Exam #1 Flashcards
Pathology - def.
- the science of the causes and effects of diseases
- the branch of medicine that deals with the laboratory examination of samples of body tissue for diagnostic or forensic purposes
Sports medicine - def.
- also known as sport and exercise medicine
- branch of medicine that deals with physical fitness and the treatment and prevention of injuries related to sports end
- heavy focus on MSK system
What does sports medicine include as its focus?
- injury prevention
- injury assessment, recognition, and diagnosis
- treatment and rehab
- performance enhancement - training, nutrition, psychology
- management of medical issues
- exercise prescription in health and chronic diseases
- medical care of sports teams and events
- environmental issues (ex altitude)
- ethical issues (ex anti doping)
- special populations
what is the main role of athletic therapy in sports medicine?
“rapid return to work and play”
what are the two components of treatment and rehab?
1) treat the presenting problem
2) treat the cause of the problem
-individualized care
the sports medicine model
- interdisciplinary field encompassing:
- athletic therapists, massage therapists, strength and conditioning coach, psychologist, dietitian, physician, etc.
name three sports medicine organizations
1) CATA
2) MATA
3) NATA
4) CASM
5) manitoba college of dietitians
6) canadian sport psychology association
7) manitoba physiotherapist association
what are the 4 steps that make up the sequence for prevention of sports injuries?
1) establish the extent of the injury
- incidence
- severity
2) establish the etiology and mechanisms of the injury
- common injuries present in different sports
3) introduce a preventive measure
4) assess its effectiveness by repeating step 1
the prevention of athletic injuries is achieved through what?
primary, secondary, and tertiary prevention
what is primary prevention?
1) the promotion of health
- i.e. PA, medical screening and movement analysis
2) injury prevention
- i.e. knee or ankle braces, protective equipment, conditioning, training techniques, facility and equipment surveys, rules and regulations
what is secondary prevention?
1) early diagnosis
- i.e. medical and orthopedic assessment, imaging
- getting athletes to come see you before they start getting aches and pains
2) early treatment intervention
- i.e. RICES
- rest, ice, compress, elevate, stabilize
what is tertiary prevention?
- rehabilitation
- i.e. manual therapy techniques, therapeutic exercise, and RTP (return to play) protocols
what are 7 internal risk factors for injury?
1) age
2) gender
3) body composition (e.g. body weight, fat mass, BMI, anthropometry)
4) health (e.g. history or previous injury, joint instability)
5) physical fitness (e.g. muscular strength/power, VO2max, joint ROM)
6) anatomy (e.g. alignment, intercondylar notch width)
7) skill level (sport specific technique, postural stability)
what is the pre-participation physical evaluation (PPE)? what is its purpose?
-test to screen athletes to see if they’re at risk for certain injuries
Purpose:
1) determine general health
2) rule out disease or predisposing orthopedic and systemic conditions
3) establish baselines
when should a PPE be completed?
prior to any athletic participation; by athlete’s family physician/team physician
what does the literature say about the usefulness of the PPE?
does not support that a PPE will predict who will develop MSK injuries
-but it’s a good way to screen and highlight a few things
what are the objectives of the PPE?
provides considerable information that is relevant, practical, and beneficial for the athlete in optimizing both their sport performance and overall health
when documenting information on past illnesses, conditions, and/or injuries, what should you include?
1) respiratory problems
- asthma, fainting
2) cardiac problems
- irregular heart beats, murmurs, sudden death in family (SCD/HCM)
- especially important in older populations
- strenuous activities, informing people to pace themselves, defibrillator on hand, emergency action plan in place
3) prior concussions/head injuries
- can cause neurological damage
4) prior neck injury
- burners, 3’s
5) prior extremity injuries
- #’s sprains, strains, contusions
6) any hospitalization or surgeries
what type of consent is needed in order to be able to share a patient’s medical information? Are there exceptions to this rule?
- need written permission to share medical or injury information with a specified individual or group of individuals
- this MUST be signed prior to releasing an individual’s medical info (PHIA and FIPPA)
- there are exceptions in the case where information must be shared with a physician or when the person is unconscious
why are injury report forms important?
