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Brad 4th Ed Part 2 > Ch. 44 Sports Medicine > Flashcards

Ch. 44 Sports Medicine Flashcards

1
Q

What is the potential biomechanical dx for lateral epicondylosis?

A

Posterior deltoid weakness

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2
Q

What is the potential biomechanical dx for hamstring strain?

A

Tight hamstring

Weak gluteal musculature

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3
Q

What is the potential biomechanical dx for metatarsal fx?

A

Supinated foot

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4
Q

What is the potential biomechanical dx for athletic pubalgia?

A

Weak core muscles

Tight hip girdle

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5
Q

What is the potential biomechanical dx for Shoulder impingement w/ rotator cuff strain?

A

Periscapular weakness or inhibition

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6
Q

What is the potential biomechanical dx for patellofemoral syndrome?

A

Quad & glut weakness/inhibition

Overpronation

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7
Q

What is the potential biomechanical dx for repetitive ankle sprains?

A

Weak peroneals

Proprioceptive dyfxn

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8
Q

What should all “pre-rehab” programs address?

A

Strength
Flexibility
Endurance

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9
Q

Describe the wind up phase of throwing

A

Start: pitcher initiates motion
Stop: max knee lift of the lead leg when ball removed from glove
Few injuries during this phase

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10
Q

Describe the early cocking/stride phase of throwing

A

Stride leg and hip/knee of pivot leg extend toward batter propelling body into stride
Throwing shoulder ABD/Ext/ER into “semicocked position”

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11
Q

Which shoulder muscles are used during the early cocking phase?

A

SA & trap protract & upwardly rotate scapula
Middle deltoid ABD
Supraspinatus positions humeral head

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12
Q

Describe the late cocking phase of throwing

A

Max shoulder ER

Amount of ER correlates with speed of ball

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13
Q

What are the dynamic stabilizers of the anterior shoulder?

A

Long head of the biceps
Subscapularis
Pec major

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14
Q

what are the static stabilizers of the shoulder?

A

Glenohumeral ligaments
Capsule
Labrum

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15
Q

What are common injuries during the late cocking phase of pitching?

A 
Anterior instability
Internal (posterior-superior) impingement
Type II SLAP lesion
Articular surface rotator cuff tears
Bicipital tendinopathy
Ulnar collateral ligament injury
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16
Q

Describe the acceleration phase of throwing

A

Shoulder moves from 175 deg ER to 90-100 deg IR at ball release
Shoulder ABD fixed at 90 deg

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17
Q

What determines arm position in vertical plane?

A

Trunk lateral flexion

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18
Q

What does hanging or dropping elbow result in?

A

Reduced pitch velocity

Risk of rotator cuff or UCL injury

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19
Q

Describe the deceleration phase of throwing

A

Eccentric muscle force of posterior shoulder girdle to decelerate rapid IR
Start: ball release
Stop: arm reaches 0 deg IR

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20
Q

Describe the final phase of throwing

A

Passive phase

Body catching up with throwing arm

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21
Q

What are common injuries from deceleration phase of pitching?

A

Posterior instability
Isolated rotator cuff tears
SLAP lesions

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22
Q

How does the gait cycle change with increase speed?

A

Stance phase decreases

Double limb support not present with running

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23
Q

How is foot strike with slower running and walking?

A

Heel to toe

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24
Q

What happens to foot strike with increase speed?

A

Forefoot strike with lowering heel to ground

Sprinting: forefoot

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25
Q

What is the entry or catch phase of swimming?

A

hand entry into the water until beginning of backward movement

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26
Q

What is the pull phase of swimming?

A

hand in vertical plane of shoulder

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27
Q

What is the push phase of swimming?

A

Hand below shoulder & pushes through water until its exit at greater trochanter

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28
Q

What is the recovery phase of swimming?

A

Aerial return of hand

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29
Q

Which muscles contribute to propulsion phase of swimming?

A

ABD/ER move to ADD/IR
Major: pec major & lat dorsi
Minor: SA, subscap, teres major

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30
Q

What is a common injury with breaststroke?

A

Medial knee injury with inc valgus load
MCL sprain
Medial plica/synovitis

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31
Q

What should be the focus of swimming pre-rehab?

A

Scapular stabilization
Endurance training og SA & lower trapezius
Stretching IR, posterior capsule, cervical & thoracic mobilization

32
Q

What should the goal of ACL injury prevention be?

A

Inc knee & hip flexion during landing

Balance quad to hamstring activation ratio

33
Q

What is doping?

A

Any substance or method used to increase performance

34
Q

How can Tylenol blunt the anabolic response of muscle to exercise?

A

Max dose can dec prostaglandins produced after eccentric exercise

35
Q

What can NSAIDs inhibit?

A

Prostaglandin E2 which plays a role in bone healing

36
Q

Which forms of steroids are prohibited by WADA?

A

Oral
Rectal
IV
IM

37
Q

Why are diuretics banned in some sports?

A

Theoretically increase urine ouput to mask use of other banned agents

38
Q

Why are beta-blockers banned in some sports?

A

Anxiolytic effects

39
Q

What is Erythropoietin (EPO)?

A

Glycoprotein hormone produced at kidney in response to tissue hypoxia to inc erythrocytes

40
Q

What is Cr?

A

Compound made from amino acids glycine, arginine, and methionine

41
Q

What is Cr phosphate supplementation proposed to do?

