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KNPE 331 > Midterm > Flashcards

Midterm Flashcards

1
Q

vasovagal response

A

may be triggered by pain or emotional upset
- results in drop in blood pressure and therefore loss of consciousness

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2
Q

what to do if athlete is experiencing or may experience vasovagal response

A
  1. avoid looking/listening
  2. block athletes view
  3. have others block the scene
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3
Q

primary injury prevention

A

reducing the incident of injury before they occur

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4
Q

secondary injury prevention

A

addressing injuries in their early stage to prevent recurrence, severity and/or secondary complications

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5
Q

examples of primary injury prevention

A
  1. safe field/court conditions
  2. protective equipment
  3. proper warm-up
  4. nutrition/hydration
  5. scanning for unsafe technique
  6. collab with coaches, S&C
  7. recognize injury patterns in a team
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6
Q

examples of secondary injury prevention

A
  1. early identification of injuries
  2. bracing/taping/wrapping
  3. sufficient rehab of injuries
  4. education of re-risk
  5. sufficient reconditioning post-injury (including psych readiness)
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7
Q

bracing vs taping

A

brace:
1. ongoing conditions
2. larger joints requiring complex tape jobs
3. maintains integrity longer than tape
tape:
1. feels tighter and more secure
***feel the tape so they are more aware of the injury

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8
Q

footwear and orthotics

A
  1. wearing proper shoe/orthotics can achieve more optimal biomechanics
  2. performing with optimal biomechanics can prevent injuries
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9
Q

orthotics

A
  1. not recommended until over 12 years old
  2. should be prescribed with supportive rehab to retrain intrinsic and extrinsic foot muscles and movement patterns
  3. can result in a noticeable difference in biomechanics up the chain
  4. made from casting foot in subtalar neutral (NWB)
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10
Q

types of sports injuries

A
  1. urgent vs. non-urgent
  2. traumatic vs. overuse
  3. acute vs. chronic
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11
Q

how do muscles/tendons get injured

A
  1. strain
    2.tendonitis/osis
  2. contusion
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12
Q

how do ligaments get injured

A
  1. sprain
    - overstretch, dislocations, subluxations
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13
Q

how do bones get injured

A
  1. fracture/break - different types
  2. bruise
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14
Q

how do nerves get injuries

A
  1. burner/stringer (head and shouder brought away from each other)
  2. contusion/crush injury
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15
Q

how does the brain get injured

A
  1. concussion, acquired brain injury (ABI)
  2. direct trauma, indirect
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16
Q

how does the skin get injured

A
  1. lacerations, abrasions
  2. contusions
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17
Q

strain vs. sprain

A

strain: muscle or tendon
sprain: ligament

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18
Q

grade 1 or 1st degree

A

tissues stretch/some fibres disrupted

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19
Q

grade 1 sprain

A

integrity of the joint maintained

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20
Q

grade 1 strain

A

contractions are strong but painful

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21
Q

grade 2 or 2nd degree

A

partial tear/many fibres disrupted

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22
Q

grade 2 sprain

A

results some instability/laxity in joint

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23
Q

grade 2 strain

A

contraction are weak and very painful

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24
Q

grade 3 or 3rd degree

A

complete tear (nerved are severed)

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25
Q

grade 3 sprain

A

results in significant instability/laxity in the joint

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26
Q

grade 3 strain

A

unable to contract and often pain-free (nerves were severed)

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27
Q

types of bone fractures

A
  1. transverse
  2. linear
  3. oblique, non-displaced
  4. oblique, displaced
  5. spiral (from rotation)
  6. greenstick (bend in bones)
  7. comminuted
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28
Q

contusions

A

crush injury to the muscle and connective tissue from blunt trauma

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29
Q

muscle response to contusion

A
  1. pain
  2. discolouration
  3. swelling
  4. spasm/guarding
  5. reflex inhibition
    - pain and/or swelling can stop voluntary muscle contraction
    - results in weakness/giving out
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30
Q

itis vs otis

A

itis: inflammation (acute)
otis: tissue breakdown (chronic)

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31
Q

overuse injuries

A
  1. tendonitis
  2. bursitis
  3. shin splits
  4. stress fractures
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32
Q

emergency action plan (EAP)

A
  1. predetermined, organized system of managing severe injury
  2. allows for quick and efficient injury management
  3. decreases chaos/panic, and creates trust and reassurance
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33
Q

what should be included in EAP

A
  1. charge person
  2. call person
  3. control person
  4. important numbers
  5. address of sports facility (map)
  6. address of nearest hospital
  7. address of urgent care/x-rays
  8. location of player medicals, AED and spinal board if available
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34
Q

charge person

A

person in charge of delivering medical care

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35
Q

call person

A

provides medical information, meets, and directs ambulance

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36
Q

control person

A

manages team/crowd/surrounding/locates supplies

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37
Q

normal/ideal gait pattern

A
  1. heel strike in slight supination
  2. arch absorbs forces as it rolls into pronation
  3. supinate back into neutral through mid-forefoot for a neutral toe off
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38
Q

foot types

A
  1. overpronators (valgus foot) - collapse through arch (pronate)
  2. supinators (varus foot) - weight stays through outside of foot (supinate)
  3. normal - ideal gait
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39
Q

contraindications - when NOT to tape

A
  1. allergies to adhesives
  2. immediately after injury (tissues bleed and swell)
  3. injury hasn’t been fully assessed
  4. RTP criteria hasn’t been fully met
  5. areas of altered skin sensation
  6. overnight - swelling
  7. check sport governing body allows tape
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40
Q

mechanism of injury

A

what position did the structure/joint/limb/athlete go into?

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41
Q

sources of MOI

A
  1. trauma: from an external force on the body
  2. overuse: repetitive strain on a tissue
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42
Q

onset of MOI

A
  1. acute/traumatic: sudden onset
  2. insidious: gradual onset and often of unknown origin
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43
Q

signs vs. symptoms

A

signs: something you see
symptoms: something the athlete feels/describes

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44
Q

signs

A
  1. bruising
  2. swelling
  3. heat/cold
  4. spasm/guarding
  5. sweating
  6. shivering
  7. vomiting
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45
Q

symptoms

A
  1. pain
  2. tingling
  3. numbness
  4. burning
  5. tight
  6. pressure
  7. nausea
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46
Q

pain

A
  1. everyone experiences it differently
  2. measure on a scale of 1-10
  3. shock and fear comes with pain so need to keep athletes calm and reassure them
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47
Q

psychological aspect of injuries

A

anger, fear, denial, sadness, catastrophizing, regret
- repeat injury leads to fears

