immediate and emergency care Flashcards
What drugs can be used with phonophoresis during the acute phase of treatment?
- Dexamethasone
- Hydrocortisone 1% and 10%
- Lidocaine
One of your athletes has been diagnosed with psoriasis. What medications are appropriate for treatment on this condition?
- Aristocort
- Kenalog
- Topicort
What are medications that are delivered via a meter-dosed inhaler for exercise induced asthma?
- Proventil
- Alupent
- Atrovent
- Ventolin
What medication is often used for anxiety or panic attacks?
Xanax
What is the primary mode of action of penicillin?
Inhibits the metabolism of bacteria
What is the appropriate treatment for an acute quadriceps contusion?
Apply ice to the injured area and put the knee into slight passive flexion to help maintain the flexibility of the quadriceps muscle
Deep frostbite is a medical emergency. What would be the proper course of treatment for this problem?
Rapid rewarming of the affected body part with warm water between 100 to 110 degrees
During which circumstances should an athlete by immediately referred to a dentist?
- The tooth is knocked out
- When a tooth is displaced 2 mm or more
- When a crown is fractured and the tooth is still alive
A male patient sustains a direct blow to the genital area. How can the athletic trainer immediately decrease the pain?
Have the patient lie supine with his knees bent to his chest to decrease the strain on the scrotum and apply ice to the affected area
Shock after a severe injury can result from __________ or _____________?
Hemorrhage or the stagnation of blood
A patient who has been diagnosed with infectious mononucleosis has just been cleared by the team physician to return to full activity. How long should the patient remain out of full contact participation from the time of onset to full recovery?
The patient can return to light activity after 3 weeks from the onset of the illness if the spleen is not enlarged or painful, the patient’s liver function studies are normal, and no fever is present
What the signs and symptoms of increasing intracerebral pressure that the athletic trainer should monitor after a player has sustained a head injury?
- Nausea and vomiting
- Pupil irregularity
- Increase in systolic blood pressure with a decrease in diastolic blood pressure
- Changes in cognition
If an athlete is unconscious from a blow to the head, he or she should be assumed to have a neck injury in addition to a possible head injury. If the airway appears to be impaired, what are the appropriate steps in management?
- Cut the facemask with an appropriate tool and move it out of the way
- Leave the helmet on
- Stabilize the head and neck
- Activate EMS
What are the appropriate steps in the management of an athlete who is experiencing a seizure?
- Keeps spectators out of the way
- Protect the athlete’s head and body from injury
- Turn the athlete on his or her side
- If the athlete is in status epilepticus or it is a first seizure, immediately seek further medical support
In what amount of time is brain damage likely to occur if the brain is deprived of oxygen?
4 to 6 minutes
Where is the carotid artery pulse palpated?
In the groove between the larynx and the sternocleidomastoid muscle
During CPR, the adult sternum must be compressed to what depth for compression to be effective?
1.5 to 2 inches
What signs and symptoms are characteristic of a tension pneumothorax?
- Tracheal deviation
- Distended neck veins
- Unilateral absence of the breath sounds
- Cyanosis
Where would the athlete complain of pain with acute appendicitis?
Lower right quadrant of the abdomen
When fitting an athlete for crutches, the elbow should be flexed to approximately what angle?
30 degrees
What is the appropriate treatment for an athlete who has sustained a rib fracture?
use of a rib belt
An athlete comes to the athletic trainer holding a tooth that has just been knocked out of his mouth. What would be the proper steps for the athletic trainer to take to allow for a successful reimplantation?
Place the tooth in a cloth soaked with saline or water and get the athlete to a dentist within 30 minutes
An athlete has sustained a fracture involving the knee. What areas should be splinted?
The lower limb joints and one side of the trunk
The acute phase of an injury lasts approximately 3 to 4 days. What occurs at the time of initial trauma?
Transitory vasoconstriction, followed by vasodilation and increased permeability
Where do primitive stem cells mature into red and white blood cells and platelets?
bone marrow
The athletic trainer notices an athlete is prone to abnormal bruising. After discussing the problem with the team doctor, he recommends what vitamin?
Vitamin K contributes to blood clotting because it imparts a calcium binding ability to certain blood proteins
A drug that is used to increase the effects of another, such as aspiring when used in combination with codeine, is known as what?
potentiating
Your patient is on a medication for a Staphylococcus aureus infection. What adverse reactions might you expect with antibiotic treatment?
- Abdominal cramping
- Diarrhea
- Nausea
- Vomiting
What is the normal dosage for one tablet of aspirin?
325 mg
Anabolic steroids are often abused by athletes. What result may occur in the female athlete after ingesting testosterone?
A female may develop a condition known as hirsutusm, which is the excessive growth of hair in unusual places, with the ingestion of testosterone
What tool has the Inter-Association Task Force recommended not be used as the primary tool for loop-strap removal on a football helmet after an injury?
a screwdriver
A predisposing condition such as spinal stenosis may mean an athlete is more likely to?
develop paralysis after a fracture-dislocation
What word means “the abnormal development of tissue”?
dysplasia
_______________ and ______________ are two conditions that will interfere with fracture healing.
Poor blood supply, poor immobilization
______________ and ______________ are both examples of histamine-2 blockers.
Tagamet, Zantac
What drug muse the athletic trainer determine the athlete is not allergic to prior to administering a NSAID?
aspirin
When transporting an athlete off the field by manual conveyance, it is most convenient to do this with how many athletic trainers?
2
What is the average respiratory rate for an adult (18 years of age or older)?
12 to 15 breaths/min
Orthostatic syncope is caused by what condition?
Sudden peripheral vasodilation
Which type of food should the athletic trainer recommend the patient avoid if a gallbladder pathology is suspected?
fatty foods
Your team physician sends a prescription to you for your athlete that reads “whirlpool treatments TID.” What does TID mean?
three times a day
If necessary, the removal of the helmet and shoulder pads from an athlete with a suspected spinal cord injury should be coordinated to avoid what?
cervical hyperextension
What is the primary reason an athletic trainer would perform pulmonary auscultation?
To identify potential abnormal breath sounds
One of your female patients presents with dysuria, a sense of urgency to urinate, decreased urine volume, nocturia, low back pain, and pyuria. What do you suspect this patient has?
Cystitis, or a bladder infection
When choosing a prophylactic knee brace, the brace should meet what criteria?
- It should not interfere with normal knee function
- It should not increase injuries to the lower extremity
- It should be cost effective and durable
When recommending a running sneaker the athletic trainer should recommend a sole that has what major qualities?
shock absorbing and durable
One of your patients presents with abnormal pain that he describes as burning. He states that it becomes worse when he lies in supine o consumes caffeine, spicy foods, or alcohol. What might you suspect is the problem?
Esophageal reflux or peptic ulcer
One of your patients presents with a sudden onset of chest pain, dyspnea, hemoptysis, and cyanosis. What do you suspect is the problem?
pneumothorax
How long should the abdomen be auscultated before the athletic trainer decides if the bowel sounds are absent?
2 to 3 minutes
One of your patients begins to complain of intense itching of the skin under the cold pack that you applied to his shoulder 5 minutes ago. When you remove the pack you notice that hives have developed on that area that has been cooled. What is this patient experiencing?
Cold urticaria is an allergic reaction to cold exposure
When treating an athlete who presents with undifferentiated somatoform disorder, the athletic trainer should do?
- Provide care for a bona fide injury
- Develop a sound relationship with the athlete to gain trust
- Avoid doing more hard by dismissing the athlete as a “symptom magnifier”
When using iontophoresis, the athletic trainer should be aware of possible _____________ and ____________ as a result of ion flux during treatment
Skin irritation and chemical burns
Why it is important that an athlete with an abdominal injury never be given anything to eat or drink?
It increases the risks of surgery if an operative procedure becomes necessary
One of your diabetic athletes appears confused and is dizzy, apprehensive, and diaphoretic. How should this athlete be treated?
This athlete should be treated for insulin shock and should be transported to the nearest hospital if he or she does not respond to sugar within 2 to 3 minutes
What is the proper protocol for administering Tylenol to an adult?
Initial dose: 2 tablets, 325 mg each, repeat every 4 to 6 hours, PRN
What is the proper protocol for administering Advil to an adult patient?
