Lectures 1-4 Flashcards
1
Q
What is Malfeasance?
Legal Consideration
A
Individual commits an act that is not his responsibility to perform
2
Q
Misfeasance
Legal Consideration
A
Individual commits act that is his responsibility to perform, but uses wrong procedure, or does the procedure wrong
3
Q
Nonfeasance
Legal Consideration
A
Fail to perform an act that was your responsibility.
4
Q
Gross Negligence
Legal
A
Total disregard of other’s safety
5
Q
What is EAP
A
Emergency Action Plan
6
Q
A very important aspect of sport EAP (home and visting field)
A
Knowing where the AED machine is
7
Q
What is Documentation used for?
A
Protect yourself in case of legal action
8
Q
H-SOAPIE
What it stands for
A
History, Subjective, Objective, Analysis, Plan, Interventions, Evaluation
9
Q
SOIE
What does it stand for
Clinical Charting Follow-ups
A
Subjective, Objective, Interventions, Evaluation
10
Q
What is laxity?
A
Looseness of a limb or muscle
11
Q
What is Elastic Deformation
A
Tissue returns to normal state after the stress is removed
12
Q
Plastic Deformation
A
Tissue is unable to return to normal state once the stress is removed (permanently deformed) -> structural injury
13
Q
Yield Point
A
Stress needed to go from elastic to plastic deformation of a tissue
14
Q
Rupture Point
A
Complete failure of tissue
15
Q
Describe Shear force
A
forces opposite each other, causing tissue to slide over adjoining surface in parallel fashion
ACL and PCL sprains, brain injuries
16
Q
Describe torsion
A
Twisting mechanism causing rotation along the fixed point
torsion fracture
17
Q
Acute vs. Chronic Injury
A
Sudden onset, single traumatic event
VS.
Gradual Onset, repetitive stress
18
Q
Acute Injuries
Contusion
1st, 2nd, and 3rd degree
A
1st - superficial tissue damage
2nd - increased pain due to increase in area and depth of damage
3rd - severe compression resulting in severe pain
Compression of soft tissue due to direct blow
19
Q
Sprain
1st, 2nd, and 3rd degree
A
1st - mild overstretching and mild pain
2nd - partial disruption of ligament, moderate pain
3rd - complete disruption, hard pop, rapid swelling
Injury to ligament or capsule structure
20
Q
Strain
1st, 2nd, and 3rd degree
A
1st - microtearing, mild pain and tenderness
2nd - partial tearing, immediate localized pain
3rd - complete tear, palpable defect
Stretching or tearing
21
Q
Neuralgia
A
pain along the path of a nerve. Compression or chronic inflammation
22
Q
Neuroma
A
Thickening of nerve due to chronic irritation or inflammation
23
Q
Inert Vs. Contractile Tissue
A
Ligaments, fasciaes, aponeurosis
vs.
Muscle
24
Q
Fracture Types
TOSSGAFIC
A
Transverse, Oblique, Spiral, Stress, Greenstick, Avulsion, Fissure, Impacted, Comminuted
25
Comminuted Fracture
Multiple fragments of shattering of the bone at site of injury
26
Avulsion Fracture
Pulling away of a piece of bone secondary to tensioning of an attaching ligament, tendon, or muscle
27
Fissure Fracture
Fracture line not extending through the thickness of the bone
28
Greenstick Fracture
Incomplete fracture through the bone, mot common in youth
29
Describe Specificity
Ability of a test to correctly identify people without the disease
| False positive: no disease found and test is positive
30
Describe Sensitivity
ability of a test to identify patients with a certain disorder
31
# What numbers should look like for
Positive likelihood VS. negative likelihood ratios
Numbers should be greater than 10
VS
Numbers less than 1
32
How many muscles touch the scapula?
17 = 17 ways something can go wrong
33
what seperates the scapula from the clavicle?
the AC joint
34
AC Sprain (seperated shoulder)
| Describe it
MOI - FOOSH
S/S - keynote deformation, pain on AC, decreased hz add
SP - AC cross-over
Tape - AC tape
35
GH Sprain
MOI - forceful abd, or hz abd with or without extension
| Common, poor stability at the shoulder (shoulder favours mobility)
36
GH Sprain
MOI - forceful abd, or hz abd with or without extension
| Common, poor stability at the shoulder (shoulder favours mobility)
37
GH Acute Dislocation
MOI:
- Anterior - abd, ext rot, ext
- Posterior - Flex, int rot, and post force
- Inferior - hyperabduction and inferior force
38
What is the most common GH doslocation?
| Location
Anterior
39
What does posterior GH dislocation look like?
