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KNPE 331 > Weeks 1-6 > Flashcards

Weeks 1-6 Flashcards

1
Q

What is a Primary Prevention?

A

Reducing the incident of injury before they occur

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2
Q

What is a Secondary Prevention?

A

Addressing injuries in their early stage to prevent recurrence, severity and/or secondary complications.

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3
Q

What are 3 examples of Primary Prevention?

A

1)Safe field/court conditions
2)Environmental conditions
3)Protective Equipment
4)Knowledge of Medical Conditions
5)Proper Warm-Up
6)Progression of Training
7)Nutrition/Hydrations
8) Scanning for unsafe technique
9)Recognize injury patterns in a team
10) Collaboration with coaches, S&C
11)Preventative Bracing
12)Mental HLTH and Sports Psych

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4
Q

What are 3 examples of Secondary Prevention?

A

1)Early identification of injuries
2)Bracing/Taping/Wrapping
3)Sufficient rehab of injuries
4)Education re:Risk (for players, parents, Coaches)
5)Sufficient reconditioning post injury (includes psych readiness)

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5
Q

When to BRACE instead of Tape? x2

A

1)Ongoing Conditions
2)Larger Joints Requiring Complex Tape Jobs (lots of time and tape)
(Eg. Knee Ligaments, Shoulder Dislocation)

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6
Q

Athletes often prefer Brace or Tape and why?

A

Tape, tighter and more secure

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7
Q

Why may a brace be better than tape?

A

Maintains Integrity Better

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8
Q

Why are proper footwear and orthotics important?

A

Help achieve proper biomechanics. which further helps prevent injuries

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9
Q

Orthotics are recommended for what age?

A

Over 12

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10
Q

What also should be done when orthotics are prescribed?

A

Supportive rehab to to retrain intrinsic and extrinsic foot muscles and movement patterns

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11
Q

Who may benefit from orthotics?

A

Effective for anyone working long shifts on feet

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12
Q

How do muscles/tendons get injured? x3

A

1)Strain
2)Tendonitis/osis
3)Contusion

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13
Q

How do ligaments get injured?

A

Sprain
Overstretch, dislocations, subluxations

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14
Q

How do bones get injured? x2

A

1)Fractures/break (different types)
2)Bruise

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15
Q

How do Nerves get injured? x2

A

1)Burner/Stinger
2)Contusion/Crush Injury

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16
Q

How do Brains get injured? x2

A

1)Concussions
2)ABI Acquired Brain Injury
-Direct and Indirect Trauma

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17
Q

How does skin get injured? x2

A

1)Lacerations/Abrasions
2)Contusions

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18
Q

What is a strain?

A

Muscle or Tendon Break

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19
Q

What is a sprain?

A

Ligament Break

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20
Q

What is a grade 1 sprain/strain?

A

Tissues Stretch and Some Fibres and Disrupted

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21
Q

Grade 1 Sprain?

A

Integrity of the joint maintained

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22
Q

Grade 1 Strain?

A

Contractions are strong but painful

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23
Q

What is a grade 2 sprain/strain?

A

Partial Tear/Many Fibres Disrupted

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24
Q

Grade 2 Sprain?

A

Results some instability/laxity in the joint

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25
Q

Grade 2 Strain?

A

Contractions are weak and very painful

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26
Q

What is a grade 3 sprain/strain?

A

Complete Tear

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27
Q

Grade 3 Strain?

A

Unable to contract and often pain free (Nerve fibres were torn too)

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28
Q

Grade 3 Sprain?

A

Results in significant instability/laxity in the joint

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29
Q

T and F a grade 3 muscle strain may be easier healed than a grade 2?

A

True, recovery can be easier for grade 3 cuz nerve still attached in 2 therefore limited by pain

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30
Q

What are the 7 types of bone fractures?

A

1)Transverse
2)Linear
3)Oblique, Nondisplaced
4)Oblique, Displaced
5)Spiral
6)Greenstick (inside fibres/bend)
7)Comminuted (piece)

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31
Q

What is a contusion or a bruise?

A

Crush injury to the muscle and connective tissue from blunt trauma

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32
Q

How does a muscle respond to a bruise? x5

A
  1. Pain
  2. Discolouration
  3. Swelling
    4.Spasm/Guarding
  4. Reflex inhibition (muscle cuts out, cant contract) due to pain or swelling
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33
Q

Do we massage out a spasm?

A

No, massage bring circulation to area and makes it worse

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34
Q

What is tendon itis/osis injuries?

A

Overuse injuries

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35
Q

What is the diffrence between tendon itis vs osis?

A

Itis = inflammation
osis = tissue breakdown (chronic stage)

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36
Q

What are the 3 overuse injuries?

A

1)Bursitis
2)Shin Splints
3)Stress Fractures

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37
Q

What are shin splints?

A

Too much traction due to overuse (mechanical issue)

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38
Q

What is Bursitis?

A

Fluid-filled sacs blow up with overuse

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39
Q

What are the roles of the student trainer? x12

A

1) Emergency Action Plan (EAP)
2) Primary and Secondary Prevention
3)Scene Survey
4) Stabilize (C-spine, injured limb)
5)Assess (urgent?)
6)Reassure
7)Prove any necessary immediate care
8)Determine safe removal from playing surface
9)Determine safe removal from playing surface
10) Prevent secondary complications
11)Refer for/arrange care
12)Support the rehab process and liaise between therapy, coaching and S&C staff

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40
Q

What is the EAP?

A

Predetermined, organized system of managing severe injury

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41
Q

Why doe we have EAP?

A

Allows for quick and efficient injury management
-Predtermined Roles
-Promotes organization
-Decreases Chaos/Panic
-Creates trust and promotes reassurance

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42
Q

What are the 3 people in the EAP?

A

1) Charge Person (person in charge of delivering medical care)
2) Call Person (Provides medical info, meets and directs ambulance)
3)Control Person (Manages team/crowd/surroundings/locates supplies)

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43
Q

What should be included in a EAP?

A

1)Important Numbers
2)Address of sports facility and directions
3)Address of nearest hospital (don’t go by ambulance)
4)Address of urgent care rays if not at main hospital
5)Location of player medical records, AED and spinal board

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44
Q

What are the 2 structural features of orthotics?

A

1)Longitudinal Arch
2)Metatarsal (MET) pas to support transverse arch

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45
Q

What is a normal gait pattern?

A

-Heel Stroke in slight supination
-Arch absorbs the forces as it rolls into pronation
-Supinate back into neutral through mid-forefoot for a neutral toe off

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46
Q

What are the 3 foot types?

A

-Overpronators (Valgus foot)
-Supinators (Varus Foot)
-Normal

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47
Q

What is a Valgus foot?

A

Overpronator
-Collapses through arch or stay in pronation

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48
Q

What is Varus foot?

A

Supinator
Weight staus through outside of foot

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49
Q

What could show a fallen transverse arch?

A

Calluses though ball of foot

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50
Q

When not to tape? x7

A

1)Allergies to adhesives
2)Immediately after injury (tissues still bleed and swell)
3)Injury has not been fully assessed
4)The return to play criteria have not been met
5)Areas of altered skin sensations (including ice or muscle rubs)
6)Overnight (swelling may occur causing the tape to cut off circulation)
7)Ensure sport allows tape

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51
Q

What are the 4 return to play criteria?

A

1)Full ROM
2)Minimum 80% strength
3)Moves with proper biomechanics
4)Able to perform the demands of the sports

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52
Q

What are 2 parts of the post tape assessment?