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48
Q

how to help athletes with psychology of injuries

A
  1. listen
  2. reassure with a plan supporting their concerns
  3. know when to refer to a specialist
  4. educate on injury/prevention and next steps
  5. coach/player/family/friend support
  6. mindful and sequential RTP
  7. keep them part of the team
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49
Q

types of skin wounds

A
  1. laceration (deep wounds)
  2. abrasions
  3. punctures
  4. contusions
  5. blisters
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50
Q

management of lacerations

A

step 1: control bleeding with pressure
step 2: clean the wound to rid infection
step 3: steri-strips

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51
Q

step 1: control bleeding of lacerations

A
  1. PPE
  2. pressure: all-gauze sponges, extra layers as needed, conforming stretch gauze
  3. elevation: above heart to decrease blood flow to area
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52
Q

step 2: clean the wound

A
  1. soap and water
  2. cinder suds - directly to wound to lift dirt and debris
    ***try to not send anyone to hospital with a dirty wound
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53
Q

step 3: steri-strips

A
  1. dry the area
  2. adhesive spray with q-tip
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54
Q

when to send for stitches

A
  1. only done effectively within 24 hours
  2. deep wounds affecting more than just skin
  3. unable to stop bleeding
  4. wound is to the face
  5. wound is across a joint
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55
Q

minor cuts and abrasions

A
  1. superficial layers of skin
  2. non-stick gauze and cover roll for RTP
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56
Q

punctures

A
  1. common in feet and hands
  2. can penetrate multiple levels
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57
Q

why should you leave the object in the limb if it punctures deep

A

to prevent further bleeding - the object may ben providing pressure on artery which is helping the bleeding
1. pad around it with gauze
2. send them for medical attention

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58
Q

treating contusions

A
  1. avoid a deep tissue massage
  2. effleurage or lymph drainage
  3. ice and protective padding (donut)
    ***if deep contusions are not treated properly there is risk of myositis ossificans
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59
Q

contusions in the clinic

A
  1. ultrasound on the pulsed setting (for inflammation) not continuous
  2. interferential current (IFC)
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60
Q

blisters

A

fluid-filled bubble caused by friction

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61
Q

prevention of blisters

A

skin lube over areas of friction

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62
Q

treatment of blisters

A
  1. if broken, clean well
  2. second-skin (gives buffer and absorbs the friction)
  3. coverroll
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63
Q

when do we seek medical attention for wounds?

A
  1. unable to control bleeding
  2. would is dirty and unable to be throughly cleaned
  3. deep wound or puncture
  4. object is still impaled (do not remove)
  5. changes in sensation (nerve affected)
  6. wound is from a human/animal bite
  7. wound is from a rusty object
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64
Q

cartilage and meniscus healing

A

limited capacity to heal due to little or no direct blood supply

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65
Q

ligament healing

A
  1. during repair phase, collagen or CT fibres lay down randomly
  2. gradually a scar is formed
  3. over following months collagen fibres align in response to joint stress/strain
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66
Q

skeletal muscle healing

A
  1. regeneration of new myofibres is minimal
  2. healing and repair follows the same process of random collagen alignment and develops tensile strength in response to stress/strain
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67
Q

nerves healing

A
  1. regeneration can take place very slowly (3-4mm/day)
  2. peripheral nerves regenerate better than central nerves
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68
Q

wound healing phases

A
  1. hemostasis
  2. inflammation
  3. repair and regeneration
  4. remodeling
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69
Q

hemostasis phase

A

process leading to cessation of bleeding

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70
Q

inflammation phase

A
  1. essential vascular and cellular response for proper tissue healing (fight infection)
  2. can be prolonged if people don’t rest
    (4-6 days)
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71
Q

repair and regeneration phase

A
  1. formation of granulation tissues (a type of new CT)
  2. repair injured tissues
  3. lay down collagen
    (4-24 days)
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72
Q

remodeling

A
  1. strengthening of tissues along lines of tension
  2. collagen straightens up and remodels the muscle
    (21days-2years)
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73
Q

phase 1: inflammatory response

A
  1. vasodilation of blood vessels
  2. white blood cells (neutrophils and macrophages) fight infection, breakdown and clean up damaged tissues to start healing
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74
Q

S&S of inflammation

A
  1. redness
  2. swelling
  3. heat (big indicator)
  4. pain
  5. loss of function
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75
Q

phase 2: repair and regeneration (proliferation)

A
  1. collagen laid down in disorganized matrix
  2. revascularization (blood vessels grow) brings O2 and nutrients
  3. edges of wound draw closer (feels tighter)
    ***could easily re-injure at this phase
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76
Q

phase 3: remodeling

A
  1. collagen reorganizes along lines of stress (wolffs law)
  2. tissues increase in tensile strength
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77
Q

bone healing

A

follows the same 3 phases but more complex
(6-8 weeks)

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78
Q

5 stages of bone healing

A
  1. hematoma formation
  2. cellular proliferation (cells grow and divide)
  3. callus formation (soft callus)
  4. ossification (hard callus)
  5. remodeling
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79
Q

goals of treatment in inflammatory phase (day 1-5)

A

decrease
1. inflammation
2. pain
3. swelling
4. activity
- protect
- educate

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80
Q

goals of treatment in demolition phase (day 3-15)

A

decrease
1. residual swelling
2. residual pain
increase
1. ROM
2. flexibility (surrounding tissues)
3. strength
4. proprioception
5. CVF
- prevent second degree complication
- educate

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81
Q

goals of treatment in healing phase (day10-8weeks)

A

decrease
1. pain or muscle spasm
increase
1. circulation
2. ROM
3. flexibility
4. strength (to support lesion)
5. sports specific CVF
6. proprioception

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82
Q

long term goals of treatment

A
  1. maintain/restore skin and CT
  2. optimal biomechanics
  3. increase proprioception
  4. protect injury site
  5. educate
  6. ensure full ROM, strength of lesion site, flexibility, psychological readiness
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83
Q

guidelines for RTP

A
  1. full ROM, 80% strength
  2. able to perform the demands of sport
  3. psychological readiness
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84
Q

when do we use heat therapy?

