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Rec and Care > Exam 1 - 1 > Flashcards

Exam 1 - 1 Flashcards

1
Q

Sports medicine - 2

A
  • broad field of medical practice related to PA and sport
  • multidisciplinary including the physiological, biomechanical, psychological, and pathological phenomena associated with exercise and sports
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2
Q

ACSM

A

american college of sports medicine

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3
Q

4 things that the coach is responsible for?

A
  • prevention of injuries
  • provide/direct appropriate health care to the injured athlete
  • thorough understanding of the skills, techniques, and environmental factors that may adversely affect the athlete
  • work closely with medical staff
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4
Q

umbrella - 2 sides of sports medicine

A

performance enhancement

injury care and management

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5
Q

8 professions of performance enhancement

A 
exercise physiology 
biomechanics 
sports psychology 
sports nutrition 
strength and conditioning 
personal fitness training 
coaching 
physical ed
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6
Q

8 professions of injury care and management

A 
practice of med - physicians and assistants 
AT
sports PT 
sports massage therapy 
sports dentistry 
osteopathic med 
orthotists/prosthetists
sports chiropractic
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7
Q

triangle sports med model

A

coach, treatment, performance, bottom is prevention surrounding the athlete

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8
Q

sports med team 1-9

A

treatment

  • sports med, physician (canadian academy of sports and exercise
  • orthopedic surgeon
  • AT
  • Sports PT
  • Massage Therapist
  • nutritionist
  • dentist
  • podiatrist
  • chiropractor
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9
Q

Sports sci 1-7

A 
biomechanist 
exercise physiologist 
sports psychologist 
strength and conditioning coach 
biochemist 
anatomist 
bioengineer
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10
Q

When collaborating with other personels on the team, what’s important

A

know the roles and responsbilities of each medical professonal and stay in your lane

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11
Q

What kind of treatments do we aspire to provide - 4

A

knowledge, competency, effective and evidence based

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12
Q

what kind of treatments can sports professionals give - 7

A
  • injury prevention and health promotion
  • clinical examination and diagnosis
  • acute care of injury and illness
  • therapeutic interventions
  • psychosocial strategies and referral
  • health care admin
  • PD and responsibility
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13
Q

sports med physician (CASEM) and 4 responsibilities

A

absolute authority in determining health status of an athlete who wishes to participate in a sports program

  • compile medical histories
  • diagnosing injury
  • deciding on a disqualification and return to play
  • attending practices and games - on call
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14
Q

AT and 3 responsibilities

A

start to finish - most time - prevention, immediate care and management of athletic injuries

  • prevention focus on MSK assessment, equipment, prophylactic support
  • immediate care includes injury assessment and basic emergency life support
  • management - contemporary rehab techniques and modalities to facilitate the healing of an injury
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15
Q

CAT - how to become one (3)

A

certified athletic therapist - devoted to the health care of the physically active ind

  • Bachelors’s, athletic therapy program at 1/7 CATA accredited institutions
  • valid first responder certificate and 1200 hrs of onfield and inclinic practical training
  • national certification exam - written and practical
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16
Q

5 competencies in AT

A 
prevention 
assessment 
intervention 
practice management 
professional responsibility
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17
Q

6 things ATs do

A

onfield urgent emerge care, assessment and management
onfield nonurgent assessment, management and transportation
sideline return to play decision
prophylactic support techniques
orthopedic physical assessment (advanced, course, spinal and peripheral)
rehab (advanced cource)

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18
Q

kinesiologists - 3

A

independently with client to develop training programs - rehab clinics, primary care networks and with other health care professionals such as chiros, PTs, OTs, ATs, and dieticians

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19
Q

CSEP - CEP

A

canadian society for exercise physiology - certified exercise physiologist

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20
Q

CSEP - CPT

A

canadian society for exercise physiology - certified personal trainer

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21
Q

exercise physiologist/therapist -2

A
  • csep- cep - assessments, prescribe conditioning exercise, exercise supervision, counseling and healthy lifestyle ed with healthy or pop. with med conditions, functional limitations or disabilities associated with MSK, cardiopulmonary, metabolic, neuromuscular and aging conditions
  • csep - cpt
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22
Q

strength and conditioning specialist - 3

A

certified strength and conditioning specialist -improve performance - sports specific testing sessions to design and implement safe and effective programs, also nutrition and injury prevention
tactical strength and conditioning facilitator
CPT/CEP
consult with and refer athletes to other professionals when appropriate

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23
Q

To participate in a sport you need - 5

A

medical clearance - communicable disease
EAP - site specific - emergency action plan - address, call person, access of facility and phone numbers
facility safety
personal equipment and readiness
observation - event, MOI throughout, previously injured athlete, high risk athletes, atheletes with pre-existing medical conditions

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24
Q

when an injury happens - 6

A

enter field when SAFE to do so - no glass
witness - info from bystander
number of athletes involved - triage
C spine mechanisms and control - stabilize head and neck
posture of athlete - decerabrate vs decordecate - call 911
Enact EAP

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25
Q

decerabrate vs decordacate

A

yardsale and limp

neurological trauma where everything is moving towards in and seizure

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26
Q

Level of consciousness - 6

A

posture of athlete
obvious LOC - talking/walking - conscious/unconsious
AVPU - alert/verbal/painful/unresponsive
C-spine control
Position/location of athlete
Unresponsive EMS activation

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27
Q

air way - 4

A

obvious open airway - talking, heavy breathing
removal of potential obstructions
airway management - practice based on your level of training - head tilt chin lift, manual maneuvers, OPA/MPA, other
EMS?

