1 Flashcards
the study of the distribution of diseases, injuries or other health states in the human population for the purpose of identifying & implementing measures to prevent their development & spread
epidemiology
scientific studies of _____ injuries are a relatively recent trend
sport
the studies of sport injuries involve determining ____ _____ that play a causative role in injury
risk factors
_____ may be identified if sufficient sports (and exercise) injury data is available
trends
what are the 3 classifications of sports?
- contact/collision (hockey soccer bball)
- limited contact/collision (vball, baseball, softball)
- non-contact (tennis, bowling, golf)
____ americans sustain injuries each year
62 million
___% of inures occur in practice
62
what sport has the highest injury rate per 1000 athletes? what sport has the lowest?
football, volleyball
fractures are most likely to occur in which sports
bball, soccer, baseball
knee injuries are most likely to occur in what sport for men & women?
womens soccer, baseball
what is the most common injury category?
contusions (soft tissue)
highest rate of injury occurs in what type of sport
contact & collision
if you are older, the injuries are more …
severe
how many people are treated a day in the ER for sport, exercise, and recreational injuries?
10,000
what is the most injured body part in weight training
hand
in weight training, what kind of injury makes up 64.1% of all injuries? 15.1% (name both)?
- soft tissue
- lacerations
- fractures/dislocations
in weight training injuries, what age group makes up 43.5% of all injuries? what about 32.5%?
- 15-24
- 25-44
what percent of all injuries in weight training are male? what are female?
male: 80.5%
female; 19.5%
what percent of weight training injuries occur at home?
40.2%
what percent of weight training injuries occur in the fitness center?
17.8%
what is an injury?
trauma or damage to a part of the body
what are the usual results of an injury?
pain, swell in, temporary loss of tissue function (mild moderate or severe)
this type of injury occurs as a rapid onset from a traumatic event
acute injury
magnitude of a single force for which the anatomical structure of interest is damaged
critical force
what are common signs/symptoms of an acute injury? name five.
- Bone or joint out of place
- Incomplete joint ROM
- Tender area of the body
- Extreme leg/arm weakness
- Swelling
this type of injury occurs as a slow onset implying a gradual development of structural damage
chronic injury
______ injuries are associated with ____ events such as running
chronic, repetitive
chronic injuries are also called what
over use injuries
what are 3 common sites of chronic injuries?
achilles tendon, patellar tendon, rotator cuff
what are the common signs/symptoms of chronic injury?
- pain when playing
- dull ache when resting
- swelling
_____ injuries involve damage to the brain & _____ _____
catastrophic, spinal cord
what is different about catastrophic injuries?
they are life threatening or permanent
sprains are an injury to the
ligament
describe the three degrees of a sprain.
1st degree: ligament is stretched
2nd degree: partial tear of ligament
3rd degree: complete tear of ligament
what is a strain?
an injury to a muscle, tendon or musculotendinous junction
describe the three degrees of a strain
- 1st degree: tissue is stretched (possible micro-tears) & pain is noticeable with use
- 2nd degree: partial tear of tissue with pain & moderate loss of function
- 3rd degree: complete rupture of tissue, significant swelling & loss of function
general cause of strains?
excessive forced stretching of muscle or tendon
what is the site of most strains?
MTJ (generally distal)
______ are extremely strong structures that can withstand stresses of _____ - ______ lbs/sq. inch
tendons; 8,700 -> 18,000
what are contusions also referred to as
bruises
bruises/contusions are also associated with what symptoms
pain, swelling, stiffness, hematoma (blood clot)
if a contusion is severe enough, what might it result in?
myositis ossificans
what are the 2 types of skeletal tissue injuries
fractures & dislocations
what are fractures
breaks or cracks in bone
what are the three types of fractures?
closed, open, stress
what type of fracture occurs when there is no wound but internal bleeding is occurring?
closed
what type of fracture occurs when there is a wound present & external bleeding
open
what type of fracture occurs when there is a fine airline fracture & no soft tissue damage?
stress
how do stress fractures occur ?
repeated overloading of bone exceeds the recovery rate
symptoms of a stress fracture
pain/tenderness, absence of trauma, repetitive activity
how long will it take for a stress fracture to show on an X-ray?
weeks or even months
_______ is the displacement of ______ surfaces or bones comprising a joint
dislocation, contiguous
what are the two types of dislocations? what is the difference?
subluxation and luxation
- subluxation: partial dislocation
- luxation: total displacement
what type of dislocations should be treated by a physician?