Head of humerus is completely behind the scapula. Looks flat from the front.
40
Hill-Sachs Lesion
Posterior aspect of humeral head's cartilage suffers small defect because of impact on glenoid fossa as humeral dislocates.
| Not a common injury because posterior dislocation is not that common
41
Usual location of chronic dislocation, and symptoms
Anterior dislocation
Dead arm syndrome
(pain, swelling the first few times)
42
How to prevent re-injury after first acute dislocation?
Immobilize arm in external rotation
43
What is a test that detects impingement but does not tell you what structure is injured?
Hawkins-Kennedy
44
What is a test that detects impingement but does not tell you what structure is injured?
| Subacromial
Hawkins-Kennedy
45
What causes tendinitis, bursitis, or impingement in the shoulder?
Overuse injury - usually overhead motion
| Throwing, swimming
46
Number of seconds that is considered too long for blood flow to return to the fingers?
Past 4 sec
47
Impingement Syndrome (posterior)
Tightness of posterior capsule
Pinching os supraspinatus (or infraspinatus) between humerus and glenoid rim
48
Biceps Tendonitis
MOI - overhead movements that involve excessive elbow flexion such as pitching, javelin throwing
S/S - pain in bicipital groove with int and ext rot
SP- Speed's test
49
Clavicular fracture
| S/S
S/S - shoulder and upper extremity appear much lower than the non-injured side
| can be life threatening if posterior displacement
50
Scapular Fracture
| S/S, RULE OUT
S/S- painful abd, individual will want to stay with arm abducted
Rule out - associated rib fracture and pneumothorax
51
What is considered a full body experience that you wouldn't expect?
Pitching
52
What should pitchers make it a habit to do after every game?
Ice shoulder
53
4 joints of the shoulder
○ Acromioclavicular
○ Sternoclavicular
○ Glenohumeral
Scapulothoracic
54
Ligaments of the AC joints
Acromioclavicular and coracoclavicular
55
What conditions at the shoulder can be life threatening?
Spinal cord injuries and heart attacks
56
What are the tests Cozen, Maudsley, and Mill for?
Sensitivity and Specificity
| Cozen and Maudsley (good sensitivity) Mill for specificity
57
What is the avg carrying angle?
| greater in females
10-15 degrees
58
Contusion
MOI - direct blow to muscle
59
# Upper arm
Tackler's Exostosis
| similar to myositis ossificans
ectopic boen formation on antero-lateral aspect of the humerus, not infiltrating the muscle tissue
MOI - repeated direct blows
60
Olecranon bursitis
| MOI, Tape
MOI - fall on elbow, direct blow
Tape - donut pad
61
Ligamentous injnury
| MCL, LCL
MOI - direct blow outside of elbow (valgus)
MOI - direct blow to inside of elbow (varus)
62
Elbow Subluxation (radioulnar)
| MOI, S/S
MOI - longitudinal traction of extended and pronated forearm (getting swung by the arms)
S/S - inability to perform pronation/supination
63
Elbow subluxation is most common in who?
Adolescents
64
Evulsion Fracture
fracture where tendon or ligament is pulling on the bone
65
Evulsion Fracture
fracture where tendon or ligament is pulling on the bone
66
Where is a tendon usually stronger?
Near a growth plate
67
Biceps Brachii rupture usually occur where
97% are proximal
68
Biceps brachii rupture MOI
sudden eccentric load, weight lifting
69
Medial Epicondylitis
MOI - repeated stress on wrist flexors
| Golfer's elbow. Or with involvement of the growth plate - little league
70
Little league elbow
| What is it
Avulsion of the medial epicondyle due to repeated tensile stress from wrist flexors and valgus stress
71
Lateral Epicondylitis
| Tennis elbow
MOI - repeated stress (eccentric) on common tendon of wrist extensors
SP: Lat epicondylitis test
72
Gamekeeper's thumb
Sprain of the thumb ulnar (medial) collateral ligament
MOI - forceful abd and ext
Tape - thumb taping
73
Interphalangeal collateral ligament sprain
MOI - excessive varus/valgus stress and hyperextension
Tape - buddy tape
74
Dislocation of the metacarpals and phalanges
MCP = rare MOI - hyperextension or shearing force causes ant capsule to tear
| Most common disloction spot is at the proximal interphalangeal joint
75
What is the weakest finger?
Ring finger because it does not have the flexor digitorum
76
Scaphoid Fracture
MOI - FOOSH
S/S - pain with palpation of anatomical snuffbox
77
What fracture accounts for 60-70% of all carpal bone injuries in general population?