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28
Q

breathing - 4

A

obvious breathing - talking breathing heavy
hypo/hyperventilation management - practice based on your training
- talk to, calm
- O2 administration
AR (CPR standard)
EMS activation

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29
Q

circulation - 3

A

obvious circulation - CCBMP = coughing, colour&skin temp, moving, breathing, pulse - always check for neck
CPR
EMS

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30
Q

deadly bleeding - 3

A

obvious arterial bleeding
femoral and carotid artery
first aid standard management - direct pressure, elevate, dressing, pressure points

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31
Q

After injury - what do you look for - 6

A 
level of consciousness 
airway 
breathing
circulation 
deadly bleeding 
CNS
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32
Q

CNS check - 3

A

Rule out spinal injury - spine not involved, no MOI, chief complaint elsewhere - if no, stabilization and through exam required with urgent paradigm
rule out head injury
- in not, thorough exam required, use SCAT or urgent paradigm
directly to peripheral jts/area

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33
Q

urgent vs non-urgent

A

stop and load - graduated model

non-urgent - staying and playing

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34
Q

focused secondary survey - 3

A

initial orthopedic scan
- jt/area defined
assessment
management

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35
Q

assessment - 4

A

what prudent skill sets and or qualifications of professional peers
SAM - skeletal - bony integrity, articular - movement (Active/passive) - luxated, dislocated, motor-control of the)
MSC - muscular- isometric/passive (dont let me move my finger), sensory - temp, 2 pt discrimination, sharp/dull, altered sensation, what am i touching? circulation - color and temp, pulse
clear joint above and below as warranted (MOI, CC)

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36
Q

management of focused secondary survey - 3

A

transport, immobilize/stabilize

  • where - sideline/med facility
  • how? - walk with aid, stretcher, 2 man lift, ems
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37
Q

Immob/transport - 5

A 
Where 
stablize - method - hand above and below 
immob - method 
transport - destination and method 
EMS?
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38
Q

assess/referral - 6

A

through clinical sideline assessment
referral - whom, when, timely follow up (regarless of RTP status
communication - player, coaches, parents
follow up
documnet
consideration for immediate RTP

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39
Q

graduated return to play/prescription - 4

A

preparation - stabilize, protect, therapy/rehab
functional test sport specific - load
decision about RTP - clearance - doc/supervisor
monitor and document - half time, post event, next workday

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40
Q

3 actions following focused secondary survey

A

immob/transport
assess/referral
graduated RTP/RX

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41
Q

liability

A

legally responsible for the harm one causes another

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42
Q

AT main responsibilities - 2

A

prevention of injury and reducing further injury or harm

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43
Q

Why do we care about liability - 2

A

accidents happen and legal lawsuits against authority - know your legal limitations and provide health care responsibilities as dictated by law

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44
Q

what is legal action tried under? - 3

A

TORT law - civil wrong done to an ind

  • act of omission/nonfeasance - ind fails to perform their legal duty
  • act of commision/malfeasance - ind commits an act that is not legally theirs to perform
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45
Q

standard of care

A

measured by what another minimally competent ind educated and practicing in that profession would have done in the same or similar circumstances to protext an ind from harm or further harm - what a resonable and prudent ind would do within your knowledge and training

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46
Q

standard care is dictated by

A

professionals duty/scope of practice - roles and responsibilities of an ind in that profession and delineates what should be learned in the professional prep of that ind

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47
Q

Why are we behind in treatment

A

conservative and the principle of not hurting anyone

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48
Q

duty of care

A

AT to their participants

failure to provide that results in liability or negligence

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49
Q

negligent torts - misfeasance

A

commiting an act that is ones responsibility to uses the wrong procedure or right procedure in an improper manner

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50
Q

negligent torts - malpractice

A

commits a negligent act while providing care

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51
Q

negligent tort - gross negligence

A

total disregard for safety of others

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52
Q

Participants assume what risks?

A

the ones inherent with PA but not the risk that a professional will breach the duty of care

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53
Q

to find an ind liable you must prove 4 things

A

there was a duty of care
there was a breach of duty
there was harm
the resulting harm was a direct cause from that breach of duty

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54
Q

good samaritan law

A

limited protection to someone who choses to provide first aid who voluntarily chooses to do so should sth go wrong but we have a duty of care

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55
Q

you will be judged on your

A

performance so know the expected competency

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56
Q

statue of limitations

A

length of time to sue for damages from negligence - 1-3 yr sometimes 3 yrs after they turn 18

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57
Q

AT and coaches can take 5 steps to limit the risk of litigation

A
  1. inform the participant about inherent risks of participation - assumption of risk by waivers - minors are your responsibilities
  2. foreseeing the potential for injury and correcting the situation before harm occurs
  3. obtaining informed consent from ind/guardian before participation and treatment - duty of care must help
  4. quality products and equipment
  5. strict confidentiality of all med records
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58
Q

16 axns that can result in litigation

A

failing to warn about risks
treating without consent
failing to provide med info concerning alt treatment or risks with needed treatment
failing to provide safe facilities, fields and equipment
aware of potentially danger but didnt do anything about it
failing to provide a adequate injury prevention program
allowing an injured or unfit player to play and resulting in further injury or harm
failing to provide quality training, instruction, supervision
unsafe equipment
moving injured before properly immobilizing
failing to employ qualified med personnel
failing to have a written EAP
failing to properly recognize injury or illness
failing to immediately refer an injured to proper physician
failing to keep adequate records
treating an injury that did not occur within your facility

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59
Q

23 things you can do to manage athletic injuries and decrease risks of litigation

A

warn of danger
supervise constantly and attentively
properly prepare and condition
properly instruct skills
proper and safe equipment and facilities
good personal relationships
specific policies and guidelines for operation of athletic health care program
develop and follow EAP
familiar with health status and med history of athletes for additional care/caution
records of injuries and rehab
document efforts to create a safe playing environment
detailed job description in writing
written consent when providing health care - esp minors
cofidentiality of records
dont dispense any drugs
certify in CPR/AED and first aid
no use/precense of faulty/hazardous equipment
work with team doc and AT and use protective equipment
no injured player unless cleared esp head
always follow orders of AT and doc
liability insurance to protect against litigation and know the limits
know limits of expertise and applicable state regulations
common sense - health and safety of athlete

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60
Q

4 - why is communication important

A

personal relationships with athletes parents and coworkers
good record of injuries and rehab
dont give drugs
common sense in decisions of safety and health

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61
Q

assumption of risk - 3

A

legal liability waiver to express/imply agreement that they assume the risk involved in the B
take a risk when they play but should be made aware of potential risks
AT’s responsibility that they are aware

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62
Q

Sample form for treatment

A

med authorization/consent for med treatment of

- agree to pay all fees and costs arising

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63
Q

general liability insurance

A

slip and fall - injury at school/work property

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64
Q

professional liability insurance - 4

A

registered kins - pro athletes with a contract - their contract is on your insurance when they are under your care