Initial dose: 1 to 2 tablets, 200 mg each, repeat every 4 to 6 hours, PRN. Do not exceed 6 tablets in a 24-hour period without consulting with a physician
What is the proper protocol for administering Pepcid AC to an adult patient?
Initial dose: 1 tablet, 10 mg each with water up to twice a day. Do not administer more than 2 tablets in a 24-hour period
One of your athletes is complaining of constipation related to dietary change. What would be the most appropriate recommendation for the athletic trainer to make?
Recommend increased fluid intake and increased intake of fruits, bulk vegetables, and cereal
What category of drugs does not have a synergistic effect to cryotherapy?
Systemic antibiotics
What category of drugs has an antagonist effect to superficial and deep heat therapy?
Systemic vasoconstricters
What are the three most common sites for avulsion fractures and apophysitis in the pelvic region?
- Ischial tuberosity
- AIIS
- ASIS
What is the possible consequence of a poorly managed shin contusion?
Osteomyelitis, which results in the destruction and deterioration of the bone
What is the appropriate treatment for a Bennett’s fracture?
RICE and analgesics followed by immobilization of the carpometacarpal joint; it is structurally unstable and the athlete should be immediately referred to an orthopedic surgeon
One of your athlete is having an anxiety attack. What process does rebreathing into a paper bag reverse?
respiratory alkalosis
What end feel is an abrupt, firm, springy resistance to motion?
muscle spasm
When symptoms are experienced distal to the pathology, this is known as what?
referred symptoms
What special test identifies ulnar nerve compression or transmission interference at the elbow?
tinel’s sign
What are the signs and symptoms of anaphylactic shock?
- Development of rash or hives
- Wheezing sounds coming from chest
- A decrease in blood pressure
- Rapid, weak pulse
What type of shock is commonly referred to as fainting?
Psychogenic shock is caused by a temporary dilation of blood vessels that reduces the normal amount of blood in the brain
What are the signs of a diabetic coma?
- Fast and weak pulse
- Deep and sighing respirations
- Livid, later pale, skin
- Fruity-smelling breath
What are the two most common sites to apply direct pressure to control bleeding of the upper and lower extremities?
brachial artery and femoral artery
What are the signs of hypovolemic shock?
- Low blood pressure
- Rapid and weak pulse
- Shallow and extremely rapid respiration
- Agitation
How long can the brain be deprived of oxygen until brain cells begin to die?
4 to 6 minutes
What carries impulses toward the central nervous system?
afferent pathways
Deep stroking during massage is known as what?
friction massage
__________ pupils indicate possible shock, hemorrhage, or cardiac arrest.
dilated
What occurs when an individual is in shock?
- Skin is pale and cool
- Pulse is rapid
- Blood pressure is low
- Respiration is shallow
How often should the athletic trainer monitor vital signs and level of consciousness after an athlete has sustained a concussion?
Every 5 minutes until the athlete’s condition clears completely
Cranial nerve dysfunction and altered breathing patterns are signs of pathology of what part of the brain?
midbrain and medulla
Diabetic ketoacidosis may result from what condition?
High blood glucose levels
What condition has a cardiac etiology as it relates to sudden death in the athlete?
wolff-parkinson-white syndrome
At what core body temperature does shivering cease, skeletal muscle stiffen, and cold diuresis occur?
below 90 degrees F
What is a normal reading for pulse oximetry?
95-100%
What is the normal systolic blood pressure range for a child between 6 to 10 years of age?
80 to 122 mm Hg
How is the correct size of an oropharyngeal airway measured and selected?
Measure the distance between the tip of the ear to the corner of the mouth
An indication for suctioning includes what?
Vomiting in an unresponsive individual
Athletic trainers are qualified to use emergency oxygen systems to care for an ill or injured athlete. What is true regarding emergency oxygen systems?
- They have pressure reading systems
- They deliver oxygen at a fixed flow rate
- It has a container holding medical-grade oxygen
- It delivers oxygen at a flow rate of at least 6 LPM for at least 15 minutes
What precautionary measures should be taken prior to transferring and securing an athlete with protective equipment to a rigid immobilization device such as a spine board?
Facemask removal and preparation of shoulder pads
What is the first step in treating an abrasion or laceration?
reduce wound contamination
When a bronchodilator is used more often than recommended, it can cause what?
tachycardia
Portable radios and land line telephones are preferred over personal cell phones when communicating in an emergency primarily because of what?
A cell phone may be unreliable in some areas due to weak cellular signals
A capillary refill of greater than ________________ seconds is a sign of inadequate perfusion.
2.0 seconds
Acute compartment syndrome is considered a medical emergency
true
During which circumstance should an athlete be immediately referred to a dentist?
- Tooth is knocked out
- When a tooth is displaced 2 mm or more
- When a crown is fx and tooth is still alive
A patient who has been dx with infectious mononucleosis has just been cleared by the team doctor to return to full activity. How long should the patient remain out of contact participation from the time of onset to the time of full recovery?
at least 3 weeks
If an athlete is unconscious from a blow to the head, they should be assumed to have a neck injury in addition to a possible head injury. If the airway appears to be impaired, what are the appropriate steps in management?
- Cut facemask with an appropriate tool and move it
- Leave helmet on
- Stabilize neck and head
- Activate EMS
What are characteristics of a tension pneumothorax?
- Tracheal deviation
- Distended neck muscles
- Unilateral absence of breath sounds
- Cyanosis
When evaluating an unconscious athlete, what should the AT do first?
Check athlete’s airway is open and they are breathing normally
An athlete has a suspected fx involving the knee. What areas should be splinted?
Lower limb joints and one side of the trunk
Which cells release histamine and serotonin during the cellular response phase of tissue healing?
Mast cells and platelets
One of your cross-country runners has an ongoing problem with tinea pedis. Which of the following actions should you take to assist this athlete in minimizing the problem?
-Use talcum powder daily and keep their feet dry after showers
A patient comes to the ATR with what appears to be a tick embedded in his lower leg. The AT should instruct the patient not to do what?
Pull the tick out with tweezers
Your patient is on mediation for Staphylococcus aureus infection. What adverse affects might you expect with the antibiotic?
abdominal cramping
A predisposing condition such as spinal stenosis may mean an athlete is more likely to?
develop paralysis after a fx-dx
Spinal immobilization is best achieved with the full body splint. What are examples of full body immobilization
- Rigid spine board
- Vacuum mattress
- Scoop stretcher
- Miller full-body splint
What means “the abnormal development of tissue”?
dysplasia
What is the primary reason an AT would perform pulmonary auscultation?
Identify abnormal breathing sounds
One of your athletes presents with rhinorrhea, rhinitis, sore throat, nonproductive cough, low grade fever, headache, chills, and malaise. What actions should be taken?
Limit activity until fever resolves, resume full activity as symptoms resolve
When choosing a prophylactic knee brace, the brace should meet all criteria of:
- Shouldn’t interfere with normal knee function
- Shouldn’t increase injury to LE
- Cost effective and durable
What materials can an AT use to construct a custom protective/supportive device
- Felt
- Gauze
- Cotton
- Foam
One of your patients presents with a sudden onset of chest pain, dyspnea, hemoptysis, and cyanosis. What do you suspect is the problem?
pneumothorax
How long should the abdomen be auscultated before the AT decides if the bowel sounds are absent?
2-3 minutes
Which of the following is not a good reason to refer an athlete to a psychiatrist or psychologist
Athlete is showing undue concern over minor injuries, but the concern is brief
An athlete receives a head injury during a soccer game. While performing the on-field eval, the AT notices the athlete has a hearing defect after testing for air and bone conduction using a tuning fork. What cranial nerve is injured?
vestibulocochlear (VIII)
What is the proper protocol for administering Pepcid AC to an adult patient?
