Exercise Injuries Final

Question 1

Clavicle Fracture

Answer 1

moi- most grequent fracture in sports, fall on outstretched arm, fall on tip of shoulder, or direct imoact, most commonly at curve
S&S- suport arm w/uninjured side and head tilted toward injyry, chin facing away from injured side. visual difference with injured side lower, pain, swelling, deformity
Care- immobilize with slig, SHOCK. sray. strap 6-8 weeks after immob. isometric exercises sling 3 more weeks

Question 2

Humerus fracture

Answer 2

MOI- direct blow, dislocation, or impact by falling on outstretched arm
S&S- w/o displacement hard to visually ientify. pain, inability to move arm, swelling pt tenderness, discoloration
Care- immediate splinting, immobilization for support, sling, SHOCK, out for 2-4 months

Question 3

Glenohumeral Dislocations

Answer 3

MOI- head of humerus if forced out of the capsule in anterior/downward position. thhroud ABDuction, external rotation, extension. arm tackle in FB or rugby. rarely poserior superior dislocation
S&S- visibly flattened deltoid area. palpate axilla an feel humerus.pt carries arm. mod pain/disabil
Care- immediate immobilization in comfortable position (reduced by physician only) control swelling w/ice, after reuced/immobilized do isometric exerciese and use sling for 1 wk. braces optional

Question 4

Biceps Tenosynovitis

Answer 4

MOI- common w/overhead activities (pitchers,tennis,volleyball) repeated stretching of biceps, inflamation of tendon and synovial sheath
S&S- tender in anterior upper arm. mild swellig inc tissue temp, crepitus to inflam, c/o pain w.activity
Care- rest for several days w/ice to reduce inflam. strengthen and stretch to protect from reinj

Question 5

Olecranon Bursitis

Answer 5

MOI- irritated bursa in elbow, superficial location of olecranon allows easy contact. results commonly from direct blow
S&S- inflamed bursa produces pain, large amounts of localized swelling, pt tnederness, swelling may appear w/o pain and heat
Care- if accute compres for 1hr. ice repeatedly and if chornic wear elbow pads to protect. may need Rx antibiotics

Question 6

Lateral epicondylitis

Answer 6

tennis elbow
MOI- over/repetitive EXTENSION of wrist. irritation and inflammation to insertion of extensor muscles of lat epicondyle
S&S- c/o aching pain in region of lat epicondyle during activity. pain grad becomes worse, weakness in had and wrist, tender at inserion and pain on resisted extension and pronation
Care- ice and rest, antiinflam meds, rom and grad strenghining of wrist/elbow. counterforce strap

Question 7

Medial epicondylitis

Answer 7

Golfers elbow
MOI- irritation of medial epicondyle due to repeated FLEXION of wrist flexors at elbow
S&S- pain occcurs at med elbow during forceful wrist flex and may radiate down arm pt tender over insertion mild swelling
Care- rest, ice, and antiinflam meds. counterforce brace, strengthen wrist/forarm flex

Question 8

Ulnar nerve injurY

Answer 8

MOI- exposed position of medial epicondle of humerus the ulnar nerve has problems. increased pronounced angle of elbow can cause fiction issues. anatomical deform, ulnar nerve can dislocate from position and gets impinged on lig
S&S- parathesia-short term paralysis to 4th-5th finger burnign /tingling in elbow
Care- no direct pressure on nerve, if cant be avoided surgery can me done to move nerve

Question 9

Forearm fracture

Answer 9

MOI- common w/active children/youth. direct blow/falling on outstretched hadn. common to both bones.
S&S- pain welling deformity. when older more danger to surrounding soft tissue and greater possibility of paralysis
Care-cold packs, ice immediately, spling and sling, cast 6-8 weeks

Question 10

Carpal tunnel syndrome

Answer 10

MOI-anterior side of wrist finger flexors and median nerve run. inflam of tendon w/i space compresses median nerve. repetitive wrist flexion/trauma to wrist
S&S-median nerve compress results in sens and motor deficits. tingling numbness paresthesia in thumb, index, mddle fing and palm
Care- REST immobilize antiinflam med inject corticosteroid poss surg decompress of transverse carpal lig

Question 11

Scaphoid (navicular) fracture

Answer 11

MOI- most common injured carpal. force on outstretched hand compressing scaphoid b/w radius and 2nd row carpals
S&S- swelling in carpals adn severe pt tenderness over scaphoid in snuffbox
Care-ice and splint, xray and cast. up to 6wks. wrist exercises no impact loading for 3 mo after immob. can lead to avascular necrosis and bone wont heal prop in untreated

Question 12

metacarpal fracture

Answer 12

MOI- FX of 5th metacarpal assoc. w/ boxing and martial arts (boxers fracture) punching wall or obj
S&S- pt tenderness and palpable deect w/shaft of 5th metacarpal rapid swelling
Care-refer to phsician fo rxray possible reduction and immobilization 3-4 weeks

Question 13

Mallet Finger

Answer 13

MOI- blow from thrown ball that strikes tip of finger jamming and avulsing EXTENSOR tendon from insertion
S&S- pain in distal DIP joint, xray show avulsion. unable to extend finger and stays at 30 deg of flextion. tender and swelling
Care- rice. if no fx spling in 30 deg flex 6-8 weeks. if fx immobilize and possible pin