  • covers claims of negligence on ind part
  • know the limits of your coverage
  • may not cover criminal complaint
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65
Q

professionalism and dating

A

just date and tell people

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66
Q

professionalism - 6

A 
look and act like one 
appropriate touching 
dont act in a sexually inappropriate way 
professional and social context 
texting and social media 
code of ethics
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67
Q

mission of CCES - 2

A

foster ethical sport for all canadians - we will not cheat

you are a educated role model now

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68
Q

CCES

A

canadian centre for ethics in sports

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69
Q

3 purposes of CCES

A

Canada’s anti doping program - govt give money to amateur sports but they are subjected to random drug tests
serve public interest and protect the rights of athletes to fair and ethical competition by promoting and striving for fair and doping free sport in canada
meet mandatory requirements of the world anti doping program

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70
Q

russians and doping

A

no anti doping officers that are wata approved

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71
Q

3 fundamentals of CCES

A

authority through govt’s canadian policy against doping in sport - when you sign as a member of the sport you promise not to cheat
sport adopt CADP into by laws for govt funding
sign on to SADP through signing as members of their sport

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72
Q

top 6 threats to good sport

A 
doping - most significant 
violence - no game or sports related 
bad parental B 
weak sport governance 
neg pro sport values 
lack of access and inclusion
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73
Q

doping

A

performance enhancing substances or methods

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74
Q

what constitutes as doping - 2/3

A

sci evidence that substances or methods have the potential to enhave sport performance - fairness
sci ecidence that use of substances/methods rep a potential health risk - harm
use of it violates the spirit of the sport - integrity

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75
Q

doping control officer

A

official trianed and authorized by CCES with delegated responsibility for onsite management of sample collection session

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76
Q

type of testing - 2

A

incompetition - game day/event
out of competition - whereabouts program
types of athletes tested - registered testing pool
domestic athletes - random - highly ranked

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77
Q

motto of CCEP

A

anytime - anywhere

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78
Q

6 ways to be considered as doping

A

presence, use, refusing, failure, tampering, possesion, traficking - just take it, admin

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79
Q

5 consequences of doping

A

presense, possesion, use = up to 4 y ban
refusal and tampering - up to 4 yr
trafficking and admin - 4+ yrs
all made public to media by CCES
must establish - how it entered the body - was not performance enhancing, did not mask - evidence

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80
Q

4 ways to decide who to test

A

random selection
targeted testing
intelligence based testing - good athletes
biological passport program

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81
Q

what % of canadians were tested before socci

A

100

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82
Q

liability of doping

A

you - responsible for what you consume and what is found in your urine/blood

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83
Q

top drug seizure in ab, bc, on

A

marijuana

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84
Q

top drug seized in quebec

A

steroids and its also the number 2 seized drug in quebec

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85
Q

whats on the prohibited list - 9

A
  1. Anabolic Agents
  2. Hormones and related substances (EPO, Insulin)
  3. Beta-2 agonists (asthma)
  4. Agents with anti-estrogenic activity
  5. Diuretics or other masking agents
  6. Stimulants
  7. Narcotics
  8. Cannabinoids
  9. Glucocorticosteroids
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86
Q

drug prohibited at all times

A

Drugs prohibited at ALL times!

  1. Anabolic Agents
  2. Hormones
    a. EPO, hGH
  3. Beta-2 Agonists
    a. Enhance flow of oxygen
  4. Agents with Anti-Oestrogenic Activity
  5. Diuretics and Other Masking Agents
  6. Methods enhancing Oxygen transfer
    a. Blood doping / packing
  7. Pharmacological, Chemical, and Physical Manipulation
    a. Urine tampering
  8. Gene Doping
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87
Q

Prohibited doping during comp only - 6

A
  1. Stimulants
  2. Narcotics
  3. Cannabinoids
  4. Glucocorticosteroids
    a. Anti-inflammatories
  5. Other Drugs
    a. Alcohol, beta blockers etc.
  6. Specified Substances
    a. Generally available but may be abused for performance enhancement purposes. i.e. ephedrine, inhaled beta-2 agonists etc.
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88
Q

3 prohibited doping methods

A
  1. Enhancement of Oxygen transfer
  2. Chemical and Physical manipulation (urine and blood samples)
  3. Gene Doping - hyperplase muscles
    - Hypoxic devices are ok.
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89
Q

gene doping

A

genetic enhancement that cannot be detected nor shut off - hyperplasia doenst stop so you die - allele with myostatin knocked out

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90
Q

how do i know if sth is ok - 3

A

drug info number - every sport fed has own rules

drug ref online - globaldro and CCES

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91
Q

how many global dro inquiries last yr

A

108000

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92
Q

suppliments

A

CCES media release supplement kaizen HMB and pos test

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93
Q

declaration of doping

A

declare all prescription and /or non meds and or supplements taken in the past 7 days

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94
Q

why does the drug program exist - 2

A

sport and society cannot exist w/o rules or agreed upon codes of conduct - protect the rights of clean athletes but not to catch dirty or cheating ones

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95
Q

8 reasons why athletes dope

A
  • Money drives the athlete to win?
  • Edge over competition
  • Peer Pressure
  • Physical appearance
  • Status, recognition
  • Coaches are paid to win
  • Parents
  • Pharmaceutical companies?
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96
Q

highest use of anti doping lab in QC - 3

A

MLB
CCES
NBA

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97
Q

anti doping lab in QC

A

second largest in the world

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98
Q

designer steroid

A

on the rise

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99
Q

stimulant s6

A

nightmare

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100
Q

stimulant s6

A

nightmare

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101
Q

new weight loss stim

A

methylhexanamine/dimethylhexanamine - bad

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102
Q

where do designer steroid/stim come from?