A

Benefits short duration, high-intensity, repetitive exercise by enhancing triphosphate regeneration

42
Q

What are the goals of PPE?

A

ID life threatening conditions
ID cond that limit competition
ID factors that predispose injury
Meet legal requirements of state & institution

43
Q

What is benign exercised associated collapse?

A

Form of postural HOTN from blood pooling in legs when pt stops running and leg muscles no longer acting as a venous pump

44
Q

Tx of exercise associated collpase

A

Oral rehydration

Lying athlete down with legs & pelvis above heart level

45
Q

Tx if exercise associated collapse does not respond after 30 minutes of conservative tx

A

Orthostatics
Electrolyte assessment
IVF

46
Q

DDx of exercise associated collapse

A 
Benign exercise associated collapse
Cardiac arrest
Heat illness/stroke
Hypoglycemia
Hyponatremia
Hypothermia
Muscle cramps
Neuro conditions
47
Q

What are the sx of exercise associated hyponatremia?

A 
Lightheadedness
Nausea
HA
Vomiting
Confusion
Obtundation
Seizures
Death
48
Q

What is the pathophysiology of exercise associated hyponatremia?

A

Fluids shifts from low osmotic pressure in blood causing cerebral edema and neurogenic pulmonary edema

49
Q

What are RF for exercise associated hyponatremia?

A

Weight gain during race
Marathon time >4 hrs
BMI extremes

50
Q

What are the fluid replacement guidelines in a marathon?

A

Drink when thirsty

400-800 ml (14-27 oz)/hr racing

51
Q

What is heat exhaustion?

A

Inability to continue to exercise in the heat but is NOT related to body temperature

52
Q

What is heat stroke?

A

Multi-organ system failure secondary to hyperthermia

53
Q

Which age group is not recommended to return to play after a concussion the same day?

A

<18 yo

Adult professionals may return

54
Q

Who should get neuro imaging after concussion?

A

Suspected intracranial ABN
Prolonged LOC
Focal neuro deficits
Progressive decline in neuro status

55
Q

When can RTP be considered after concussion?

A

After patient is asx of concussion sx

56
Q

What is the cause of a stinger/burner?

A

Tensile (stretch) or compressive injury to the cervical nerve root or brachial plexus

57
Q

Who is more likely to get a tensile injury to the brachial plexus?

A

Young athletes with weaker neck and shoulder girdle strength leaving them at risk for lateral neck bending and ispilateral shoulder/arm depression

58
Q

Who is more likely to get a compression injury to the cervical nerve root?

A

Older, stronger and experienced athlete from forceful cervical extension and rotation narrowing the neural foramen
ex) professional defensive backs or offensive lineman

59
Q

What is the clinical presentation of a stinger?

A

Sudden onset of burning pain in one upper limb in a single dermatome lasting seconds to minutes after a traumatic event

60
Q

What are the MC dermatomes stingers happen in?

A

C5, C6 or C7

61
Q

Which stingers should be evaluated for SCI?

A

Bilateral sx
Motor impairment
Multiple stingers

62
Q

Which patients with stingers can RTP the same day?

A

Sx fully recover in <15 minutes

63
Q

If a patient has multiple stingers when can they RTP?

A

Holder for number of weeks that correspond to stingers in a season or if >3 stingers end the season

64
Q

Which athletes are MC to present with exericesed induced bronchospasm (EIB)?

A

Cross-country skiers
Winter sports
Runners

65
Q

What is the proposed mechanism of EIB?

A

Water loss and cooling in the airway that occurs with hperventilation triggers bronchoconstriction

66
Q

What are tx for EIB?

A

Warm up prior to sport
Short, vigours bursts of exercise (15-20 minutes) prior to competition
Short-acting beta-agonist 15 min prior to exercise
Adding cromolyn if sx persist and then inhaled corticosteroids

67
Q

What are common causes of anemia in athletes?

A

Iron def
Physiologic or Pseudoanemia
Foot-strike hemolysis

68
Q

What will be shown on labs in iron def anemia?

A

Microcytic anemia
Ferritin <30 ng/mL
TIBC elevated

69
Q

What is pseudoanemia?

A

Seen in endurance athletes

Lower Hgb due to plasma volume expansion causing dilution

70
Q

What is foot-strike hemolysis?

A

RBC destruction in feet from running impact

71
Q

Which athletes are at a higher risk for an eating disorder?

A 
Femailes
Gymnastics
Figure skating
Dancers
Distance runners
Divers
Swimmers
72
Q

What is anorexia?

A

Body wt 15% below expected
Morbid fear of fatness
Feeling thin when fat
Amenorrhea

73
Q

What is bulimia nervosa?

A

Binge eating 2/wk for at least 3 mo
Loss of control over eating
Purging behavior
Overconcern with body shape

74
Q

Describe L1 locomotor impairment the cycling athlete

A

Minor or no lower limb impairement

75
Q

Describe L2 locomotor impairment the cycling athlete

A

Disability in one leg but able to pedal normally w/ or w/o prosthesis

76
Q

Describe L3 locomotor impairment the cycling athlete

A

Lower extremity disability, pedal using one leg, w/ or w/o upper limb disability

77
Q

Describe L4 locomotor impairment the cycling athlete

A

Severe disability affecting both lower limbs, w/ or w/o upper limb disability

Brad 4th Ed Part 2 (28 decks)

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