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Rec and Care > Exam 1 - 2 > Flashcards

Exam 1 - 2 Flashcards

1
Q

4 ways that thermal energy is transmitted

A

conduction- heat from warmer to cooler - hot pack
convection - transfer of heat through movement of fluid or gases - hot tub
radiation - heat is transferred through space from one object to another - shortwave and microwave diathermy
conversion - heat generation from another source such as sound, electricity and chemical agents - tigerbalm and ultrasound

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2
Q

cryotherapy

A

cold packs or ice - principle of conduction where the body part comes in direct contact with the cold agent

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3
Q

magnitude of the temp change in the tissue will depend on 4

A

temp diff between the cold agent and the tissue
time of exposure
thermal conductivity of the area being cooled - muscle faster than fat
type of cooling agent

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4
Q

4 things that cold applications do

A

induces vasoconstriction and therefore limits bleeding - swelling
analgesic - decrease pain fibre transmission
reduce inflammation - decrease metabolic rate
reduces muscle guarding/spasm - slows pain that causes spasm, decreases metabolic rate so decreases the irritating chemicals

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5
Q

physiological effect of cold - 2

A

cold to skin at 10 degrees, vasoconstriction occurs - reduction of blood flow
hunting response - cold application for 15-30 mins causes a slight temp increase - fight response for hypothermia

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6
Q

4 contraindications for cold application

A

allergy to cold - jt pain, swelling and hives
poor circulation - diabetes
circulatory impairment - Raynauds phenomenon - vasospasm of digital arteries lasting for min/hrs that could lead to tissue death
wound opening

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7
Q

feeling of ice application

A

Cold - 0-3 mins
Burning - 2-5 min
Aching - 4-7 mins
Numbness 5-12 mins

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8
Q

should you wrap ice

A

no - hunters response - but dont put chemicals directly on skin

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9
Q

cryotherapeutic methods - 4

A

conduction
ice massage - frozen ice cups for small body parts
cold water/ice water immersion - gravity dependent use after initial acute stage
ice packs - with pressure in acute stage
vasocoolant sprays - freeze towel in a desert
- chemicals used to reduce muscle spasms/cramps to reduce nerve ending signals

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10
Q

electrolyte for cramps

A

not much

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11
Q

Thermotherapy - 2

A

application of heat to injuries

after initial inflammatory response has subsided after first 3 days

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12
Q

5 physiological effects of heat

A

analgesic effects by gate control
vasodilation to increase bloodflow, circulation and removal of metabolic wastes
decrease muslce spasm caused by ischemia, decreases muscle spindle activity and increases blood flow to area
increase ROM - increases elasticity of lig, capsule, and muscle
increase local tissue temp

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13
Q

for heat physiological responses to occur

A

heat must be absorbed into tissue to increase molecular activity - once absorbed it spreads to adjacent tissues

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14
Q

5 contraindications of heat

A 
loss of sensation to area 
immediately after injury - acute inflammatory state 
decreased arterial circulation 
eyes/genitals - gonads will die 
abdomen during pregnancy
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15
Q

moist heat therapies - 4

A

moist heat packs -
whirlpool baths
paraffin bath - wax
contrast bath

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16
Q

moist heat packs

A

conduction and convection

- relaxation and reduction in pain - spasmischemia - hypoxia pain cycle - hydroxalator pack - ongoing isometric

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17
Q

whirl pool baths

A
  • chronic for pitted edema - milk massage after heated - decrease swell
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18
Q

paraffin bath

A

fighters and their knuckles

chronic extremity injuries

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19
Q

contrast bath - 2

A

alternating vasoconstriction and vasodilation - ice and heat - 10-12 mins, hr/45min to remove existing swelling
new blood assists in removing edema by unclogging and vasculature

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20
Q

knee - 4

A

tibiofemoral jt
frequently injured
complex jt
poor stability

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21
Q

knee - type of jt and 4 movements

A

synovial, modified hinge jt

flex/ext/int rot/ext rot

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22
Q

3 parts of the knee

A

femur - not congruent with tib,
tibia plateau
patella - sesamoid bone

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23
Q

Fibula in regards to the knee

A

not involved and not weight bearing
site for muscle/lig attachment
sup tibiofib jt - head of fibula and LCL
posterolateral knee injuries