A

china

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103
Q

anabolic steroids in 1988 vs 2006

A

20 vs more than 200

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104
Q

top 3 steroids

A

testosterone
nandrolone
stanozolol

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105
Q

the clear

A
  • THG or Tetrahydrogestrinone (often referred to as THG or The Clear) is an anabolic steroid.
  • THG is a Designer steroids which means it was designed to keep the T:E ratio low.
  • Kelli White – modafinil and THG
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106
Q

top 3 sports with AAs

A

cycling - pedal harder
baseball
hockey - power endurance

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107
Q

HGH - 8

A
  • Somatrem or Somatropin
  • Anabolic hormone that affects all body systems and is important in muscle growth
  • One of the most highly sought after drugs among athletes. Why?
  • Anabolic properties and difficult to detect
  • hGH causes hyperplasia vs. hypertrophy with AAS
  • Affects of hGH persist after cessation of use vs. AAS
  • Beware!
  • Acromegaly, stimulation of ALL tissues including internal organs, nonreversible effects, injection administration
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108
Q

EPO

A

metabolic agent
erythropoietin - increases the oxygen carrying capacity of the blood, decreases exercise heart rate, and lowered post-exercise lactate levels
• Normally taken with AAS such as nandrolone to potentiate the effects of EPO!
• BEWARE – Increased systolic blood pressure, increased blood viscosity, seizures, thrombosis, as you dehydrate, your hematocrit % increases or your blood thickens! 50% to 60%

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109
Q

the way you play

A

how you live, behave and who you are

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110
Q

etiology

A

cause of injury/disease - mechanism

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111
Q

pathology

A

structural or functional changes that result from the injury process

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112
Q

symptom

A

perceptible change that indicates injury or disease - (what they feel and or describes)

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113
Q

sign

A

objective, definitive and obvious factor for a specific condition

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114
Q

diagnosis 1 -3

A

name of a specific condition - physician
legal implications
differential Dx - ATs
index of suspicion

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115
Q

prognosis - 4

A

prediction of the course and outcome of the condition - spectrum
what is to be suspeccted as it heals (when can i play)
how long will you be experiencing pain/disability - permanent?
time frame/expected outcome

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116
Q

sequela

A

condition resulting from disease or injury, development of a additional condition as a complication of an existing injury

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117
Q

syndrome

A

group of S&S that together, indicate a particular injury or disease

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118
Q

anatomical planes - 3

A

med profes refer to sections of the body in terms of anatomical planes/flat surfaces - imaginary lines drawn through and upright body -used to describe specific body part

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119
Q

axial

A

transverse anatomical direction

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120
Q

what are anatomical planes in references to?

A

anatomical position

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121
Q

midline

A

sagittal plane

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122
Q

ventral

A

ant

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123
Q

cephalad/cranial

A

head

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124
Q

caudal/caudad

A

tail/tail end

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125
Q

What do we do with abdominopelvic quadrants

A

palpate for tenderness and gas

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126
Q

right upper quadrant - 6

A

liver, rt, kidney, colon, pancreas, gall bladder

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127
Q

right lower quadrant - 4

A

appendix, ascending colon, right ureter, major vessels - artery and vein

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128
Q

left upper quadrant - 5

A

stomach , spleen, left kidney, transverse and descending colon, pancreas

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129
Q

left lower quadrant - 4

A

descending colon, small intestine, left ureter, major vessels - aetery and vein

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130
Q

eversion

A

turning outward

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131
Q

inversion

A

turning inward

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132
Q

pronation to the foot vs hand - 3 -1

A

combo of eversion, abduction of forefoot and dorsi flexion

hand turned down

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133
Q

supination to the foot vs hand - 3 - 1

A

inversion, plantarflexion and adduction of the forefoot

hand turned up

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134
Q

valgus

A

deviation of part of extremity distal to jt towards midline - knocked knees

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135
Q

varus

A

deviation of part of extremity distal to jt away from midline - bow legged

136
Q

bones of the foot

A

26
14 phalangeal
5 metatarsal
7 tarsal

137
Q

foot anatomy compared to hand anatomy

A

wider base for balance and propelling the body forward

138
Q

metatarsals

A

5 bones articulate with the tarsals and phalanges

139
Q

tarsals

A

between lower leg and metatarsal

140
Q

medial longitudinal arch

A

medial border of calc to distal head of 1st metatarsal

141
Q

lat longitudinal arch

A

lat aspect of calc, cuboid, and 5th metatarsal

142
Q

ant metatarsal arch

A

distal heads of metatarsals

143
Q

transverse arch

A

transverse tarsal bones - cuboid and middle cuneiform

144
Q

interphalangeal jt - 1- 2

A

bw proximal and distal phalanx - flexion and extension

145
Q

metatarsophalangeal jt 1-4

A

MT and proximal phalanx - flexion, ext, add, abd

146
Q

tarsometatarsal jt 1-4

A

cuboid and all 3 cuneiforms and MT

flex, ext, add, abd

147
Q

subtalar jt - 4

A

talus and calc - pronation, sup, in/e

148
Q

talocrural jt 2-2

A

ankle mortis
talus and distal tib fib
ankel PF and DF

149
Q

why are you unstable on your toes?

A

talus is wide in the front and narrow in the back

150
Q

2 phases of gait

A

stance - move from pos lat to big toe
heel strike, midstance and toe off
swing - after toe off and initiate contact for heel strike

151
Q

greater trochanter bursitis

A

too much swing in hips

152
Q

why is pronation important for gait

4 prolonged pronation injuries

A

shock absorption

stress fracures, tendonopathies, medial tibial stress syndrome, knee pain

153
Q

why is supination important for gait?

3 prolonged supination injuries

A

forceful propulsion of body forward

stress fractures, tendonopathies, lower back pain

154
Q

high arch

A

supinated - tight musculature on the inside of your calf

155
Q

ATFL injury from

A

Supination

156
Q

Footware for pronation - 4

A

rigid heel counter, less flexible shoe, board lasted

hypermobility problems

157
Q

footwear for supination - 4

A

flexible shoe, increased shock absorption, stitch lasted

hypomobility problems

158
Q

lower leg

A

portion of lower extremity that lies between the knee and ankle
tibia, fibula, talus and calcaneous

159
Q

tibia - 2

A

2nd longest bone in body

3 surfaces - pos, med, lat

160
Q

fibula - 2

A

attachment for muscles

6 wks you can play with plates

161
Q

talus

A

link between lower leg and foot

162
Q

calcaneous - 2

A

heel and site of attachment for achilles

163
Q

sup and inf tibiofibular jt

A

sup - reinforced by stabilizing ligs ant and post

inf - reinforced by ankle ligs

164
Q

interosseous membrane - 2

A

cover entire length of both bones - ant and pos tibfib lig is the distal of the interosseous mem