- initial dose: 1 tablet; 10 mg each with water twice a day
- No more than 2 tablets in 24-hours
Which category of drugs do not have a synergistic effect to cryotherapy?
systemic antibiotics
What category of drugs has an antagonistic effects to superficial and deep heat therapy
systemic vasocontrictors
Inflammatory Response
characterized by redness, swelling, tenderness, pain, increased temperature, and loss of function
Occurs : injury day-day 4
Rubor
redness
tumor
swelling
dolor
tenderness & pain
calor
increased temperature
functio laesa
loss of function
phagocytes
neutrophils, macrophages, and leukocytes that ingest microorganisms, other cells, and foreign particles
exudate
accumulation of fluid that penetrates through vessel walls into and joining extravascular space
vasoconstriction
the immediate vascular response to tissue damage ; decreases in diameter of a blood vessel
chronic inflammation
occurs when the acute inflammatory response does not respond sufficiently to eliminate the injuring agent and restore tissue to its normal physiological state/ from repeated microtraumas and overuse
fibroblastic repair phase
proliferative and regenerative activity leading to scar formation and repair of the injured tissue
Occurs: Day 4 - Week 6
fibroplasia
period of scar formation
collagen
a strong, fibrous protein found in connective tissue
type 1 collagen
found in skin, fasciae, tendon, bone, ligaments, cartilage, and interstitial tissues
type II collagen
found in hyaline cartilage and vertebral disks
type III collagen
found in skin, smooth muscle, nerves, and blood vessels
Maturation-Remodeling Phase
long-term process; this phase features a realignment or remodeling of the collagen fibers that make up scar tissue
Occurs: Week 3-(2-3 yrs)
wolff’s law
bone and soft tissue will respond to the physical demands placed on them, causing them to remodel or realign along lines of tensile forces
microtears
overuse
macrotears
acute trauma
atrophy
wasting away of muscle tissue
factors that impede healing
Microtears Macrotears Edema Hemorrhage Poor Vascular Supply Separation of Tissue Muscle Spasm Atrophy Corticosteroids Keloids Hypertrophic Scars Infection Humimdity, Climate, & Oxygen Health, Age, Nutrition
metaplasia
conversion of one kind of tissue into a form that is not normal for that tissue
hyperplasia
excessive proliferation of normal cells in the normal tissue arrangement
Muscle Strain Healing
the time required for rehab is fairly lengthy; rehab time for this particular injury is usually longer than for a ligament strain
hamstring strain healing period
6-8 weeks
tendon healing period
4-5 weeks
nerve healing
cannot regenerate once the nerve cell dies
methods for soft-tissue healing
anti-inflammatory medications
therapeutic modalities
exercise rehabilitation
Avascular Necrosis
a portion of the bone degenerates due to a poor blood supply
Conditions that interfere with fracture healing:
poor blood supply
poor immobilization
infection
soft tissues between severed ends of bone
stress fracture
created by cyclic forces that adversely load a bone at a susceptible site; may be the result of axial compression or tension created by the pull of muscles.
pain
“an unpleasant sensory and emotional experience associated with actual or potential tissue damage:
acute pain
lasts less than 6 months ; tissue damage occurs and serves as a warning to the patient
chronic pain
lasts longer than 6 months or continues beyond the normal healing time
referred pain
occurs away from the actual site of irritation
types of referred pain
myofascial
sclerotomic
myotomic
dermatomic
myofascial pain
trigger points
trigger points
small, hyperirritable areas within a muscle where nerve impluses bombard the CNS and are expressed as referred pain
Sclerotomic, Myotomic, & Dermatomic Pain
deep, achy, and poorly localized pain
nociceptors
pain receptors
afferent nerve fibers
transmit impulses from the nociceptors toward the spinal cord
efferent nerve fibers
(i.e. motor neurons), transmit impulses from the spinal cord toward the periphery
types of neurotransmitters
serotonin norepinephrine substance P enkephalins B-endorphins
Visual Analog Scales
Quick, simple tests that consist of a line, usually 10 cm in length, the extremes of which are taken to represent the limits of the pain experience
3 models of pain control
gate control theory
descending pathway pain control
release of B-endrophin
Moving and Transporting injured patient
first establish if they are breathing and have a pulse. if prone they must be turned over for CPR or secured to a spine board. one person stabilizes the neck and head while the spine board is places as close to the patient as possible. each assistant is responsible for a segment of the athlete. then as a unit they will roll the athlete on to the spine board.
Acute Strains of the Neck and Upper Back
usually caused by a sudden turn of the neck, forced flexion, extension, or rotation. usually localized pain, point tenderness, and restricted motion, muscle guarding is also common. care includes RICE, ROM exercises, isometric exercises, cryotherapy, &NSAIDs
Cervical Sprain (Whiplash)
results from a violent motion of the neck, sudden snap of the head. produces tears in the ligaments. all signs of a strain are displayed but persist longer. pain may not occur right away. rule out a Fx, dislocatin, or disk injury. cervical collar may be worn. RICE for 48-72 hrs, may need 3 days bed rest.
Acute Torticollis (Wryneck)
“stiff neck” pain on one side of the neck after sleeping. occurs when a small piece of synovial membrane lining the joint capsule is impinged within a facet joint in the cervical vertebra. there is point tenderness, muscle spasm, and restricted movement. modalities can be used the break the pain-spasm-pain cycle, joint mobilization my also be used. can last 2-3 days
Cervical Spine Stenosis
narrowing of the spinal canal in the cervical region. can be due to bone spurs, osteoporosis, or disk bulges. there my be pain, tingling, and weakness. x-ray may be needed. continuing participation is discouraged.
Brachial Plexus Neuropraxia (Burner)
disruption of normal nerve function with out degeneration. primary MOI is stretching the brachial plexus when the neck is forced laterally to the opposite side while the shoulder is depressed. pain and numbness radiating to all fingers of the hand (C6,7,&8)
Spondylolysis & Spondylolisthesis
often attributed to a congenital weakness and the defect occurs as a stress fracture. may produce no symptoms, begins unilaterally. there may be slipping of one vertebra on the one below it (spondylolysis). usually results in hypermobility. pain aching across low back with increased pain after activity, tenderness. may require bed rest 1-3 days, bracing, trunk strengthening, core strengthening,
Cerebral Concussions (mild traumatic brain injury)
caused by a direct blow to the head, either when an object hits the head or the head hits a fixed object. two primary symptoms are loss of consciousness, and/or post traumatic amnesia.
Second Impact Syndrome
occurs when the head is struck a second time after the concussion hasn’t healed. it happens because rapid swelling and herniation of the brain. usually they wont LOC but will look stunned; 15 seconds to several minutes the condition will rapidly worsen. pupils will dilate, loss of eye movement, LOC, coma, and respiratory failure. life threatening.
Epistaxis
nose bleed, usually caused by a direct blow. they should sit up right with cold compressed over their nose.
nasal fractures
most common of the face. may cause a lot of bleeding. deformity is present. control the bleeding first, the x-ray. they should be able to return to activity in a few days.
Auricular Hematoma (Cauliflower Ear)
a compress or shearing injury that causes subcutaneous bleeding. to prevent wear protective head gear. most common in wrestling
Otitis Externa (swimmers ear)
infection of the ear canal caused by pseudomonas aeruginosa; water getting trapped in the ear canal. causes pain, dizziness, itching, discharge, and hearing loss. treated with ear drops, antibiotics, and/or ear plugs.
Otitis Media (middle ear infection)
accumulation of fluid in the middle ear caused by local and systemic inflammation and infection. pain, fluid drainage, loss of hearing, fever, headache, irritability, nausea, and loss of appetite may be present. analgesics and drawing the fluid out of the ear is common treatment. will usually improve in 24-72 hrs.
Orbital Hematoma (black eye)
bruised by direct contact may initially injure surrounding tissue and produce capillary bleeding. apply cold and rest. don’t blow nose because it will increase hemorrhaging.
Orbital Fracture
fx of the bony framework around the eye. they will have diplopia, restricted eye movement, downward displacement of the eye, pain, swelling, and hemorrhaging. most are treated surgically.
Acute Conjunctivitis (pink eye)
conjunctiva is the tissue that lines the back of the eye lid. usually caused by various bacteria or allergens. the eye lid will swell, prudent discharge, itching. it can be highly infectious. 10% solution of sodium sulfacetamide is used for treatment.
Clavicular Fractures
most frequent in sports. results from a fall on an outstretched arm, fall on top of shoulder, or direct impact. majority occur in the middle 1/3 of the bone. broken clavicle will appear slightly lower than uninjured side. swelling, point tenderness, and mild deformity will be present. x-ray, place in sling 6-8 weeks
Acromioclavicular Sprain (AC Sprain)
common in collision sports. direct impact on top of shoulder or a fall.
