Lecture 9 Flashcards
Peritoneal folds of the abdomen and thorax
-parietal
-visceral
3 regions of the spine
-cervical
-thoracic
-lumbar
Viscera of the abdomen and thorax
-liver
-stomach
-small intestine
-large intesine
-bladder
What is a fascial chain
-muscles in lower limb come up to insert into lumbar spine
-often share fascial wall with other structures so if muscles are tight it may effect other structures
What are the cervical vertebrae
-C1-C7
What are the thoracic vertebrae
-T1-T12
What are the lumbar vertebrae
-L1-L5
What are the structures included in the spine
-facet joint
-vertebral body
-disc
-nerve roots
-spinous process
-transverse process
What are the 4 regions of the abdomen
-right upper
-left upper
-right lower
-left lower
What is included in the right upper quadrant
-liver
-gallbladder
-duodenum
-head of pancreas
-right kidney and adrenal gland
-hepatic flexure of colon
-part of transverse and ascending colon
What is included in the left upper quadrant
-stomach
-spleen
-left lobe of liver
-body of pancreas
-left kidney and adrenal gland
-splenic flexure of colon
-parts of transverse and descending colon
What is included in the right lower quadrant
-caecum
-appendix
-right ovary and tube
-right ureter
What is included in the left lower quadrant
-part of descending colon
-sigmoid colon
-left ovary and tube
-left ureter
What to remember when palpating the abdomen
-start superficial
-gradually increase pressure
What is a sports hernia
-fascial weakness in abdominal wall, where abdominals and adductors attach into pubic bone
What is medical term for sports hernia
-athletic pubalgia
MOI sports hernia
-repetitive strain to area
What are sports are hernias common in
-hockey
-football
-soccer
-sprinters/hurdlers
-rugby
Signs and symptoms of sports hernia
-pain with sitting up, quick cutting, sprinting and coughing
What is special about sports hernias
-they do not usually protrude like traditionally hernias
Special test for sports hernia
-resisted sit-up
Acute management of sports hernia
-PIER
-adductor wrap
-conservative treatment 4-6 wees
Why do sports hernias have sequential RTP
-easily re-irritated
Visceral structures potentially affected in sport
-kidney contusions
-spleen rupture
-lungs
-bladder rupture
-testicular contusions
-heart
What can a spleen rupture chance be increased from
-mono
What can happen to the lungs
-pneumothorax
MOI of abdominal injuries
-direct blow
-fall from height
Signs and symptoms of abdominal injuries
-pain
-rigidity in abdomen
-feeling unwell
-shock
What is the cullen sign
-umbilicus discolouration
What is the grey turner sign
-flank discolouration
Acute management of abdominal injuries
-quadrant palpation
-call 911
-rest comfortably
-treat for shock
-reassure
MOI kidney injuries
-blow to the back
Signs and symptoms of kidney injuries
-pain in low back
-peeing blood
-feeling unwell
-shock
Acute management of kidney injuries
-refer
Causes of sudden death in athletes
-usually due to cardiac disease
Types of cardiac disease
-congenital abnormalities of coronary arteries
-hypertrophic cardiomyopathy
What is hypertrophic cardiomyopathy
-genetic condition causing thickening of heart muscle
-leading cause of sudden death in athletes
What is the incidence of hypertrophic cardiomyopathy
-1 in every 200 000
What does hypertrophic cardiomyopathy cause
-altered rhythm
-reduced blocked blood flow
Warning signs of hypertrophic cardiomyopathy
-fainting or seizure
-dizziness or light headedness
-chest pain
-palpitations
-shortness of breath
What are emerging causes of acquired heart disease in young athletes
-anabolic steroids
-peptide hormones
-stimulants (energy drinks, high doses of caffeine)
What is a blow to the solar plexus
-wind knocked out of you
-spasm of the diaphragm muscle
MOI of blow to solar plexus
-blow to abdomen or chest
-fall on butt or back
Signs and symptoms of blow to solar plexus
-pain
-difficulty breathing
-panicky
Acute management of blow to solar plexus
-bring athletes knees gently towards chest
-guided breathing
-diaphragmatic breathing
-able to RTP once symptoms resolve
MOI facet joint sprains
-forced rotation
Signs and symptoms of facet joint sprains
-hear/feel pop
