Midterm Review Flashcards
(140 cards)
1
Q
What is scope of practice?
A
Describes the services that a qualified healthcare professional is deemed competent to perform and permitted to undertake
2
Q
What is standard of care?
A
Medical treatment guidelines. It specifies appropriate treatment based on evidence and collaboration between medical professionals involved in the treatment of a given condition
3
Q
What is risk assessment?
A
It is a process of measurement/estimation of risks to teams and athletes
4
Q
What is risk evaluation?
A
It involves determining the significance and acceptability of the risks
5
Q
What is risk control?
A
It is a process of identifying and implementing methods to control the risks and the consequences
6
Q
How do you create an effective risk management system for a team?
A
Injury surveillance, season analysis, preseason screening, monitoring “at risk” team members, return to sport, education, equipment and facilities and emergency action plan
7
Q
What is everyday risk management?
A
Environment (i.e. weather), equipment (i.e. first aid kit) and athlete (i.e. previous injuries)
8
Q
What is a risk compensation?
A
It is a term that may describe a change in behaviour within an athlete when protective equipment is given
9
Q
What are components of an EAP?
A
Charge person, call person, first aid kit, AED and ambulation aid
10
Q
What should be ina first aid kit?
A
Communication sheet, Information about AED, spine board, and player/staff medical profile cards
11
Q
What is a SOAP note?
A
S (Subjective information/history), O (objective information), A (assessment), P (plan)
12
Q
What is Van Mechelen’s Model?
A
- Establish the extent of the injury problem
- Find the mechanisms and risk factors (cause)
- Introduce a preventive measure
- Evaluate the effectiveness of intervention
13
Q
What are the levels of prevention?
A
Primary prevention (reduce occurence)
Secondary prevention (early diagnosis)
Tertiary prevention (Minimize consequences)
14
Q
What is neuromuscular training?
A
NMT is a specialized form of physical training that focuses on improving the coordination and function of the nervous and muscular systems
15
Q
What are the key components of NMT?
A
Balance training, proprioceptive training, coordination, agility drills, plyometrics and strength training
16
Q
What are some associations between injuries and training load?
A
- Rapid increase in training loads
- Insufficient practice vs. competition
- Too little variation in training load (monotony)
- Spikes in training load
17
Q
What is training load?
A
- Intensity, duration and frequency of exercise
- Specific to exercise type
- External training load vs. internal training load
18
Q
What is sport injury?
A
Tissue damage/derangement of normal physical function due to participation in sports, generally due to external forces
19
Q
What is a direct contact injury?
A
- Force applied directly to area of injury
- Contact with player
- Contact with object
20
Q
What is an indirect contact injury
A
Injury occurs in a different area than the contact occurred
21
Q
What is articular cartilage?
A
Flexible cartilage, provides smooth surface for joint movement
21
Q
What is a non-contact injury?
A
Related to athletes own movement or landing errors, no external contact
22
Q
What is fibrocartilage?
A
A tough cartilage, able to absorb loads
23
Q
What are the four stages of wound healing?
A
Hemostasis, inflammation, proliferation and remodelling
24
What is hemostasis?
Stopping the bleeding, vascular spasm, formation of platelet plug, blood clotting and formation of final clot
25
What is inflammation?
Defensive response of tissues to a physical or chemical injury or bacterial infection
26
What cells does inflammation recruit?
Neutrophils, macrophages and lymphocytes
27
What are the steps in proliferation?
1. Angiogenesis
2. Fibroblast migration
3. Epithelialization
4. Wound retraction
28
What is remodelling?
Granulation tissue matures into scar, stage could last several months to years, form and function of the scar tissue depend on loading during this stage and you will never achieve the same tissue strength after the injury
29
What are important factors in would healing?
Nutrition, hypoxia, infection, immunosuppression, chronic disease, wound management, age, genetics, and surgical technique
30
What are the goals of early treatment of soft tissue injuries?
- Limit bleeding
- Limit swelling
- Relieve pain
- Improve conditions for subsequent treatment and healing
31
What does PEACE mean?
Protect
Elevate
Avoid
Compress
Educate
32
What does LOVE mean?
Load
Optimism
Vascularization
Exercise
33
What is the other acronym for acute injury management?
PRICE and POLICE
34
What are the stages of tissue healing?
Acute stage (DO NO HARM)
Subacute stage (Rehab stage)
Chronic stage (Training stage)
35
What are the elements of diagnosis?
History, physical examination (neural testing, spinal examination, biomechanical examination), imaging
36
What are the three stages of treatment and rehabilitation?