A

1)Ensure sufficient capillary refill
2)Re-test that it successfully limits the ROM

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53
Q

Why to avoid bulges, wrinkles and windows?

A

Cause more harm than good
-Bulges = Too tight, no capillary
-Wrinkes = Creates pressure points

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54
Q

What are the 5 parts of the pre-tape assessment?

A

1) Explain Tape Job Chosen and Why
2) Ask permission
3) Clear Contraindications
-Check and Cover cuts, abrasions, blisters
-Rxn to tape?
-Sensitive to Adhesives
4)Check ROM you want to limit
5)Check circulation via capillary refill distal to area being taped

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55
Q

How many inches away should pre-tape adhesive spray be sprayed?

A

4 inches in sweeping motion

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56
Q

What is MOI (mechanism of injury)?

A

How an injury happened
-What position did the structure/joint/limb/athlete go into?

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57
Q

What are 2 sources of MOI?

A

Trauma: From external force on the body
Overuse: Repetitive strain on a tissue

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58
Q

What are the 2 types of onset?

A

Acute/Traumatic: Sudden onset
Insidious: Gradual and often unknown origin

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59
Q

Why is MOI important?

A

How its happened helps determine what happened and how to treat
-Ask athletes, coaches, parents, teammates, etc.

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60
Q

What are signs?

A

Something you see

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61
Q

What are symptoms?

A

Something the athlete feels/describes

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62
Q

Examples of Signs? x7

A

Bruising
Swelling
Heat/Cold
Spasm/Guarding
Shivering
Sweating
Vomiting

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63
Q

What is the cause of spasm/guarding?

A

Nerve Protection (need to be extra cautious)

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64
Q

What are 3 signs of shock?

A

Sweating
Shivering
Vomiting

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65
Q

Examples of Symptoms? x7

A

Pain
Tingling
Numbness
Burning
Tight
Pressure
Nausea

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66
Q

What comes with pain x2?

A

Shock
Fear/Catastrophizing

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67
Q

What is the essential role of pain management?

A

Reassurance

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68
Q

How do we measure pain?

A

Scale 1-10
but subjective and relative to individual experience

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69
Q

What are the 6 psychology of injuries?

A

Fear
Anger
Denial
Sadness
Catasophizing
Regret

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70
Q

Repeat Injury impact psych?

A

Add to fear

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71
Q

What are the 2 support systems for athlete?

A

Logistically Support System
Emotional Support System

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72
Q

What are 5 aspects of dealing with psychology of injuries and performance?

A
  1. Coping Strategies
  2. Support at Home
    3.Access to Care
    4.Professional Support
  3. Team/ Coach Support
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73
Q

What are ways AT can support athlete’s psychology?

A
  1. Reassurance
  2. Know when to refer
  3. Educate of injury, injury prevention and next step (player, coach, family, friends)
  4. Mindful and Sequential Return to play
  5. Keep them a part of the team
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74
Q

What are the 5 types of skin wounds?

A
  1. Lacerations
  2. Abrasions
  3. Punctures
  4. Contusions
  5. Blisters
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75
Q

3 Steps to Manage Lacerations?

A

Step 1: Control Bleeding (if possible elevate)
Step 2: Clean the wound
Step 3: Steri-Strips

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76
Q

Step 1: How to control bleeding? x3

A
  1. PPE (gloves)
    2.Pressure using gauze
    3.Elevation above heart to decrease blood flow to area
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77
Q

Why do we elevate?

A

to DECREASE blood flow to the area

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78
Q

Do we remove extra layers of gauze?

A

NO! Could rip wound and make it worse

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79
Q

Step 2: How do we clean the wound?

A
  1. Soap and Water
    2.Cinder Suds
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80
Q

What are three field coverage considerations for steri-strips?

A
  1. Dry the area around the laceration
  2. Adhesive spray via Q-tip (do not spray directly on skin)
  3. Rub the Q-tip on either side of the laceration where steri-strips will be applied
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81
Q

When do we send for stitches? x5

A
  1. Stitches can only be done effectively within 24 hrs of injury
  2. Deep wounds affecting more than just skin
  3. Unable to stop the bleeding
    4.Wound is to the face
  4. Wound is across a joint
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82
Q

What is a minor cut and abrasion?

A

Superficial layers of skin

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83
Q

Return to play for minor cut and abrasions?

A

Non-stick gauze and cover roll to dry skin

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84
Q

If a puncture is large and deep, you should what? 3 steps

A

1) Leave it in because it could cause more bleeding
2)Pad around it with gauze rolls
3)Send for medical information

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85
Q

What is a contusion?

A

Bleeding under the skin from blunt trauma

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86
Q

Why do contusions need proper management?

A

To avoid myositis ossificans

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87
Q

How to treat a contusion x4?

A

1) No deep tissue massage
2)Effleurage or lymph drainage
3)Ice
4)Protective padding (donut pad)

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88
Q

How can a contusions be treated in clinic x2?

A

1) Ultra sound (pulsed setting- not continuous)
2) Interferential Current (IFC)

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89
Q

What are blisters?

A

Fluid-filled bubble caused by friction

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90
Q

How to prevent blister?

A

Skin lube over areas of friction

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91
Q

How to treat blister? x3

A

1)If broken clean well
2)Second -Skin
3)Coverrol

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92
Q

What should we seek medical attention x7?

A
  1. Unable to control the bleeding
  2. The wound is dirty and unable to be thoroughly cleaned
  3. Deep wound or puncture
  4. Object is still impaled
  5. Changes in sensations (nerve)
  6. Wound is from a human/animal bite
  7. The wound is from a rusty object
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93
Q

Cartilage and Meniscus Healing? x2

A

Limited Capacity to heal
Little or no direct blood supply

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94
Q

Ligament Healing x3

A

-During the repair phase, collagen and connective fibres lay down randomly
-Gradually a scar is formed
-Over following months collagen fibres align in response to joint stress/strain

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95
Q

Skeletal Muscle Healing x2

A

-Regeneration of new myofibers in minimal
-Healing and repair follows the same process of random collagen alignment and develops tensile strength in response to stress/strain

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96
Q

Nerve Healing x2

A

-Regeneration can take place very slowly (3-4mm/day)
-Peripheral nerves regenerate better than CNS

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97
Q

What are the 4 stages of wound healing?

A

Hemostasis
Inflammation
Repair and Regeneration
Remodeling
3 Main are last 3

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98
Q

Hemostasis

A

Process leading to cessation of bleeding

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99
Q

Inflammation and how long

A

Essential vascular and cellular response for proper tissue healing
-4-6 days

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100
Q

Repair and Regeneration and how long

A

Formation of granulation tissues (a type of new connective tissue)
-4-24 days

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101
Q

Remodelling and how long

A

Strengthening of tissues along the lines of tension
-21-2years

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102
Q

What are the 3 phases of acute musculoskeletal (MSK) injury?

A
  1. Inflammatory (acute)
    2.Repair and Regeneration (proliferation)
    3.Remodelling
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103
Q

WHAT is Phase 1 of MSK: Inflammatory Response

A

-Vasodilation of blood vessels
-White blood cells fight infection, break down and clean up damaged tissue to start healing process

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104
Q

Signs and symptoms of inflammation x5

A

1) Redness
2) Swelling
3) Heat
4) Pain
5) Loss of Function

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105
Q

WHAT is Phase 2 of MSK: Repair and Regeneration (proliferation) x3

A

1) Collagen laid down in a disorganized matrix
2) Revascularization brings O2 and nutrients
3) Edges of wound draw closer

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106
Q

What is Phase 3 of MSK: Remodelling x2

A

1) Collagen reorganizes along the lines of stress (Wolff’s Law)
2) Tissues increase in strength

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107
Q

Summary 3 Things that occur in the inflammatory response phase of Tissue Healing?