A
  1. healing phase and beyond
  2. relaxation
  3. promote flexibility in the tissues
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85
Q

tissue response to heat

A

decrease
1. pain
2. spasm
increase
1. circulation
2. inflammation
3. metabolism
4. edema/swelling

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86
Q

types of heat

A
  1. moist heat application (hot wet towel)
  2. electric heating pads
  3. hot shower/tub/bacl
  4. microwaveable bean bag
  5. infrared sauna
  6. ultrasound - continuous setting
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87
Q

infrared vs traditional saunas

A

infrared: heats your skin/body
traditional: air around you

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88
Q

what conditions do infrared saunas benefit

A
  1. high blood pressure
  2. heart failure
  3. dementia
  4. headaches
  5. type 2 diabetes
  6. arthritis and chronic pain
  7. relaxation
  8. improved circulation
  9. sweating = detox
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89
Q

contraindications to heat

A
  1. inflamed tissues/post-injury
  2. bleeding disorders
  3. blood clots (heat moves it)
  4. impaired sensation (could burn skin)
  5. metal implants
  6. infection (heat spreads it)
  7. open wounds
  8. pregnancy, illness, multiple sclerosis
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90
Q

tissue response to cold (cryotherapy)

A

decrease
1. inflammation
2. edema/swelling
3. pain
4. circulation
5. hematoma formation
6. muscle spasm
7. tissue metabolism
8. enzymatic activity
9. extensibility

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91
Q

types of cold therapy

A
  1. crushed ice or ice cubes (remove air pockets, 15-20min)
  2. gel packs or frozen peas (15-20min)
  3. frozen beanbag (10-15min)
  4. ice cup massage (5-10min)
  5. cold immersion
  6. hyperbaric gaseous cryotherapy (spray crystals)
  7. cryochamber (cools full body - not head)
  8. liquid nitrogen (2-4 min)
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92
Q

cold immersion

A
  1. cold tub - no neck only to shoulders
  2. ice bucket - for foot, ankle. hand and tricky contours
    ***10 degrees for CBAN
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93
Q

CBAN

A

stages of the cold therapy
C- cold
B- burn
A- achy
N- numb

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94
Q

contraindications to cryochamber

A
  1. pregnancy
  2. high BP
  3. blood clots
  4. heart conditions
  5. infection
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95
Q

contraindications to cold

A
  1. raynauds phenomenon
  2. urticaria - hives/rash from cold
  3. clotting disorders
  4. over superficial nerves
  5. altered skin sensation
  6. complex regional pain syndrome (body is not responding properly)
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96
Q

raynauds phenomenon

A

caused by decreased blood flow to fingers/toes due to vasospasm in those areas
- turn white, blue or red

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97
Q

when to massage

A
  1. tight muscles (decrease pain, increase extensibility)
  2. injured muscles
  3. increase circulation
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98
Q

when to massage injured muscles

A
  1. inflammatory phase only do lymph drainage (light)
    - decrease pain and swelling
  2. in healing phase, deeper massage
    - increase circulation to promote healing
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99
Q

contraindications to the massage therapy

A
  1. acute inflam (only effleurage)
  2. contusions (only effleurage)
  3. acute spasm around other injury
  4. over open wounds
  5. altered sensation
  6. possible blood clot
  7. bleeding disorders
  8. over varicose vein
  9. deep vein thrombosis (DVT) - calf pain
  10. cancer
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100
Q

four main principles of massage therapy

A
  1. general - specific - general
  2. superficial - deep - superficial
  3. proximal - distal - proximal
  4. peripheral - central - peripheral
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101
Q

3 techniques for massage

A
  1. petrissage
  2. shaking/rocking
  3. vibration
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102
Q

what massage techniques can you do before a game

A
  1. petrissage
  2. shaking
  3. vibration
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103
Q

what massage techniques can you do after a game

A
  1. stripping
  2. pressure point
  3. petrissage
  4. shaking
  5. vibration
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104
Q

wound dressings

A
  1. sterile gauze: once wound has been cleaned or to help clean wound
  2. non-stick gauze: to dress the wound for long term application
  3. hypafix/coverroll: to secure to non-stick gauze
  4. gauze roll: conforming stretch gauze bandage
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105
Q

when should you ice vs. heat

A

ice: inflammatory phase
heat: in healing phase

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106
Q

lymphatic drainage

A
  1. superficial draws from deep
  2. can see effect immediately
  3. can be used for post-op, facial drainage and in a cast to decrease swelling
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107
Q

player medical records

A

keep these with you because knowing ahead of time will help manage injuries

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108
Q

what is in medical records

A
  1. medical conditions (epi-pen? know where its kept)
  2. allergies
  3. previous injuries (watch how athletes move)
  4. emergency contact info
  5. level of experience/# years playing
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109
Q

what are the keys goals during emergency conditions

A
  1. provide care to manage conditions
  2. minimize secondary complications
  3. determine safe removal
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110
Q

if you’re unsure about what to do in an emergency condition what can you do?

A
  1. ask more questions to see if anyone saw what happened
  2. ask for help (another AT, certified, other team)
  3. err on the side of caution, if unsure what to do, call ambulance
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111
Q

general hierachy of conditions

A
  1. ABCs, major bleeds (get rid of immediately)
  2. acquired brain injury/concussion
  3. spinal
  4. fracture/dislocation (can cause shock and be bigger prob)
  5. sprains/strains
  6. abrasions
    ***also assess for shock too
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112
Q

emergency on-field assessment

A
  1. survey the scene (it is safe?)
  2. control the c-spine (block head)
  3. assess LOC (how alert - AVPU)
  4. assess vitals (ABCs)
  5. secondary survey (history, SAMPLE, PQRST)
  6. head-to-toe (other injuries)
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113
Q

scene survey

A
  1. any safety concerns in the immediate environment
  2. any clues to indicate what happened?
  3. did anyone see anything happen - ask questions
  4. how many athletes or bystanders are injured
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114
Q

what do you do if multiple athletes are injured?

A

determine who is the most injured and help them first

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115
Q

control the cervical spine (c-spine)

A
  1. block the head (hand on forearm, and make them remain still (no yes and no) - DO NOT COVER EARS (CSF)
  2. once rule c-spine out get someone else to hold head so you can finish assessment
  3. if unaligned and do not have ABC you need to re-align them and watch expressions
  4. if unaligned and have ABCs do not move them
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116
Q

level of consciousness

A
  1. remove mouth guard or anything in mouth (helps airway)
  2. rate athletes LOC using AVPU scale
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117
Q

AVPU scale

A
  1. Alert: eyes open; able to verbalize
  2. Verbal: responds to commands or questions
  3. Painful: facial grimace, flexion, extension, or withdrawal of body part; moan or groan
  4. Unresponsive: no response
    ***as soon as you see they’re unresponsive don’t go on with further assessment
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118
Q

ABCs

A

A: airways
B: breathing
C: circulation

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119
Q

A-airway

A
  1. is it open?
  2. position of head - is it in alignment?
  3. speaking or crying - if so we know airway is opened
  4. unconscious? do a jaw thrust
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120
Q

airway management

A
  1. oropharyngeal airway - keeps tongue out of back of throat (only for unconscious)
  2. nasopharyngeal airway - use anytime
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121
Q

B-breathing

A
  1. look (chest rise)
  2. listen (breathing)
  3. feel breathe on the cheek
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122
Q