165
Q

medial lig - 5

A

ant talofibular, pos talofibular and calc tabolibular
deltoid - triangle
later mal is longer so eversion less than inversion
med surface of talus, calc, and navicular
resistance to eversion - eversion test

166
Q

3 lateral lig

A

ant talofib - refrain ant displacement of talus
calcfib - restrain inversion of calc
pos talofib - refrains pos displacement oftalus

167
Q

3 muscles of the ant compartment and function

A

tibialis ant, extensor hallicus longus - in front of med mal, extensor digitorum longus - dorsiflex

168
Q

3 muscles of lat compartment and functions

A

peroneous longus and brevis - evert foot

peroneous tertius - dorsiflex ankle

169
Q

2 muscles of sup pos compartment and function

A

gastroc and soleus - achilles tendon - plantarflex

170
Q

3 muslces of deep pos compartment and function

A

tibialis pos, flexor digitorum longus and flexor hallicus longus - behind medial malleous

171
Q

3 articulations in your foot

A

proximal and distal interphalangeal jt

metatarsalphalangeal jt

172
Q

intrinsic muscle in the foot

A

extensor digitorum brevis

173
Q 
Ant compartment 
3 muscles 
pulse 
muslce 
action
A 
Tom's hairy dog - med to lat on ant surface 
TA - most prominent and medial 
extensor hallicus longus - DF first toe 
extensor digitorum longus - extends toe 
dorsalis pedisis artery pulse 
peroneous tertius 
DF ankle and extend toes
174
Q

lateral compartment - 2

A

peroneous longus and brevis - evert and DF foot

175
Q 
Deep pos compartment 
3 muscles 
nerve 
muslce 
function
A

Tom dick and harry - ant to pos
tib pos - invert and PF foot
flexor digitorum longus - flx toes
pos tibial artery - main blood supply to foot
tibial nerve - main nerve supply to sole of foot (tarsal tunnel
flexor hallicus longus - cannot be palpated
invert the ankle

176
Q

claw toes - 2

A

hyperflexion of MTP and flexion of proximal and distal IP jt
associated with pes cavus and painful calluses

177
Q

hammer toes

A

similar to claw

178
Q

morton’s foot - 2

A

second toe is longer than first - stress to 2nd toe and hypomobility to 1st toe
difficulty putting on tight shoes

179
Q

accessory navicular - 2

A

double ankle jt

prominence on the navicular tubercle

180
Q

pes cavus - 2
signs and symptoms - 3
management - 3

A

high arch
excessive supination
general foot pain,
metatarsalgia
abnormal shortening of achilles tendon asymptomatic dont correct
orthotic,
stretching achilles tendon and plantar facsia

181
Q

pes planus -2
cause - 2
signs and symptoms - 2
management - 3

A

flat foot
excessive foot pronation
weak musculature invertors or stretched plantar lig
pain and feeling of weakness in the med longitudinal arch
calcaneal eversion, bulging of navicular bone, flattening of the medial longitudinal arch
asymptomatic dont treat
orthotics
strengthening of the foot invertors, toe curls

182
Q

assessment of the foot - 7

A 
weight bearing 
walking - stance, swing, push off 
running 
talocrural - dorsiflex - active 20, plantarflex - active 50 
subtalar 
supination 
pronation
183
Q

mechanical injury - 2

A

injuries occur when force applied to any part of the body results in a harmful disturbance in function and or to the structure
- external force directly on the body or occur internally within the body

184
Q

tissue properties - 2

A

tissues have the ability to resist a particular load - stronger the tissue, greater the magnitude of load it can with stand

185
Q

stress strain curve

A

toe - elastic - (ultimate strength) - plastic (necking) -failure range (strain deformation

186
Q

toe

A

1.5-4% of total fibre lengthening that is possible

187
Q

necking

A

point at which tissue strength noticeably decreases so that less stress is needed to cuase a change in the tissues length - partially rips

188
Q

plastic range

A

doesnt completely recover

189
Q

stretching and tissue properties - 2

A

toe is where everyone goes
has to go through plastic for permanent deformation - PNF - passive to barrier (passive restraint) then you keep going and get past it - compensation from the body and scream and push back but hold for 10 seconds and repeat till no slack - you have to hurt a little

190
Q

does static stretching increase flexibility?

A

no

191
Q

slow vs fast load

A

fast much more dangerous and forceful

192
Q

load

A

outside forces acting on tissue

193
Q

stress

A

internal reaction or resistance to an external load

194
Q

strain

A

extent of deformation of tissue under loading

195
Q

viscoelastic

A

material whose mechanical properties vary depending on rate of load

196
Q

yield point

A

elastic limit of tissue

197
Q

mechanical failure

A

elastic limit of tissue exceeded, causing tissue to break

198
Q

5 primary tissue stresses leading to injuries

A

tension, stretching, compression, shearing, bending

199
Q

tension

A

force that pulls or stretches tissue

200
Q

stretching

A

when go beyond yield pt leads to rupturing of soft tissue or fracturing of bone

201
Q

compression

A

large force that crushes tissue

202
Q

shearing

A

force that moves across in a parallel fashion across tissue - muscle is okay but bone will break

203
Q

bending

A

force on a horizontal axis that places enough stress to cause the structure to bend

204
Q

acute injuries and 6 examples

A

within 3 days- some sort of healing and it was an event - sudden and traumatic
contusions, sprains, strains, dislocations, subluxations, fractures

205
Q

contusions - 6
MOI
What happens

A

bruise
external force causes soft tissues to be compressed against hard bone
capillaries may break and cause bleeding into the tissues which accumulates under the connective tissue
deep contusions can bruise the bone
pain improves within a few days and discoloration decreases with a few weeks
muscle pain with active contraction

206
Q

myositis ossificans
MOI
What happens

A

dont take care of the inflammation - you need to pad and let it heal
occurs when a muscle or soft tissue is bruised repetitively
ca begins to deposit in muslce fibre - blood pooling and ph changes
may impact movement

207
Q

Treatment of myositis ossificans

A

usually surgical intervention is needed

208
Q

prevention of myositis ossificans

A

protect from repeated contusions - use padding

209
Q

common 2 places of myositis ossificans

A

quads and biceps

210
Q

muscle strain

A

tearing or stretching of the muslce fiber when its forced to contract against increased resistance