A

1)Pain, Swelling and Redness
2)Decrease collagen synthesis
3)Increase number of inflammatory cells

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108
Q

Summary 3 Things that occur in the fibroblastic repair phase of Tissue Healing?

A

1)Collagen fiber production
2)Decreased collagen fiber organization
3)Decreased number of inflammatory cells

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109
Q

Summary 2 Things that occur in the maturation-remodeling phase of Tissue Healing?

A

1)Proper collagen fibre alignment
2)Increased tissue strength

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110
Q

T or F bone healing follows the same 3 stages of soft tissue healing (inflam, repair and regen, remodelling) but more complex

A

T

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111
Q

On average, how long does bone healing occur?

A

6-8 Weeks

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112
Q

5 Stages of bone healing?

A

1)Hematoma Formation
2)Cellular Proliferations (cells grow and divide)
3)Callus formation (soft callus)
4) Ossification (hard callus)
5) Remodeling

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113
Q

What are the 6 Aims of Treatment in the inflammatory phase day 1-5?

A

1) Decreased Inflammation
2) Decreased Pain
3) Decreased Swelling
4) Decreased activity
5) Protect
6) Educate

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114
Q

What are the 9 aims of treatment for the demolition phase day 3-15?

A

1) Decreased Residual swelling
2) Decreased Residual Pain
3) Increased ROM
4) Increased Flexibility
5) Increased Strength
6) Increased Proprioception
7) Prevent 2-degree complications
8) Increased CV fitness
9) Educate

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115
Q

What are the 7 aims of treatment for the healing phase (day 10- 8 weeks)?

A

1) Increased Circulation
2) Decreased pain or muscle spasm
3) Increased ROM
4) Increased Flexibility
5) Increased Strength (sport lesion)
6) Increased CV (sports specific)
7) Increased Proprioception

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116
Q

What are the 7 long term goals of treatment?

A

1) Maintain/restore skin and connective tissues (prevent scar adhesions)

2)Ensure
-Full ROM
-Strength of lesion site
-Maintain/increase overall flexibility
-Psychological Readiness

3)Optimal Biomechanics

4)Correct training habits/equipment

5)Maintain/Increased Proprioception

6)Protect injury site (injury/tapping)

7)Educate

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117
Q

What are the 3 guidelines for return to play (RTP)?

A

1)Full ROM 80% Strength
2)Able to perform the demands of sport
3)Psychological Readiness

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118
Q

What are the 6 tools student trainers have?

A

1)Massage
2)Educate
3)Exercise
4)Taping and Wrapping
5)Wound Care
6)Heat and Cold

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119
Q

What are the 3 heat indications?

A

1)Healing phase and beyond
2)Relaxation
3)Promote Flexibiity

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120
Q

What are the 6 tissue responses to heat?

A

1) Increased Circulation
2) Increased inflammation
3) Increased metabolism
4) Increased edema/swelling
5) Decreased Pain
6) Decreased Spasm

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121
Q

What are 6 types of heat?

A

1) Moist Heat Application
2)Electric Heating Pads
3)Hot Shower, Bath, Hot Tub
4) Microwaveable Bean Bag
5) Infrared Sauna
6) Ultrasound - Cont. Setting

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122
Q

How are infrared different from traditional saunas?

A

-Heats your skin/body vs. air around you

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123
Q

What are the contraindication to heat? x8

A

1)Inflamed tissues/post injury
2)Bleeding Disorders
3)Blood Clots
4)Impaired Sensations
5)Metal Implants
6)Infections
7)Open Wounds
8)Additional contras for whole body
-Pregnancy or trying to conceive
-Multiple Sclerosis due to heat intolerance
-Illness

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124
Q

What are the 9 tissue responses to cold/cryotherapy?

A

1) Decreased inflammatory response
2) Decreased edema/swelling
3) Decreased Pain
4) Decreased Circulation
5)Decreased hematoma formation
6) Decreased muscle spasm
7) Decreased tissue metabolism
8) Decreased enzymatic activity
9) Decreased extensibility

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125
Q

Cryotherapy Types? x5

A

1)Crushed ice or ice cubes
2)Gel packs or frozen peas
3) Frozen Beanbag 10-15 min
4)Ice cup massage
5)Cold Immersion (no neck, bucket for selected areas)
6)Hyperbaric Gaseous Cryotherapy
7)Cyrochamber (electric an liquid nitrogen)

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126
Q

Considerations for ice cubes/crushed ice and ice packs?

A

1) Barrier between the ice and the skin
2) Remove air pockets by sucking out the air before twisting the bag to close
3) 15 -20 min

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127
Q

Cold immersion temperature?

A

10 celsius
CBAN: cold, burning achy numb

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128
Q

What are the five contraindication for the electric cyrochamber?

A
  1. Preggo
  2. High BP
  3. Blood Clots
  4. Heart Conditions
  5. Infection
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129
Q

What are the contraindications to cold?

A
  1. Raynauds
  2. Utricaris (hives/rash from cold)
  3. Clotting Disorders
  4. Over Superficial Nerves
  5. Altered Skin Sensation
  6. Complex Regional Pain Syndrome
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130
Q

What is Raynauds Phenomenon?

A

Caused by decreased blood flow to fingers/toes due to vasospasm in those areas

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131
Q

Cole Response for
Pain
Spasm
Metabolism
Blood Flow
Inflammation
Edema
Extensibility

A

Decreased (Vasoconstrictions)

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132
Q

Heat Response for
Pain
Spasm
Metabolism
Blood Flow
Inflammation
Edema
Extensibility

A

Increased all but decreased pain and spasms (vasodilation)

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133
Q

When to use massage? x3

A

-Tight Muscles
-Injured Muscles
-Increased Circulation

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134
Q

How does massage help tight muscles?

A

1) Increased extensibility
2) Decreased Pain

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135
Q

How does massage help injured muscles in inflammatory phase?

A

Effleurage/lymph drainage only
-Decreased Pain
-Decreased Swelling

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136
Q

How does massage help injured muscles in healing phase?

A

Deep forms of massage
-Increased circulation to promote healing

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137
Q

What are the 5 Massage Protocols?

A

1) Educate on why use massage
2) Clear Contraindications
3) Always obtain consent/permission to treat
4)Expose the area to be treated (sports massage through clothes)
5)Be Proffesional

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138
Q

Contraindications to massage? x11

A

1)Acute inflam (except effleurage/lymph drainage)
2)Contusions (except effleurage/lymph drainage)
3)Acute Spasm round another injury
4)Over open wounds or skin reactions
5)Altered Sensation
6) Possible Blood Clot
7)Bleeding Disorders
8)Over Varicose Veins
9) Deep Vein Thrombosis (DVT)- symptoms: deep, buring calf pain
10) Cancer
11)Some Cases cancer

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139
Q

Diabetes and Massage?

A

-Can be beneficial but avoid areas of peripheral neuropathy
-May lower blood glucose levels

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140
Q

4 Main principles of massage therapy?

A

1) General - Specific - General
2) Superficial - Deep- Superficial
3) Proximal -Distal - Proximal
4) Peripheral -Central -Peripheral

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141
Q

What are the 5 reasons why a binder it player medical records are important?

A

1)Medical Conditions
2)Allergies
3)Previous Injuries
4)Emergency contact info
5)Level of experience/# years playing

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142
Q

What are the 4 options for removal from the playing surface?