C-circulation

A
  1. do they have a carotid pulse? (check side that you are on)
  2. obvious major bleed? - put pressure
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123
Q

secondary survey summary

A
  1. rapid body scan
  2. history
  3. decision on next steps
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124
Q

rapid body scan

A
  1. major bleeds
  2. deformities
  3. anything indicating a life-threatening emergency
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125
Q

history

A
  1. what happened?
  2. pain in neck, head, back? (ask one at a time)
  3. any tingling in limbs?
  4. can you wiggle fingers and toes?
  5. does anything hurt?
    ***if yes to pain in neck/back - check for pain on palpation of spinous processes
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126
Q

call EMS if what signs are occuring

A

any 2 out of 4 red flags (or unsure)
1. central pain on palpation (spinous processes)
2. tingling/numbness/unable to move extremities
3. MOI
4. unwillingness to move (cannot move them if they say no)

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127
Q

head injury

A
  1. trauma to head
  2. pain in head
    ***head injury assessment
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128
Q

head injury assessment

A
  1. clear cervical spine first
  2. check active ROM - flexion, extension, side bending, rotation
  3. if clear, then check symptoms
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129
Q

head injury assessment - symptom check

A
  1. any pain or pressure in head?
  2. any ringing in your ears?
  3. feel dizzy?
  4. feel nauseous?
  5. anything blurry or seeing double?
    ***one symptom is considered a concussion = no RTP
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130
Q

head injury assessment - observable signs

A
  1. check ears/nose for blood or CSF
  2. look/feel for any deformities in head
  3. bruising behind ears (battles sign)
  4. black eyes (raccoon eyes)
  5. aggressive/emotional behaviour
  6. not making sense
  7. altered speech
  8. unable to focus
  9. seizure
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131
Q

head injury assessment - ocular/motor screen

A
  1. PEARL - pupils equal and reacting to light
    - cover one eye and see what happens to the other
  2. tracking - follow my finger
  3. peripheral vision
  4. ability to focus: ‘how many fingers’
    - near and far
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132
Q

head injury assessment - cognitive screening

A
  1. orientation - todays date, which team playing
  2. immediate memory - ask them to remember unrelated 3 words
  3. delayed recall - ask what those 3 words are a few minutes later
  4. concentration - ask to count backwards by 3, starting at 100
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133
Q

decision making for emergency conditions

A
  1. c-spine clear
  2. on-field assessment complete
  3. continue with head-to-toe exam and decide how to safely remove them from field
  4. complet SCAT6 on sidelines
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134
Q

what are you looking for in the head–to-toe assessment

A
  1. pain (watch facials)
  2. bleeding
  3. spasm
  4. deformities
  5. bruising/wounds
  6. distal circulation in ankle/foot
  7. distal circulation in fingers
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135
Q

major fractures and dislocations

A
  1. large bone
  2. unstable or displaced
  3. compounded fracture (open fracture)
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136
Q

what to do when someone has a major fracture or dislocation

A
  1. stabilize
  2. treat for shock
  3. call 911
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137
Q

emergency medical conditions

A
  1. diabetic emergency
  2. epilepsy/seizures
  3. asthma
  4. anaphylactic shock - food or bee
  5. heat/cold emergencies
  6. abdominal injuries
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138
Q

shock

A
  1. circulatory system fails to adequately circulate blood
  2. life threatening - medical emergency
139
Q

symptoms of shock

A
  1. pale, cool, clammy akin
  2. rapid breathing
  3. rapid and weak pulse
  4. changes in LOC/confused
  5. naseau
  6. decreasing blood pressure
140
Q

care for shock

A
  1. blanket to maintain body temperature
  2. rest in comfy position that minimizes pain
  3. have athlete lie down if necessary = increase blood to organs/brain
  4. reassure
  5. oxygen if available
141
Q

what do you do if someone has a helmet on when you are checking c-spine

A

keep it on to avoid further injury

142
Q

when do you do a non-urgent assessment

A

when emergency condition is ruled out, they are
1. alert
2. ABCs
3. no concerning head/spine MOI
4. c-spine and head assessment clear

143
Q

non-urgent conditions

A
  1. sprains
  2. strains
  3. simple fractures
  4. contusion
  5. abrasions/minor lacerations
144
Q

HOPS on field-assessment

A

History: what happened
Observation: what you see
Palpation: what do you feel? where is pain? - start gently just to identify injury
Special Test: put injury under stress to confirm suspicion

145
Q

history taking

A
  1. SAMPLE
  2. PQRST
146
Q

SAMPLE assessment

A

S- signs and symptoms
A- allergies
M- medication
P- past medical history
L- last oral intake
E- events leading up to injury

147
Q

PQRST pain assessment

A

P-provoke - what makes it worse?
Q- quality - sharp, dull, achy, burning?
R- region/radiate - does pain shoot anywhere?
S- severity (1-10) - 10 is worst possible pain (everyone different)
T- time - when did it start? is it intermittent or constant?

148
Q

history - symptoms

A
  1. what happened
  2. where does it hurt - broad or specific
  3. did you hear or feel anything (snap, crack, pop)
  4. did it give out?
149
Q

history - medications

A
  1. ask if they are on any medication and if no as what they are
  2. could the medication be dampening symptoms?
150
Q

history - past medical history

A
  1. any medical conditions
  2. have you been feeling sick lately?
  3. any previous injuries?
  4. have you hurt this area before?
151
Q

history - last oral intake

A

food
1. low blood sugar?
2. need to know if eaten if they need surgery
drink
1. dehydrated?
***what did they consume and when?

152
Q

history - events leading up to injury

A
  1. what happened
  2. did they collide with someone (gives clue that there could be another injured athlete)
  3. piece together what happened
  4. looking for MOI to indicate possible injuries
152
Q

HOPS - observations

A
  1. what do you see?
  2. whats around the athlete
  3. what position are they in (may indicate MOI)
  4. expose the injury site to check for
    - bruising/discolouration
    - swelling
    - deformity
    - bleeding
    - rashes/hives
153
Q

HOPS - palpations

A
  1. have athlete show location
  2. check distal circulation - cap refill
  3. is location warm vs the other side?
  4. do you feel a divot or deformity vs other side?
  5. check above and below injury to be sure you’re not missing anything
154
Q

index of suspicion

A

based on HOP you create an index of suspicion and confirm it with special tests
- what structure do you suspect is injured?
1. muscle
2. ligament
3. bone

155
Q

HOPS - special tests

A

what test can you do to confirm suspected injury and rate severity?