211
Q

degree of strain is related to

A

number of muscle fibres torn

212
Q

grade 1 of muscle strain

A

some fibres stretched or torn - minimal swelling, tenderness and pain with AROM, rest doesnt hurt and full ROM

213
Q

grade 2 muscle strain

A

more fibres torn, increased pain and greater loss of muslce function with AROM - divot or depression - may be swelling

214
Q

grade 3 muscle strain

A

complete rupture

no pain, palpable defect, loss of muscle function, swelling and bruising

215
Q

what is the usual MOI for a grade 3 muslce strain

A

fast eccentric force

216
Q

3 common grade 3 muscle strains

A

biceps, achilles, hamstrings

217
Q

charlie horse RTP rule

A

if you cant actively get 90 degrees

218
Q

ligaments

A

tough inelastic bands connecting bone to bone

219
Q

lig sprain

A

when jt is forced to move beyond normal limits, damage to lig or jt capsule that provides support to a jt - crushing and tearing - disrupting the integrity of a joint

220
Q

can you play on a lig injury?

A

yes if your muslces are still good

221
Q

how are lig sprains graded?

A

severity of damage

222
Q

grade 1 sprain

A

minor stretching /tearing of fibers - pain, localized swelling, minimal instability

223
Q

grade 2 sprain

A

more tearing, increased pain, swelling, more instability

224
Q

grade 3 sprain

A

complete rupture of fibres, little to no pain, groww swelling, joint stiffness, complete instability

225
Q

dislocation/luxation - 2

A

one bone in a jt forced completely out of normal alignment - deformity
can result in other soft tissue injuries - rupture of lig and tendons, avulsion fractures, chronic joint stability

226
Q

how to reduce a dislocation

A

manually or surgically

227
Q

common dislocation - 3

A

shoulders, elber, fingers

228
Q

subluxation - 3

A

partial dislocation
bone forced out but goes back into alighment
can cause lig stretching/tearing, capsular distention - increase likeliood of reoccurrence

229
Q

common subluxation - 3

A

patella, shoulder jt, fingers

230
Q

fractures

signs and symptoms

A

extreme stress/strain on bones
deformity, point tenderness, swelling, pain with AROM/PROM, crepitus
X-ray or other dianostics to rule out

231
Q

open/closed fracture

A

protrude/breaks through skin

little or no displacement between bone ends

232
Q

our tests for fractures - 4

A

tuning for, vibration, indirect pressure, axial loading

233
Q

chronic injuries - 2

6 ex

A 
repetitive microtraumas and overuse 
inflammation is the process for acute injuries - when the source of irritation is not removed, inflammatory process becomes chronic 
tendinopathy
tendinitis
tenosynovitis 
bursitis 
osteoarthritis 
stress fractures
234
Q 
tendinitis 
MOI
signs and symptoms 
treatment 
ex - 4
A

inflammation of tendon
repetitive movements - when it moves or slides on other things its irritated and inflamed
pain with movement, swelling, increased temp, crepitus
rest, cross training to allow tendon to rest/decrease inflammation
tennis elbow, bicep tendinitis, achilles, ITB

235
Q

cross training

A

2 or more aerobic classes

236
Q

ankle - 6 bones

A 
tib
fib 
talus 
calc 
navicular 
metatarsals
237
Q

tibia - 3 parts

A

ant border
posteromedial border
med mal

238
Q

fibula - 2

A

head of fibula in sup ribiofibular jt

lat mal

239
Q

important part of talus

A

head

240
Q

calcaneous - 3

A

sustentaculum tali - supports talus and attachment site for spring (deltoid lig)
peroneal tubercle - distal to la mal, separate peroneus longus and brevis
medial tubercle
med tubercle
- med plantar surface
- attachment of plantar aponeurosis
- weight bearing

241
Q

part of navicular

A

navicular tuberosity

242
Q

metatarsals - 2 things we need to know

A

1st and 5th metatarsal

styloid of 5th

243
Q

medial lig

A

deltoid

244
Q

dorsum lig

A

ant inf tibiofibular lig

245
Q

lat lig - 3

A

ant talofibular lig
cfl
pos talofibular lig

246
Q

4 special tests

A

eversion
inversion
ant drawer
thompson

247
Q

eversion test - 2

A

stabilize tib and evert calc

assess deltoid lig stability

248
Q

inverstion test - 2

A

assess ATFL and CFL stability

talus gaps in ankle mortise

249
Q

Ant drawer test - 2

A

ATFL is the only structure preventing forward subluxation of the talus
stablize tib, grip calc and draw calc (and talus) forward while pushing the tib pos

250
Q

thompson test - 3

A

tests continuity of the achilles tendon
patient lies prone on table, squeeze muslce belly of the gastroc - should have resultant PF of foot
may also present - pain, swelling, TOP, inability to PF foot strongly, able to walk but absense of push off, toe off, and flat foot gait

251
Q

6 common injuries to the ankle and lower leg

A 
ankle sprains
achilles tendonitis, rupture 
shin splints 
plantar fasciitis (Arch) 
mortons neuroma 
turf toe
252
Q

ankle sprains
MOI
S&S - 4
management

A

most common athletic injury esp inversion sprains
inversion of the ankle with PF or DF (inversion or lateral sprains), eversion with generally DF
pain and disability, unable to weight bear, swelling, bruising
PIER, xray to rule out fracture, strenthening and balance exercises

253
Q

grade one ankle sprain

A

tearing of some fibres

254
Q

grade 2 ankle sprain

A

more tearing of fibres with noticable laxity in the jt

255
Q

grade 3 ankle sprain

A

complete rupture of fibres

256
Q

what might lead to ankle injury

A

poor balance

257
Q

after an ankle injury

A

balance may be affected due to subject’s inability to determine position of ankle therefore gait will be affected as well