Scaphoid Fracture
78
Monteggia's Fracture
Fracture of proximal third of the ulna with an associated dislocation of the radial head
79
Galeazzi's Fracture
Distal radius with associated dislocation or subluxation of the distal radioulnar joint
80
Colles' Fracture
Distal metaphysis of the radius, with displacement of the distal fragment dorsally
81
Smith's Fracture
distal radius with displacement of the distal fragment towards the palmar aspect
82
Lunate Fracture/ Kienbock's Disease
Fracture of lunate bone that can present with minimal pain because of the amount of cartilage surrounding it.
MOI - FOOSH
| Hard to diagnose
83
Bennett's Fracture
Articular fracture of proximal end of first metacarpal
MOI - axial compression
84
Avascular necrosis description
dark area showing that the bone is dying
| tx - reattachment of the bone
85
Boxer's Fracture
distal epiphysis of 4th or 5th metacarpal
MOI - punch (poor technique or against very hard surface)
86
Phalangeal fracture
MOI - direct blow or hyperextension
87
What does the Rectus Femoris corss?
The hip joint
88
Hip Pointer
| What is it
Contusion of the iliac crest (looks bruised)
MOI - blunt trauma to the iliac crest
Tape - donut pad
89
Quad Contusion
Bruising of quad muscle
90
Myositis Ossificans
Abnormal ossification (bone formation) within quad muscle tissue
S/S - palpable mass within muscle tissue
91
How cna you prevent myositis ossificans/.
no massage, heat, stretching 72 hours post injury to quads
92
Greater trochanteric bursitis
Between greater trochanter and gluteus maximus
s/s burning, aching pain over posterior to tip of g trochanter
93
Iliopsoas bursitis
Inflammation in the joint due to degeneration can cause the bursitis
s/s - pain medial and anterior to the joint, not easily palpated
94
Ischial Bursitis
| What causes it
Direct fall on ischium, prolonged sitting, especially with leg crossed
95
Hip Flexor Strain
| MOI, Tape
MOI - overuse, quick hip flexion or sudden stretch
Tape - hip spica
96
What is the trendelenburg test?
Assessment of capacity of gluteus medius to stabilize pelvis
| One leg, look for contralateral drop of pelvis
97
Avulsion Fracture
Rapid sudden acceleration or deceleration (strong muscle contraction)
98
Femoral Fracture
MOI - tremendous impact forces
| Potentially life threatening
99
Femoral Fracture s/s
| Displaced vs. Non-displaced
severe pain, swelling, shortened limb deformity
vs.
pain on palpation, muscle weakness and spasms
100
Stress Fracture
| Common locations, risk factors
- Pubis, femoral neck
- sudden increase in training load, change in running surface, improper footwear
101
Pelvis Fracture
Sacrum, pelvis ring, iliac crest
102
What should be treated as a spinal injury even though it is located in the hip?
Pelvis fracture
103
Why is the hamstring the most strained muscle of the body?
Biarticular, and sustains lots of eccentric forces
104
Eccentric Force
A force that does not pass through the centre of gravity of the body on which it acts or through a point at which the body is fixed.
105
If not treated appropriately, what condition can a quads contusion develop into?
Myositis Ossificans
106
What restricts posterior displacement of tibia on the femur?
ACL
107
What type of nerves on the leg once compressed can could lead to neurological deficit in the lower leg?
Superficial nerves
108
Bursa
| What is it
Fluid-filled sac that reduces friction between muscles/tendons and bones
109
MOI Bursitis
Prepatellar - direct blow (most superficial)
Deep infrapatellar - overuse (quad friction)
Pes anserine - overuse
Semimembranosus - tight hammy
Suprapatellar - secondary to knee inflammation
Subcutaneous infrapatellar - other knee injuries
110
Tx of Bursitis includes
RICE
Mod of activites
111
Screw-home mechanism
Screw home mechanism (SHM) of knee joint is a critical mechanism that play an important role in terminal extension of the knee.
112
PCL Sprain
MOI - fall on knee/hyperflexion
Symptoms will worsen over time
113
MCL Sprains
get tackled outside the knee while your foot is planted.
Grade 1 and 2 do not involve mensicus
Grade 3 does
| Valgus stress
114
Dynamic knee valgus
caused by the lack of strength and control of your hip and knee muscles. Research has shown that increased dynamic knee valgus increases your risk of ACL injuries and other lower leg injuries
115
LCL Sprains
Impact to inside of the knee with foot grounded
Grade 3 is where 50% of patients will develop OA
| Varus Stress
116
Which meniscus is bigger the lateral or medial?
Lateral
117
What type of injury are tears most associated with?