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24
Q

patella - 3

A

largest sesamoid bone in the body
lined with hyaline cartilage
allows stronger muscle pull of quads due to changing the angle of the patellar tendon

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25
Q

menisci

4 functions

A 
fibrocartlaginous discs in knee 
improved congruency 
aid in jt nutrition 
transmit force 
decrease contact load - slides nice together
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26
Q

medial vs lateral meniscus

A

c and o shaped

med has less movement and high incidence rate

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27
Q

blood supply to meniscus - 3

A

only to outer 1/3
poor healing capacity
stitch a bucket handle

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28
Q

bursae of the knee
function
3 most injured

A

fluid filled sac
reduce friction across gliding surfaces
prepatellar, suprapatellar, infrapatellar

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29
Q

6 things that make up the knees stability

A 
bone 
lig
articular cartilage 
jt capsule 
tendons 
menicus
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30
Q

ACL bands
attachment sites
function - 2

A

anteromedial
posterolateral
intermediate bands
ant/med aspect of tibia and lat femoral condyle
prevent ant translation of tibia relative to femur
secondary restraint to valgus (l-m)/varus (m-l) force

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31
Q

injury to acl

diagnosis by different methods

A

damaged in 72% of knees with hemarthrosis
stick needle in and if there is blood - jt line swelling - divits on your knee and under your jt
85% can be detected by a skilled clinician
less than 80 for MRI and 80% get sent for 1, our clinic does 2.7 %
scope - 100%

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32
Q

PCL
O/A
function

A

less frequent in isolation - low surgical success
lat/pos tib to med femoral contyle
prevent pos translation of tib relative of the femur

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33
Q

MCL
O/A
function

A

lots of blood vessels and nerves
med femoral condyle to tib
resists valgus (lat to med) stress and lat rotation of the tib

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34
Q

LCL - O/A

function

A

lat femoral condyle to head of fib

resists varus stress

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35
Q

ant thigh muscles - 4

function

A

4 muscles
vastus lat/med/intermedias/rectus femoris
knee extension

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36
Q

pos thigh muscles - 3

function

A

biceps femoris - lat
semitendinosis - most prominent
semimembranosis - med to lat
knee flexion

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37
Q

special tests

- 2

A

end of orthopedic test to verify to see if its what you think - provoking test so be careful
- degree of injury - proper decisions for management and RTP

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38
Q

muscle tests are also

A

exercises

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39
Q

Ant drawer for the knee
look for
false pos
false neg

A

ACL
laxity and stretched
great flexibility and laxity to begin with
contracted hamstrings - make sure they relax

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40
Q

when you’re assessing, always

A

compare both sides

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41
Q

pos drawer
procedure
what to look for

A

PCL
stablize foot, put thumb on tibial tuberosity - apply force pos
sag sign

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42
Q

valgus stress test

procedure

A

MCL - one shot bc they will tighten up after
supine with leg extended, holding the patients leg apply a medial force - look and feel for MCL laxity - fully extended then 30 degrees of flexion

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43
Q

varus test

A

LCL

supine and hold their leg to apply slow lateral force and feel for laxity

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44
Q

faber position

A

boy cross legged position
flexed knee and, abduct and externally rotate
LCL - not definitive

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45
Q

apleys compression
procedure
signs

A

meniscus
prone with affected knee bent at 90 degrees
stablize thigh and apply downward pressure while rotating the lower leg internally and externally
med tear - externally rotate
lat - internal rot

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46
Q

why be careful with cartilage tests

A

you can lock it

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47
Q

MCL sprain

MOI

A

often in conjunction with ACL tears

direct blow to the lat aspect of knee or tibial ex rotation

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48
Q

grade 1 sprain

A

pain, slight swelling, no instability

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49
Q

grade 2 sprain

A

pain, mod swelling, unable to bear weight

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50
Q

grade 3 sprain

A

immediate severe pain, gross instability, swelling, unable to bear weight

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51
Q

management of sprains

A

depending on the degree/severity of the sprain

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52
Q

MCL management Grade 1

A

PIER, strengthening quads, hams, adductors, balance

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53
Q

MCL management Grade 2

A

PIER, crutches, strengthening, balance

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54
Q

MCL management Grade 3

A

PIER, doc, NWB, splint

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55
Q

LCL sprain
MOI
S&S - 5

A 
Varus for and internal rotation of tib 
lat knee pain 
swelling/bruising
LCL laxity 
tenderness
altered gait/WB
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56
Q