258
Q

achilles tendon rupture
MOI
S&S - 5
management - 2

A 
quick motion from PF to DF 
sudden snap in achilles area 
pain may be present 
swelling over tendon 
point tenderness 
inability to raise up onto toes 
non-operative - PIER, Nonsteroidal anti-inflammatory drugs, casting, gentle stretching and strengthening 
operative - surgical attachment of ends of achilles, then PIER, ROM, strengthening and balance exercises
259
Q

achilles tendonitis
MOI - 2
S&S - 3
management - 5

A 
overloaded due to excessive stress - decreased flexibility is also a contributing factor
pain and stiffness in area
decrease in strength of G/S complex 
crepitus with movement 
need to decrease stress on the tendon 
PIER and correct faulty mechanics 
Heel lift to put the foot into slight PF 
Stretching GS complex 
casting if athlete is non-compliant
260
Q

shin splints - 4

A

medial tibial stress syndrome
stress reacion inflammation of the periosteal and musculotendonis fascial junctions
distance runners
rule out stress fracture and ant compartment syndrome

261
Q

Shin splint MOI - 4
S&S - 3
Management - 6

A

training errors, improper or poor footwear, tight achilles
repetitive microtrauma
pain in middle or distal 1/3 of lower leg
varies in intensity from with activity only to pain with ADL
4 grades of pain
referral to physician to rule out stress fracture
modify activity
correct abnormal pronation, local treatment, stretch GS, taping

262
Q

plantar fasciitis - 2

A

pain under proximal arch and heel

plantar fascia supports the arch of the foot

263
Q

5 causes of plantar faciitis pain

A 
stretching of facia as in toe extension 
fascia shortens as a result of improper footwear or gait mechanics 
leg length discrepancy 
excessive pronation 
tightness of GS
264
Q

Plantar fasciitis S&S - 2

management - 6

A 
pain on anteromedial aspect of heel with weight bearing and toe extension 
burning pain with weight bearing esp morning 
orthotics 
night split
PIER 
arch taping
stretching GS 
proper footwear
265
Q

Metatarsalgia/morton’s neuroma

5 causes

A

pain in forefoot
tight GS
increased pressure on forefoot due to gait alterations
causes nerves to be impinged between matatarsals
aggravated with collapse of transverse arch
pronated foot

266
Q

2 S&S for metatarsalgia/morton’s neuroma

management -3

A

pain in forefoot
tingling and/or numbness in forefoot
orthotics, stretching GS
strenthening foot intrinsic muslces with toe curls

267
Q

Turf toe causes - 2

A

hyperextension results in sprain of MTP jt of 1st toe

occur b/c shoes are very flexible of turf (surface) is very sticky and allows more flexion of the 1st MTP jt

268
Q

2 S&S of turf toe

4 management

A

pain and swelling in and around 1st MTP jt
pain with 1st toe flexion when pushing off
stiffer shoes in the forefoot
taping to prevent toe extension
PIER

269
Q

Retrocalcaneous bursitis cause - 3

A

inflammation of the bursa that lies bw the achilles and calcaneous

  • pressure and rubbing
  • exostosis - bony outgrowth - pump bump
270
Q

2 S&S of retrocalcaneal bursitis

4 management

A 
pain with palpation 
swelling on both sides of insertion 
PIER
NSAIDS 
heal lift to decrease irritation on tendon 
find irritating cause
271
Q

clonic spasm vs tonic spasm

A

intermittent contraction and relaxation vs constant muscle contraction

272
Q

MOI of leg cramps

A

unknown - thought to occur from lack of fluid

273
Q

S&S of Leg cramps

A

considerable pain and cramping

274
Q

management of leg cramps - 3

A

stretching with pressure applied over muscle cramp
ice
rehydrate

275
Q

acute leg fractures MOI

S&S - 2

A

direct/indirect trauma
pain and disability
immediate swelling over fracture site
splint and refer

276
Q

stress fracture MOI - 3

A

repetitive trauma
pronated - fibular stress fractures
supinated - tibial stress fractures

277
Q

S&S of stress fractures -3

A

along bone with palpation
positive fracture test at times
bone scan to rule out fracture

278
Q

management of stress fractures

A

correct mechanical causes, NWb for rest

stretch tight structures

279
Q

Type of tape for prophylactic taping principles

A

white, non-elastic, adhesive 1 1/2 inch width

280
Q

what to consider while buying tape - 3

A

grade of backing fibres - thread count/quality
quality of adhesive
winding tension

281
Q

Tape prep for prophylactic taping - 4

A

skin surface, nicks and cuts, shaving, allergies

282
Q

9 things for a tape job

A 
razor 
soap 
tape remover - dehesive 
tuff skin 
prowrap 
heel and lace 
skin lube 
tape and stretch tape 
scissors/shark
283
Q

3 phases of healing process

A

inflammatory (hemostasis) response - 0-4d
fibroblastic repair 1-inf
maturation - remodeling 2-inf
continuum - overlap and have no set/end pt

284
Q

goal of you during healing process

A

create an environment that is conducive to the healing process

285
Q

When does inflammatory begin

what does it result in?

duration?

A

once tissue is injured - direct injury to cells of soft tissue

Release of materials needed for the inflammatory response

2-4 d - ice in 72 hrs

286
Q

purpose of inflammation - 2

A

protect/splint, localize and rid body of some injurious agent in prep of healing
associated with vascular, cellular and chemical responses

287
Q

Why is the inflammation phase critical?

A

if it does not accomplish what is needed/does not subside, normal healing cannot take place

288
Q

Symptoms of inflammatory response

A 
Swelling 
Heat 
Altered function 
Redness 
Pain
289
Q

2 events of inflammatory phase

A

vascular reaction

formation of a clot

290
Q

vascular reaction - 2

A

vascular spasm - vasoconstriction of vascular walls to reduce blood flow (5-10min - ice, tensor, immob), followed by vasodilation
formation of a platelet plug, blood coagulation, and growth of fibrous tissue
chemical mediators released - histamine, leukotaxin, necrosin to limit amt of exudate and swelling, swelling depends on the extent of tissue damage

291
Q

formation of a clot - 3

A

damage to BV exposes the endothelium and collagen fibers
platelets and leukocytes adhere to the exposed fibers, eventually forming a plug
localize the injury process

292
Q

Fibroplasia

A

Period of scar formation

293
Q

Fibroblastic phase
time frame
S&S- 2

A

formation of scar
first few hours and up to 4-6 weeks
inflammatory S&S subside
tender to touch and painful with certain movements - depends on the tissues diff peak points