Adhesive Capsulitis (frozen shoulder)
most common in old people. involves a contracted and thickened joint capsule that is tight around the humeral head with little synovial fluid. they will have pain in all directions of movement.
Thoracic Outlet Syndrome
compression of the brachial plexis, and subclavian artery in neck and shoulder. they will complain of parasthesia, pain, cold sensation, impaired circulation, muscle weakness.
Olecranon Bursitis
injury to the olecranon bursa in the elbow. its the most injured bursa. when inflamed it will produce pain, swelling, and point tenderness.
Ulnar Collateral Ligament Injuries
most often as a result of valgus force from repetitive trauma resulting in ligament failure, tendinitis. there will be pain along medial aspect, tenderness over MCL. rest, NSAIDs, and tommy john surgery may be used for treatment.
Lateral Epicondylitis
Tennis Elbow. repetitive micro trauma with over use of extensor muscle. pain during and after activity. tenderness and decreased elbow motion may occur. treat with rom, rice, nsaids, analgesics, massage, and stretching
Medial Epicondylitis
Golfers Elbow. repeated forceful flexions of the wrist and extreme valgus of the elbow. pain around epicondyle of hummerus that may radiate down arm, point tenderness, and mild swelling. cryotherapy, ultrasound, sling and splinting for 7-10 days may be needed.
Little League Elbow
microtrauma from throwing. injury onset is slow, may have tightness/ weakness, locking/catching, and decreased rom. use rice and nsaids. throwing is stopped until pain free and full rom is back
Volkmans Contracture
type of forearm ischemic contracture resulting from brachial artery injury. involvement with median nerve and degeneration of the muscle. the wrist is flexed and the muscles in the forearm that flex and extend the forearm are involved. irreversible muscle necrosis begins 4-6 hrs after injury. first indication is pain the the forearm. remove everything from forearm, elevate, and monitor very close.
Triangular Fibrocartilage Complex (TFCC)
the TFCC is a fibrous and cartilaginous structure that separates the radiocarpal joints and inferior radioulnar joints of the wrist. it is a major ligamentous stabilizer and provides flexible mechanism for stable rotation. it is most often injured from swinging a bat with a violent twist of the wrist, forced hyherextension, and falling on an out stretched hand. there will be pain along ulnar side, pain with wrist extension, clicking or catching, swelling. refer to physician. immobilized for 4 weeks, surgery may be needed
Carpal Tunnel Syndrome
the carpal tunnel is on the anterior aspect of the wrist. this injury results from inflammation of the tendons and synovial sheath which leads to compression of the median nerve. most often occur with repeated flexion. tingling, numbness, paresthesia, and weakness will be present,
DeQuervain’s Syndrome
“hoffmans disease” a stenosing tendosynovitis in the thumb. the first tunnel of the wrist becomes contracted and narrowed as a result of inflammation of the synovial lining. primary symptom is an aching pain which may radiate in the hand. theres also point tenderness and weakness.
Trigger Finger
caused by a repeated movement causing inflammation of the tendon of the wrist and hand leading to swelling, crepitus, and painful movement.
Extensor Tendon Avulsion (Mallet Finger)
Occurs from the rupture of the extensor tendon from the distal which causes the patient to be unable to extend the distal phalanx’s it will be painful, and they will have point tenderness. RICE is used. If there’s no fracture it should be splinted into extension for 6 to 8 weeks.
Boutonniere deformity
It occurs from a rupture of the extensor expansion dorsal to the PIP joint. Severe pain and inability to extend DIP joint. There is swelling. Tenderness and obvious deformity treat with cold split into extension for 5 to 8 weeks
Flexor Digotorum Profundus Rupture (Jersey finger)
A rupture of the flexor tendon and loss of ability to flex finger it most often occurs to the ring finger there will be pain and point tenderness usually need surgery to repair rehab requires 12 weeks
Gamekeepers thumb
A sprain of the ulnar collateral ligament at the MCP joint of the thumb there will be pain tenderness swelling. x-rays needed. thumb splint for three weeks. if there is a tear surgery is needed
Swan neck deformity
The volar plate of PIP joint is injured from severe hyperextension. Pain swelling tenderness. Treat with RICE and analgesics finger splint for three weeks then buddy tape
Leg-Calve-Perthes Disease
Avascular neurosis of the fomoral head occurs in children 4 to 10 years of age is greater in boys. Pain in groin and limping it occurs slowly over a number of months then bed rest, nonweightbearing if not treated can lead to problems later in life.
Osgood Schlatter Disease
An apophysitis characterized by pain at the attachment of the patellar tendon to the tibial tubercle. This condition resolves itself when the patient reaches 18 yo. Is repeated avulsion of the patellar tendon at the apophysis of tibial tubrical. most common in adolescent knees
Patellar Tendonitis (jumpers knee)
jumping as well as kicking and running place tension on the knees extensor muscle complex. as a result one or more injuries occurs in the patellar and quadriceps tendon. they will have pain and tenderness at the inferior pole of the patella
runner’s knee
caused my repetitive and over use. effects the IT band and pes anserine.
IT band- overuse in runners and cyclist who have genu varum and pronated feet. irritation occurs where the band inserts, obers test is positive
pes anserine-inflammation results from excessive genu valgum, and weakness of vastus medialis muscle. produced by running on a slope with one led higher than the other.
Apophysitis of the calcaneus (severs disease)
occurs in the young who are physically active. injury at apophysis of the heel. pain at posterior heel below attachment of Achilles tendon.
pes plantus
flat foot
pes cavus
high arch foot
Second Meteatarsal Stress Fx (Morton’s toe)
there is an abnormality; short 1st meteatarsal so the 2nd meteatarsal looks larger. since the 2nd is larger there is uneven weight distribution which may cause a stress fx. pain during and after activity, point tenderness. orthotics may help
jones fx
can be caused by inversion and plantar flexion, direct force, or repetitive stress. most commonly occurs at the diaphysis at the base of the 5th metatarsal. healing is slow swelling is immediate
bunion
most frequent painful deformity. occurs at the head of the 1st metatarsal. most common in women due to foot wear
Great toe hyperetension (turf toe)
hyperextension of the great toe, results in a sprain of the metatarsophalangeal joint either from trauma or repetitive use. pain and swelling.
hammer toe
flexible deformity that becomes fixed. caused by flexion contracture at PIP joint
mallet toe
caused by flexion contracture at the distal DIP joint involving flexor digitorum longus tendon
claw toe
flexion contracture at DIP joint and also hypertension at the MP joint
closed fx
fx doesnt penetrate superficial tissue
open fx
penetrates superficial tissue
greenstick fx
incomplete breaks in bone that haven’t completely ossified, seen in kids
comminuted fx
3 or more fragments at the fx site. can be caused by a hard blow or fall. difficult healing because of displacement. surgery may be needed.
linear fx
bone splits along its length. results from jumping from a tall height and landing
transverse fx
occurs in a straight line. direct blow usually causes this
oblique fx
occurs when one end of the bone receives sudden torsion or twisting while the other end is fixed
spiral fx
have an S -shaped separation, seen in football and skiing. when the foot is planted and the body is rotated the opposite direction.
impacted fx
results from a fall from a height which causes a long bone to receive directly on its long axis. requires immediate medical attention.
avulsion fx
separation of a bone fragment from its cortex at an attachment of a ligament or tendon
blowout fx
occurs to the wall of the eye orbit
collies fx
Fx of the distal radius with dorsal and radial displacement of the wrist and hand “dinner fork”. often seen in people with osteoporosis.
Exercise induced bronchospasm
symptoms usually occur 10-15 min after the on set of exercise. more common in winter outdoor activities. shortness of breath, chest congestion, chest tightness, dry cough, unusual fatigue, the feel out of shape. treat with inhaled B2-agonist from a metered inhaler (albuterol).
Bronchitis
any inflammatory condition of the bronchial passages.
acute: the inflammation most commonly comes from self-limited viral infection. productive cough, clear septum, chest congestion, mild SOB, (fever, chills, night sweats if infectious) (runny nose, nasal congestion, sore throat it viral).
treated with mycolytics, cough, supressants, and nsaids. may last 7-10 days. the athlete my play if they can tolerate it.