156
Q

special test for muscle/tendon

A

have the tissue contract (resisted testing 1-5)

157
Q

special test for ligament

A
  1. test to open the joint it stabilizes
  2. testing for level of stability
  3. what motion should the ligament limit?
158
Q

special test for bone

A

fracture testing

159
Q

kendalls resisted muscle testing

A
  1. rate quality of strength out of 5
  2. mark with an * if triggers pain
160
Q

kendals resisted muscle testing scale

A

0- no visible or palpable contraction
1- visible or palpable contraction
2- full ROM, gravity eliminated
3- full ROM, against gravity
4- full ROM against gravity, moderate resistance
5. full ROM against gravity, maximal resistance

161
Q

fracture test 1: tap testing

A
  1. gentle tap at location on the bone AWAY from suspected fracture site
  2. vibration may cause pain at suspected fracture site
  3. don’t test if there is a deformity
162
Q

fracture test 2: compression test

A
  1. compress the two ends of the bone together
    - direct: either end of long bone
    - indirect: compress bone around the small bone with suspected fracture (carpals/tarsals)
163
Q

fracture test 3: tuning fork

A
  1. bang the end on TF off shoe/hard surface
  2. place base of TF on bone with suspected fracture, AWAY from fracture site
  3. resulting vibration may cause pain at suspected fracture site
164
Q

tuning fork

A
  1. is able to rule out a fracture
  2. not the best technique
  3. good for out of clinic
165
Q

fracture testing inconclusive

A
  1. err on the side of caution - get an x-ray
  2. prevent secondary complications
    - further muscle/ligament injury surrounding fracture
    - nerve/vessel damage
    - major bleeds - emergency
166
Q

sideline assessment

A

more detailed than on-field HOPS assessment
1. rule out joint above and below (for muscles crossing 2 joints mostly)
2. full physiological ROM for joint
3. 3 special tests to rule out/confirm
4. more extensive palpation

167
Q

physiological ROM

A
  1. flexion
  2. extension
  3. abduction
  4. adduction
  5. internal rotation
  6. external rotation
  7. dorsiflexion
  8. plantarflexion
  9. cross-flexion
  10. cross-extension
  11. pronation
  12. supination
  13. ulnar deviation
  14. radial deviation
168
Q

accessory movements (intra-articular)

A

will not be able to get full physiological movement without the accessory movements
1. roll
2. spin
3. glide

169
Q

roll, spin, glide

A

roll: rotating across a stretch
spin: rotating in one spot
glide: non-rotating slide

170
Q

eg of the intra-articular movements

A

glenohumeral joint
- must roll upwards and slide downwards for abduction to happen in shoulder

171
Q

sideline assessment: ROM and strength

A
  1. Active ROM
    - overpressure if the end of range if full and pain-free
    - ROM must be 100% for RTP
  2. resisted testing - must be 80% for RTP
172
Q

what does it mean if they dont have full ROM

A

body is telling them something happened

173
Q

impressions

A

we cannot diagnose, so we only have an impression and must include a documentation

174
Q

what do you include in your impression documentation

A
  1. severity
  2. structure
  3. injury
  4. assessment done
  5. treatment provided
  6. plan
175
Q

plan included in the impression documentation

A
  1. RTP decision
  2. immediate care
  3. educate (reassure)
  4. communicate
  5. transport (urgent or no)
  6. referral (where to send)
176
Q

sideline management for sprains

A
  1. ice and elevation
  2. wrap (pressure pad) to support, approximate tissues, provide compression
  3. crutches for WB extremities
177
Q

sideline management for strains

A
  1. ice and elevation
  2. wrap for compression
  3. pressure pad over strained tissues to approximate ends and provide compression
  4. crutches for WB extremities
178
Q

sideline management for contusion

A
  1. ice
  2. donut pad with cover pad to protect from 2nd insult
  3. wrap padding on to area with herringbone technique
  4. NO MASSAGE (only effleurage)
  5. RTP?
179
Q

sideline management for fractures (non-urgent)

A
  1. splint (SAM - more comfy or speed)
  2. split above and below
  3. monitor for shock
  4. refer for imaging
180
Q

sideline management for abrasions

A

tefla/non-stick pad and cover-roll

181
Q

sideline management for minor lacerations

A
  1. tefla/non-stick pad and cover-roll
  2. steri-strips if it needs more support
182
Q

steri-strips

A

put them according to what your goal is RTP or clinic

183
Q

keys structures of the foot and ankle to consider following injury

A
  1. talus position - anterior
  2. cuboid position - rotated
  3. navicular position - rotated or dropped
  4. base of the 5th - tender on palpation (TOP)
  5. sesamoid bones
184
Q

plantar fascia (aponeurosis)

A

O: medial process of calcaneal tuberosity
I: proximal aspect of digits
***medial attachment is where people experience symptoms

185
Q

lateral ligaments of the ankle

A
  1. anterior talofibular lig (ATFL) - most commonly injured
  2. calcaneofibular lig (CFL)
  3. posterior talofibular lig (PTFL) - harder to injure
  4. anterior inferior tibiofibular lig (AITFL)
  5. posterior inferior tibiofibular lig (PITFL)
186
Q

what two lateral ligaments are commonly sprained together

A

ATFL and CFL

187
Q

ligaments of the medial ankle

A
  1. deltoid ligament (MCL)
  2. spring ligament (plantar calcaneonavicular lig)
188
Q

deltoid ligament (MCL)

A

4 ligs make a triangle (deltoid lig)
1. tibionavicular
2. tibiocalcaneal
3. tibiospring
4. tibiotalar

189
Q

3 layers of tibiotalar

A
  1. anterior tibiotalar
  2. posterior superficial tibiotalar
  3. posterior deep tibiotalar
190
Q

key structures to consider in the foot and ankle

A
  1. tib post (PF and INV)
  2. flexor digitorum longus (PF and toe flex)
  3. flexor hallicus longus (PF and hallicus flex)
  4. tib ant (DF and INV)
  5. peroneal (fibularis) tendons
    - peroneus longus (EV)
    - peroneus brevis (PF and EV)
  6. achilles tendon (PF)
191
Q

functional anatomy tibialis anterior

A

eccentrically lowers the longitudinal arch

192
Q

functional anatomy tibialis posterior

A

stabilizer of longitudinal arch

193
Q

functional anatomy plantar fascia

A

important for dynamic longitudinal arch support
- absorbs the forces when WB

194
Q

functional anatomy anterior talus

A

what happens up the chain?
- injury to anterior talus could cause pain up the chain

195
Q

ROM of the toes

A
  1. flexion
  2. extension
  3. abduction
  4. adduction
    *** if cannot abduct toes it’ll cause lack of base of support
196
Q

ROM of tibiotalar joint

A
  1. dorsiflexion (extension)
  2. plantarflexion (flexion)
197
Q

ROM of subtalar joint

A
  1. pronation
  2. supination
198
Q

turf toe

A

MOI: hyperextension of big toe
1. 1st MTP sprain of plantar ligs/capsule
S&S: swelling, bruising, pain, loss of toe DF ROM, weak hallux flexion
- can result in instability of 1st MTP with Gr 3 sprain