- in case of law suits
- for the sake of remembering what happened
- can aid in the injury diagnosis
Prevention: what should you be looking for when conducting a facility survey?
1) indoor FOP conditions
- lay of the playing surface
- proper ventilation and lighting
- visibility and accessibility of exits
- cleanliness and proper maintenance
- presence of a safety zone beyond court boundaries
2) outdoor FOP conditions
- gopher holes, divots, lay of the surface
- cleanliness and proper maintenance
- presence of a safety zone
3) presence of dangerous obstacles
- sport equipment is safely stored and or secured
- presence of hazards left unprotected
- underground sprinklers, benches, goal posts, or standards, debris sport equipment, etc.
Prevention: what should you be looking for when conducting an equipment survey?
1) is equipment in safe operating condition
- i.e. no frayed cables or ropes, missing springs, broken or projecting parts, cracks, rusted bolts/clips, etc.
2) adherence to info provided on warning labels regarding instructions on appropriate/recommended use
what do you do with equipment/facility survey results?
- when hazards are identified, ensure you record the problems and submit report to your immediate supervisor
- ensure that the hazards identified are repaired before future use
- do not use defective or unsafe equipment - remove until repaired
what are the 3 main purposes of protective equipment?
1) prevent injury
- help reduce the severity of injuries, but not 100% effective
2) prevent re-injury
- can also be utilized to RTP an athlete after an injury
3) improve performance
- designed in such a way as to not interfere with movement and/or the sporting activity
what are the 5 ways in which we can ensure our equipment works properly?
1) effectively protects the body part it is DESIGNED for
2) must provide a good fit
- appropriate for the athlete
3) allows for good heat exchange
- when equipment is covering a large portion of the body
4) maintained and repaired often
5) kept clean
the effect of a physical impact is dependent on which 3 things?
1) magnitude of the force
2) duration of the force
3) area of the body it is applied to
protective equipment protects by which 4 mechanisms?
1) absorbing the force
- decreasing the magnitude and increasing the duration of impact
- padding or foam
- ex: hockey helmet
2) deflect forces
- decreasing duration of impact
- ex: cup
3) dissipating forces
- over larger and stronger areas using a cantilever system
- ex: shoulder pads
4) restricting abnormal joint movement
- ex: ankle brace
protective equipment should incorporate which 5 things?
1) an absorptive phase between impact and rebound
- some kind of padding or foam, varying in thickness and density depending on the sport
2) distribute impact to larger and stronger areas
- proper size and fit
3) not endanger an opponent
- ex: metal cleats in soccer
4) not be affected by temperature changes
5) not cause excessive heat build up
what are the 6 factors that should be considered upon purchasing equipment?
1) sport and hazard
2) age group
3) mobility required
4) ease and cost of maintenance
5) quality and workmanship (CSA, NOCSAE)
6) price
when wearing protective equipment, there is always a trade off between ______ and ______
mobility, protection
what must manufacturers include on ALL their pieces of equipment being sold?
- must forsee all possible uses and misuses
- must warn all users of any potential risks inherent with use or misuse or product
how can we decrease liability when buying/wearing protective equipment?
1) buy equipment from reputable manufacturers (i.e. CSA, NOCSAE)
2) assemble according to guidelines - “to the letter”
- need to make sure you aren’t altering anything about the way equipment is supposed to be used
3) routinely inspect and replace/repair
4) regular and proper maintenance
5) use caution when customizing
6) DO NOT use defective equipment
what is “preventative conditioning”?
- it is important to have the necessary strength, flexibility, etc. to do the activity you’re doing
- need to know how to do things safely
- risk of injury is related to fitness level
during which periods do the majority of injuries occur?
1) during training camp
- just getting back into a sport, may not have done as much off season training as you were supposed to, not ready for sport demands
2) during first 1/3 of season
- coaches like to go hard, get back into shape, expect players to be ready
3) last 1/3 of the season
- people get tired/lazy - long seasons
- pushing towards the playoffs, working harder
what is the relationship between injury rates and whether someone is winning or losing a game?