ALL OF THEM
rate at which bleeding occurs depends on ___ and ____ of ____
size and type of vessels
3 types of external bleeding
mild, moderate & severe
type of bleeding occurs in the capillary, results in oozing
mild bleeding
type of bleeding ochres in the veins & produces a steady dark red flow
moderate bleeding
type of bleeding located arterially and produces bright red {oxygenated} blood in strong spurts {pulse}
severe
how should you control mild bleeding?
direct pressure
disinfect wound
sterile dressing
how should you control moderate bleeding?
direct pressure, sterile dressing, elevate body part, treat patient for shock {if necessary}
how should you control severe bleeding?
pressure, elevate –>
if unproductive, apply pressure to arterial pressure point {brachial or femoral}, treat patient for shock –>
if all fails apply tourniquet
t/f you should treat a suspected injury as an actual injury until proven otherwise
true
when should you see a doctor (as pertaining to an injury)
- injury results in severe swelling/numbness
- unable to bear weight
- old injury hurts
- old injury swells
- joint feels irregular or unstable
sports medicine is also referred to as
athletic training
inappropriate decisions by you (the person in charge) may jeopardize _____ & possibly result in ____ action
health, legal
define tort
harm or civil wrong done to another for which the law holds the wrongdoer responsible
in tort cases, the court will provide a _____ usually in the form of ____, usually money
remedy, damages, usually money
the person suing usually uses ______ as a reason for issuing the legal action
negligence
what is negligence?
failure to do what a reasonably prudent person would have done under similar circumstances OR doing something that a reasonably prudent person would NOT have done under similar circumstances
define reasonably prudent person
hypothetical person who exercises qualities (attention knowledge intelligence judgment) which society requires of it’s members for the protection of & interests of others
each person in charge is responsible for acting in a _____ and _____ manner
reasonable and prudent
Negligence is referred to as an act of ______
commission
what is an act of commission?
committing an act that’s not legally yours to perform (ex: PE teacher setting a broken bone)
what is the act of omission? example?
failure to carry out a legal duty; not performing CPR on someone after being trained
what are two scripture references that assess the act of omission and commission
James 4:17 & Genesis 3:1-7
What are the 4 elements of negligence?
- Duty
- Proximate legal cause
- breach of duty
- Damage (harm/injury)
The plaintiff (person suing you) must prove __ elements in order for _____ to exist
all four elements, negligence
what is a duty?
an obligation to protect individuals from unreasonable risk of harm
are you required to render aid when no legal duty exists?
no
the _____ must prove that it was the Emergency Services personnel’s ___ ____
plaintiff, legal duty
what are the 6 legal duties of E/S personnel?
- planning
- supervision
- instruction
- warnings
- safe participation environment
- medical assistance
which of the 6 legal duties of the E/S personnel overlap the other legal responsibilities?
planning
which is one of the most prevalent allegations in sports injury litigation?
failure to warn; warnings should be put into a waiver
what are the two responsibilities that come with medical assistance?
- 1st aid until qualified medical assistance arrives
2. initiating emergency medical procedures (which should be planned in advance)
negligence only exists when a ____ is _______
duty, breached
true or false: E/S is also negligent when a person suffers due to people under him/her not responding or responding out of job
True
one is not guilty every time a duty is breached. what must occur?
injury
What occurs in “proximate or legal cause”
plaintiff must prove the personnel actions caused harm (whether they did or did not do something) & this needs to be a substantial factor
explain “Damage”
plaintiff received physical or emotional harm resulting in economic loss, physical pain or suffering, emotional distress, or physical impairment
name the 4 legal defences
- contributory negligence
- comparative negligence
- assumption of risk
- act of God
what occurs with contributory negligence
exists when plaintiff conduct helps aggravate plaintiff injury [partially/totally responsible for harm]
what occurs with comparative negligence
plaintiff & defendant are guilty; plaintiff receives partial compensation on a prorated basis (as determined by the judge & jury)
what occurs with assumption of risk
plaintiff assumes responsibility for injury bc they agreed to participate & were fully informed (signed a waiver, etc.)