ACL sprain

MOI

A

deceleration force with tib internal rotation and valgus force/hyperextension - sheer force - non contact

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57
Q

why are females at more risk of ACL injuries - 3

A

strength - eccentric loading of quads
anatomy - increased Q angle
hormonal changes

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58
Q

signs and symptoms of ACL injury

A

audible pop
immediate swelling - hemarthosis - jt line welling, hot, doesnt bend well
instability with ant drawer

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59
Q

management of ACL - 5

A 
PIER 
NWB
crutches 
brace 
doc
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60
Q

why sent acl to doc

A

damage will cause abnormal wear and tear to the knee which accelerates arthritis

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61
Q

what type of exercises for ACL rupture - 4

A

ROM
strengthening of ham, quad, glutes
functional exercises
proprioception

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62
Q

ACL surgery

rehab protocols

A

focus on hamstring strength
patellar or hamstring tendon graft into ant aspect of tib to posteriolateral aspect of femur to approximate ACL
vary

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63
Q

PCL injury - 3

A

Quad strength
not as common
3-37% of all cases of hemarthrosis

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64
Q

MOI PCL strength

signs and symptoms - 4

A 
direct trauma or fall onto flexed knee - dashboard injury 
audible pop
swelling 
instability 
sag sign -
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65
Q

5 management

A 
NWB 
doc 
crutches 
PIER 
brace
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66
Q

4 rehab

A

ROM
strengthening
functional exercises
proprioception

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67
Q

PCL surgical?

A

not usual - poor post surgical success rates

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68
Q

why are medial tears more likely to happen?

A

lack of mobility

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69
Q

MOI of meniscal tears - 3

A

often happen with lig tears

axial loading and rotation - forceful extention to flexion or flexion to extension

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70
Q

healing of meniscal tears

A

slow - poor blood supply - if you rest on it it will heal

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71
Q

SS for menical tear - 3

A

locking/giving away
jt swelling
pain with pivoting

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72
Q

management of meniscal tear - 5

A 
PIER 
strength of quads and hams 
balance 
stationary bicycle 
surgical intervention
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73
Q

Why are meniscal injuries bad

A

poorly managed - change mechanics and premature arthritis

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74
Q 
Bursitis 
MOI 
SS - 3
Management - 5
note
A 
direct trauma or constant irritation due to repetitive stress 
swelling, pain, enlarged bursal sac 
pad it and dont make it worse 
PIER 
correct mechanical cause
address strength of quads, hams, core 
foot mechanics 
extracapsullar is better than intra
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75
Q 
Patellar subluxation or dislocation 
mistaken as 
MOI - 2
predisposing factors - 5
SS - 4
management - 3
rehab 
reduce
A

tibiofemoral problems
Valgus force with decel from quads, twisting/pivoting - large hips
wide pelvis, genu valgum, patella alta, weakness of VM and adductor magnus, pronation of the subtalar jt - pes planus
pain, swelling, deformity, loss of knee function
splint above and below, refer to rule out fracture - ER with straight leg, brace with hole in the middle, patella stabilizer
strengthen VM and adductors
flex hip and knee then lift leg slightly

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76
Q 
Patellofemoral pain syndrome 
prone lifestyle - 4
MOI
5 prone anatomy 
4 SS 
4 strengthening 
4 stretching 
tape?
A 
sedentary, obesity, weakness, nutrition 
chronic, improper tracking of patella 
tight hams, ITB, increased pronation of foot/ankle, large Q angle, muscle imbalances 
asymtomatic at rest 
pain in ant, pain with knee flexion and stair climbing and hills, pos theatre sign
quads hams glutes core 
quads hams ITB, gastroc  
helps how the patella tracks, brace
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77
Q

Chondromalacia patella
MOI
4 SS
management

A 
softening of the articular cartilage
chronic, exact cause is unknown but may be related to poor patellar tracking 
pain under patella 
pain with stair climbing 
grinding with activity 
pos theatre sign 
rest
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78
Q

osgood schlatter disease
MOI
4 SS
5 management

A

enlarge soft tissue calcifying - boys that grow super fast
avulsion of patellar lig from tib tubercle due to excessive repeated strain - immature athletes/open growth plates
swelling, ant knee pain, pain with jumping, running, squatting, enlarged tub
PIER, cessation of causative act, may require casting, bracing, tape - rest, address muscular imbalances/mechanics, strength through eccentric, core, glutes