Acute stage, rehabilitation stage and training stage
37
What do you do for acute injuries and chronic injuries in the acute stage?
Acute injury: PEACE and PRICE and POLICE
Overuse injury: partial unloading of the uninjured structured
38
What are the steps in the rehabilitation phase?
Monitor pain and swelling, esure normal ROM, ensure normal strength, ensure normal neuromuscular function and ensure aerobic capacity
39
What are the elements of the training stage?
Transition from controlled rehab to sport specific training, perform functional and sport specific testing to determine if athlete can tolerate sport specific training loads, necessary that at least 85-90% of strength has returned
40
How do we define RTS?
RTS is individualized, could be return to participation or return to performance, and is a shared decision making process, three elements of the RTS continuum (return to participation, return to sport, and return to performance)
41
What evidence supports an RTS decision?
Functional and sport specific conditioning tests are important, using closed and open skills and being psychologically ready
42
What is the most common type of groin injury?
Adductor - related groin pain
43
How do they diagnose and treat groin injuries?
MRI's, history and physical exam, exercise therapy programs
44
What is the Hölmich Exercise program?
Isometric and dynamic exercises (2 weeks)
Heavier resistance training, balance and coordination (6-10 weeks)
Jogging is allowed after 6 weeks (if pain free)
NO STRETCHING
45
What are the three milestones in RTS progression?
1. Clinically pain free
2. Controlled sports training
3. Full team training --> RTS
46
How are ligaments structured?
Dense bands of collagen tissue (collagen, elastin, proteoglycan and other proteins)
47
What is a ligaments function?
Connect on bone to another and provide passive support; serve important proprioceptive function
48
What is a ligaments response to injury?
Ligament scars have weaker tensile strength and poor viscoelastic properties - high risk of reinjury! Lead to decreased proprioception and increased laxity
49
What is an intra-articular ligament?
Inside the joint capsule, i.e. cruciate ligaments
50
What is an extra-articular ligament?
Outside of the joint capsule, i.e. calcaneofibular ligament
51
What is a capsular ligament?
Part of the joint capsule, i.e. anterior talofibular ligament
52
How do ligaments adapt to training?
The adapt slowly to increased loading but weaken rapidly as a result of immobilization - cross sectional ligament strength can go up by 10-20 % wiht systematic training
53
What does joint stability depend on?
Passive, active and neural subsystems
54
What injuries cause hemarthrosis (bleeding into a joint)?
ACL, peripheral meniscus tear, osteochondral injuries, and fractures
55
What injuries do not cause hemarthrosis (bleeding into a joint)?
MCL tear, central meniscus tear, PCL tear and cartilage injury
56
What is needed for all dislocated knees?
Imaging (MRI)
57
What are some ACL complications?
Osteochondral injury, ACL injury and meniscus tear, unhappy triad (meniscus, MCL ACL), and osteoarthritis in 15-20 years
58
What is the goal of ACL treatment?
To prevent subsequent injuries, such as meniscus tears, and recurrent giving way
59
What are the three options for ACL injuries?
Modification of activities, bracing for light twisting, or ACL reconstruction
60
How can we prevent ACL injuries?
Modifiable risk factors (strengthening muscles) and knee control training program
61
What are mechanisms for shoulder subluxations and dislocations?
Direct blow to the shoulder or landing on an outstretched arm
62
What are the two types of bone tissue?
Trabecular (spongey) and cortical (compact) bone
63
What is the purpose of red and yellow bone marrow?
Red: produces red blood cell
Yellow: stores fat
64
What are the functions of bone?
Mechanical purposes (protects internal organs, provides basic body shape, facilitates movement, provides framework for support), mineral storage, blood cell production, fat storage and hormone regulation
64
What are bones adaptions to training?
Increases bone mass, increases bone strength at specific sites, driven by dynamic loading (only a short duration is necessary) and peak strength and density is from 25 to 30
65
What are the types of bone injuries?
Traumatic fracture, pathological fracture, stress fracture, bone contusion, osteitis and periostitis
66
What are the different fracture patterns?
Transverse (tension), oblique (compression), butterfly (bending), and spiral (torsion)
67
What are treatments for fractures?
- Conservative treatment: splinting or bracing, casting and bandages
- Surgery: Intramedullary rods or locking and stabilizing plates
68
What are the stages of fracture healing?
Stage 1: Blood clotting and inflammation (3-7 days)
Stage 2: Soft callus forms (2 weeks)
Stage 3: Hard callus forms (2 weeks)
Stage 4: Bone remodelling (can last for years)
69
What is woven bone?
Quickly formed during the soft callus phase, first bone formed during the healing process
70
What is lamellar bone?
