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Sports Injuries > Injury Assessment Basics > Flashcards

Injury Assessment Basics Flashcards

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1
Q

List the steps and injury assessment from the top of the funnel to the bottom

A

History, observation, range of motion (ROM), resistance, special tests, palpation

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2
Q

The history and observation steps allow us to…

A

Gather lots of information

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3
Q

The range of motion and resistance steps allow us to…

A

Perform tests on movement

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4
Q

Special test allow us to…

A

Administer test designed to detect specific structures + injury conditions

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5
Q

Palpation allows us to…

A

Palpate specific structures we think are most likely to be injured in addition to some nearby

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6
Q

Describe the main objective of taking someone’s history

A
  • we have two ears in one mouth so we can listen twice as much as we speak
  • taking history is an art, actively listening, as person becomes the storyteller
  • A lot of information you need to come out but you need to usually follow up with a range of questions
  • We will generate questions and move them into categories
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7
Q

Name the four steps of taking someone’s history

A

Introduction, injury story, clinical presentation, personal info

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8
Q

What does the introductions to step of taking someone’s history entail?

A
  • introduce yourself and ask for their name (pronounce correctly)
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9
Q

What is the injury story step of taking someone’s history consist of?

A
  • Encourage them to tell your story it was something general
    “ tell me about what brings you here”
    “ what can I help you out with?” what can I help you?
  • Questions about their injury story or focussed on the mechanics of the situation or the “how” and timeline you’re dealing with
  • We want to know if it’s an acute or chronic injury and where the person is in the overall healing process
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10
Q

What’s the difference between an acute and chronic injury?

A

Acute: starts with a specific incident
Chronic: develops overtime, fluctuating on and off over week/months

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11
Q

Describe the clinical presentation step of taking someone’s history

A
  • Clinical presentation questions. Focus on the consequences of the injury (signs, symptoms, functional impact on daily life)
  • Symptoms are subjective and only evident to the person who has an injury (ex. pain)
  • Signs or objective, and can be seen by someone else (ex. bruising)
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12
Q

Describe the personal information step of taking someone’s history

A
  • The main characters the person with the injury: questions here focus on previous history, general health, and current physical activity demands, including sports and activities of daily living
  • Questions are a bit looking forward to ideal state and looking backward to find factors that may contribute to current issue
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13
Q

In the observation stage of injury assessment, we use _ to guide observations

A

Information from history

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14
Q

What’s an important first step of the observation stage in injury assessment?

A

ASKING FOR CONSENT
- before observing an injured area it’s important to ask for consent to see that area and determine if the person is comfortable exposing it (sometimes this is not possible for a variety of personal, religious, or cultural reasons)

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15
Q

Observations sent to be qualitative and performed _ so that we can compare the affected versus unaffected sides

A

Bilaterally

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16
Q

What three things are we looking for in the observation stage?

A

Swelling, deformity, discolouration

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17
Q

Name the importance of identifying discoloration, and something to keep in mind when looking for it

A
  • skin colour can tell you a lot: highlights inflammation, bruising, and lack of blood flow of skin turns purple gray/blue/purple
  • VERY IMPORTANT to look more closely at individuals with darker skin, richer pigmentation can make these signs less obvious and easy to miss
    Ex: cellulitis can look a lot less red and dark skin
  • Taking care is considering impact of skin colour on observations help determine the best care available
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18
Q

How is range of motion recorded in the range of motion chart?

A
  • ROM is recorded as an angle in degrees with a tool called a goniometer
  • The chart has a range of motion, active, passive, and strength section (strength just for resistance testing later)
  • Painful motions are recorded with an *
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19
Q

Each motion for ROM chart is performed how many times?

A

2x, once passive, and once active

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20
Q

Describe the difference between active and passive range of motion

A

ACTIVE range of motion means the person with the injury does all the work and tester does none: Person actively contracts are muscles in order to demonstrate how much ROM they have available without any help

PASSIVE range of motion means the person with the injury does nothing and tester takes a joint through its available range of motion: no muscle activity is required

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21
Q

What’s a reasonable value for knee flexion?

A

140 degrees

22
Q

What’s a reasonable value for knee extension?

A

0°

23
Q

What’s a reasonable value for a knee medial rotation?

A

30°

24
Q

What’s a reasonable value for knee lateral rotation?

A

40°

25
Q

What’s a reasonable value for hip flexion?

A

120°

26
Q

What’s a reasonable value for hip extension?

A

30°

27
Q

What’s a reasonable value for hip medial rotation?

A

45°

28
Q

What’s a reasonable value for hip lateral rotation?

A

45°

29
Q

What’s a reasonable value for ankle dorsiflexion?

A

20°

30
Q

What’s a reasonable value for ankle plantarflexion?

A

50°

31
Q

What’s a reasonable value for ankle inversion?

A

20°

32
Q

What’s a reasonable value for ankle eversion?

A

20°

33
Q

What’s a reasonable value for shoulder flexion?

