Exam 3 Flashcards
Thermal physiological effects
Increased collagen extensibility, decreased pain, decreased spasm, decreased edema, improved blood flow
Modalities include
Thermal, electrical, electromagnetic, accoustic, mechanical
Thermotherapy includes ___ and should not be used _____
Hot packs, paraffin, whirlpools.
In the acute phase of unjury
Cryotherapy
Vasoconstriction, dec. cellular metabolism. Ice packs, massage and whirlpools/baths
Electrical modalities physiological eff. And methods.
Stem causes pain modulation, muscle contraction, would healing.
Neuromuscular e stem, micro current, iontophoresis. Little objective evidence of benefits!
Electromagnetic energy
Shortwave diathermy & low level laser
Shortwave diathermy
Electrical current produces a radio wave that can be absorbed by the body. Phys effects same as heat
Low level laser physical eff
Improves circulation, increased collagen prod, decrease inflammation
Ultrasound phys eff of thermal and non thermal
Thermal: same as heat
Non: decrease inflammation improve circulation
Mechanical modalities
Traction, intermittent compression, massage
Traction
Elongation of spine/ soft tissue. Improves circulation alleviates impinged nerves and pain from disc problems
Intermittent compression
Use of air or water in sleeve to increase external pressure, decreasing inflammation
Phase components of rehab.
Acute care, range of motion, strength intensive, neuromuscular control
Pharmacology
Study of drugs and their effects on living organisms
Pharmacokinetics
Method drugs are absorbed, distributive, metabolized, eliminated
Inunctions, ointments, pastes, plasters
Inunctions: oil based, ointments: water based, pastes: fat based, plasters: nonfat based
Bioavailability
How much of a drug can be absorbed
Efficacy
Capability to produce a specific effect
Potency
Dose of drug necessary to get therapy ethic effects
Livers role
Drugs broken down into inactive compounds- metabolism
Exercise does what to absorbtion
Decreases oral absorbtion and increases intramuscular and subcutaneous absorbtion
Administer
Hand out single dose
Long term control of asthma
Corticosteroids, beta antagonists
Narcotics derived from
Opiates. For pain. Is a highly controlled substance.
Non narcotic pain relief
Acetaminophen. Hard on liver controls fever
Acetylsalicylic acid
GI reaction. Reye’s Syndrome: brain damage in small children
Antimetics
Nausea/vomiting
Performance enhancing drugs
Stimulants, narcotics (pain relief), beta blockers (improves steadiness), diuretics, anabolic steroids
Talus fracture
Extreme dorsiflection
Plantar fasciitis causes, s&s and management
Poor running tech, change in shoes, excessive pronation. Pain in morning, heel pain. Orthotics, heel cup, stretching.
Jones fracture
Fracture at base of 5th metatarsal. Pain on outside of foot. Management: immobilization, surgery
Lisfranc fracture
Fracture/dislocation/sprain of mid foot caused by twisting with axial loading. Deformity and swelling. Management: internal fixation
Turf toes
Hyper extension of the great toe. Control with ice and modalities. Rigid sole
Sesamoiditis
Irritation of sessom is bones at the great toe often caused by turf toes. Control inflammation, surgery
Ankle and lower leg
Most common type of injury in athletics
Talicrural joint
Plantar/dorsiflexion
Subtalar joint
Inversion, eversion, supination and pronation
Lateral Ligaments in ankle
Anterior talofibular l: most commonly injured
Medial ankle ligs
Deltoid ligament
Compartments and use
Anterior: dorsiflex, extend toes. Lateral: eversion. Posterior deep: inversion, flex toes. Posterior superficial: plantarflexion
Functional anatomy
Lateral malleolus extends further than medial=more injuries to lat structures, thus ankle is more unstable in inversion/plantarflexion
Percent of dorsiflexion and plantarflexion necessary for normal gait
10%dorsiflexion, 20% plantarflexion
Tap/compression test
Tests for fracture
Thomson test:
Tests for Achilles’ tendon rupture.
Anterior Drawer test
Anterior talofibular ligament sprain
Kleiger test
Deltoid ligament sprain
Functional tests
Walk on heels, toes, lateral and medial borders, hop
Inversion ankle sprain
Foot is inverted/plantarflexed
Eversion ankle sprain
5-10% sprains. May involve avulsion fracture
Syndesmotic ankle sprain
High ankle sprain, involves tibiofibular ligs. Caused by dorsiflexion with rotation.
Ankle dislocation
High rotational force/trauma. Obvious deformity
Achille’s tendon rupture
Excessive dorsiflexion often seen in older patients. Feel a snap, inability to plantarflex. Athlete: surgery.
Tendinitis
Weakening of tendon due to overuse. Tendons: anterior and posterior tibialis, Achilles, and perineal.
Compartment syndrome
Acute: true medical emergency. Swelling pain shiny skin. Chronic from repetitive motion. General achy pain swelling and pressure.
Medial tibial stress syndrome
Shin splints. Generalized pain along anterior shin. Causes: right gastroc, weak anterior tibialis, overpronation, overtraining, poor shoes
Functional progressions of ankle/lower leg injuries
Figure 8s, agility ladder, cutting/changing direction, low intensity ploy metrics
Patella
Largest sesamoid bone in body, acts as lever to improve quads output, distributes compressive forces
Menisci
C=medial, o=lateral.
Acl
Prevents anterior translation (forward movement) of tibia. Supported by hamstrings
Pcl
Prevents posterior translation of tibia. Supported by quads.
MCL
Medial collateral lig protects from Valgus forces (forces applied outside towards in)
LCL
Lateral collateral lig. Prevents varus force. (Medial force applied outward)
Quad:
Extension. Rectus femoris, vastus lateralis/medialis/intermedius.
Hamstrings
Flexion. Biceps femoris, semitendinosus, semi membranous.
Sartorius
Flexion, external rotation.
Gracilis
Internal rotation
Gastrocnemius
Flexion
Screw home mechanism
Tibia externally rotates as it extends.
What degree of extension is necessary for a normal gait?
0 deg
Genu valgus
Knock knees
Genu varus
Bow legs
Genu recurvatum
Hyperextention
Lachman test
ACL
Valgus stress test
Medial collateral lig
Varus stress test
Lateral collateral
Sag test
PCL
McMurray
Meniscus
Functional test for knees.
Squats, duck walk, cutting drills
Prevention braces. Prophylactic:
Functional:
Prophylactic prevents knee injury. Functional limits stress on injured structures
MCL sprain
Mechanism: valgus stress
Unhappy triad:
ACL, MCL, medial meniscus
Meniscus tear
Rotational, valgus force. Locking/clicking noise
Patella femoral pain syndrome
Generic name for anterior knee pain
Osgood-schlatter’s disease
Apophysitis seen in pre-adolescent boys
Rehab:
Focus on extension and muscles to support injured structures, balance, plyometrics
Tensor fascia latae
Abduction
Iliopsoas
Hip flexor
Glutes
Extension rotation
Iliofemoral
Ischiofemoral
Pubofemoral
Largest ligament, sits at head of femur. All3 prevent excessive extension and external rotation
Type of pain:
Bony:sharp
Muscle: dull achy
Femoral fracture
Arteries huge issue, possible internal bleeding. Shock is common
Hip dislocation
Can cause avascular necrosis, the disruption of blood flow to femoral head
Young athlete conditions of hip and thigh: Legg-Calve-Perthes disease. Slipped Capital femoris epiphysis
LCP disease: avascular necrosis causes flattened femoral head in boys 4-10. Slipped capital-bone shifts at epiphyseal plate
Hip pointer
Contusion to iliac crest