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79
Q

patellar tendonitis
MOI - 2
4 SS
5 management

A

jumper/kickers knee - proximal part of tendon
older athelete - 20 and up
overuse - eccentric more force than concentric
eccentric loading of quads cause tendon to become irritated,, maltracking patella
TOP inf pole of patella
pain during and post activity - worse with running and jumping, may swell, bony protuberance
PIER, find the cause - mechanics and movement pattern, improve flexibility, strengthen quads, glutes, core, cho pad strap to change the insertion pt of patellar tendon

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80
Q

ITB friction syndrome
MOI - 3
5 SS
management 4

A

tensor fascia - cross jt line
more common in ladies - knocked knee and use tensor fascia as a flexor
chronic, repetitive compression of ITB against lat fem condyles- inflammation
act with repetitive flex/ex of knee - running, cycling, swimming, rowing
muscular imbalance/weakness, abnormal gait, foot/knee alignment
pain up and down stairs, pain running esp downhill, pain at a specific time/distance during act, improves with rest/cessation of activity, TOP distal ITB
find the cause and treat it - terrain, footwear, mileage
stretch ITB, glutes, quad
strengthen - glutes, core
address gait patterns
knee and goot alignment

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81
Q

ladies and ITB friction

A

put them on an exercise program - some people are not made for running

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82
Q

runner 3 weeks out

A

treat symptoms

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83
Q

goals with blood borne disease

A

prevent the spread of infectious diseases

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84
Q

why is the spread of infectious disease a concern in sporting activities

A

close physical contact

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85
Q

failure to protect yourself from blood borne pathogens

A

may put yourself and others at risk as transmitter or carrier

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86
Q

bloodborne pathogens

where is it - 4

A

pathogenic microorganisms that can potentially cause disease
present in bodily fluids such as blood, CSF, synovial fluid, other fluid types that may contain blood

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87
Q

possible blood borne diseases - 3

A

hepatitis B, C, HIV

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88
Q

HIV

A

human immunodeficiency virus

89
Q

Virus - 3

A

very small, biggest is the size of smallest bacteria
invade other cells and hijack their cellular machinery to reproduce, attach to a cell and inject their genes or are swallowed up by the cell
parasitic organism

90
Q

bacteria - 2

A

very large

all the genetic materials necessary to replicate

91
Q

hepatitis b

A

virus - attacks your liver

get a shot

92
Q

liver - 3

A

digest food, store energy, rid of poisons

93
Q

will i die from hepatitis b - 3

A

most people dont
can cause permanent liver damage - cirrhosis
liver cancer maybe death

94
Q

3 ways to get hepatitis b

A

high risk act with ind with hep b
born to a mother with hep b
contact with dried blood or contaminated surfaces

95
Q

you can pass hep b to other if - 2

A

acute hep - just contracted

chronic hep - carrier

96
Q

7 symptoms of hep b

note

A

flu like - fatigue, weakness, nausea, abdominal pain, headache, fever, possibly jaundice
may exhibit none and be a carrier - may take up to 2m to show up and may stay in your blood for m/yrs

97
Q

will i get rid of hep b

A

acute - 9/10 will after a few months

chronic - 1/10 - never rid of it - carriers

98
Q

can hep b be prevented?

A

yes - 3 shots if you have never had it and get long lasting protection

99
Q

hep c - 3

A

acute/chronic liver disease
most common bloodborne infection, may require a liver transplant
high probability from acute to chronic

100
Q

spread of hep c - 3

A

contact with blood of an infected ind

  • tattoo/piercing
  • personal care items that might have traces of blood - needles or razors
101
Q

SS for hep c

A 
flu like 
nausea
fatigue 
muslce/jt pain 
dark urine
loss of appetite 
mild abdominal pain - URQ
jaundice 
many are asymtomatic
102
Q

prevention/management - 3

A

dispose of sharps properly
use barrier precautions such as gloves
no preventative vaccine -
- monitored by physician for liver disease and placed on certain meds

103
Q

HIV transmission - 3

A

exposure to infected blood or other infected bodily fluids or by intimate contact