Chronic Obstructive Pulmonary Disease (COPD)
closely related to asthma. non-reversible airway obstruction. typically found in smokers. people with this tend to be older, hae wheezing, decreased breath sounds, smokers cough, and usually have heart failure
pneumonia
any condition that results in inflammation of the lung parenchyma. the cause is usually infectious. they will have sob, pleuritic chest pain, productive cough, labored breathing. antibiotics are used for treatment. 7-10 days
influenza flu
viral infection, most common during the fall and winter months, transmitted via contagious droplets that spread through coughing an sneezing. high fever, muscle aches, headache, cough, chest pain, sob, fatigue, loss of appetite, nasal congestion, and sore throat. 7-10 days
upper respiratory infection
fever, cough, nasal congestion, sore throat, runny nose. may last 7-10 days.
Spontaneous Pneumothorax and Hemothorax
pneumothorax- when air or gas is trapped in the chest between the parictal and visceral pleura and causes the lung to collapse. sudden chest pain and sob.
hemothorax- more serious condition where blood collects in the pleural cavity due to trauma. chest pain, dyspnea. worsens rapidly.
both are medical emergencies.
Sudden Cardiac Death
hypertrophic cardiomyopothy, coronary artery abnormalities, myocarditis, wolff-parkinsons-white syndrome
Hypertrophic Cardiacmyopathy
leading cause of cardiac death in athletes 35 yo and younger. its an abnormally hypertrophied but non-dilated left ventricle. symptoms are fatigue, dyspenea, exertional angina, and syncope. medical emergency
Wolff-Parkinson-White Syndrome
disorders of the electrical system of the heart. caused by the presence of abnormal accessory electrical condition pathway between the atria and the ventricles. usually asymptomatic but may have palpitations, dizziness, sob, and syncope. treated with surgery.
Marfan Syndrome
hereditary disorder of connective tissue characterizes by overly tall and thin physical stature with hyper-mobile joints, sternal deformity, and arm span that exceeds the persons height. athletes with marfan are restricted from collision sports.
blood pressure
normal- about 120/80
pre-hypertension- 129-139/80-89
hypertension stage 1: 140-189/ 90-99
hypertension stage 2: greater than 160/100
crisis: 180/110 or higher
Deep Vein Thombosis
when a blood clot becomes lodged in a large vein. mostly occurs in lower leg and caused by a trauma. swelling, pain, distal edema
Pulmonary Embolus
a catastrophic complication of deep vein thrombosis. acute dyspea and chest pain
Myocarditis
inflammatory process of the cardiac myocyes often resulting from enteroviral infections. red flags are body aches, fever, nausea, vomiting, diarreha, mild fatigue, dyspnea, syncope, exercise intolerance, palpitations. treated with diuretics and antiarrhythmic drugs. only 30% return to full activity
Irritable Bowel Syndrome
chronic condition in people under the age of 35. its a disorder of gastrointestional motility with abnormal cycles of muscle contractions and relaxation. diarrhea, constipation, upper abdominal bloating, pain, discomfort, and mucus in stool. high fiber diets, stress management, and treating the symptoms may help
appendicitis
most common cause of urgent abdominal surgery in the US. it is caused by acute obstruction and inflammation of the appendix. pain in the lower right quadrant within 12 hours, maximal point tenderness @ mcburney’s point, low grade fever, nausea, vomiting.
kidney stones
when urine becomes supersatuated with a salt that is capable of forming a solid crystal. kidney stones are mostly composed of calcium. men are 3 times more likely to get them. they’ll have unilateral frank pain that will radiate to the groin, nausea, vomiting, and tenderness
urinary tract infection
occurs in the upper of lower urinary tract, most commonly involve urinary bladder. sexually active women have the highest risk. dysuria, increased frequency of urination, small amounts of urine at a time, discomfort when urinating. prevent by showering before and after sex, urinating after sex, and wearing breathable underwear. treat with antibiotics
vaginitis
inflammation of the vagina. discharge is present. treat with metronidazole.
Dysmenorrhea
sever cramps and pain associated with menstruation. treat with nsaids
Amenorrhea
primary- the absence of menstruation before are 16.
secondary- menstruation has stopped after having been normal
genital warts
caused by human papillomavirus, via sexual contact.
syphillis
sexually transmitted, caused by treponema pallidum. begins with sore at point of contact. treated with penicillin. it is a reportable disease.
gonorrhea
sexually transmitted caused by nosseria gonorrhoeae and can effect the epithelium of the urethra, cervix, rectum, pharnyx, and congunctiva. most common in people 15-29 yo. discomfort and discharge may be present. must be reported
chlamydia
most common, may affect the eye, respiratory system, and genital tract. it can cause infertility, chronic pelvic pain, male urethral infection. treated much like gonorrehea, resistant to penicillin, doxycycillin can be used. must be reported
Hodgkin’s Lymphoma
malignant disorder of the larger lymphnode in lower anterior neck. its usually not tender, firm, and rubbery. it requires radiation therapy and chemo. it is cured in most patients
leukemia
uncontrolled proliferation of white blood cells in the bone marrow, which accumulate and replace normal blood cells in the marrow. then it can spread to different parts of the body. it mimics a common viral infection with fatigue, loss of appetite, fever, enlarged spleen/lymphnodes/liver, weakness, pallor, nose bleeds, and weight loss. treated with radiation, chemo, blood transfusions.
80% survival rate in children, 66% in adults
Raynaud’s Disease
characterized by vasospasm of the arteries (hands mostly). stressors are cold temperatures and emotional trauma.
chicken pox
Varicella. virus, begins rapidly with headache and a rash that leads to vesicles. last 3-4 days. fever, chills, backache. self eliminating but acyclovir is used
shingles
Herpes Zoster. a reactivation of the varicella disease. presents rash that is followed by nerve root pain. acyclovir is used to treat
impetigo
highly contagous skin disorde. transmitted through skin contact. most common on head, face, back, and trunk. treated with a topical antibiotic (bactoban)
nonbullous- yellow / honey colored crusted leasion
bullous- moist red skin, looks like a burn
folliculitis
bacterial skin infection. an inflammatory reaction in the hair follicles, most common on face, chest, axilla, butt, goin, and legs. treated with topical and oral antibiotics, warm saline compress, and washed with antibacterial soap 2-3 times a day
herpes simplex
cold sores
tinea corpis
ringworm
tinea cruris
jock itch
tinea unguium
ringworm of the nails
tinea pedis
athletes foot
tinea capitis
ringworm of the scalp
tinea versicolor
yeast infection on trunk, arms, neck or abdomen
head lice
tiny insects that live on the human scalp while feeding on human blood. transmitted by contact with and effected person. there is intense itching of the scalp. topical medications and nit combs are used.
scabies
a parasite associated with skin infection that is a result of direct contact, sexual transmission, sharing clothes or a bed. intense itching that interferes with sleep. usually on wrist, fingers, and ankles. small red bumps develop. usually no symptoms the first two week.
gout
rheumatic arthritis. build up of uric acid in the joint. sudden onset of severe pain, swollen joint, tenderness, and pain worse with motion.
Eating Disorders
red flag; frequent comments about being over weight, fluctuation or changes in weight, avoidance of social situations involving food, mood problems, excessive training, dizziness,wearing baggy clothing
Anorexia Nervosa
when the person restricts or compensates for eating to the point they are 85% below ideal body weight. potentially life threatening. my have gastrointestinal problems, amenorhea, dehydration, decrease muscle mass and body fat, and increased injuries. they are always worried about their image.
Bulimia
more common. binge eating followed by using a laxative, vomiting, exercise and dieting. this results in fluid / electrolyte imbalance, gastrointestinal difficulties, inflammation of the esophagus, dental conditions, muscle weakness, and menstrual irregularities.