A

1)Weight Bearing (WB)
2)Non-weight bearing (NWB)
3)Assisted
4)Advanced care required?

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142
Q

What is the general hierarchy of conditions? x6

A

1)ABC, Major Bleeds
2)Acquired Brain Injury/Concussions
3)Spinal
4)Fracture/Dislocation
5)Sprains/Strains
6)Abrasions

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143
Q

Order of hierarchy on field assessment x6

A

1)Survey the scene (safe to approach)
2)Control C-Spine (Block the head)
3)Assess LOC (AVPU)
4)Assess vitals (Airway, Breathing, Circulation)
5)Secondary Survey (Rapid Blood Survey, History)
6)Head to Toe

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143
Q

In emergency situations what are we always assessing for?

A

Shock

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144
Q

What occurs in the primary survey in emergency conditions?x4

A

1) Survey the scene
2)C-Spine control
3)LOC (AVPU)
4)Vital Check (ABC)

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145
Q

What is apart of the scene survey? x4

A

1)Any safety concerns in the immediate environment (safe to approach)
2)Clues to indicate what happened
3)Did anyone see what happened
4)How many athletes or bystanders were injured? (triage)

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146
Q

When not to align the C-Spine

A

If not already in alignment and they have ABC present then leave them

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146
Q

How to control the cervical spine (C-SPINE)

A

Block the Head
-Hand on forehead to minimize movement
-Remain still (no nodding)
-Ask assistant to take over c-spine control using in line stabilization

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147
Q

How to assess LOC?

A

1)Remove the mouth guard or anything in the mouth
2)Rate LOC using AVPU

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148
Q

What is AVPU scale?

A

For LOC assesment
Alert: eyes open, able to verbalize
Verbal: Responds to commands or questions
Painful: Facial grimace; flexion, extension or withdrawal of body part, moan or groan
Unresponsive: No response

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149
Q

How to check for vitals?

A

ABC
Airway
Breathing
Circulation

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150
Q

How to check airway vital? x3

A

Is it open?
-Speaking or Crying
-Position of head = alignment = head tilt-chin lift
-Unconcious = can’t rule out c-spine = jaw thrust

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151
Q

What are the two types of airways?

A

Oropharyngeal Airway
Nasopharyngeal Airway

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152
Q

How to assess for breathing vital?

A

Look (Chest Rising)
Listen (Breathing sounds)
Feel (Breath of cheeks)

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153
Q

How to assess for circulation vital? x2

A

-Do they have a carotid pulse?
-Obvious major bleed = immed pressure

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153
Q

When to use head tilt-chin lift?

A

Assess for open airway Aligned c-spine and conscious

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154
Q

When to use jaw tilt?

A

Assess for open airway, unconscious or unaligned c-spine

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155
Q

What is apart of the secondary survey? x3

A

1)Rapid Body Scan
2)History
3)Decision on next steps

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156
Q

What is apart of the rapid body scan? x3

A

1)Major Bleeds
2)Deformities
3)Anything indicating a life threatening emergency

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156
Q

What question should be asked when assessing history in the secondary survey? x8

A

1)What happened?
2)Do you have any pain in your head?
3)Do you have any pain in your neck?
4)Do you have any pain in your back?
5)Can you wiggle your fingers?
6)Can you wiggle your toes?
7)Does anything else hurt?

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157
Q

T or F history questions can be asked in groups to make it faster?

A

False

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158
Q

Why is a history important for a secondary survey?

A

Helps decide next steps

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159
Q

Any 2 out of the 4 following are a suspected spinal and a call to ems, what are they?

A

1) Central pain on palpation (of the spinous process)
2)Tingling/numbness/unable to move extremities
3)Mechanism of injury
4)Unwillingness to move

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160
Q

What are 2 things that result in head injury assessment?

A

1)Trauma to the head
2)Pain in the head

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161
Q

What are the 2 things to check for before completing head injury assessment?

A

1)Clear C-Spine (if head trauma than enough force for C-spine)
2)Check Active ROM

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162
Q

What are the 5 questions apart from the head injury assessment symptom check?

A

1)Do you have any pain or pressure in head?
2)Do you have ringing in your ears?
3)Do you feel dizzy?
4)Do you feel nauseous?
5)Is anything blurry or seeing double?

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163
Q

T or F head injury assessment symptom check questions should be asked more than once?

A

True, symptoms chan change over time

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163
Q

T or F one system of the head injury assessment symptom check is a concusionn?

A

True = No return to play

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164
Q

What are the 9 head injury assessment observable signs?

A

1)Check ears/nose for blood or CSF fluid
2)Look/feel for any deformities in head
3)Black Eyes
4)Bruising BehindEars (Battle’s SIgn)
5)Aggressive/emotional behaviour
6)Not making sense
7)Altered speech
8)Unable to focus
9)Seizure

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165
Q

What is PEARL?

A

Pupils Equal And Reacting to Light

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166
Q

What is a part of the cognitive screening head injury assessment? x4

A

1)Orientation (Date, team, where, last practice)
2)Immediate Memory (3 unrelated words to remember and repeat immediate)
3)Delayed Recall (3 unrelated words to remember and repeat later)
4)Concentration (Count backwards)

166
Q

What is apart of the head injury assessment ocular/motor screen?

A

PEARL (cover one eye and what happens to the other)
Tracking (follow finger)
Peripheral vision
Ability to focus (how many fingers, near andfar)

167
Q

When can you proceed with a head-to-toe exam and decide on how to safely remove it from the field? x2

A

1)Clear C-Spine
2) On-field head assessment clear

168
Q

What head assement should be made on sidelines?

A

SCAT6 (Sports concussion assessment tool) includes balance and coordination

169
Q

What is a part to head to a the exam? x1

A

1)Head
2)Neck
3)Shoulders (incl clavicles)
4)chest/sternum
5)Ribs
6)Abdomen
7)Back
8)Pelvis (compress lateral sides)
9)Legs/feet
10)Arms/hands

170
Q

What are we looking for in head to toe exam? x7

A

1)Pain (watch face)
2)Bleeding
3)Spasm
4)Deformaties
5)Brusing/wounds
6)Distal circulation in ankle/foot
7)Distal circ in fingers

171
Q

What are the 3 signs of a major fracture x3?

A

1)Large Bone
2)Unstable or Displaced
3)Compound fracture (aka open fracture)

172
Q

What to do for a major fracture or dislocation in emergency? x3

A

1)Stabilize
2)Treat for shock
3)Call 911

173
Q

What are the 6 emergency medical conditions?

A

1)Diabetic Emergency
2)Epilepsy/Seizure
3)Asthma
4)Anaphylactic Shock
5)Heat/cold emergencies
6)Abdominal Injuries

174
Q

What is shock?

A

-Circulatory system fails to adequately circulate blood

175
Q

Is shock a medical emergency?

A

yes, life-threatening condition

175
Q

What are the 6 symptoms of shock?

A

1)Pale, cool, clammy skin
2)Rapid breathing
3)Rapid and Weak Pulse
4)Changes in LOC/confusedNausea
5)Decreased BP

176
Q

How to care for shock? x5

A

1)Blanket to maintain body temp
2)Rest in comfortable position that minimizes pain
3)Have athlete lie down if necessary to increase blood to organs/brain
4)Reassure
5)O2

177
Q

Emergency Situations x9?

A

1)ABC not present or irregular
2)Major Bleeds
3)Severe head injuries
4)Unconscious or decreased LOC
5)Persistent pain/pressure in chest or abdomen
6)Sudden ilnnes/medical emergency
7)Suspected spinal injury (2/4 red flags or unsure = 911)
8)Major fractures or dislocations
9)Shock if not responding to care

178
Q

If back and neck pain on history taking check for ?