104
Q

SS of HIV - 6

A 
fatigue
weight loss 
muscle or jt pain 
painful or swollen glands 
night sweats 
fever
105
Q

development of HIV

A

8-10 years before developing any SS

ppl who test pos for HIV have a high probability of developing AIDS

106
Q

acquired immunodeficiency syndrome - 5

A

collection of SS that are recognized as the effects of an infection or condition
do not have protection against the simplest infection
50% of aids become HIV in 10 yrs
2 years to live after SS
no vaccine and no cure

107
Q

prevention of aids

A

ed

how its contracted, safe sex, other personal protextion, dont share needles and protect from bodily fluids

108
Q

4 sports that have the greatest risk for blood borne pathogens

A

boxing
martical arts
wrestling
rugby

109
Q

4 sports that have the mod risk for blood borne pathogens

A

basketball
football
soccer
speed skating

110
Q

low risk sports for blood borne pathogen

A

ind

111
Q

4 universal precautions

A

cuts wounds and abrasions should be covered prior to competitions
bleeding on field has to be cleansed with disinfectant and covered appropriately
bloody uniform must be removed from athlete
blood rules

112
Q

personal precautions- 7

A

latex gloves, double in heavy bleeding
washed skin with hot soapy water
wash hands between each patient contact
first aid kits must have gloves, resuscitation mouth pieces and towelletes for cleaning skin surfaces
clothes that come in contact with blood should be washed in hot water with chlorine bleach
dispose of bloody gloves, needle, razors in SHARPS container that has been labeled biohazardous waste
open wound - refrain from direct cont with ind until wound is healed

113
Q

wound

mechanical forces can injure soft tissue - 7

A

trauma to tissues that causes a break in the continuity of that tissue
rubbing, scraping, compression, pressure, tearing, cutting and penetration

114
Q

wounds are classified by

A

mechanical forces that caused them

115
Q

friction blisters

A

cont rubbing over the skin surface causes fluid to accumulate under

116
Q

abrasion

A

scraped skin against a rough surface, top layer rubs away exposing capillaries

117
Q

laceration

A

flesh irregularly torn - high risk of infection

118
Q

avulsion wounds

A

tissue ripped away from body - major bleeding - reattached and transported in moist tissue with the athlete

119
Q

incision

A

sharply cut, smooth edges

120
Q

puncture wounds

A

penetration of the skin by a sharp object - can introduce bacteria into the bloodstream - physician

121
Q

immediate care for wounds - 4

A

all are considered contaminated by microorganisms
clean and dress
soap and water or saline
dont use hydrogen peroxide immediately

122
Q

dressing - 4

A

sterile
gauze/adhesive bandage
change frequently if draining
antibacterial ointment

123
Q

good wound care - 3

A

min inflammatory process, speed healing and min scarring

124
Q

When to suture - 4

A

deep wounds - lacerations, incisions, punctures - irregular edges
physician
immediately up to 12 hrs
approximate edges to min scar formation, tissue damage and inflammation

125
Q

infection signs - 7

A

Swelling, heat, altered function, redness, pain, pus, fever

126
Q

2 treatment for infections

A

oral/IV antibiotics

tetanus vaccine - every 10 yrs

127
Q

EAP is needed for

A

every team, sport, field, court

128
Q

Activate EAP immediately bc

A

time is the essence when dealing with injury - permenant brain damage in 5mins with lack of o2

129
Q

when do you establish EAP

A

prior to actual emergency and practice every mouth

130
Q

primary concern of EAP

A

maintain CV and CNS function

131
Q

3cs

A

charge person - most experienced
call person - designated by charge
control person - security/calm person

132
Q

charge person - 4

A

leader and instructs member of med team
most important body part - head/neck for spinal and control cspine
most experience
direct assistants as needed

133
Q

call person - 3

A

signalled by call person to call 911/landline/local number - knows
knows routes of ambulance to enter field of play - keys to admittance to field
knows location of nearest emerge medical facility

134
Q

control - 5

A

everyone whos touching the patient needs to be authorized
control crowd - under 18 parent has to be there
bystanders away
assist charge when needed
liasises with other ppl but no med info for media

135
Q

other than 3cs, what else does EAP need - 8

A

seperate EAPs and equipment needed at each
procedure for removal of equipment
location and accessibility of phones
transportation of athlete - ambulance or personal vehicles
procedure for amittance to emerge - under 16?
company? cant be trainer - AC, parent, chaperone
pertinent med info on a card ready to go with player
communication

136
Q

legal aspects of EAP

A

everyone is under a legal duty to provide necessaries of life to a person under his/her care

137
Q

how are you evaled?