what occurs with Act of God
injury is a result of factors beyond the control of the defendant (ex: earthquake or lightning strike during practice)
what is it called when government employees are provided a certain degree of immunity from tort litigation (lawsuits) as long as the employee acts within the scope of their job description
doctrine of sovereign immunity
what are good Samaritan laws?
serve to protect those who voluntarily provide first aid to injured person(s);
what are the rules behind good Samaritan laws?
the act cannot be grossly negligent or constitute willful misconduct; only apply in emergencies; must act without compensation; must not be part of your job
what is gross negligence?
negligent act done with utter unconcern for safety of others
what are four major potential liabilities
- failure to be reasonable prudent
- failure to hire competent personnel
- failure to provide safe equipment
- failure to provide instruction
what are ways we can be protected?
- be vigilant regarding risks
- ask employer about their liability protection
- acquire liability insurance
- don’t assume you’re covered by a policy
how can you reduce the chances of going to court
- written contract w/ duties
- perform duties properly
- 1st aid/cpr trained
- form emergency plan
- document all injuries
- inspect facilities
what should you do if you get sued?
- contact pro liability insurance company and a lawyer
- write detailed description of events
- make no statement to the media
- pray without ceasing
every effort should be made to reduce likelihood of injury. This means examining the ____ _____ that contribute to injuries.
risk factors
what kind of risk factors are participant dependent?
intrinsic factors
what kind of risk factors are event/situation/environment dependent?
extrinsic factors
8 intrinsic factors
- age & physical growth/development
- gender specific concerns
- body size
- injury history
- ligament laxity
- flexibility
- fitness level
- exercise competence level
- existing medical conditions
- psychological state
- overall intelligence
4 extrinsic risk factors
- safe equipment & facilities
- appropriate & safe environment
- appropriate activity for participants
- conditioning errors/poor judgement
intervention strategies for extrinsic factors
enhance modify or eliminate
intervention strategies for intrinsic factors
minimize modify or eliminate
many intrinsic factors can be significantly modified as a result of …
effective conditioning programs
what should injury prevention strategies focus most on?
preseason conditioning & training throughout the season
what does general conditioning focus on?
the 4 components of fitness
what does sport specific conditioning focus on?
all aspects of the sports that are unique to it
stable enduring qualities of an individual
personality
5 characteristics that may be related to sports injuries include
- general personality
- trait anxiety
- locus of control
- self-concept
- stress response
permanent personality characteristics are called
personality traits
temporary changes in personality characteristics are called
personality states
general disposition to perceive a threat & react with an anxiety response
trait anxiety (emotional stability)
people’s belief (or lack thereof) that they are in control of events occurring within their lives
locus of control
what is the general thought in regards to internal locus of control
I am responsible for what happens to me
what is the general thought in regards to external locus of control
I have little control over events in my life
theory currently being studied that says a low self-concept is less able to deal efficiently with competition stress
self concept (can be raised with counseling & exercise)
these develop through interaction between the participation & a changing social environment
psychosocial variables & injuries
a strong relationship exists between _______ events & ______
negative; injury
what is a stressor?
anything that affects the body’s physiological or psychological condition & upsets homeostatic balance
dynamic equilibrium of the internal environment and the external environment
homeostasis
injury is a _______ stressor for athletes according to Weiss & Troxel
psychological
describe the four phases of the psychological response
one: adapts to activity restriction
two: appraises short & long term significance of the injury
three: emotional responses
four: deals with long term consequences
injury rates are estimated to be as high as ____ per year for individuals who regularly engage in ____ ______ activities such as _____
50%, high intensity, running
majority of sports have ________ parameters for participation
narrow
sports demand ____ for success
leanness
self-starvation motivates by an obsession with thinness & overwhelming fear of fat
anorexia nervosa
repeated bouts of binge eating followed by purging
bulimia nervosa
what is the 3rd type of eating disorder
atypical eating disorder
4 characteristics of subclinical disordered eating (atypical)
- dieting excessively when not overweight
- preoccupation with food, calories, nutrition, cooking
- excessive exercise
- frequent weighing
more than _____ have reported to using at least one extreme dieting method
1/3
___ - ____ % female athletes were classified as having symptoms & patterns of clinical disordered eating
25-32%
_ - __ % athletes were classified as having a clinical diagnosis of an eating disorder
2 - 3.4 %
two risk factors of eating disorders
- gener & age
2. socioeconomic factors
the NEDA has classified all risk factors into what 4 categories?