199
Q

runners toe (subungual hematoma)

A

MOI: repeat trauma to end of toes
S&S: pain and pressure under nail, discolouration of nail
1. most common in big toe
2. nail falls off
3. excessive pressure may need to be relieved
4. results from foot sliding in toe, tight or loose toe box, running downhill, toes rubbing against shoe

200
Q

prevention of runners toe

A

proper shoe fitting, varied course/terrain

201
Q

sesamoiditis

A

caused by jumping in plantarflexion repeatedly
- sesamoids act like pulleys

202
Q

MOI of sesamoiditis

A

repeat trauma to ball of foot

203
Q

S&S of sesamoiditis

A
  1. pain over sesamoids
  2. swelling (to FHB)
  3. limited big toe extension
  4. weak/painful flexion
    ***usually no bruising
204
Q

treatment of sesamoiditis

A
  1. rest
  2. treat inflammation
  3. padded insoles
205
Q

plantar fasciitis

A

role of PF: absorber, support long arch
- often present with association tight achilles (or further up chain)

206
Q

MOI of plantar fasciitis

A

poor biomechanics/overuse stress

207
Q

S&S of plantar fasciitis

A

TOP medial calcaneus or along longitudinal arch, pain with 1st steps in morning, ankle/toe DF stretch pain

208
Q

treatment of plantar fasciitis

A

find the cause
1. retrain biomechanics
2. night splints
3. orthotics

209
Q

S&S of bunions (hallux valgus)

A
  1. big toe aligns towards 2nd toe
  2. tender bump medial MTP joint
  3. inflammation
210
Q

cause of bunions

A
  1. genetics
  2. poor foot mechanics
  3. tight/narrow footwear
211
Q

when are bunions painful

A
  1. when weightbearing
  2. plantarflexion
  3. inflammation
212
Q

how can bunions be used as a red flag

A

tells us
1. footwear must be adjusted
2. improper biomechanics
***can prevent all foot mechanics by fixing foot mechanics

213
Q

how do we retrain foot biomechanics

A
  1. toe spreaders
  2. do exercises that create a stable base
214
Q

MOI for tendonitis and shin splints

A
  1. poor mechanics
  2. poor playing field
  3. overuse
    ***potential for stress fractures at muscle origin due to traction on bone
215
Q

common structures affected in tendonitis and shin splints

A
  1. peroneal tendons
  2. tibialis anterior
  3. Tib post
  4. flexor digitorum longus
  5. flexor hallicus longus
216
Q

S&S of tendonitis and shin splints

A
  1. TOP over inflamed tissues
  2. pain with running/walking
  3. pain with resisted muscle testing or stretch of affected structure
217
Q

treatment of tendonitis and shin splints

A
  1. correct foot/lower extremity mechanics
  2. taping (shin, arch)
  3. proper footwear
  4. insoles/orthotics
  5. heel lift for achilles to take tension out (both sides)
    ***combining shin and arch tape is more effective
218
Q

MOI of lateral ankle sprains

A

ankle inversion (in neutral or DF or PF)

219
Q

possible structures affected in a lateral ankle sprain

A
  1. ATFL
  2. CFL
    3.PTFL
    4.AITFL
  3. PITFL
  4. peroneals
  5. cuboid (can be pulled out by peroneals)
  6. base of 5th MT
220
Q

S&S of lateral ankle sprain

A
  1. “pop”
  2. giving out
  3. swelling (immediate)
  4. brusing
  5. limping (antalgic gait)
221
Q

sideline management for lateral ankle sprain

A

1.HOPS
2. educate
3. WB or NWB
4. support them so they can properly WB

222
Q

inflammation management for lateral ankle sprain

A
  1. limit swelling with ice/compression
  2. support with taping
  3. lymph drainage
  4. prevent second degree injuries
  5. ensure team involvement
  6. work on proprioception
223
Q

healing phase for lateral ankle sprain

A
  1. restore proper mechanics
  2. increase circulation through heat
  3. massage
  4. increase ROM
  5. shock wave therapy and ultrasound (continous)
  6. dynamic support to muscles and injured structure through exercise
224
Q

RTP for lateral ankle sprain

A
  1. psychological readiness
  2. 100% ROM, and 80% strength
  3. tape ankle and get them to do figure 8 (challenges ankle)
225
Q

MOI for medial ankle sprains

A

ankle eversion
*** doesn’t happen as often due bone structure of talus and fibula

226
Q

possible structures affected in medial ankle sprain

A
  1. deltoid lig
  2. spring lig
  3. TDH
  4. navicular (fib fracture)
227
Q

S&S of medial ankle sprain

A
  1. “pop”
  2. giving out
  3. swelling
  4. bruising
  5. limping (antalgis gait)
228
Q

treatment for medial ankle sprain

A

would be the same as lateral ankle sprain but would challenge it differently with exercise to change specific movement pattern

229
Q

fractures in the foot/ankle

A
  1. jones fracture
  2. metatarsal fracture
  3. talus
  4. calcaneus
  5. fibula
  6. tib-fib (with dislocation = urgent)
230
Q

surgical management for fractures

A
  1. unstable fracture is either
    1. redued = put back to proper spot
    2. fixated = weights and screws to stabilize it
  2. stable fracture is immobilized (not as secure)
231
Q

jones fracture

A

peroneus brevis avulsion of base of 5th MT
- ankle sprain symptoms may distract from these

232
Q

MOI of a jones fracture

A

inversion sprain (lateral ankle sprain)

233
Q

S&S of a jones fracture

A
  1. tender on palpation (TOP) base of 5th MT
  2. pain in WB
234
Q

MOI of a talus fractures

A
  1. severe ankle sprains
  2. land from height
  3. forced DF
235
Q

S&S of a talus fracture

A
  1. vary with severity
  2. pain with WB (or unable to)
  3. loss of ROM
236
Q

MOI of a calcaneus fracture

A

fall/jump from a height

237
Q

S&S of a calcaneus fracture

A
  1. extreme pain
  2. unable to WB
238
Q

MOI of a fibula fracture

A
  1. direct blow to side of the leg
  2. ankle sprain mechanism
    ***sometimes people can walk with this fracture because the fibula is not a WB bone
239
Q