ACL injuries
118
MOI of meniscal injuries
twisting with compression and flexion or involved with MCL injury
119
List the meniscus tear types
Vertical longitudinal, vertical radial, oblique, bucket handle, horizontal,
| Tx is surgery mainly
120
Patellofemoral stress syndrome
| Also called lateral patellar compression syndrome
possible causes - tight quads, weak quads, weak glutes
s/s - dull, aching pain under knee cap that increases with activity
121
Chondromalacia
Cartilage degeneration of the knee cap
| seen on x-ray and MRIs
122
Patellar dislocations
lateral dislocation of the knee cap due to imbalance
123
Patellar Dislocation
immediate treatment - > immobilize send to ER
124
What is another name for Jumper's knee?
Patellar Tendinitis
125
Patellar tendinites
Inflammation of patellar tendoncaused by excessive running and/or jumping
s/s pain after or with activtiy, decreased quad flexibility, pain with end range knee flexion
eccentric quad strengthening
126
Extensor tendon rupture (quad)
MOI - powerful muscle contraction
S/S - patella can appear higher (superior) compared to the opposite side if the rupture is inferior to the patella
127
Iliotibial band (ITB) friction syndrome
Tight TFL/ITB causes friction of the ITB on lateral femoral condyle
128
Plantar Fascitis
Overuse injury that is common in runners
MOI - factors affecting risk: pes cavus or planus, improper footwear, reduced flexibility of plantar muscles and calf, improper running pattern
s/s - pain underneath the foot or medial heel at the first step in the morning
129
What is the most common injury of all the sports?
Lateral ankle sprain
130
Lateral Ankle Sprain
MOI - forceful inversion
S/S - swelling around lateral malleolus, point tenderness on ligaments, can't bear weight on injured side
SP - medial talar tilt/anterior drawer
## Footnote
q
131
What is the most sprained ligament?
Anterior Talofibular (ATFL)
| Anterior drawer tests specifically for ATFL
132
Medial Ankle Sprain
MOI - forceful eversion
S/S - swelling around medial malleolus
SP - lateral talar tilt
133
Syndesmosis Sprain
| High ankle sprain
MOI - dosiflexion and eversion
s/s - extreme tenderness on distal anterior tibiofibular lig.
134
Predictors of Ankle Sprains
People with inflexible ankles, more eversion increases risk for inversion sprain
135
Avulsion Fracture
A piece of bone chipped away with the ligament
136
Avulsion of deltoid ligament from the medial malleolus
| Term
Medial Ankle Sprain
137
Avulsion of peroneus brevis tendon from the 5th metatarsal
Lateral Ankle Sprain
138
Gastrocnemius Strain
Stretching of muscular fiber of the calf muscle
MOI - forced dorsiflexion with extended knee or forced knee extension with dorsiflexed ankle
Muscular fatigue resulting in muscle cramps
S/S - decreased strength in plantar flexion, decreased flexibility in dorsiflexion, tenderness on muscle belly
T - strain tape
139
Achilles Tendinopathy
| MOI, Risk Factors
MOI - overuse
Risk Factors - improper footwear, foot misalignment, change in exercise environment
S/S - decreased in plantar flexion, decreased flexibility in dorsiflexion, pain in tendon
140
Achilles tendon rupture
MOI - muscular contraction while stretching, knee extended
S/S - pop, visible defect in the tendon, inability to do plantar flexion on walk on tip of toes, feeling of being shot in the leg
141
Most severe acute muscular injury
Achilles tendon rupture
142
Medial Tibial Stress Syndrome (MTSS)
Shin splints
S/S - pain on the medial side of the tibia, increased with running, trigger points at the insertion of the soleus on the medial tibia
T - shin splint tape with foam compression
143
Stress Fracture
Often in running and jumping
Risk Factor: increased in mileage, change in surface or shoe
144
Syndesmosis Sprain
Sprain between the tibia and fibula
| Seperation caused by dorsiflexion and eversion
144
Syndesmosis Sprain
Sprain between the tibia and fibula
| Seperation caused by dorsiflexion and eversion
145
# Ottawa ankle rules
When would you send a patient to the emergency room for ankle x-rays?
Pain with palpation of the distal posterior 6 cm of tibia or fibula
Inability to BW for 4 steps
146
# Ottawa ankle rules
Send to emergency room for midfoot x-rays?
Pain with palpation of base of 5th metatarsal or navicular bone
Inability to BW for 4 steps
147
What does the Ottawa ankle rules not guarantee even if it is positive?
Does not mean there is a fracture
148
What movements are likely to be limited with a medial ankle sprain?
Eversion