- psychological factors
- interpersonal factors
- social factors
- biological factors
what are 2 sports that have high risk factors for eating disorders
gymnastics, distance running
females are more likely to have ______ ____ habits than males
pathogenic dietary
6 physical problems associated with Eating Disorders
- gastric upset
- esophageal inflammation
- erosion of tooth enamel
- hormone imbalances
- amenorrhea
- kidney/heart problems
two prevention efforts for eating disorders
- place less emphasis on weight
2. avoid referral to weight in a negative manner
____ of all eating disorder cases do not respond to therapy
1/3
failure to plan means
planning to fail
what are 3 things to include in an emergency plan
- ID personnel involved in carrying out plan
- specify necessary equipment
- establish mechanism for communication
members of the emergency plan personnel are responsible for what 4 things
- immediate care of student/client
- emergency equipment retrieval
- activation of EMS
- directing EMS to injury scene
what are two rules in regards to first aid/ CPR training
- all emergency personnel should be trained
2. should be conducted by a nationally recognized organization
if the person is seriously injured, what should you do?
- note if they are alert (eyes open, state name, etc.)
- if fails, establish verbal communication
- if fails, verify response to painful
what do we do if a spine/head injury is suspected
immobilize them immediately
what is the AVPU scale
A - alertness
V - respond to verbal stimulus
P - respond to painful stimulus
U - unresponsive to any stimulus
What is the DOT(S) method for assessing injury
D - deformity
O - Open wounds
T - tenderness
S - swelling
where do you start if assessing injury
head, neck, chest, abdomen, pelvis, extremities
what is the difference between signs and symptoms
signs are objective (hard data) symptoms are subjective (can’t measure)
examples of signs & symptoms
signs: swelling, temperature
symptoms: nausea, pain
signs and symptoms of shock
- profuse sweating
- dilated pupils
- elevated perspiration
- extreme thirst
- clammy skin
- elevated pulse
- irritability
- nausea, vomiting
3 types of treatment
- supine position w/ legs elevated
- light covering
- calm/reassure individual
what is the HOPS physical exam?
H- istory (medical history)
O- bservation (signs & symptoms)
P- alpation
S- hock
how do muscle/tendon injuries often occur
excessive tension
muscle/fascia injuries often occur during _____ contraction
eccentric
tendons are strong & can withstand ___ - _____ lbs/sq. inch
8700 - 18000
strains most often occur where
MTJ
most common soft tissue sport injuries are
MTJ strains
3 mechanical forces of injury
- compressive (bones absorb this)
- tensile (tendons/lig. resist this)
- shearing (tendons/lig. resist this)
what is the major difference between the 3 mechanical forces of injury
the direction of angle of the force
- compressive: pushing perpendicular to tissue
- tensile: pulling in opp. direction parallel to tissue
- shear: pulling in opposite direction perp. to tissue
amount of force that tissue can withstand
critical force
critical force varies for each _____ type
tissue
critical force may vary within the same tissue type depends on what 5 things
- age
- temperature (environment)
- skeletal maturity
- gender
- body weight
when tissues are damaged, the body reacts with a predictable sequence of physiological actions which is commonly called ______
swelling
____ begins during the first few ____ following an injury
swelling; minutes
3 normal signs and symptoms of the inflammatory process
- swelling
- pain
- reddening of skin
3 specific stages of the inflammatory process
- acute inflammatory process
- resolution (healing) phase
- regeneration & repair phase
the inflammatory phase is a result of _____, which destroys millions of cells.
trauma
acute inflammatory phase results in _______ followed by _______ which results in a ________
vasoconstriction, vasodilation, a hemotoma (bruise_
localized collection of extraverted (out of vessels) blood
hematoma
what type of injury can result in additional destruction after hematoma
secondary hypoxic injury
______ release powerful enzymes (chemicals)
lysosomes
3 groups of enzymes
- degradatie (cellular breakdown)
- vasoactive (vasodilators of vessels)
- chemotactic (attract cells)
powerful inflammatory chemical released from a # of different cells
histamine
the release of histamine results in short-term ________ which increases the permeability of the _______
vasodilation, capillaries
how long does the acute inflammatory phase last?