- people tend to get more injured when they’re losing
- take more risks
- motivation is also down, may not be doing everything as they should
what should be the main focus in order to decrease risk of injury throughout a season?
preventative strategies should focus on pre season conditioning followed by a maintenance program throughout the season and into the post season
periodization - def.
an approach that attempts to bring about peak performance while decreasing injuries and over training
- different needs at different points in the season
- organizes program of training into cycles or periods
periodization: macrocycle
- whole training period
- can be a year, season, 4 year plan, etc.
- different for each person
periodization: mesocycle
- 2-3 weeks or month within the macrocycle
- preparatory, competition, transition period
- cross training (various sports to learn different movement patterns)
what are the 10 principles of conditioning?
1) safety - i.e. proper protocol
2) warm up/cool down
3) motivation
4) overload - SAID principle (specific adaptations to imposed demands)
- making sure you’re exposed to proper stresses, want to overload without causing damage
5) consistency
6) progression
7) intensity
8) specificity
9) individuality
10) minimal stress
- don’t want to stress too much, also a mental aspect
which three things must we take into consideration when executing a pre season conditioning program?
1) nature of the sport or activity
- strength, endurance, contact, non-contact, explosive (plyometrics), etc.
2) areas of predominant stress
- shoulders, knees, elbow
3) predominant fitness components
- muscular endurance, CV endurance, strength, agility, flexibility
ALL pre-season conditioning must include which 6 aspects?
1) CV endurance - FITT principle
- frequency (3-5 days per week, intensity (HR), type (sport specific, cross training)
2) strength training
3) muscular endurance
4) flexibility
5) sport related skills
6) skill development
how does in-season conditioning differ from pre-season conditioning?
1) is utilized to avoid de-conditioning
- maintenance
2) every in-season program involves: 1-2 sessions per week at 80% max and includes all fitness components of the pre-season program
3) training at this level will suffice to athlete’s fitness level
post-season conditioning
- commonly dedicated to restoration
- time to unwind and recover from the season and recuperate from injuries
- means “active rest” - not being a couch potato
- also a time for surgery and subsequent rehab from injuries sustained during the season
liability - def.
being legally responsible for the harm one causes another person
what do we mean when we talk about th e”good samaritan law”
only perform skills within your scope of practice
what are the two courses that can be taken by legal action? explain them
1) criminal suit: deals with serious offenses
- i.e. robberies, assaults, murders
2) civil suit: deals with non-premeditated offenses
- most common litigation in sport
negligence - def.
not providing reasonable or ordinary care
tort - def
a legal wrong
nonfeasance (act of omission) - def
failure to perform a specific legal duty
-ex: not calling for advanced help in a life threatening situation
malfeasance (act of commission) - def
commit an act that is not legally yours to perform
-ex: cutting someone open
misfeasance - def
improperly doing something that you have the legal right to do
-ex: transporting someone with a spinal
foreseeability - def.
condition whereby danger is apparent or should have been apparent, results in unreasonable, unsafe conditions
-facility management
there are 4 things used to establish negligence, what are they?
1) a duty of care existed between the person injured and the person responsible for the injury
- ex: random person off the street can’t sue you
2) the defendant breached this duty by conduct that fell short of the standard of care
3) the defendant caused the injury to occur
4) personal, property, or punitive damages resulted
what are the 6 ways in which we can avoid litigation?
1) warn individuals of potential hazards of the sport
2) supervise regularly and attentively
3) properly prepare and condition athletes/participants
4) properly instruct individuals in the skills of their sport (progressions)
5) utilize proper and safe equipment
6) never delay in seeking medical assistance or compel a person to participate against their wishes
- i.e. never advise a person to play injured
what are the 6 ways in which individuals can reduce liability?
1) maintain strong relationships with athletes, parents, coaches
2) establish policies and procedures
3) establish/practice emergency action plans
4) obtain and review current medical history of athletes
5) documentation of injuries and safety surveys of facilities and or equipment
6) obtain sufficient liability insurance
what are some defenses that can be used against negligent actions?