A

180°

34
Q

What’s a reasonable value for shoulder abduction?

A

180°

35
Q

What’s a reasonable value for shoulder medial rotation?

A

70°

36
Q

What’s a reasonable value for shoulder lateral rotation?

A

90°

37
Q

What are things we should keep in mind when using the average range of motion table?

A
  • not a complete or a comprehensive collection of values, but OK for us to use
  • Average values are coming from a textbook, there’s a degree of variability in many of these ranges
  • Just because someone doesn’t have a certain range of motion, this doesn’t indicate significant pathology
    BUT this gives an idea of what might be normal
38
Q

What questions should we ask ourselves about range of motion once assessed?

A

Is it limited?
- Limited/smaller than expectation
- Comparing to average values/function of other limb (unless hyper mobile)

Is it excessive?
- Can be a problem as well
- Might mean ligaments the constrain motion or not constraining properly, “letting it happen”
- can see this with damaged ligaments capsules and dislocating joints

Is it painful?
- Mark with an *

Interpret!
- If something is painful, what does that mean?

39
Q

What two questions should we ask when interpreting range of motion results?

A

Does this motion tear apart or pull a part in injured structure?
- if so, what is the injured structure?

Ex: ligaments the limit inversion for passive inversion, that lie on lateral side of ankle = anyone of lateral ligaments
- could also be perennials because they’re also running on the lateral side and get pulled apart with inversion

Does this test that I performed ( painful/weak) asking injured structure to contract?
- What’s contracting to cause this?
- Applies to active and resistant columns

Ex: active plantarflexion with pain
WHAT PLANTARFLEXES? (But pulling apart on dorsiflexion side)
- Gastrocnemius
- Soleus
- Tibialis posterior

40
Q

Describe the main goal of resistance testing and some things we might aim for.

A
  • look at strength of muscle groups, a perform primary join actions
  • In manual strength testing, waiting for a few things:

ISOMETRIC TEST: no actual movement going on, so we don’t pull apart any injured structures (but we can ask injured structures to contract)
MID-RANGE OF MOTION: no end range usually (ex. If testing resisted dorsiflexion, you’d be somewhere in between dorsiflexion and plantar flexion)

41
Q

Why don’t we want to ask for full range of motion in a resistance test?

A
  • When you put a muscle into mid length, this is usually wear it’s strongest
  • Tricky to quantify but for now as long as you’re not too close to end range, you’re OK
42
Q

How do we grade a resistance test?

A

From 0 to 5

43
Q

How would a score of zero on a resistance test show up?

A
  • ask the person to do an action and they can’t contract at all
  • Usually won’t happen much in most orthopaedic clinical practises and most sports injuries, BUT would show up if you had a significant neurological injury/spinal cord injury
44
Q

How would a score of one show up on a resistance test?

A
  • Flicker of a contraction: something is getting through to the muscle, it can contract something
    BUT contraction is not enough to create motion at the joint
  • Very low level of function
45
Q

How would a score of 2 show up on a resistance test?

A
  • enough muscle activation at the joint can move, but not enough to actually overcome gravity
  • Start to think about the position your testing in! Have to be flexible about it
  • Normally start the person in an antigravity position
  • If you cannot overcome gravity, you’re not more than a 2
  • Can change body position after (lying on the side)
46
Q

How might a score of 3 show up on a resistance test?

A
  • can overcome gravity, but all you can do is hold it against gravity
  • It’s tester tries to press down with extra force against the motion, they fail
  • Max effort= hold against gravity
47
Q

How would a score of 4 show up on a resistance test?

A
  • Can I add extra resistance as they are making emotion, can meet some of the resistance and overcome gravity?
  • a 4 score has lots of variability can be very different or not super different
48
Q

How would a score of 5 show up in a resistance test?

A
  • strength is equal to opposite/uninvolved side (no limitation)
49
Q

Describe special tests

A
  • Special test mean that we are picking structures to test from our iOS list ( index of suspicion) play. This means it’s the list of candidates, gone through and done all of the tests and come down funnel arriving at 5 to 6 structures that might be the issue
  • We need to have a special test for each structure on iOS list/each condition we suspect
  • In a special test we’re hoping to either reproduce the mechanism of injury (ex. Testing the integrity of the MCL by reproducing what happened on a minor level OR reproduce pain/symptoms they are talking about - aka is it the “injury sore”)
50
Q

No special test is a perfect test! What does this mean in terms of testing?

A
  • often we need to perform a battery of tests (2/3/4 tester all go after the same condition, or same possible injured tissue)
  • If we keep getting positives (ow yes that’s the same pain/sensation) we can feel stronger about our findings
    For this course, we will do 1-2 tests per condition
51
Q

What does the key knowledge that lies behind palpation skills?

A
  • know your anatomy!!
  • Palpation is built on understanding of surface anatomy, take inside, understanding of structure and translate it to outside

Sports Injuries (21 decks)

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