294
Q

What is happening in fibroblastic phase - 2

A

new capillaries bud into wound to deliver oxygen - increase blood flow and nutrients to site - initially a granulation tissue to fill in gaps
as healing continues fibroblast accumulate at the would site and synthesize new extracellular matrix that contains collagen, elastin, ground substance and additional proteins

295
Q

day 6-7 of fibroblastic - repair phase - 3

A

collagen fibers deposited in a random fashion, forming a scar
tensile strength increases in proportion to the rate of collagen synthesis
increase in tensile strength decreases fibroblast production to begin next phase

296
Q

Maturation-remodeling phase - 5

A

long term - up to several yrs
realignment or redeling of collagen fibers that make up the scar tissue and ongoing breakdown and synthesis of collagen
increased stress and strain causes the collagen fibers to realign along the lines of tension
tissues gradually assume normal appearance and function
by the end of 3 weeks - firm, strong, contracted, non-vascular scar forms

297
Q

Chronic inflammation - 4

A

acute inflammatory phase does not eliminate the agents and restore tissue to normal state
can last for m to y
repeated microtraumas and overuse of a particular structure
typically resistant to both physical and pharmacological treatments

298
Q

Cartilage healing capability

A

dependent on whether the damage is to the cartilage or subchrondral bone - bone progresses normally

299
Q

Lig healing capability - 3

A

normal
fibrin clot helps to bridge the torn ends of the lig
over m scar continues to mature in response to stress and strain - up to 12 m

300
Q

why is lig healing variable - 2

A

scar tissue is insufficient

lig not reattached to the proper location on the bone - lig failure

301
Q

3 stages of healing in muscles

A

in large and force producing muslces - hemorrage, edema, phagocytosis to clear debris
scar formation, myiblastic activity to regenerate myofibrils
maturation - collagen fibers arrange themselves along lines of tensile force - needed for active muscle contraction

302
Q

active muscle contraction is needed for

A

normal tensile strength

303
Q

Length of rehab in muscles depend on

A

degree of strain = can be longer than lig sprain

304
Q

Muscle strain and too soon for return to play

A

reinjury and start healing process again

305
Q

Nerve healing

process - 3

A

cells dont regenerate when they die but nerve fibers do
peripheral nerve regeneration at 3-4mm/d
damaged nerves in CNS regenerate very poorly bc they lack CT sheaths and schwann cells dont proliferate
surgical intervention in severed nerve - increases healing potential

306
Q

Bone healing - 3

A

callus formation needs to occur at the fracture site
remoddling process - ongoing where osteoblasts lay down new bone and osteoclasts remove bone according to the forces placed on the healing bone - wolff’s law - bone adapts to the mechanical stress and strain by changing size, shape and structure
osteoblast/clast activity may cont for 2-3 years

307
Q

3 types of trauma to bone

A

contusion of periosteum
closed nondisplaced fractures
displaced open fractures that involve soft tissue

308
Q

factors that impede healing - 7

A 
extent of injury - 
edema
hemorrhage 
poor vascular supply 
infection 
separation of tissue 
muscle spasm 
health, age and nutrition
309
Q

extent of injury and healing -2

A

greater the damage the more inflammation present - microtears vs macrotears

310
Q

edema and healing

A

increased pressure causes tissue separation, inhibits neuromuscular control and impedes nutrition to the injured structure

311
Q

hemorrage and healing - 3

A

increased bleeding causes increased pressure, additional tissue damage
if its bleeding its not healing

312
Q

poor vascular supply and healing

A

poorly and slow - tendons and ligs

313
Q

infection and healing - 2

A

delays healing and increases granulation tissue

314
Q

separation of tissue and healing - 2

A

need more scare tissue to fill the gap

smooth edges vs jagged/separated edges

315
Q

muscle spasm

A

cause traction of torn tissue, separating the 2 ends, affecting approximation

316
Q

health, age and nutrition - 2

A 
older age has less elastic properties of tissue 
vit c(collagen synthesis), vit k(clotting), vit A(immune system)
317
Q

PIER

A

pressure - pressure on blood vessels to make it harder for fluid to leak out
ice - vasocontriction therefore reducing swelling
elevation - uses gravity to assist in fluid drainage in area
rest - ceases damage to the area by not placing stress on injured structures

318
Q

Pain - 2

A

subjective sensation

unpleasant sensory and emotional experience associated with actual or potential tissue damage

319
Q

Goal with pain

A

control acute pain by encouraging the body to heal through exercise designed to progressively increase functional capacity and return the patient to full activity as quick and safe as possible

320
Q

acute vs chronic pain

A

less than 6m vs greater than 6m and cont beyond usual normal healing time

321
Q

referred pain

A

away from the actual site of irritation

322
Q

How do you treat pain -2

A

therapeutic modalities and manual therapy techniques
ex: heat, cold, electrical stim, ultrasound, manipulation, ART, massage etc
medication - Physician - NSAIDs or analgesics

323
Q

4 ways to treat pain with therapeutic exercises

A

exercises/stretches to ROM; helps enhance realignment of scar tissue
exercises to help strengthen injured tissues or surrounding areas
include proprioception
advance to functional exercise

324
Q

infection in inflammatory stage

A

cant get out of it

325
Q

what colors are healed scares

A

white, if its pink small roots of capillaries are still feeding it

326
Q

what to make sure with scars

A

mobile and flexible to ensure consistency matches skin

327
Q

healing by primary intention

A

stitches

328
Q

how to figure out when to use stitches

A

open it to see deepness and if it goes back together its okay steri strip, if not - get stitches

329
Q

In what environment do cuts heal better in?

A

moist environment

330
Q

how do you heal chronic inflammation

A

reset it to square 1

331
Q

stability for a jt after a lig injury

A

generally pretty good, some are within the jt capsule and gets less blood

332
Q

3 treatments during skeletal inflammatory

A

milk massage, ice, anti inflammatory

333
Q

2 treatments of skeletal during fibroblastic phase

A

gentle ROM, take gravity out and test

334
Q

2 treatments of skeletal during fibroblastic phase

A

gentle ROM, take gravity out and test

335
Q

smoking and healing

A

worse - 256x for CO to bind to RBC than O2

336
Q

1-10 scale for pain

A

5 you are stopping2, for a break, 7 youre crying, 9/10 hospital

Rec and Care (11 decks)

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