-sharp localized pain
-pain with motions that open joint
-muscle guarding
What causes facet joint sprains
-unexpected hit
-common in c spine due to large ROM
Special test for facet joint sprains
-quadrant test
-positive if pain on opposite side
Acute management of facet joint sprains
-PIER
-refer
What is facet joint effusion
-irritation of facet joint
MOI of facet joint effusion
-sudden episode of extreme ROM
-may have felt a click or sharp pain
-localized pain
-spasm around irritated joint
-closing joint will be painful
Special test for facet joint effusion
-quadrant test
-positive if pain on same side
Acute management of facet joint effusion
-PIER
-refer
MOI disc protrusions
-acute or chronic compression through disc, often in flexed position
What does disc protrusion result in
-bulge of disc resulting in changes to myotomes and dermatomes
Signs and symptoms of disc protrusion
-pain with repeat forward bending
-relief with extension
-pain with cough/sneeze
Acute management of disc protrusion
-refer
What are dermatomes
-sensory areas of the skin that are innervated by specific nerve roots
Sensations of the dermatomes
-pain
-tingling
-numbness
-pressure
What is a special test for myotome testing
-cervical nerve root involvement
-lumbosacral nerve root involvement
How are cervical nerve root involvement tests performed
-resisted tests are performed 5x bilaterally
-look for weakening
Nerve root C1 test
-cervical flexion
Nerve root C2 test
-cervical rotation
Nerve root C3 test
-cervical side bending
Nerve root C4 test
-shoulder elevation (shrug)
Nerve root C5 test
-shoulder abduction
Nerve root C6 test
-elbow flexion
Nerve root C7 test
-elbow extension
Nerve root C8 test
-thumb extension
Nerve root T1 test
-hand intrinsics (spread fingers)
Nerve root L1, L2 test
-hip flexion (in high sitting)
Nerve root L3 test
-knee extension
Nerve root L4 test
-foot dorsiflexion and inversion
Nerve root L5 test
-hallux extension
Nerve root S1, S2 test
-plantar flexion in standing (toe raises)
Nerve root S1 test
-knee flexion
Nerve root S2 test
-hallux (big toe) extension
What reflex will be dampened if there is pressure on C5
-biceps
What reflex will be dampened if there is pressure on C6
-brachioradialis
What reflex will be dampened if there is pressure on C7
-triceps
What reflex will be dampened if there is pressure on L3, L4
-patellar tendon
MOI muscle strains of neck and back
-overstretch or eccentric load
-rotation at a high velocity
-may have external force
What reflex will be dampened if there is pressure on S1
-achilles tendon
What sports are muscle strains of neck and back common in
-tennis
-golf
-baseball
Signs and symptoms of muscle strains of neck and back
-abrupt pull
-pain
-protective spasm
-divot (large strains)
Acute management of strains of neck and back
-PIER (never to anterior neck cuz of major vessels)
-altered activity
MOI of rib and scapula fractures
-direct blow
-compression of ribs
Signs and symptoms of rib fractures
-pain with deep breath
-pain with compression
-TOP area of fracture
Signs and symptoms of scapula fractures
-TOP
-pain with movement of shoulder
Acute management of rib and scapula fractures
-stabilize the segments with padding and tensor
-tube sling for scapula fracture
-send for imaging
4 spondy’s of the spine
-pars interarticularis
-spondylolylis
-spondylolisthesis
-spondylitis
MOI spinal fractures
-axial load
-compression through spine
Signs and symptoms of spinal fractures
-central pain
-tingling
-numbness
-unwillingness to move
-spasm
How can paralysis happen in spinal fractures
-displacement of segments can put pressure on spinal cord or nerve roots
What type of paralysis happens with c spine fracture
-quadriplegia
What type of paralysis happens with T and L spine fractures
-paraplegia
Acute management of spinal fractures
-stabilize
-call 911
What is the pain spasm cycle
-more pain causes more spasm
-more spasm then causes more pain
How to break the pain spasm cycle
-PIER
-education
What is spondylolysis
-stress fracture in the pars interarticularis
What is spondylolisthesis
-stress fracture and sliding of vertebrae
What is spondylolitis
-inflammation in the vertebrae that could lead to fusion