A

Pain on palpation of spinous processess

178
Q

T or F: ABC are clear if talking?

A

True

178
Q

What needs to be done on the on-field assessment before non-urgent assessments? x4

A

Emergency conditions must be ruled out
-C-Spine
-ABCs
-Non-concerning head/spine MOI
-C-Spine and head assessment clear

179
Q

What are the 5 types of non-urgent conditions?

A

1)Sprains
2)Strains
3)Simple Fractures
4)Contusions
5)Abrasions/Minor Lacerations

180
Q

What is HOPS used for?

A

On-field assessment for non urgent injuries

181
Q

What does HOPS stand for?

A

History
Observations
Palpation
Special Test

182
Q

Why are special tests used?

A

Test the can confirm your index of suspicion

183
Q

What is SAMPLE and PQRST used for?

A

History Taking non urgent injuries

184
Q

What does SAMPLE stand for?

A

Signs and Symptoms
Allergies
Medications
Past Medical History
Last Oral Intake
Events Leading up to Injury

185
Q

What does PQRST stand for?

A

Provoke
Quality
Region/Radiate
Severity (1-10)
Time

186
Q

What is PQRST used for?

A

Assessing pain

187
Q

What history taking questions should be asked for addressing symptoms for non-urgent conditions? x5

A

1)What Happened?
2)Where does it hurt?
3)Did you hear or feel anything?
4)Did it give out?
5)PQRST

188
Q

What 5 questions/considerations should be asked for when discussing medications?

A

1)Are you taking any meds?
2)What are they?
3)What are they for?
4)Were they prescribed?
5)Could they be damping symptoms?

189
Q

Why is it important to ask about last oral intake? x3

A

Food: Low Blood Sugar or if surgery is required
Drink: Dehydrated?

190
Q

What needs to be observed when assessing athletes’ fields for non-urgent conditions that could indicate what happened? x3

A

1)What do you see?
2)What is around the athlete
3)What position are they in?

191
Q

What does the injury need to be checked for on the initial non-urgent assessment? x5

A

1)Brusing
2)Swelling
3)Deformity
4)Bleeding
5)Rashes/hives

192
Q

What to look for when performing a palpation? x5

A

1)Get athletes to show the location of the injury and pay attention to how they do it
2)Check capillary refill distal to injury
3)Warm versus the other side? (Warm=injury)
4)Divot or deformity
5)Above and below injury

193
Q

What is your index of suspicion based on?

A

HOPS
What structure: Bone, Ligament, Muscle

194
Q

What special test is used for suspected muscle/tendon injury?

A

Make the tissue contract
Resisted testing 1-5

195
Q

What special test is used for suspected ligament injury?

A

Test to open the joint it stabilizes

196
Q

What special test is used for suspected bone injury?

A

fracture testing

197
Q

What is Kendall’s Resisted Muscle Testing?

A

Rate quality of strength out of 5 (0-5) (0 bad)

198
Q

Grade 0 KRMT

A

No visible or palpable contraction

199
Q

Grade 1 KRMT

A

Visible or palpable, contraction without motion

200
Q

Grade 2 KRMT

A

Full ROM, Gravity Eliminated

201
Q

Grade 3 KRMT

A

Full ROM against Gravity

202
Q

Grade 4 KRMT

A

Full ROM against gravity, moderate resistance

203
Q

Grade 5 KRMT

A

Full RO against gravity, max resistance

204
Q

How many grades/classifications of sprains and strains?

A

3

205
Q

What is a Grade 1 classification SS

A

Tissue Stretch/ Some Fibres Disrupted

206
Q

Grade 1 Strain

A

Contractions are strong but painful

207
Q

Grade 1 Sprain

A

Integrity of joint maintained

208
Q

What is a Grade 2 classification SS

A

Partial tear/many fibres disrupted

209
Q

Grade 2 Sprain

A

Results in some instability/laxity in the joint

210
Q

Grade 2 Strain

A

Contractions are weak and very painful

211
Q

What is a Grade 3 classification SS

A

Complete Tear

212
Q

Grade 3 Strain

A

Unable to contract and often pain free (nerve fibres were torn)

213
Q

Grade 3 Sprain

A

Significant instability/laxity in joint

214
Q

What grade 2 or 3 is easier for healing?

A

3 less pain

215
Q

What are the 3 fracture tests?

A

Tap test
Compression Test
Tuning Fork (above site)

216
Q

If we see a bone deformity, do we do a fracture test?

A

No

217
Q

How is a Tap Test completed?

A

A gentle tap at a location on the bone AWAY from the suspected fracture site
-Vibrations cause pains

218
Q

How is a Compression Test completed Direct?

A

Compress the two ends of the long bone together

219
Q

How is a compression test completed indirect?

A

Compress the bones around the small bone with suspected fracture

220
Q

How to complete a tuning fork test?

A

-Bang the end of the tuning for of shoe or hard surface
-Place the base on bone with suspected fracture, away from fracture site
-Vibrations

221
Q

Sensitivity of Tuning Fork?

A

75%-92%

222
Q

Specificity of Tuning Fork?

A

18%-94%

223
Q

Why may fracture testing be inconclusive? x2

A

1)Error on the side of caution (X-Ray)
2)Prevent Secondary Complications

224
Q

What are the 3 types of secondary complications that could result from fracture?

A

1)Further muscle/ligament injury surrounding fracture
2)Nerve/vessel damage (impaired nerve/blood supply)
3)Major Bleeds (ER condition)

225
Q

What is included on a side-line assessment for non-urgent injuries that is not on in the on-field assessment? x4

A

1)Rule out joints above and below
2) Full physiological ROM
3) 3 Special test to confirm
4) More extensive palpation

226
Q

What are examples of physiological ROM? x14

A

1)Flexion
2)Extension
3)Abduction
4)Adduction
5)Internal Rotation
6)Extenral Rotation
7)Dorsiflexion
8)Plantar flexion
9)Cross-flexion
10)Cross-extension
11)Pronation
12)Supination
13)Ulnar deviation
14)Radial deviation

227
Q

What are accessory movements (Athrokinematics)/intra-articular (within joint) movements needed to complete ROM? x3

A

1)Roll
2)Spin
3)Glide

228
Q

Are accessory movements tested on sideline assessments?

A

No, but can be the cause for limited physiological assessments

229
Q

What is Roll?

A

Multiple points along one rotating articular surface contact multiple points on another articular surface

-A tire rotating across pavement

230
Q

What is Glide?

A

A single point on one articular surface contacts multiple points on another articular surface.

-A non-rotating tire skiddings on icey pavemnt

231
Q

What is Spin?

A

A single point on one articular surface rotates on a single point on another articular surface

-A toy top rotation on one spot on floor

232
Q

What is AROM?

A

Active Range of Motion

233
Q

What is required for RTP? x3

A

AROM:
-Overpressure the end range if full and pain free
-ROM must be full

Resistant Testing at 80%

234
Q

What are the 6 steps of non-urgent injuries?

A

1)RTP Decision
2)Immediate Care
3)Educate
4)Communicate
5)Transport
6)Referral

235
Q

What is sideline management of sprains? x3

A

1)Ice and Elevation
2)Wrap to support approximate tissues, provide compression
3)Crutches

236
Q

T or F we cannot diagnose?