Slowly formed, more organized, replaces the woven bone in the later stages
71
What are other treatments for fractures?
Bone grafts, stem cell therapy, ultrasound, or electrical stimulation
72
What bones take the longest to heal?
Femoral neck, femur, tibia and vertebra
73
What are complications with bone fractures?
Infection, delayed union or non union, acute compartment syndrome, osteonecrosis, nerve injury, vascular injury, osteoarthritis, deep vein thrombosis
74
What are risk factors for spondylolysis and spondylolisthesis?
Hyperlordosis, improper technique and excessive extension and rotation
75
What is medial tibial stress syndrome?
Comes with running and jumping, and repetitive loading leads to inflammation along the tibia
76
What is a tendon?
Collagen tissues, connects muscle to bone, excellent tensile properties
77
What is the enthesis?
The junction between muscle and bone, fibrocartilage
78
How do tendons adapt to training?
They increase cross- sectional area, load tendons every 2-3 days, takes longer to develop tendon strength
79
What is enthesopathy?
Injury affecting the enthesis, overuse injury or a direct blow, inflammation and degeneration
80
What causes tendinopathy?
Repetitive tensile loading or inadequate recovery between loadings
81
What is the Cook-Purdam Model?
Reactive tendinopathy - stress to the tendon area, thickening
Tendon disrepair - worsening tendon pathology, structure becomes disorganized
Degenerative tendinopathy - chronic stage
82
What are risk factors for tendinopathy?
Intrinsic - older age, male sex, previous injury, genetics, menopause, systemic conditions, medications and biomechanics
Extrinsic - Training load, increased load, periods of deconditioning, and biomechanical change
83
How do you manage tendinopathy?
Education, load monitoring, pain monitoring and exercise based progressive rehab programs
84
What are other treatments for tendinopathy?
Shock wave therapy, laser and ultrasound, medications, injectable therapies, passive treatments, experimental treatments or surgery
85
How to achilles tendon ruptures happen?
Eccentric loading of the calf (lengthened)
86
What is an isometric contraction?
During the contraction the length of the muscle stays the same
87
What is an isotonic contraction?
The length of the muscle changes, concentric is shortening, eccentric is lengthening
88
How does muscle adapt to training?
Rapid response to training, neural factors in early stages, muscular factors (prolonged training) and muscle fibers increase their cross-sectional area
89
What are direct muscle injuries?
Contusions or lacerations
90
What are indirect muscle injuries or disorders?
Muscle strains, DOMS, fatigue induced muscle disorder, neuromuscular muscle disorders
91
What are other muscle injuries?
Cramps, and chronic compartment syndrome
92
What are some muscle contusion complications?
Acute compartment syndrome, myositis ossificans, muscle fibrosis, chronic pain and weakness and recurrent injury
93
What are the two types of hamstring ruptures?
Type I - Sprinting related (biceps femoris)
Type II - Stretching related (semimembranosus)
94
What are the two types of neuromuscular disorders?
Spinal or spinal nerve related, and neuromuscular endplate related
95
What are the phases of muscle injury healing?
Destructive phase
Repair phase
Maturation phase
96
What is the rehab for muscle strains?
Mobilization
Progressive strengthening
Functional exercises
Other body regions
97
What is prevention of hamstring strains?
Stretching??? Actually proper training, nutrition, education
98
What is apophysitis?
It's a traction injury, repetitive stress on these areas cause inflammation and irritation
Osgood-schlatter disease
little league elbow
severs disease
99
What is synovitis?
Inflammation of the synovial membrane caused by overuse or arthritis
100
What is chondrromalacia?
Affects the cartilage of the knee, compression loading leads to inflammation
101
What is fasciitis?
Inflammation of the fascia, caused by overuse, improper footwear or biomechanical issues
102
What is chronic compartment system?
Exercise induced condition of the muscle, repetitive impact activity, common in runners, aching burning tightness
103
What is bursitis?
Inflammation of the bursa, overuse and repetitive movements, pain during movement
104
How many people in the general population vs the athlete population have back pain?
General - 85%
Athletes -1-94%
105
What are risk factors for LBP?
Previous back injury, family history, anatomical structure of the spine, improper technique, sleep deficits, nicotine use, overloading the structures of the spine and stress
106
What is Degenerative Disk Disease (DDD)?
Heavy stress to the spine, intervertebral disk wears down
107
What is an avulsion fracture?
Tendon or ligament pulls a piece of bone from attachment point, very common at ASIS and ischial tuberosity
108
What structures are affected in a lateral ankle sprain?