1) pure accident
2) assumption of risk (reasonable based on age, experience, warning signs, waivers, inquiries as to physical fitness)
3) contributory negligence: failure to act as instructed or reasonable
4) not directly or indirectly related to circumstances in instructor’s control
5) acts of god
what is explicit consent?
- consent given by injured individual when they agree to 1st aid - “can I help you?”
- can be withdrawn at any time
what is implied consent?
- consent whereby the individual is not capable of giving explicit consent but needs it regardless
- an emergency - used to save a life
what are the components of a non urgent MSK assessment?
1) rule out life threats (primary survey)
2) rule out spinal injuries (primary)
3) assess vitals
4) HOPS assessment - history, observation, palpation, special tests
5) immediate treatment/management
6) safe removal from FOP
7) sideline assessment and management
8) document injury evaluation
to establish that any given situation is non urgent, you first need to rule out what?
the presence of a life threatening injuries and or illnesses
primary survey - components
1) assess level of consciousness (LOC)
- AVPU scale
- if athlete is unconscious call 911
2) assess CAB (circulation, airway, breathing)
- 10 second breathing and pulse check
- begin CPR or rescue breathing as needed
- obtain an AED
3) check for profuse bleeding
- body scan
- use of gloves for protection
4) shock
- common with severe bleeding, fractures or internal injuries
- pre-disposing conditions (extreme fatigue, extreme exposure to heat/cold, extreme dehydration and mineral loss, illness)
how do we know which vessels blood is coming from?
- arterial blood is bright red, and comes out in spurts
- venous blood is dark red, and comes out as a continuous flow
- capillary blood blood exudes from tissue
what are the treatment methods for profuse bleeding?
- Primary method: direct pressure and elevation
- Secondary method: pressure points (brachial or femoral artery)
what are the three different types of shock?
1) hypovolemic: stems from blood loss
2) anaphylactic: results of severe allergic reaction
3) pyschogenic: fainting (syncope), temporary reduction in blood to brain
what are the signs and symptoms of shock?
1) slow, shallow breathing - rapid or panting initially
2) confused or disoriented
3) decreased LOC - listless
4) dilated pupils
5) restlessness or irritability
6) rapid but weak irregular pulse
7) pale, cool and moist skin
8) nauseous or vomiting
9) drop in blood pressure
explain the process of ruling out a spinal injury
1) unconscious patient (especially if MOI un-witnessed)
- assume possible neck and cervical spine injury
2) conscious patient
- ask about neck/back pain, numbness, and tingling in extremities
- ask to wiggle fingers/toes (motor)
- ask if they can feel your touch (sensory)
- palpate neck/back looking for obvious signs of injury (i.e. crepitus and deformities, muscular spasm)
3) suspected spinal injury
- do not remove patient
- call 911
- maintain proper stabilization of the head and neck
- help patient maintain normal breathing (vitals)
- treat any profuse bleeding or shock
- keep patient quiet and calm
what are the three primary vital signs?
1) pulse
2) respiration
3) blood pressure
assessing vital is part of the first or secondary survey?
secondary
what are the 9 vital signs
1) LOC
2) pulse
3) respiration
4) bp
5) temperature
6) skin colour
7) pupils
8) movement
9) abnormal nerve response
how can we measure pulse? what can pulse tell us?
- measured with carotid artery in neck or radial artery in wrist
- normal pulse (adult) = 60-100 bpm - athletes are normally lower
- Rapid and weak pulse - shock, bleeding, diabetic coma or heat exhaustion
- Rapid and strong pulse - heatstroke or severe fright
- Strong and slow pulse 0 stroke or skull fracture
- No pulse - cardiac arrest or death
how can we assess breathing? what is considered a normal breathing rate?
- look for movement of chest
- listen for air passing in and out of the nose and mouth
- feel chest (supine) or back (prone) rise and fall
- normal breathing rate (adult) = 12-20 breaths/minute
- may be increased or decrease by athletic participation
- can be altered due to chock (shallow) or rib fracture (frothy blood coughed up)
systolic blood pressure
left ventricle contracts (pumping blood)