A

T, Impression that share to appropriate people

237
Q

What is sideline management of strains? x3

A

1)Ice and Elevation
2)Wrap with pressure pad to support approximate tissues, provide compression
3)Crutches

238
Q

What is sideline management of contusions? x4

A

1)Ice
2)Donut pad with cover to protect from 2nd insult
3)Wrap padding on area with herringbone
4)No Massage (Lymph drainage or effleurage ok)

239
Q

Sideline management of fractures? x3

A

1)Splint (SAM and Speed)
2)Splint joints above and below
3)Refer for imaging

240
Q

Sideline management of abrasions?

A

Telfa/Non-stick pad and cover roll

241
Q

Sideline Management of Minor Lacerations? x2

A

Telfa/Non-stick pad and cover-roll
Steri Strips

242
Q

What is the purpose of wrapping?

A

Support and Minimize swelling through compression

243
Q

What are the 5 key structures of the ankle/foot than should be considered following injury?

A

1)Talus Position
2)Cuboid Position
3)Navicular Position
4)Base of the 5th metarsal (Tender of Palpation)
5) Seasomoid Bones

244
Q

Talus Position to be aware?

A

Anterior

245
Q

Cuboid Position to be aware?

A

Rotated

246
Q

Navicular Position to be aware?

A

Rotated or Dropped

247
Q

Base of the 5th metarsal to be aware?

A

TOP (Tender on Palpation)

248
Q

Seasomoid Bones to be aware?

A

Within Flexor Hallucis Brevis Tendons

249
Q

Tib Posterior Action

A

PF and INV

250
Q

Flex Digitorum Longus action

A

PF and Toe Flex

251
Q

Flex Hallcucis Longus action

A

PF and Big Toe Flex

252
Q

Tib Anterior action

A

DF and INV

253
Q

Peroneus Longus action

A

Eversion

254
Q

Peroneus Brevis action

A

PF and Ev

255
Q

Tib Ant. action of the longitudinal arch?

A

Eccentrically lowers (against ground)

256
Q

Tib Post. the action of the longitudinal arch?

A

Stabilizer (shin splints)

257
Q

Plantar Fascia . the action of the longitudinal arch?

A

NB for dynamic longitudinal arch support (Absorbs forces)

258
Q

Anterior Talus action for longitudinal arch?

A

Effects up chain (neck pain)

259
Q

What are the 4 toes ROM?

A

1)Flexion
2)Extension
3)Abduction
4)Adduction

260
Q

Ankle ROM of the Tibiotalar joint? x2

A

Dorsiflexions (Extension)
Plantarflexion (Flexion)

261
Q

Ankle ROM of the subtalar joint? x2

A

Pronation
Supination

262
Q

What is Turf Toe and MOI?

A

Hyperextension of the big toe
-1st MTP sprain of plantar lig/capsule

263
Q

What are the symptoms of turf toe? x4

A

Swelling, Bruising, Pain, Loss of Toe DF ROM. Weak Halluc Flexion
-Gr 3 sprain of 1 MTP

264
Q

What is Runners Toe and MOI?

A

Subungual Hematoma due to repeat trauma or the end of toe(s)

265
Q

What are the the symptoms of runners toe?

A

Pain and Pressure under the nail, discolouration of the nail

266
Q

What is Sesamoiditis and MOI?

A

Inflammation to flexor hallucis brevis (FHB) repeat trauma to the ball of the foot

267
Q

What are the symptoms of Sesamoiditis?

A

Pain over Sesamoids, Swelling, limited big toe ext., weak and painful flex

268
Q

Treatment for Sesamoiditis?

A

Rest
Treat Inflammation
Padded insoles

269
Q

Treatment for runners toe?

A

Proper shoe fitting
Changing course (Limit downhills)

270
Q

What is plantar fasciitis and MOI?

A

Inflammation and degeneration of plantar fascia due to poor biomechanics/overuse stress

271
Q

What are the symptoms of plantar fasciitis? x3

A

Tender under palpation: med calcaneus (origin) or along the longitudinal

C/O pain with 1st steps in morning

Ankle/Toe DF stretch pain

272
Q

plantar fasciitis is often associated with what?

A

Tight Achilles

273
Q

How to train plantar fasciitis?

A

Find Cause
-Retrain biomechanics

274
Q

What are Bunions?

A

Big toe aligns toward 2nd toe, tender bump med MTP joint

275
Q

What causes Bunions? x3

A

Genetics
Poor Foot Mechanics
Tight/Narrow footwear

276
Q

What is important to consider for arch taping?

A

Bunions

277
Q

What are 2 things bunions can be used as a red flag for?

A

1)Shoe doesn’t fit
2)Improve biomechanics to prevent secondary conditions

278
Q

What are tendonitis and shin splints and MOI?

A

Poor Mechanics and overuse of peroneal tendons, Tib Ant., T,D,H

279
Q

What are the symptoms of tendonitis and shin splints ?

A

Tender under pressure over inflamed tissues
Pain with running
Pain with resisted muscle testing or stretch of the affected structure

280
Q

Secondary condition of tendonitis and shin splints?

A

Potential for stress fracture at muscle origin due to traction on bone

281
Q

Treatment for tendonitis and shin splints?

A

Correct foot/lower extremity mechanics
Taping (shin and arch)
Proper Footwear
Insole/Orthotic

282
Q

What is the MOI for a lateral ankle sprain?

A

Ankle inversion (In neutral of DF or PF)

283
Q

What are the 8 possible structures affected by a lateral ankle sprain?

A

ATFL, CFL, PTFL, AITFL, PITFL, Peroneals
Cuboid Position, Base of 5th MT

284
Q

What are the signs and symptoms of a lateral ankle sprain?

A

Pop, giving out, swelling, bruising, limping (antalgic gait)

285
Q

What 6 things occur on sideline?

A

1)HOPS
2)NWB
3)Sideline Assessment
4)Educate
5)Ice/Compress
6)Support

286
Q

What 5 things to do to handle/focus for inflammation treatment?

A

1)Decrease Inflammation
2)Lymph Drainage
3)Support
4)Prevent 2nd
5)Team Involvement

287
Q

What 7 things to do to handle/focus on healing?

A

1)Increased circulation
2)Heat
3)Massage
4)Increase ROM
5)Shock Wave
6)Strength
7)Proprioception

288
Q

What is needed for RTP assesment? x4

A

1)80% Resitance
2)FROM
3)Sport Specific Exercise
4)Psych Readiness

289
Q

T or F what is more common lateral or medial ankle sprains?

A

Lateral, (medial is eversion and we dont often fall inwards)

290
Q

What is the MOI of a medial ankle sprain?

A

Ankle Eversion

291
Q

What are the 5 possible structures affected in a medial ankle sprain?

A

1)Deltoid Lig
2)Spring Lig
3)TDH
4)Navicular Position
5)Fibula Fracture

292
Q

For ankle and foot fractures what should be done for injury management? x4

A

1)Urgent vs Non-Urgent
2)Distal Circulation
3)Monitor for Shock
4)Splint and send for x-rays NWB

292
Q

What are the 6 types of ankle/foot fractures?

A

1)Jones Fracture
2)Metatarsal Fracture
3)Talus
4)Calcaneus
5)Fibula
6)Tib-fib (with dislocation)

292
Q

If a fracture is stable what is the surgical management?

A

Immbolization

292
Q

What are the signs and symptoms of a medial ankle sprain? x5

A

Pop, giving out, swelling, bruising, limping (antalgic gait)

292
Q

If a fracture is unstable, what is the surgical management? x2

A

1)Reduction
2)Fixation

293
Q

What is a jones fractures and the MOI?