Anterior talofibular ligament, posterior talofibular ligament, calcaneofibular ligament, personal tendons
109
What are the grades of ankle sprains?
Grade 1 - partial rupture of ATF, PTF or CF
Grade 2 - total rupture of one of three ligaments or partial rupture of two
Grade 3 - total rupture of two ligaments
110
What strictures are affected in a medial ankle sprain?
Deltoid ligament, tibialis posterior and toe flexor , sometimes a combination with malleolar fractures or syndesmosis injury
111
What is a syndesmosis injury?
A high ankle sprain, external rotation trauma, sprain of the ligaments that connect the tibia and fibula
112
What are the complications of ankle sprains?
Increased risk of recurrent injuries, unstable joint, ankle joint osteoarthritis and persistent pain
113
What are solutions for chronic ankle instability?
Surgery, brace and balance and strength
114
What are osteochondral fractures and chronically injuries?
Usually occur in association with ankle sprains, recurrent pain, stiffness or locking, could progress to osteoarthritis
115
What is osteoarthritis?
Degeneration of articular cartilage in the synovial joints, disease of the whole joint
116
What are the symptoms of OA?
Popping, cracking, stiffness, loss of flexibility, pain, swelling, bon spurs
117
what can osteoarthritis lead to?
Poor quality of life, inactivity, comorbidities, disability and mortality
118
What causes OA?
Multi factorial disease, aging and intra-articular joint injury are the main risk factors, but also genetics, obesity, sex and hormones, and environmental factors
119
What is the treatment pyramid for OA?
All: Education, exercise and weight loss
Some: Pharmacological pain relief, orthoses/aids, and passive treatment given my a therapist
Few: Surgery
120
What is exercise therapy’s role in the treatment of OA?
The number 1 therapy, works and is cost effective, can delay surgery, can reduce pain, can importers function and limit disability
121
What are the GLAD results?
Pain - Knee -28%, Hip -26%
Physical activity - Knee +20%, Hip +22%
Sick leaves - Knee -42%, Hip -21%
122
What does the GLAD program consist of?
NMT exercises, warm up, then lower limb muscle strength, core muscle strength, functional exercises and positional exercises
123
What don’t more people use exercise therapy?
Lack of education, large drug industry and quick pain fixes all get in the way
124
What is post traumatic osteoarthritis?
Arises after repetitive joint trauma or repetitive joint injury, trauma causes joint deterioration, progressive joint pain and dysfunction (about 12% of OA cases)
125
What is PTOA triggered by?
Acute ligament strain, chronic ligament instability, ACL rupture, meniscus, injury, fracture, cartilage damage, or a combination of these
126
What is the risk profile for PTOA?
Intra-articular injury, early return to sport, obesity, adiposity, physical inactivity, muscle weakness, fear of movement, poor diet, inaccurate beliefs or joint dysplasia
127
What are the roles of exercise in knee OA?
Pain management, increasing physical activity, reducing the risk of comorbidities, improving strength, and improving alignment and gait
128
How can you tell if its arthritis or not?
Active (done by the patient) v.s passive (done my the physician) range of motion
If painful in both then it is articular, and therefore is arthritis
129
How can we tell if it is inflammatory?
If the pain in the morning lasts longer than 30 minutes, the person has systemic symptoms, if there is a joint pattern, or of there is other features such as nodule, rashes and other organ involvement
130
What is rheumatoid arthritis?
Fluid in the joint, ore common in females, occurs in about 1% of population, some genetic markers found
130
How does RA usually present in the joints?
Usually in small a joint or joints and it is usually symmetrical
130
What are the symptoms of RA?
Fluctuating joint pain and swelling, morning stiffness usually lasting longer than an hour, systemic conditions (weight loss and fatigue)
130
What are the goals of treatment for RA?
1. To prevent or control joint damage
2. To preserve or prevent loss of function
3. To decrease pain and swelling
131
What are the approaches to treatment of RA?
- Non pharmacological
- Pharmacological
- Surgical
- Alternative
131
What are some lifestyle adjustments for treatment of RA?
Rest
Smoking cessation
Reduced stress
Healthy eating
Education
131
What are the risk factors for RA?
Genetic factors, environmental factors such as smoking and sex hormones, or an infection
131
How does physiotherapy and exercise help with treatment of RA?
- Decreases joint pain
and stiffness
- Improves ability to carry out activities of daily living
- Enables sleep and relaxation
- Strengthens muscles and tendons to take stress off of joints
- Helps maintain healthy weight
132
How does occupational therapy help in treatment of RA?
Joint protection, using your joins in ways to avoid excessive stress