S&S of a fibula fracture

A

vary with severity

240
Q

when to tape

A
  1. chronic ankle instability from previous sprains
  2. RTP following treatment of recent ankle sprain
  3. when ankle bracing doesn’t fit athletic shoe properly or a sport does not permit bracing
241
Q

ankle testing

A
  1. anterior drawer - ATFL
  2. talar tilt - CFL
  3. eversion talar tilt - deltoid lig
  4. wedge test - AITFL
242
Q

supination of foot

A
  1. talocrural
  2. sole of foot faces medially
  3. combination of PF, INV and adduction
243
Q

pronation of foot

A
  1. talocrural
  2. sole of foot faces laterally
  3. combination of DF, EV, and abduction
244
Q

knee joint

A
  1. tibiofemoral joint
  2. patellofemoral joint
  3. superior tibiofibular joint
245
Q

compartments of the lower leg

A
  1. lateral: peroneal
  2. anterior: extensor (DF) group
  3. posterior: flexor group
    - deep and superficial
246
Q

anterior compartment of the lower leg

A
  1. tib anterior
  2. extensor hallicus longus
  3. extensor digitorum longus
  4. fibularis (peroneus) tertius
247
Q

lateral compartment of the lower leg

A
  1. peroneus longus
  2. peroneus brevis
248
Q

deep posterior compartment of the lower leg

A

Tom, Dick and Harry
1. tib posterior
2. flexor digitorum longus
3. flexor hallicus longus
***dynamically stabilize the medial ankle together

249
Q

superficial posterior compartment of the lower leg

A
  1. gastrocnemius
  2. soleus
  3. achilles tendon
250
Q

intracapsular structures of the knee

A
  1. ACL
  2. PCL
  3. meniscus (medial and lateral)
  4. cartilage
  5. joint surface
251
Q

wipe test for intracapsular swelling

A
  1. helps identify if one of the intracapsular structures are affected
  2. if intracapsular structure is affected it will be full of fluid
252
Q

medial vs lateral meniscus

A

medial: c-shaped oval
lateral: round o shaped

253
Q

meniscus

A

shock absorber

254
Q

quadriceps muscle

A

muscles with lateral pull on patella
1. rectus femoris
2. vastus lateralis
3. vastus intermedius
muscles with medial pull on patella
1. vastus medialis (most injured due a natural imbalance)

255
Q

medial hamstrings

A
  1. semimembranosus
  2. semitendinosus
256
Q

lateral hamstrings

A

biceps femoris

257
Q

pes anserine group (goose’s foots)

A

adduction and to add dynamic stability on the medial side
1. semitendinosus
2. gracilis
3. sartorius

258
Q

function of the gluteus medius

A
  1. hip abduction
  2. prevents pelvis on stance side from dropping during gait (trendelenburg gait)
259
Q

anterior fibres of gluteus medius

A

internally rotate hip and assists with hip flexion
- eccentrically controls IR of femur in WB

260
Q

posterior fibres of gluteus medius

A

extend and externally rotate the hip

261
Q

what happens if glute medius is weak

A

it’ll cause pressure on knee and foot affecting things down the chain

262
Q

quads to hammy ratio

A
  1. ideally 3:2
  2. post ACL injury 1:1
263
Q

medial tibial stress syndrome (MTSS) - shin splints

A
  1. exercise-induced pain over the anterior tibia and is an early stress injury
  2. excess pull though tendons and muscles
  3. could cause stress fracture if not caught early
  4. often due to foot pattern that there is tension and traction
    - tape arches
264
Q

compartment syndrome

A
  1. excessive pressure within a muscle/fascial compartment
  2. often overlooked as shinsplints - overuse
  3. trauma following bone fracture (acute)
265
Q

S&S of the compartment syndrome

A
  1. red or pale
  2. hot
  3. shiny
  4. very painful
  5. numb
  6. weak
  7. faint pulse distal to site
266
Q

acute management for the compartment syndrome

A
  1. no pressure (need it gone)
  2. reduce inflammation
  3. no RTP
  4. NWB
  5. refer to sports med Dr.
  6. occasional need for fasciotomy to release pressure
267
Q

gastroc/soleus strains

A

overstretch in DF with knee extension especially with forceful contraction

268
Q

S&S of gastroc/soleus strain

A
  1. “pop” or “pull”
  2. sharp pain
  3. swelling and bruising
269
Q

special tests for gastroc/soleus strain

A
  1. muscle tests for gastrocs, soleus, deep flexors
  2. thompson test to rule out achilles rupture
  3. toe raises
270
Q

acute management of gastroc/soleus strain

A
  1. PIER
  2. pressure pad with wrap over injured tissues (reduce swelling and bring ends together)
  3. NWB
  4. avoid stretch
  5. avoid contraction
271
Q

can an athlete RTP with a gastroc/soleus strain

A

NO, usually self-limiting
- once rehabbed can tape with heel lift for initital RTP (both sides)

272
Q

MOI of an achilles rupture

A

sudden forceful contraction

273
Q

achilles rupture

A

common in stop and go sports - basketball, tennis, squash

274
Q

S&S of an achilles rupture

A
  1. sudden sharp pain (partial rupture)
  2. feeling of being kicked in back of leg
  3. unable to PF
  4. swelling
  5. delayed onset bruising (becomes extensive)
275
Q

special tests of an achilles rupture

A

thompson test on both sides

276
Q

acute management of an achilles rupture

A
  1. PIER
  2. NWB
  3. pressure pad over injured tissues with tensor
  4. educate
  5. refer to consult with sports med Dr.
277
Q

patellofemoral pain syndrome (PFPS)

A

most often overuse condition; occasional acute onset

278
Q

MOI of PFPS

A

poor tracking of patella in femoral condyle

279
Q

S&S of PFPS

A

TOP posterior aspect of patella

280
Q

what to check with PFPS

A
  1. mechanics from bottom up and top down
  2. stable base
  3. quad imbalance
  4. 1 leg squat
281
Q

MOI of a patellar dislocation

A

valgus force with foot planted causing internal rotation of femur

282
Q

patellar dislocation

A

most common in active children ages 10-17

283
Q

S&S of a patellar dislocation

A
  1. patella positioned on lateral side of knee
  2. significant pain
  3. usually in knee flexion
284
Q

special tests of a patellar dislocation

A

none if dislocated
- if subluxed do an apprehension test

285
Q

what do you need to do if its a 1st time dislocation

A
  1. rule out osteochondral fracture
    - can affect patella or femoral condyle
    -very common and requires surgery
286
Q

acute management of a patellar dislocation

A
  1. rule out fracture
  2. PIER if reduced
    3.refer
  3. braced in full extension for 3 weeks, then ROM and strengthening
287
Q