A

vs my peers at your academic level

138
Q

children in emergency situations

A

implied consent - signed release from parent

139
Q

do we need consent for emergency care

A

yes but you can always call 911

140
Q

unconcious victim

A

implied consent

141
Q

must provide care if 2

A

duty to act

person under your charge is injured

142
Q

criminal negligence - 2

A

failed to act as another reasonable person

failed to act that caused more injury or death

143
Q

do we put others before us?

A

not if we are in danger - no fire no wire no gas no glass

144
Q

7 things for trainer

A 
latex gloves 
scissors 
face shield 
tape for splinting 
towel/sterile gauze pads 
cell phone 
tools for sport to remove equipment
145
Q

infield injury assessment will

A

provide direction in the decision making process concerning emergency care

146
Q

5 life threatening things that you should call 911 right away

A 
airway 
breathing 
circulation 
deadly bleeding 
shock 
CNS
147
Q

UABCD

A

life-threatening - 911/ems
unconscious
airway and cspine control
breathing - look listen feel rate and quality
circulation - quality and rate, radial palpable - 80mmHg, radial not palpable - late shock - deadly bleed internal/external, faint beating heart
deadly bleeding - wet check and scan

148
Q

Level of consciousness

A 
AVPU 
alert 
verbal stim 
physical stim 
unconscious/unresponsive
149
Q

some causes for unconsiousness

A 
AEIOUTIPS 
allergies 
epilepsy 
insulin/diabetic 
overdose 
underdose 
trauma 
infections 
psychiatric 
stroke & heat
150
Q

after consciousness

A

expose and examine
focus on trunk - head spine and femur
monitor vital signs cont - between deadly bleeding and CNS - BP, pulse, respiration, skin temp, color, pupils, state of consciousness, weakness of movement, sensory changes every 5 mins

151
Q

vital signs - 9

A

pulse - adult 60-80bpm, children 80-100, radial or carotid
respiration - 12 adults, 20-25 kids
bp 120/80 higher in males
temp
skin colour - red - heartstroke, high BP, elevated temp, pale - insufficient circulation, shock, fright, hemorrhage, insulin shock, blue - cyanosis, airway obstruction, respiratory insufficiency, not enough o2
pupils - small - depressant, dilated - head injury/stimulant, upper, not responsive to light,, use edge of light
state of consciousness
movement - inability to move - spinal cord injury
abnormal nerve response - babinsky reflex, numbness/tingling

152
Q

perral

A

equal pupils round and reactive and accomodating to light

153
Q

arterial blood

A

spurting
pulsating flow
bright red

154
Q

vein blood

A

steady, flow flow

dark red

155
Q

capillaries blood

A

slow even flow

156
Q

external bleeding

A

rest
elevation - reduce hydrostatic bp and facilitate venous and lymphatic drainage
direct pressure and pressure pts proximally to injury site over major artery - brachial/femoral

157
Q

internal bleeding of head - 4

A

dizziness, ringing in ears, nausea, altered psychological functioning

158
Q

internal bleeding

A

hard to determine byt altered functioning

hospitalization and further diagnostics

159
Q

abdominal injuries internal bleeding

A

rigidity, pain in other area, rebound tenderness, bulging, tummyache

160
Q

shock - 4

A

possibility with any injury
potential goes up with fractures, severe bleeding or internal injuries
dim blood to circulatory system
not enough oxygen to tissues esp the NS
collapse of vascular system - widespread tissue death - death

161
Q

Battle field colors

A

black - no ABC
red - mins
yellow - hours

162
Q

hypovolemic shock

A

trauma causing blood loss and organs not supplied with sufficient o2 - not enough to pump and wont pump if there is an air bubble

163
Q

respiratory shock

A

lungs unable to supply o2 to blood baused by pneumothorax - air/gas in pleura or injury to lung

164
Q

neurogenic shock

A

general dilation of blood vessels and blood cannot service CV and cant supply to body

165
Q

psychogenic shock

A

fainting/synocope caused by temp dilation of vessles and reduce blood to brain - not enough to go around