A

Peroneus brevis avulsion of base of 5th metatarsal (MT) caused by inversion sprain

294
Q

What are the signs and symptoms of a jones fracture?

A

Tender on palpation of 5th MT, pain in weight-bearing
-Ankle sprain symptoms may distract from #

295
Q

What is the MOI for a talus fracture? x3

A

Severe ankle sprains
Land from height
Forced Dorsi Flexion

296
Q

What are the signs and symptoms of a talus fracture?x2

A

Vary with Severity:
Pain with WB (or unable to)
Loss ROM

297
Q

What is the MOI of a calcaneus fracture?

A

Fall/Jump from Height

298
Q

What are the Signs and Symptoms of a calcaneus fracture?x2

A

1)Extreme Pain
2)Unable to WB

299
Q

What is the MOI of a fibula fracture? x2

A

1)Direct Blow
2)Ankle Sprain Mechanism

300
Q

What are the signs and symptoms of a fibula fracture?

A

Vary with severity

301
Q

What are the 5 steps of a pre-tape assessment?

A

1)Explain tape job chosen and why
2)Ask permission
3)Clear contraindications (Cuts, abrasions and blisters, Reactions, sensitivities)
4)Check ROM you want to limit
5)Check circulation distal to area being tapped

302
Q

What are the 7 contraindications of when not to tape?

A

1)Allergies to adhesives
2)Immediately after injury
3)Injury is not fully assessed
4)ROT criteria not been met
5)Areas of altered skin
6)Overnight
7)Check to see if sport rules allow tape

303
Q

What are the 4 ROT criteria?

A

1)FULL ROM
2)Minimum 80% strength
3)Moves with proper biomechanics
4)Able to perform the demands of sport

304
Q

What are the 3 ankle taping indications?

A

1)Chronic ankle instability from previous sprains
2)RTP following treatment of recent ankle sprain
3)When bracing doesn’t fit in the shoe or bracing is not permitted

305
Q

3 Ankle tests pre and post tape job?

A

1)Drawer Sign
2)Talar Tilt
3)Wedge Test

306
Q

What does drawer test for in ankle?

A

Anterior Talofibular Ligament (ATFL)

307
Q

What does talar tilt test for in ankle?

A

Calcaneofibular Lig (CFL)
-Eversion talar tilt = deltoit lig

308
Q

What does wedge test for in the ankle?

A

Anterior Inferior Tibfib lig (AITFL)

309
Q

What does eversion talar tilt test for in ankle?

A

deltoit lig

310
Q

Indications for prowrap? x2

A

1)Sensitivity to adhesives
2)Hair
(less effective application so tape directly on skin if possible)

311
Q

Indications for Arch Taping?

A

1)Arch Pain
2)Medial Tendonitis/osis
3)Shin Splints
4)Bunions

312
Q

What may a successful arch tape indicate?

A

Good indicator as to whether orthotic may be helpful

313
Q

What is the pre and post-test for arch position?

A

Standing

314
Q

What is pronation

A

Combo of plantar flexion, inversion, and adduction
-Causes the sole of the foot to face medially

315
Q

What is supination?

A

Combo of dorsiflexion, eversion and abduction
-Causes the sole of the foot to face laterally

316
Q

What test is used for intracapusular swelling?

A

Wipe Test: Narrows in on structures affectced

317
Q

If the Gluteus medius (hip abduction) is damaged what gait results?

A

Trendelenburg Gait, pelvis on stance side dropping during gait

318
Q

What eccentrically control IR of femur in weight-bearing?

A

Post Fibres of Glut Medius

319
Q

What is the ideal Quad:Ham Ratio?

A

Ideally 3:2

320
Q

What is the quad:ham ratio post acl injury?

A

1:1

321
Q

What is medial tibial stress syndrome (MTSS)?

A

Shin Splints

322
Q

What are shin splints?

A

Involves exercise-induced pain over the ant. tibia and is a early stress injury in the continuum of tibial stress fractures

323
Q

What is compartment syndrome?

A

Excessive pressure within a muscle/fascial compartment (Swelling is contained and pressure build, top open and bottom closed)

324
Q

How can compartment syndrome occur acutely?

A

Trauma or Following a long bone fracture

325
Q

How can compartment syndrome occur due to overuse?

A

Often overlooked as shin splints

326
Q

What are the S&S of compartment syndrome?

A

-Red, Hot, Shiny, Very Painful, Numb, Weak, Faint Pulse Distal
-Pale Skin and over damaged tissue

327
Q

Acute management of compartment syndrome? x6

A

No Pressure
Reduce Inflam
No RTP
NWB (Not Weight Bearing)
Refer to sports med Dr.
Fasciotomy to release pressure

328
Q

How does a gastrocs/soleus strain occur?

A

Overstretch in dorsiflex with knee ext. (gastrocs) especially with forceful contraction

329
Q

S&S of gastrocs/soleus strain? x4

A

Pop or Pull
Sharp Pain
Swelling
Brusing

330
Q

What are the special tests used for gastrocs/soleus strain? x3

A

Muscle Test for gastrocs, soleus, deep flexors
Thompson test to rule out Achilles Rupture
Toe Raises

331
Q

Acute Management of gastrocs/soleus strain? x4

A

PIER (Pressure, Ice, Elevate, Rest)
Pressure pad with wrap over injured tissues
NWB
Avoid Stretch or contraction

332
Q

RTP for gastrocs/soleus strain?

A

NO, usually self-limiting; once rehabbed, can tape with heel lift

333
Q

What is the MOI of an Achilles rupture?

A

Sudden forceful contraction (common in stop and go sports)

334
Q

S&S of Achilles Rupture x4

A

1)Sudden Sharp Pain (parial) or feeling of being kicked/hit in back of leg
2)Unable to Plantar Flex/ go up on toes
3)Swelling
4)Delayed-onset bruising

335
Q

What are the special tests used for an Achilles rupture? x2

A

1)Thompson Test
2)Two Foot and 1 Foot Toe raise

336
Q

Acute Management of Achilles rupture? x5

A

PIER
NWB
Pressure pad over injured tissues with tensor
Educate
Sports Med

337
Q

MOI of Patellofemoral Pain Syndrome (PFPS)

A

Poor tracking of patella in femoral condyle

338
Q

S&S of Patellofemoral Pain Syndrome (PFPS)

A

Tender Under Palpation post aspect of the patella

339
Q

Checks for Patellofemoral Pain Syndrome (PFPS)? x4

A

1)Mechanics bottom-up and top up
2)Stable Base
3)Quad imbalance (med or lat pull)
4)1 leg squats (does femur collapse into IR)

340
Q

Patellofemoral Pain Syndrome (PFPS) acute onset or overuse?

A

More often overuse

341
Q

MOI of patellar dislocation?

A

Valgus force with foot planted causing IR of femur

342
Q

What is most common in active children ages 10-17?

A

Patellar Dislocation

343
Q

S&S of patellar dislocation? x3

A

Patella positioned on lat side of the knee
Significant Pain
Usually in KF

344
Q

Special tests for patellar dislocation? x2

A

None if dislocated
-If subluxated (partial disloc) : Apprehension Test

345
Q

The first time a patellar dislocation occurs, what needs to be ruled out?

A

Osteochondral Fracture
-25-75% of cases
-Surgical
-Affect patella or fem condyle

346
Q

Acute management of patellar dislocation? x3

A

1) Rule out fracture
2) PIER if reduced
3)Refer

347
Q

How long to be braced for patellar dislocation?

A

3 Weeks

348
Q

MOI Patellar Tendonitis?