MOI of patellar tendonitis

A

excessive traction on patellar tendon

288
Q

S&S of patellar tendonitis

A
  1. pain
  2. swelling and heat over patellar tendon
  3. pain with jumping, running, quick change in direction or quad contraction
  4. pain with flexion and extension
  5. can often train/compete through the pains
289
Q

special tests for patellar tendonitis

A

thomas test; resisted quads

290
Q

acute management for patellar tendonitis

A
  1. PIER
  2. roll/soft tissue mobility for quads
  3. lower extremity mechanics - how are they moving for their sport
  4. train hamstrings to prevent anterior translation of tibia
    RTP: patellar tendonitis tape
291
Q

bursas

A

fluid-filled sacs that lay between areas of friction

292
Q

MOI of knee bursitis

A
  1. direct trauma
  2. friction from tight muscles/tendons
293
Q

S&S of knee bursitis

A
  1. rebound pain
  2. often painless
  3. visible fluid-filled sacs
294
Q

acute management of knee bursitis

A
  1. protect with padding to avoid repeat insult
  2. soft tissue mobility of tight muscles
295
Q

chronic bursitis

A

can develop granular rice-like texture

296
Q

MOI of stress fractures - MTSS/shin splints

A

overuse/poor mechanics

297
Q

MOI of patellar fracture

A
  1. direct blow
  2. patellar dislocation
298
Q

MOI of tibial plateau fracture

A
  1. varus or valgus load
  2. direct blow
299
Q

meniscus function

A
  1. poor blood supply
  2. cushion the joint during loading
300
Q

types of meniscus tears

A
  1. vertical
  2. transverse
  3. peripheral
  4. bucket-handle (surgical)
  5. parrot-beak
  6. flap
301
Q

MOI of a meniscus tear

A
  1. plant and twist
  2. contact
  3. wear and tear/degeneration
302
Q

S&S of a meniscus tear

A
  1. sharp pain at specific ROM - loaded rotation and deep squat
  2. catching/clicking/locking
  3. swelling (24 hours later)
303
Q

meniscus tear

A

commonly associated with ACL injuries
- bracing doesn’t work because you can’t stop rotation in a brace

304
Q

special tests for a meniscus tear

A
  1. McMurrays
  2. Apleys
  3. duck walk
305
Q

acute management for a meniscus tear

A
  1. PIER
  2. NWB
  3. educate
306
Q

ligament sprains

A
  1. MCL
  2. LCL
  3. ACL
  4. PCL
307
Q

anterior cruciate ligament (ACL)

A
  1. antero-medial aspect of intercondylar area of tibial plateau
  2. passes up and back to postero-medial aspect of lateral femoral condyle
  3. prevents anterior translation of tibia on femur and limits IR of tibia
  4. major stabilizer of the knees
308
Q

2 bundles of the ACL

A
  1. posterolateral: taught in extension with less than 30 degree rotation
  2. anterolateral: taught going into flexion and rotation
309
Q

MOI of an ACL tear

A
  1. sudden cut or pivot (rotational force)
  2. sometimes from added external force from a tackle/collision (valgus, hyperextension)
310
Q

S&S of an ACL tear

A
  1. swelling
  2. extreme pain throughout the knee
  3. difficulty/unable to WB
  4. delayed-onset bruising
311
Q

incidence of an ACL tear

A
  1. higher incidence in females vs males
  2. 30% from direct contact
  3. 70% from wrong movement
312
Q

special test of an ACL tear

A
  1. anterior drawer
  2. lachmans
  3. pivot shift (hard for the hammies to kick in)
313
Q

acute management of an ACL tear

A
  1. PIER
  2. NWB
  3. educate
    COMPRESSION - swells a lot
    NO RTP
314
Q

ACL surgery

A

depends on how unstable joints are
1. autograft (person’s tissue’s) vs allograft (cadaver)
2. bone-tendon-bone graft
3. hamstring graft (re-create ACL)
4. unilateral vs contralateral (graft from other side)
5. BEAR - new

315
Q

what is the dynamic protection of the ACL

A

the hamstrings
- need proper reconstruction of the hamstrings for ACL recovery

316
Q

BEAR

A

bridge enhanced ACL repair

317
Q

posterior cruciate ligament (PCL)

A
  1. antero-lateral aspect of medial femoral condyle within the notch inserts along posterior aspect of tibial plateau
  2. can do without, ACL is the primary stabilizer
318
Q

MOI of a PCL tear

A
  1. hyperflexion
  2. forced posterior translation of tibia on the femur
319
Q

S&S of a PCL tear

A
  1. swelling
  2. extreme pain throughout the knees
  3. difficulty/unable to WB
  4. delayed-onset of bruising
320
Q

special tests of a PCL tear

A
  1. posterior drawer
  2. sag sign (does the tibia drop with gravity)
321
Q

acute management of a PCL tear

A
  1. PIER
  2. NWB
  3. educate
322
Q

medical collateral ligament (MCL)

A
  1. superficial and deep fibres
  2. commonly associated with ACL injuries
  3. doesn’t usually need a surgery
323
Q

MOI of a MCL tear

A
  1. valgus stress on the knees (direct blow to the outside of the knee)
  2. plant and twist (with lateral rotation of femur on tibia)
324
Q

special tests of a MCL tear

A

valgus stress (0 then 30 degrees)

325
Q

acute management of a MCL tear

A
  1. PIER
  2. NWB
  3. pressure pad to approx ends
326
Q

lateral collateral ligament (LCL)

A
  1. only superficial fibres
  2. doesn’t usually need a surgery
327
Q

MOI of a LCL tear

A

varus stress to the knees

328
Q

S&S of a LCL tear

A
  1. lateral knee pain
  2. swelling
  3. TOP LCL
  4. stiffness
329
Q

S&S of a MCL tear

A
  1. medial knee pain
  2. swelling
  3. TOP MCL
  4. stiffness
330
Q

special test of a LCL tear

A

varus stress

331
Q

acute management of a LCL tear

A
  1. PIER
  2. NWB
  3. pressure pad to approx ends
332
Q

importance of strengthening dynamic stabilizers

A
  1. these are not usually reconstructed
  2. proprioception
333
Q

knee special tests

A
  1. wipe test - intracapsular swelling
  2. valgus at 0 degrees (superficial fibres) and at 30 degrees (deep fibres) - MCL
  3. varus at 0 degrees - LCL
  4. lachmans - ACL
  5. anterior drawer - ACL
  6. posterior drawer - PCL
  7. sag sign - PCL
  8. mcmurrays - meniscus
  9. apleys - meniscus
334
Q

what is vibration massage technique used for

A

over particularly tight areas or “knots”

335
Q

sensitivity of a tuning fork

A

75-92%

336
Q

specificity of a tuning fork

A

18-94%

337
Q

is tuning fork good?

A

some value it for ruling out a fracture, but not for ruling in a fracture
***false positives

338
Q

what ligaments are involved in high ankle sprains?

A

AITFL and PITFL - they keep the tibia and fibula together

339
Q

common structures affected with shin splints

A
  1. peroneal tendons
  2. tib ant
  3. TDH
340
Q

talar tilt

A

plantarflexion and inversion

341
Q

what do you do for resisted muscle testing?

A

put the structure into its opposite motion for then to resist
ex. tib ant, put them into PF and EV so they resist

342
Q
A

KNPE 331 (3 decks)

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