166
Q

cardiogenic shock

A

inability to pump enough blood to body

167
Q

septic shock

A

severe bacterial infection which causes small vessels to dialte

168
Q

anaphylactic shock

A

allergic reaction

169
Q

metabolic shock

A

severe illness goes untreated or extreme loss of bodily fluids - urination, vomiting, diarrhea

170
Q

SS for shock - 9

A 
LBP systolic below 90 
moist, pale, cool, clammy 
rapid and weak pulse 
shallow and rapid respiration 
personality changes - irritable, restless, disinterest, sudden excitement 
nausea 
extreme thirst 
urinary retention 
fecal incontinences
171
Q

shock management for shock - 3

A

911
keep them warm
elevate their legs 12 inches

172
Q

no life threatening

A 
secondary survey 
vital signs 
history 
SAMPLE and med bracelets 
symptoms 
allergies 
medications 
past medical history 
last meal 
events preceding accident
173
Q

after the sample questions you look for 2

A 
DCAPBLS 
deformities 
contusions 
abrasions 
penetrations 
burns 
lacerations 
swelling 
TIC 
tenderness
instability 
crepitus
174
Q

where do you perform DCAPBLS

A

head neck chest abdomen pelvis extremiteis - arms legs fingers toes

175
Q

brief neurological exam

A

AVPU
motor/myos/movement
sensation / derm
pupils

176
Q

focused secondary survey

A

finish bandaging and splinting

177
Q

secondary survey decisions - 4

note

A 
seriousness 
type of first aid and immob
immediate referral to doc? 
where are you going and how are you getting there 
doc findings
178
Q

emerge splinting - 3

A

suspected fracture should be splinted before moving
use anything
splint above and below an din the position it was found

179
Q

3 types of splints

A

rapid form vacuum immob
- injuries angled and must be splinted in that position
- air sucked out of sleeve to give cardboard like rigidity
speed splint
- thick plastic
- bend and snap in place
- reusable
-xray permeable
air splint - filled with air after application to provide support

180
Q

fitting of the crutch

A

6inches from outer margin of shoe and 2in in front
1 in from axilla to top of crutch
wrist - radial styloid level with hand grips and elbows at 30 degrees

181
Q

fitting of cane

A

greater trochanter to gloor

182
Q

walking with cane/crutches

A

tripod
- stand on one foot with affected off the ground
- crutche goes 12-15 in and they lean and straighten arms to swing through stationary crutches
repeat

183
Q

proper injury care can only be provided if

A

nature and severity were understood

184
Q

goal of eval process

A

perfect diagnosis, recovery, rehab

185
Q

eval process must be

A

systematic and orderly
consistent
standardized

186
Q

history

A

greatest clinical significance
MOI
Feel/hear
Result
age, gender, sport, position, what increases or decrease pain, med imaging, med records, reports of injury, fam history, pain and function scale
open ended questions - anything else?
red flags - severe relenting pain, pain unaffected by med or position, severe night pain, severe pain with out history of injury, severe spasm, BB change/dysfunction, elevated temp, psychological overlay - external blaming or too focused on pain

187
Q

observation

A 
explain process 
dress and drape 
manner/fluidity of movement 
limping swelling discoloration deformity scars asymmetries 
bilateral 
pictures they tool
188
Q

HORSPSS

A 
in clinic assessment 
history 
observation 
ROM - a and p
strength 
palpation 
special test 
summary
189
Q

ROM

A 
active - contractile ability 
- when and where pain 
- intensity and quality of pain 
- reaction to pain 
- degree 
pattern 
rhythm and quality 
willingness to move 
passive - bones cartilage lig
- relaxed 
- careful of over power, block in the middle is jt issues 
- when and where pain 
- intensity and quality of pain 
- end feel 
amt of PROM 
all ROM of jt and bilaterally
190
Q

strength

A

becareful if anything was pos
- resisted isometric movement for 6s - unaffected side first
muslce tendon or bone where tendon attaches is at fault - weakness
dont let me move you