A

Excessive traction on patellar tendon

349
Q

S&S Patellar Tendonitis

A

1)Pain, Swelling and Heat over the patellar tendon
2)Pain with jumping , running, quick change in direction or string quad contraction
3)Pain with Flexion and extesnsion

350
Q

T or F People with Patellar Tendonitis can often train through pain

A

T

351
Q

Special Tests for Patellar Tendonitis x2

A

Thomas Test
Resisted Quad Test

352
Q

Acute management of Patellar Tendonitis x3

A

PIER
Roll/Soft Tissue Mobility for quads
Lower extremity mechanics

353
Q

Why is a knee brace often used for people with Patellar Tendonitis?

A

Train hamstrings to prevent anterior translation of tibia on femur and stability at hip and knee

354
Q

What is Tendinopathy rehab for?

A

Patellar Tendonitis

355
Q

Examples of tendinopathy rehab? x2

A

Cross Fit
Eccentrics

356
Q

RTP for Patellar Tendonitis?

A

Patellar Tendonitis Tape Job

357
Q

MOI for knee bursitis?

A

Direct trauma, friction from tight muscles/tendons

358
Q

S&S for knee bursitis x3

A

-Rebound Pain
-Often Painless
-Visible fluid-filled sace

359
Q

Acute Management for knee bursitis? x2

A

Protect with padding to avoid repeat insult
Soft Tissue Mobility of tight muscles

360
Q

T or F Chronic bursitis can develop a granular rice-like texture.

A

T

361
Q

What is a stress fracture of the knee?

A

MTSS/Shin Splints

362
Q

Stress Fracture (MTSS/SHIN SPLINTS) Moi?

A

Overuse/poor mechanics

363
Q

Patellar Fracture MOI?

A

Direct blow, patellar dislocation

364
Q

Tibial plateau fracture MOI?

A

Vargus of valgus load, direct below

365
Q

What are the 6 types of meniscus tears?

A

1)Vertical
2)Transverse
3)Peripheral
4)Bucket-Handle
5)Parrot Beak
6)Flap

366
Q

MOI of Meniscus Tears? x3

A

Plant and Twist
Contact
Wear and Tear/Degeneration

367
Q

S&S Meniscus Tears? x5

A

Sharp pain at specific ROM
Loaded Rotation
Deep Squat
Catching/clicking/locking
Swelling (24h later)

368
Q

Meniscus Tears common with what type of injury?

A

ACL Injuries

369
Q

Special Tests for Meniscus Tears? x3

A

McMurray’s
Apley’s
Duck Walk

370
Q

Acute management of Meniscus Tears? x3

A

PIER
NWB
Educate

371
Q

ACL MOI? x2

A

1) Sudden cut or pivot (rotational force),
2)Sometimes from added external force from a tackle/collision (valgus,hyperextension)

372
Q

S&S ACL x3

A

1)Swelling + Extreme pain throughout Knee
2)Difficulty/unable to WB
3)Delayed onset bruising depending on structures affected

373
Q

ACL injuries higher in males than females?

A

F, higher in females

374
Q

____% ACL injuries are direct contact
_____% ACL injuries are from wrong movement

A

30%
70%

375
Q

Special Tests for ACL? x3

A

Anterior Drawer
Lachman’s
Pivot Shift

376
Q

Acute management of ACL injuries x3

A

PIER
NWB
Educate

377
Q

5 Types of ACL Surgery?

A

1)Autograft (persons tissue) vs Allograft (Cadaver)
2)Bone-Tendon-Bone Graft
3)Hamstring Graft
4)Unilateral vs. Contraleteral (If other inuries or past)
5)BEAR

378
Q

PCL MOI x2

A

Hyperflexion
Forced post translation of tibia on femur

379
Q

S&S PCL x3

A

Swelling + Extreme pain throughout the knee joint
Difficulty or Unable to WB
Delayed-onset bruising depending on structures affected

380
Q

Special Test PCL x2

A

1)Posterior Drawer
2)Sag Sign

381
Q

ACUTE Management of PCL? x3

A

PIER
NWB
Educate

382
Q

MCL MOI? x2

A

Valgus stress on the knee (Direct blow to outside of knee)
Plant and Twist (with lat rotation of femur on tibia)

383
Q

Special test MCL?

A

Valgus Stress

384
Q

Acute Management MCL x3

A

PIER
NWB
Pressure pad to approx end

385
Q

T or F MCL and LCL repaired more commonly then ACL and PCL

A

False

386
Q

LCL MOI?

A

Varus stress to the knee

387
Q

S&S LCL x3

A

Lateral Knee Pain and Swelling
Tender Of Palpation LCL
Stifness

388
Q

Special Test for LCL

A

Varus Stress

389
Q

Acute Management of LCL? x3

A

PIER
NWB
Pressure Pad to Aprox. Ends

390
Q

WIPE Test Use

A

Intracapsular Swelling

391
Q

Valgus test at 0 use

A

Superficial Fibre MCL

392
Q

Valgus test at 30 use

A

Deep Fibres MCL

393
Q

Varus Test at 0 use

A

LCL

394
Q

Lachmans Test use

A

ACL

395
Q

Anterior Drawer Test use

A

ACL

396
Q

Posterior Drawer Test use

A

PCL

397
Q

Sag Sign Test Use

A

PCL

398
Q

McMurray’s test use

A

Meniscus

399
Q

Apley’s test use

A

Meniscus and ligamentous

400
Q

What are the 8 Knee Special tests?

A

Valgus at 0 and 30
Vargus at 0
Lachman;s
Ant. Drawer
Post. Drawer
Sag Sign
McMurray’s
Apley’s

401
Q

Knee Taping Pre/Post Tests x2

A

Hyperextension ROM
Varus or Valgus

402
Q

Suspected tib ant strain indications? x2

A

Ant. Shin Splints
Excessive PF Mechansim

403
Q

Suspected tib post strain indications? x2

A

Medial Ankle Sprain Mechanism
Post Shin Splints

404
Q

What is Urticaria?

A

Cold Allergy
-Hives/rash from cold

405
Q

What are the 4 contraindications of cold? x3

A

1)Clotting Disorder
2)Over Superficial Nerves
3)Altered Skin Sensation
4)Complex Regional Pain Syndrome

406
Q

What are the 7 contraindications of heat?

A

1)Inflamed tissues/post-tissue
2)Bleeding Disorders
3)Blood Clots
4)Impaired Sensation
5)Metal Implants
6)Infection
7)Open Wounds

407
Q

What are the 10 contraindications for massage>

A

1)Acute Inflam
2)Condition
3)Acute Spasm
4)Open Wounds or Skin Reactions
5)Altered Sensations
6)Possible Blood Clot
7)Bleeding Disorders
8)Varicose veins
9)Deep Vein Thrombosis (DVT)
10)Cancer

408
Q

What are the symptoms of deep vein thrombosis (DVT)?

A

Deep, Burning Calf Pain

409
Q

Acute Stage of injury use heat or cold?

A

Heat

410
Q

If multiple sclerosis should you use whole body/sauna heat?

A

No, if due to heat intlolerance

411
Q

If ill should you use full body heat/sauna?

A

NO

412
Q

If preggo or trying to receive should you use full body heat?

A

NO

413
Q

WHAT does RICE stand for?

A

Rest
Ice
Compress
Elevate

414
Q

What does PEACE and LOVE Stand for?

A

Protect, Elevate, Avoid anti-inflammatory medication/ice, Compression, Educate, Load, Optimism, Vascularization, Exercise;

415
Q

What does PIER stand for?

A

Pressure
ICE
Elevate
Rest

KNPE 331 (2 decks)

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