Spina Bifida
a congenital spinal cord disability in which the neural tube fails to close completely during the first 4-6 weeks of fetal development. one or more of the vertebra doesnt develop properly,leaving an opening in the spinal column. most often at the low back and in females
Cerebral Palsy
a chronic neurological disorder caused by a lesion in the brain that affects movement and posture. it occurs before, at, or soon after birth. not hereditary
Frost Bite
prolonged outdoor cold exposure during sport or recreational activities. caused by vasoconstriction in response to cold resulting in freezing tissue of affected body part. 4 stages:
1-frost nip- erythema, swelling, cutaneous numbness, pain..full recovery
2-frost bite-causes redness, swelling, blisters..may heal but will be left with long term sensory neuropothy
3-full thickness destruction of skin with formation of hemorragic blisters and hard waxy skin..
4- loss of entire body part, edema, redness, gray/white skin, numbness, tingling, burning, loss of motion, cold, hard skin
All of the following drugs may be used with phonophoresis during the acute phase of treatment except: A.Dexamethasone B.Hydrocortisone 1% C.Lidocaine D.Naproxen E.Hydrocortisone 10%
D. Naproxen is the generic form of the bran name drug Naprosyn, which is an NSAID. Naproxen does not come in a topical form and is delivered orally.
One of your athletes has been diagnosed with psoriasis. All of the following medications are appropriate for treatment of this condition except: A.Aristocort B.Keflex C.Zoloft D.Betadine E.benadryl
D. Betadine: Artisocort, Kenalog, and topicort are all corticosteroids that are used to treat inflammation and pruritic manifestations of psoriasis. Butadiene is a topical microbicide agent used for skin and wound infection.
Which of the following is not a medication that is delivered via a metered-dose inhaler for exercise-induced asthma. A.Proventil B.Alupent C.Atrovent D.Ventolin E.Butisol
E. Butisol is a barbiturate used as a sedative in the treatment of insomnia
What medication is often used for anxiety or panic attacks?
xanax is a medication used to treat anxiety and panic disorders
What is the primary mode of action of penicillin?
inhibits the metabolism of bacteria.
Which of the following is considered a medical emergency? A.Acute compartment syndrome B.Navicular fracutre C.Bulimia D.Mitral valve prolapse E.cellulitis
A. acute compartment syndrome is a condition in which soft tissue pressure is increased and the viability of the muscles and nerves of the anterior lower leg are jeopardized. This condition may progress from an initial hematoma, usually resulting from a blow to the anterolateral side of the leg, to total foot drop as a result of injury to the peroneal nerve.
All of the following treatments would be inappropriate for an acute quadriceps contusion except:
A.Light message
B.Pulsed ultrasound
C.ice message
D.Ice pack with compression wrap with the knee in flexion
E.Heat pack and message
D. It is appropriate during the acute stages of a quadriceps contusion to apply ice to the injured area and put the knee into a slight amount of passive flexion to maintain flexibility of the quadriceps muscle.
Deep frostbite is a medical emergency. What would the proper course of treatment be for this problem?
With deep frostbite, there should be rapid rewarming of the body part in warm water between 100 to 110 degrees. Rewarming of the body part should continue until it is a deep red/bluish in color.
During which circumstances involving the teeth should an athlete be immediately referred to a dentist?
An athlete should be immediately referred to a dentist if a tooth has been knocked out, if a tooth has been displaced 2mm or more, or when a crown is fractured and the tooth is still alive.
A male patient sustains a direct blow to the genital area. How can the AT immediately decrease the pain?
When a male athlete sustains a direct blow to the genitalia, the testicular area may go into spasm. It is best to have the athlete lie supine and flex his knees to his chest until the pain subsides and the apply an ice pack to the scrotal area.
shock after a severe injury can result from ___ or ___
hemorhage or stagnation of blood
A patient who had been diagnosed with infectious mononucleosis has just been cleared by the team doctor to return to full activity. How long should the patient remain out of contact participation from time of onset to the time of full recovery?
A patient who has been diagnosed with mono is vulnerable to a possible spleen injury/rupture if the patient returns too soon. The patient may resume light activity after 3 weeks from the onset of the illness if the spleen is not enlarged or painful, the patients liver function studies are normal, no fever is present, and any other complications are resolved.
A ruby player sustains a confirmed head injury during a game and is removed from the game. All of the following symptoms/signs of increasing intracerebral pressure that the AT should monitor except:
A.nausea and vomiting
B. Pupil irregularity
C. Increase in systolic blood pressure with decrease in diastolic blood pressure
D. Rombergs sign
E. Changes in cognition
D. Rombergs sign is the inability to balance the body when the eyes are shut and the feet are together. It is a sign of sensory ataxia.
If an athlete is unconscious from a blow to the head, he or she should be assumed to have a neck injury in addition to a possible head injury. If the airway appears to be impaired, all of the following would be appropriate steps in management except:
A. cut the facemark with an appropriate tool and move it out of the way
B.Leave the helmet on
C.stabilize the head and neck
D.do a finger sweep of the mouth to remove any debris and clear the airway
E.Activate EMS
D. In this case, it is known the patient is unconscious from a blow to the head and neck, not from aspirating an object or debris. It is only necessary to perform a finger sweep if the AT cannot ventilate the patient and an object that is blocking the passage of air is visible in the mouth.
During the foreign body airway obstruction maneuver, the AT should grasp one fist with the other hand and place the thumb side of the fist where?
The proper position for the fist that is resting on the patients body is on the abdomen between the typhoid process and the umbilicus.
An athlete is brought into the athletic training facility with a 2.5 in nail embedded in his foot. All of the following actions are appropriate in the treatment except:
A.immediately remove the nail from the foot
B.Keep the athlete calm
C.pack the nail and foot as they are in a large dressing to help control the bleeding and stabilize the object
D.Transport the athlete to the hospital with the nail is embedded in the foot
E.Varify that the athlete’s tetanus shot is current
A. when treating an impaled object, always leave the object in place and apply a bulky bandage around it to control bleeding and stabilize the object.
What are the appropriate steps in the management of an athlete who is experiencing a seizure?
During a seizure, it is best to keep the area around the patient clear of objects or spectators and protect the patients head and body from further injury. It is important to turn the patient on his or her side if he or she vomits, he or she will not aspirate. A prolonged seizure is a serious medical situation, and it is prudent to call for additional medical support.
It is critical that CPR be administered as soon as possible during a life-threatening situation. In what amount of time is brain damage likely to occur if the brain is deprived of oxygen?
Brain damage is most likely to occur if the brain is deprived of oxygen for approx 4 to 6 min
During CPR, it is most convenient and efficient to monitor the athlete’s circulation by palpating the carotid artery. Where is this pulse located?
The carotid pulse is palpated in the groove between the larynx and sternocleidomastoid muscle.
During CPR, the adult sternum must be compressed to what depth for compression to be effective?
the sternum must be depressed 1.5 to 2 in for compression to be effective in an average-sized adult during CPR
Which type of heat injury is considered a medical emergency? A.Dehydration B.Heat cramps C.Heat stroke D.Heat exhaustion E.All of the above except A
C. Heat stroke is considered a medical emergency. Heat stroke results in severe hyperthermia with the failure of the thermoregulatory system and dysfunction of the CNS. This condition does not spontaneously reverse its course, and the patient may die without immediate medical attention.
Which of the following signs and symptoms are characteristic of a tension pneumothorax? A.Trachial deviation B.Distended neck veins C.Unilateral absence of breath sounds D.Dizziness E.Cyanosis
Signs of acute tension pneumothorax include tracheal deviation, distended neck veins, unilateral absence of breath sounds, and cyanosis.
An athlete has been kicked in the lower back area during a soccer game. He is complaining of significant flank pain, is having difficulty voiding, and there is blood in his urine. What should the AT suspect is injured?
All are signs of kidney, bladder, or urethra injury.
When evaluating an unconscious athlete, what should the AT do first?
During emergency care of the unconscious patient, the AT should make sure the patient’s airway is clear and he or she is breathing normally.
What is the most common and devastating mechanism of injury seen in neck injuries sustained during football?
The most devastating cervical injuries sustained in athletic participation occur from cervical hyperextension and axial compression.
Where would the athlete complain of pain with acute appendicitis?
The patient will complain of severe lower right abdominal pain wit acute appendicitis and will complain of tenderness to the same area with palpation.
What is the prudent method of transporting an athlete with a suspected spinal injury?