Question 14

Jersey finger

Answer 14

MOI-rupture of finger FLEXOR at dp common in ring finger trying to grab jersey but keep running
S&S- cant flex finger in extended position. pain and tenderness and swellign
Care-if not surgical finger will nee flex a d dip jt agian weakness in grip strength. 12 wks rehab

Question 15

phalanx fracture

Answer 15

MOI- stepped on, direct contact, twisted
S&S- pain, swellign in finger tender at fracture
Care- splint in position found avoid full extension, xray, splint until second xray to show calcification

Question 16

Ankle sprain

Answer 16

MOI- excesive inversion causing lig to fail
S&S- grading stretch in fibers instability pain sweling stiffness, jt separation, rubture
Care- may need surgery immobilize crutches rehab return to play lat most comm

Question 17

Shin splints ( medial tibial stress syndrome)

Answer 17

MOI- strain of post tib muscle and sheath at attatchment to periosteum. faulty footwear, tight achilles tendon, pes planus
S&S- pain over med tib and surrounding tiss. 1st only hurts after workouts then worses daily can get to stress fx
Care- r/o stress fx. orthodics, modify activity. ICE. stretch achiles and lower leg musc. tape longitudinal arch b/c excessive pronation

Question 18

achilles tendonitis

Answer 18

MOI- inflammation of tendon repetitive stress w/ run/jump conditiong w/o w/o proper fitness
S&S- gen pain getting worse w/stiff. tendon may be warm/painful to ouch inflam can cause scar tissue and thicken tendon
Care-not quick fix, limit modify activity, stretcing, heel lift, anti inflam meds, can lead ot rupt untreated

Question 19

Plantar fasciitis

Answer 19

MOI- leg legth dif, inflex longit arch, tight gastroc/soleus, improper shoes
S&S- pain at ant med heel, attatch of fascia, more painful in morning or after sitting
CAre- stretch of lower leg and plantar fascia in arch, cushion for support, arch taping to supor arch/orthodics

Question 20

Pes planus flat foot

Answer 20

ankle folds medially
toes turn slightly laterally
supportive insoles

Question 21

MCL sprain

Answer 21

MOI- valgus force causing lig to fail commonly w/rotation. acl and poss meniscus can be involved
S&S- graded. tender jt stiff, sswell Rom gjt gapping
Care-RICE, immob, not wt bea for 2 wks, functional hinge brace 2-3 wks after immob. rehab return to play lasting 1-3 weeks

Question 22

ACL anterior cruciate ligament

Answer 22

MOI- foot planted femur ext rot leaves ACL susceptible to inj. hyper ext from post directed force, severe enough MCL and menis
S&S- pop tears w. rapid swelling, immediate pain subsides an athleete feelsconfident to walk, lack of stability does not allow activity
Care- surgical repair for athletes, 2-3 wks immobiilizer, 8-10 months of rehab

Question 23

Meniscus Injury

Answer 23

MOI-wt bearing and rotation w/ext or flex. med meniscus had higher injury than lat due to atatchment to MCL and more prone to rotational an valgus force inj
S&S- swelling develop grad, jt line pain loss of motion, locking , giving way feeling and pain w/squatting. recurrent inj exp pop or collaps
Care- RICE immob if nec, work back to full ROM. surgery can be done by arhroscop removal of portions of menis, mimimize removal for pain free

Question 24

Myositis Ossificans

Answer 24

iritated tissue produces tissue resembling carilage of bone
2-4 wks can be seen in xray
attempt to run off or too big treatment can cause condition or cause existing to worsen
care- rest, surgical removal 1 yr after can return if done too early

Question 25

Iliac Crest contusion (hip pointer)

Answer 25

MOI- direct blow to IC of lat pelv, severe pinch to soft tissue of region
S&S- immed pain, spasm, transitory paralysis of soft tissue, cant rotate trunk or flex thigh w/o pain
care- ice compression immediately w/48 hrs, rest 1-2 if need. xray to rule out fx

Question 26

anti anginals

Answer 26

nitroglycerin, betablockers

Pts have decreased capacity to supply heart with O2 Decreased HR response to ex

Question 27

Anti hypertensives

Answer 27

Clonidine, HCTZ, diuretics Dehydration, drop in BP (hypotension),
Decreased HR response to ex

Question 28

Anti arrhythmics

Answer 28

Lidocaine, Amiodarone Irregular HR, dizziness may indicate toxicity
Decreased HR response to ex

Question 29

Bronchodilators

Answer 29

Albuterol Postural drainage prior to ex, emergency inhalers on hand

Question 30

Hypoglycemics

Answer 30

Insulin, Glyburide Exercise exaggerates hypoglycemic effect (sugar drops)
Have high glucose foods on hand for emergency

Question 31

Psychotropics

Answer 31

Amitriptyline Haloperidol, Lorazepam

Too relaxed to exercise safely, irritable, motor changes

Question 32

Hypoglycemia

Answer 32

headache fatigue hunger sweating anxiety confusion
can lead to coma/death
treatment ingest high glucose foods (soft drink juice)