3-4 days unless aggravated by additional trauma
during this phase special cells migrate into the area of injury
resolution (healing) phase
all cells in the resolution phase serve to do what
break down cellular debris
the resolution phase, which breaks down cellular debris, sets the stage for the final step in the inflammatory process which is
regeneration and repair
formation of new capillaries
angiogenesis
angiogenesis is essential for the provision of ______ and the removal of _____
nutrients; waste
except for _____, body tissues heal with scaring that begins to form _____ days after the injury
bone; 3-4 days
fiber producing cells
fibroblasts
3 characteristics of fibroblasts
- migrate to damaged area
- mature into several types of cells
- produce collagen fibers
____ formation can take months but can be __% as strong as original tissue
scar; 95%
when a scar forms, _____ is helpful (rehabilitation exercises are critical to this process)
stress
bone tissue heals by way of specialized cells called
osteoblasts
what are the 2 steps in recovery & repair of bone tissue?
- osteoblasts migrate into the area
2. osteoblasts develop a zone of collagen known as a “callus” which fills the area of the fracture
perception of an uncomfortable stimulus
pain
presentation or response to an uncomfortable stimulus
pain
what is important to remember in regards to pain?
everyone copes with pain differently
pain is as much _______ as it is physiological
psychological
pain results from ____ input received through the ______ system
sensory; nervous
what does pain indicate?
location of tissue damage
pain is not a useful indicator of
severity
what are given a higher priority, messages concerning sensory information (touch) or pain messages ?
messages concerning sensory information, because pain messages travel more slowly
rubbing the injured area sends _____ signals to the brain faster than _____ signals
touch; pain
2 methods to administer cryotherapy
- crushed iced bags
2. ice water baths
after the acute phase of injury, application of ____ is appropriate
heat
one method of controlling the inflammatory process
cryotherapy
what does the direct application of cold from cryotherapy result in?
vasoconstriction during the first few minutes
immediate application of cold reduces the severity of
the secondary hypoxic injury
in extremeties, ______ and ______ are helpful
elevation & compression
what does RICE stand for
Rest
Ice
Compression
Elevation
cold application to an injured area has what kind of effect
analgesic
what is the recommended procedure for cryotherapy
20 minutes of ice, 1 hour off, then 20 minutes on (repeat for 24 hours minimum)
ICE during inflammatory period helps promote _____ and reduces ____ ____ by reducing ____ required
healing; recovery time; 02
what is a risk of cryotherapy?
frostbite (human tissue freezes at 25 degrees F)
research shows ________ _____ should NEVER be applies to an acute injury
thermotherapeutic agents
when are thermotherapies useful?
final stages of injury repair
what type of heat is best for thermotherapy
warm moist heat
why is thermotherapy useful in the final stages of tissue repair
increases available oxygen, stimulates vasodilation in region of injured tissues
_______ should only be used under the supervision of trained allied health personal
ultrasound
2 types of medications that can be used for injuries
anti-inflammatories
analgesics
2 pharmacological agents drugs
steroidal & non-steroidal (NSAID)
side effects of steroids
interference with college formation
steroids may reduce what 23things
permeability of capillaries; effectiveness of WBCs in phagocytosis; local fever
steroids may be injected or taken orally & include what 3 drugs
cortisone
hydrocortisone
prednisone
common NSAIDS (non steroid anti inflammatory drugs) include
aspirin, ibuprofen, naproxen
do NSAIDS have the same negative effect on connective tissue as steroids?
no
some NSAIDs function as ______, relieving pain
analgesics
what kind of physical activity is most effective for many injuries
properly supervised physical activity
properly supervise physical activity can have a positive effect on what 2 things
- collagen (scar tissue) formation
2. return of muscle strength
best approach to take care of soft tissue injury
RICE
when does collagen formation occur
within 2-3 weeks
complete scar tissue formation may take up to
4 months
rehab exercise involves these 4 phases
passive
active assisted
active
resistive
who performs each rehab exercise
passive - PT or ATTR
active assisted - partial ROM assisted by PT or ATTR
active ex - full ROM
resistive ex - external resistance used in performing exercise