When transporting a patient with a suspected spinal cord injury, a spine board should be used to stabilize the patient during transport and additional medical support should be employed.
When fitting an athlete for crutches, the elbow should be bent to approximately what angle?
the elbow should be slightly flexed to approximately 30 degrees, which places the hand at hip level.
Under what conditions can CPR be stopped?
CPR should not be stopped until the AT is too exhausted to continue, spontaneous breathing and circulation have resumed, or another responsible party continues CPR in place of the AT.
After an athlete has suffered a ruptured spleen, he or she may experience pain that radiates down the left shoulder and approximately one-third of the way down the upper left arm. What is this pain called?
Reflex pain experienced in the left shoulder and upper arm after a severe blow to the abdomen, resulting in a ruptured spleen, is known as a Kehr’s sign
What is the appropriate treatment for an athlete who has sustained a rib fracture?
Although total immobilization of the ribs is not possible, a rib belt or rib taping may help minimize movement and make the patient more comfortable.
All of the following are basic functions of athletic taping and bandaging except: A.to support an injured body part B.To protect wounds from infection C.To enhance the athlete's skill D.To hold protective equipment in place E.B and D
Athletic taping and bandaging serves many functions, including supporting or immobilizing an injured body part, protecting wounds from further injury or infection, holding protective equipment in place, and controlling hemorrhage.
Taping continuously around a limb may cause what problem?
continuous taping around a limb may result in compromised circulation.
An athlete reports to the AT with a deep laceration to his thigh. The cut is approximately 1/8 in deep, 1 in long, and bleeding moderately. What would be the proper steps for the AT to take to treat this wound?
Applying pressure will minimize the bleeding. Keep the area clean with sterile saline or hydrogen peroxide, apply butterfly strips for temporary closure, and use ice and a compressive dressing to minimize further bleeding. Refer the patient to the physician for sutures, if necessary.
An athlete comes to the AT holding a tooth that has been knocked out of his mouth. What would be the proper steps for the AT to take to allow for a successful reimplantation?
Placing the tooth in a moist cloth and encouraging immediate implantation is the only means by which to save the tooth. Tooth reimplantation after 24 hours has a poor success rate.
During an emergency, all of the following information should be given over the telephone by the AT to emergency personnel except:
A.The type of emergency
B.The current status of the athlete
C.Where the athlete is currently located
D.The type of treatment currently being given to the athlete
E.the name of the nest of kin
During an emergency, important information the AT should provide to the emergency personnel includes the type of emergency, the type of injury that is suspected, the current status of the patient, the type of care currently being given to the patient, and the exact location of the emergency (including landmarks)
An athlete has a suspected fracture involving the knee. What areas should be splinted?
With a suspected fracture of the knee joint or of the surrounding area, the splint should stabilize all the lower limb joints and one side of the trunk.
What cell releases histamine and serotonin during the cellular response phase of tissue healing?
mast cells and platelets release histamine and serotonin during the reaction phase of an acute injury.
The acute phase of an injury lasts approximately 3 to 4 days. What occurs at the time of the initial trauma?
During the initial phases following a soft tissue injury, there is a transitory vasoconstriction followed by vasodilation and increased permeability, causing redness and swelling of the area.
Where do primitive stem cells mature into red and white blood cells and platelets?
The bone marrow contains immature stem cells that differentiate into red and white blood cells and platelets.
An athlete has just been injured on the basketball court, and the AT begins administering first aid. During the initial contact, the AT notices the athlete is hyperactive, argumentative, and sarcastic in his responses to questions. All of the following actions by the AT are inappropriate except:
A.Telling the athlete he or she is a wimp and that it is “not that bad”
B.Being abrupt and telling the athlete to snap out of it
C.Allowing the athlete to express his emotions they occur
D.Calling the referee over to calm the athlete
E.Walking away to prevent an argument
When and athlete is injured he or she may react strongly to pain and become very fearful of the possibility of being disabled. During this time, the athlete may display signs of overreacting by becoming argumentative or sarcastic. It is important that the AT provides emotional support and allows the athlete to express his or her emotions. It is best to reassuring and divert the athlete’s attention away from the injury.
The AT notices an athlete is prone to abnormal bruising. After discussing the problem with the team doctor, he recommends what vitamin?
Vitamin K contributes to blood clothing because it imparts a calcium binding ability to certain blood proteins, such as prothrombin.
An acronym used for the immediate care of an acute musculoskeletal injury is what?
RICE stands for rest, ice, compression and elevation
A drug that is used to increase the effect of another, such as aspirin when used in combination with codeine, is known as what?
A potentiating drug is one that is used to increase the effect of another drug
Which of the following is not the proper action for an athlete to take if lightning is observed during a game?
A.Avoid standing near metal bleachers on the field
B.Stand near a telephone pole
C.Assume a crouched position in a ditch
D.Take cover in an automobile if he or she cannot get indoors
E.A and C
B. Athletes should avoid standing near tall objects, such as trees or telephone poles, which may attract a lightning strike.
One of your cross-country runners has an ongoing problem with tinea pedis. What action should you take to assist the athlete in minimizing the problem?
Tinea pedis or athlete’s foot, is caused by fungus infection. The AT should advise the patient to keep their feet clean and dry and wear clean socks on a daily basis.
A patient comes to the ATF with what appears to be a tick embedded in his lower leg. The AT should instruct the patient not to do what?
Pulling the tick off the skin can leave the ticks head still embedded in the skin. Covering the tick’s body with mineral oil or nail polish remover will cause the tick to remove its head from the skin.
What is a major side effect of the NSAID group?
the primary adverse side effect is gastrointestinal discomfort.
Your patient is on a medication for a staphylococcus aureus infection. What adverse reaction might you expect with antibiotic treatment?
common side effects of antibiotic therapy are abdominal cramping, diarrhea, nausea, and vomiting.
All of the following are possible side effects of oral contraceptives except: A.nausea and vomiting B.Shortness of breath C.fluid retention D.Amenorrhea E.Feeling sluggish
B. shortness of breath is not a side effect of oral contraceptives
Anabolic steroids are often abused by athletes. What may occur in the female athlete after ingesting testosterone?
a female may develop a conditon known as hirsutism, which is the excessive growth of hair in unusual places
What is the best way to prevent otitis externa?
Otitis externa is a bacterial or fungal infection of the outer ear canal that is characterized by severe ear pain, hearing difficulty, drainage from the ear canal, swelling of the canal, and occasional dizziness. Prevention includes avoiding prolonged exposure to water and keeping the ear dry after water activities with acetic acid or a similar drying agent.
Under what conditions should an athletic helmet be removed after injury?
The helmet should be left in place unless the facemask cannot be removed to gain access to the airway, or if with the facemark is removed, ventilation still cannot be provided, or if the helmet and chin strap do not hold the head secure, or if the helmet prevents immobilization for transport in an appropriate position.
What tool has the Inter-Association Task Force recommended not be used as the primary tool for loop-strap removal on a football helmet after an injury?
Because rust can develop on the screws and t-bolts of a helmet or the screw can be damaged during a rescue, the effectiveness of a screwdriver has been determined to be limited and unreliable.
A predisposing condition such as spinal stenosis may mean an athlete is more likely to:
A patient with congenital or acquired spinal stenosis is more likely to develop paralysis after a fracture-dislocation because the spinal canal is already too small for the spinal cord.
Spinal immobilization is best achieved with the full-body splint. All of the following are examples of full-body immobilizations equipment except: A.the standard rigid spine board B.vacuum mattress C.A stryker frame D.Scoop stretcher E.Miller full-body splint
C. a stryker frame is not a full-body immobilization
After an acute injury, chemical mediators are given off by various cells. What chemical is first to appear?
Histamine is given off by blood platelets, basophilic leukocytes, and mast cells during the beginning of the inflammatory process, causing arterial dilation and capillary permeability.
What terms means “the abnormal development of tissue”?
Dysplasia is the abnormal development of tissue.
___ and ___ are 2 conditions that will interfere with fracture healing.
poor blood supply and poor immobilization are 2 conditions that interfere with fracture healing.
One of your patients has been stung by a bee. He appears to be showing signs of anaphylaxis. What medication would be appropriate to administer to stop the reaction?
epinephrine is a sympathomimetic drug that may be delivered via an injective device, such as an EpiPen, to halt an anaphylactic reaction.
