test

-elbow extension

Nerve root C8 test

-thumb extension

Nerve root T1 test

-hand intrinsics (spread fingers)

Nerve root L1, L2 test

-hip flexion (in high sitting)

Nerve root L3 test

-knee extension

Nerve root L4 test

-foot dorsiflexion and inversion

Nerve root L5 test

-hallux extension

Nerve root S1, S2 test

-plantar flexion in standing (toe raises)

Nerve root S1 test

-knee flexion

Nerve root S2 test

-hallux (big toe) extension

What reflex will be dampened if there is pressure on C5

-biceps

What reflex will be dampened if there is pressure on C6

-brachioradialis

What reflex will be dampened if there is pressure on C7

-triceps

What reflex will be dampened if there is pressure on L3, L4

-patellar tendon

MOI muscle strains of neck and back

-overstretch or eccentric load -rotation at a high velocity -may have external force

What reflex will be dampened if there is pressure on S1

-achilles tendon

What sports are muscle strains of neck and back common in

-tennis -golf -baseball

Signs and symptoms of muscle strains of neck and back

-abrupt pull -pain -protective spasm -divot (large strains)

Acute management of strains of neck and back

-PIER (never to anterior neck cuz of major vessels) -altered activity

MOI of rib and scapula fractures

-direct blow -compression of ribs

Signs and symptoms of rib fractures

-pain with deep breath -pain with compression -TOP area of fracture

Signs and symptoms of scapula fractures

-TOP -pain with movement of shoulder

Acute management of rib and scapula fractures

-stabilize the segments with padding and tensor -tube sling for scapula fracture -send for imaging

4 spondy's of the spine

-pars interarticularis -spondylolylis -spondylolisthesis -spondylitis

MOI spinal fractures

-axial load -compression through spine

Signs and symptoms of spinal fractures

-central pain -tingling -numbness -unwillingness to move -spasm

How can paralysis happen in spinal fractures

-displacement of segments can put pressure on spinal cord or nerve roots

What type of paralysis happens with c spine fracture

-quadriplegia

What type of paralysis happens with T and L spine fractures

-paraplegia

Acute management of spinal fractures

-stabilize -call 911

What is the pain spasm cycle

-more pain causes more spasm -more spasm then causes more pain

How to break the pain spasm cycle

-PIER -education

What is spondylolysis

-stress fracture in the pars interarticularis

What is spondylolisthesis

-stress fracture and sliding of vertebrae

What is spondylolitis

-inflammation in the vertebrae that could lead to fusion

Special test for spondylolysis or spondylolythesis

-stork stance

How to perform stork stance

-stand on one leg on side of pain and extend backward through lumbar spine