191
Q

strength of contraction

A 
no palpable contraction or jt motion 
1 palpable but no jt motion 
2- unable to complet ROM with min gravity 
2 complete ROM with min G
2+ initiate ROM with G
3- does not complete ROM  with G but more than half 
3 complete ROM without resistance 
3+ <50% resis
4->50% resis 
4+ near max
5 max
192
Q

strong and pain free isometric

A

normal

193
Q

strong and painful isometric

A

lesion in muscle or tendon

194
Q

weak and painfree

A

nerve/musculotendinous rupture

195
Q

weak and painful

A

serious - fracture to unstable jt

196
Q

8 causes of muslce weakenss

A 
strain 
pain/reflex inhib - splint pain 
peripheral nerve injury - distal 
nerve root lesion - myotome - higher up 
upper motor neuron lesion 
tendon pathology 
aculsion 
psychological overlay
197
Q

palpation - 4

A

know bony and surface anatomy
deep enough to distinguish diff structures
thumb and finger tips, back of hand
palpate unaffected, start away and move in - superficial to deep

198
Q

6 things to note while palpating

A

tissue tension and texture - muslce spasm
tissue thickness and texture - swelling type
abnormalities
tenderness on palpation
temp
abnormal sensation - dyesthesia hyperesthesia, anesthesia, crepitus

199
Q

special tests - 5

A

orthopedic and also exercises
delineate between structures in the same area
various tests for same structure - 2-3 min, 4 max
what am i looking for?
type of injury?

200
Q

summary - 4

A

proper treatment plan
what do i see what should i do
reassurance
follow up before participation

201
Q

injured body

A

affects the mind

202
Q

neg psychological response to injury

A

longer and more difficult rehab

203
Q

sports med personel and psychology of injury

A

significant impact

204
Q

goal with their minds

A

mind and body ready for competition

205
Q

Response to injury

A

diff for every one

206
Q

injury severity classification

A 
severity - length of rehab 
short term <4wks 
long >4wks 
chronic - reoccurring 
terminating - career ending
207
Q

reactive phases of injury process

A

reaction to injury
to rehab
to return to play or career terminating

208
Q

influences on responses - 5

A 
severity of injury 
coping skills 
past history 
social support 
personality
209
Q

3 predictors of injury

A

injury prone - risk takers, tender minded, apprehensive, overprotective, distracted, poor coping skills
stress and risk of injury
- neg stress, lack of focus, missing cues, muscle tension, peripheral stress - microsystem
overtraining
- imbalance between physcial load and coping capacity
staleness and burnout - decrease load to let them rest

210
Q

4 coping sources

A

goal setting
social support systems
stress management skills
mental skills - pos self talk, thought stoppage

211
Q

poor coping resources

A

vulnerable to higher lvls of stress and more difficulty dealing with stress response - increasing risk for injury

212
Q

strong support systems

A

recover quickly from setbacks than those with a weak support system -

213
Q

7 things an injured atheltes can lose

A 
specific contest 
opportunity to compete 
financial incentives 
starting sport 
physical mobility 
control over life 
personal identity or sense of self
214
Q

mitigating factors to dealing with an injury

A 
emotional distress 
injury site - reinjury 
amt of pain 
timing of injury 
severity
215
Q

factors arising during treatment

A 
whom they blame - locis of control 
degree of compliance with prescription 
effectiveness of Rx perceived by athlete 
reinjury druing Rx 
pain 
meds abuse 
deterioration in psych functioning 
support form others 
fans/media
216
Q

5 normal responses to an injury

A 
anger/frustration 
some denial and min of injury 
concern about pain 
discouraged 
concern over losing conditions
217
Q

5 possible warning responses to injury

A

fixation on injury - blame, tears, obsessed RTP
extensive denial, reinjury
dwell on minor aches and sensations despite reassurance
missing prescrived appts
overly worried about body image and weight

218
Q

psych rehab for injury recovery

A

SCRAPE - needs
social support - part of a team, ppl they know and respect, similar injury, used with substance abuse, dont compare and always over estimate
confidence and competence - buy in, what were doing, what were expecting how well assess - increase function - obtainable goals and always optimistics
refer - know your limitations - anxiety, self esteem depression - report self harm
accomodate - wants vs needs - individualize - build trust - youre on the same team - flexibility in treatment schedule
physicological skills - imagery, goal setting, relaxation, confidential rehab journal for progress
educate - injury pathology, typical recovery time, necessary restricitons, rationale for therapeutic interventions - prognosis, contraindications - written/educational materials on the injury

Rec and Care (11 decks)

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