__ and __ are both examples of histamine-2 blockers.
Tagamet (cimetidine) and Zantac (ranitidine) are both examples of histamine-2 blockers, which reduce stomach acid output by blocking the action of histamine cells in the stomach.
What drug must the AT determine the athlete is not allergic to prior to administering a NSAID?
Before administering a NSAId, the AT must determine if the patient is allergic to aspirin because a cross reaction may occur in patients allergic to aspirin.
When transporting an athlete off the field by manual conveyance, it is most convenient to do this with how many ATs?
Manual conveyance is a method by which an injured patient is transported a greater distance than he or she is able to walk with ease. The most convenient carry is performed by 2 ATs
Where should the bell of a stethoscope be placed when taking blood pressure?
The bell of the stethoscope should be placed over the brachial artery during auscultation.
If necessary, the removal of the helmet and shoulder pads from an athlete with a suspected spinal cord injury should be coordinated to avoid what?
When there is a suspected spinal cord injury and the decision is made to remove the helmet and shoulder pads, they should be removed simultaneously to avoid cervical hyperextension.
The inter-association task force recommends that no fewer than __ persons lift athletes suspected of having a spinal cord injury.
the Inter-Association Task Force recommends that no fewer than 4-plus persons lift a patient suspected of having a spinal cord injury.
What instrument is used to visually examine the ear canal and tympanic membrane?
otoscope
What is the primary reason an AT would perform pulmonary auscultation?
the primary reason an AT would perform pulmonary auscultation is identify potential abnormal breath sounds that would indicate a pathological condition.
One of your female patients presents with dysuria, a sense of urgency to urinate, decreased urine volume, nocturia, low back pain, and pyuria. What do you suspect the patient has?
All symptoms indicate the patient has cystitis, which is a bladder infection.
All of the following symptoms should alert the AT to serious pathology that requires immediate referral to a physician except:
A.itchy skin, especially when it involves areas on the feet and toes
B.painful urination
C.Unexpected weight loss
D.Night pain
E.palpable lump in the breast or axilla
A. itchy skin, especially when it involves areas on the feet and toes
For which of the following injuries would the use of a hard shell pad be appropriate? A.cover a large skin infection B.a toe injury C.A painful contusion D.Plantar fasciitis E.None of the above
C. a painful contusion
When choosing a prophylactic knee brace, the brace should meet what criteria?
It should not interfere with normal knee function, it should not increase injuries to the lower extremity, it should be cost effective and durable.
When recommending a running sneaker the AT should recommend a sole that has what major qualities?
shock absorbing and durable
Which of the following materials can the AT use to construct a custom protective or supportive device? A.felt B.Gauze padding C.Cotton D.Foam E.all of the above
E. all of the above
One of your patients presents with abnormal pain that he describes as burning. He states that it becomes worse when he lies in supine or consumes caffeine, spicy foods, or alcohol. What might you suspect is the problem?
Esophageal reflux or peptic ulcer
One of your patients presents with a sudden onset of chest pain, dyspnea, hemoptysis, and cyanosis. What do you suspect is the problem?
pneumothorax
One of your athletes presents with diarrhea, vomiting, and abdominal cramping 1 to 6 hours after eating at a local restaurant. What do you suspect is the problem?
food poisoning
How long should the abdomen be auscultated before the AT decides if the bowl sounds are absent?
2 to 3 min
One of your patients begins to complain of intense itching of the skin under the cold pack that you applied to his shoulder 5 min ago. When you remove the pack you notice that hives have developed on the area that has been cooled. What is the patient experiencing?
cold urticaria
When treating an athlete who presents with undifferentiate somatoform disorder. The AT should do all of the following except:
A.provide care for a bona fide injury
B.Develop a sound relationship with the athlete to gain his or her trust
C.Avoid doing more harm by dismissing the athlete as a “symptom magnifier”
D.provide the athlete with psychological counseling focused on having the athlete recognize and acknowledge the source of his or her anger
E. all of the above
D. provide the athlete with psychological counseling focused on having the athlete recognize and acknowledge the source of his or her anger
When using iontophoresis, the AT should be aware of possible __ and __ as a result of ion flux during treatment.
Skin irritation, chemical burns
Why is it important that an athlete with an abdominal injury never be given anything to eat or drink?
It increases the risk of surgery if an operative procedure becomes necessary
One of your diabetic athletes appears confused and is dizzy, apprehensive, and diaphoretic. How should this athlete be treated?
This athlete should be treated for insulin shock and should be transported to the nearest hospital if he or she does not respond to sugar within 2 to 3 min
When taking a blood pressure with a sphygmomanometer, at what point is the systolic pressure noted?
At the point at which the pulse is first heard
An athlete receives a head injury during a soccer game. While performing the on-field eval, the AT notices the athlete has a hearing defect after testing for air and bone conduction using a tuning fork. Which cranial nerve is injured?
VIII vestibulocochlear
Which of the following is the proper protocol for administering Tylenol to an adult patient?
A. initial dose: 2 tabs, 200 mg each, repeat every 6 to 8 hours,PRN
B.initial dose: 2 tabs, 225 mg each, repeat every 4 to 6 hours, PRN
C. initial dose: 2 tabs, 325 mg each, repeat every 4 to 6 hours, PRN
D. initial dose: 2 tabs, 12.5 mg each, repeat every 6 hrs, PRN
E. intial dose: 3 tabs, 200 mg each, repeat every 8 to 12 hours, PRN
C. Initial dose: 2 tabs, 325 mg each, repeat every 4 to 6 hours, PRN
What is the proper protocol for administering Advil to an adult patient?
Initial dose: 1 to 2 tabs, 200 mg each, repeat every 6 hours, PRN. Do not exceed 6 tabs in a 25 hr period without consulting with a physician.
What technique should be used on a patient with an obstructed airway and a suspected spinal injury?
Head-tilt chin lift
What should core body temperature be reduced to in patient suffering from EHS before transportation?
102 degrees
Acute Subdural Hematoma
progress rapidly and acts like an epidural hematoma, occurs due to arterial bleeding
Chronic Subdural Hematoma
occurs due to venous bleeding, which is low pressure, so the rising intracranial pressure tamponades the bleeding before serious intracranial pressure occurs
What is a blow to the head or skull fracture can cause a tear
of the meningeal arteries, which results in rapid blood
accumulation and creation of a hematoma (within a few minutes to a few hours) known as?
Epidural Hematoma
If a patient is losing a lot of blood, what kind of shock will they go through?
Hypovolemic Shock
Proper crutch fitting
Place tip 6 inches anteriorly, 2 inches laterally; underarm brace should be 2-3 finger widths; arm flexion of 30 deg
What is a halo sign indicative of? How is special test performed?
Basal skull fracture –> wipe a patients ear with cotton ball and cerebrospinal fluid will be present if patient is showing signs of basal skull fx.
Sickle cell trait athletes should be tested and are at increased risk in what situations?
Heat, humidity, or altitude
They can also be exempt from conditioning testing
A circulatory condition in which narrowed blood vessels reduce blood flow to the limbs.
Peripheral artery disease
Occurs when a portion of the heart muscle dies because of the lack of an adequate supply of oxygenated blood
Acute myocardial infraction
Coup vs countercoup MOI
A coup injury results from trauma to a nonmoving head such as being struck by a moving object (ex. soccer ball)
A countrecoup injury occurs when a moving head strikes a non-movable object such as the floor
Describe the differences between Myocardial Infarction and Angina Pectoris?
Myocardial Infraction occurs when there is a disease in oxygenated blood flow to the heart muscle due to the blockage of a coronary artery.
Angina Pectoris is transient chest pain that results when the heart’s demand for oxygenated blood exceeds supply from the coronary artery spasm. Patients are usually diagnosed with this disease before it occurs in the athletic setting and when diagnosed are given nitroglycerin.
What is compartment syndrome?
Compartment syndrome can occur following a fracture due to rapid swelling in a closed compartment of the leg and forearm. The lower leg and elbow to hand are most common, but it can occur in other areas.
The signs are pain, pallor, paresthesia, pulselessness, and paralysis
