Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sports Injuries > Midterm 2 > Flashcards

Midterm 2 Flashcards

You may prefer our related Brainscape-certified flashcards:
Sports Trivia flashcards
1
Q

What 4 pairs of ranges of motion are relevant when assessing shoulder girdle injuries

A
  1. Flexion and extension
  2. Adduction and abduction
  3. Internal and External rotation
  4. Cross-flexion and Cross-extension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

AC Joint Sprain (seperated shoulder)
MOI, Muscular response, Role of gravity, Clinical presentation

A

MOI
- Direct blow to shoulder (on acromion process)
- FOOSH
MUSCULAR RESPONSE
- Increased activation of upper traps
- Decreased activation of rotator cuff
GRAVITY
- gravity acts to pull arm down, which is attached to scapula, but additional force on damaged ligaments
CLINICAL PRESENTATION
- Localized pain, bruising, swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Rockwood Classifications

A

TYPE 1
- only damage to AC joint capsule and ligament
- CC still good
- won’t look deformed
TYPE 2
- AC joint capsule and ligament destroyed
- Damage to CC
TYPE 3
- Almost entirely, if not fully destroyed CC
- AC gone
- Could potential also have damaged to connecting fibers of anterior deltoid and upper/middle traps
OTHER TYPES RESULT IN SURGURY AND HAVE TO DO WITH DIRECTION OF DISPLACEMENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

SC joint injury

A
  • can range from sprain to sublux to dislocation
  • similar MOI to AC joint sprain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Clavicle Fractures

A
  • commonly partnered with AC joint injury
  • most common to occur in middle third (80%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What factors impact the likelihood of a fracture?

A
  • low bone density
  • small cross-sectional area
  • at a point where shape is changing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What important structures may be involved if a clavicle fracture occurs

A
  • Lungs
  • trachea
  • esophagus
  • Carotid artery
  • brachial plexus
    In general neurovascular structures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Glenohumeral Dislocation MOI

A
  • abduction 90+, cross extension, external rotation
  • stretch GH ligaments
  • most common to occur anteriorly where hummerus moves anterior and inferior
  • can also be directly inferior or posterior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Glenohumeral Dislocation Clinical Presentation

A
  • Clear deformity in deltoid contour
  • Subject will often want to grab arm
  • significant difficulty moving (dead feeling)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Continuum of instability (GHI)

A

range from sprain to subluxation to dislocation
SUBLUXATION
- feel a shift
- almost shift out of joint but not quite
DISLOCATION
- committed to leaving joint cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What other structures should be considered with a GH dislocation

A
  • GH ligaments
  • Tendons of RC (mostly subscapularis)
  • Axillary Nerve (if dislocation goes inferiorly)
  • Bankart Lesions (Damage to posterior-inferior aspect of labrum)
  • Hill-Sachs Lesion (Compression fracture to humeral head
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bankart Lesions

A
  • When dislocation occurs labrum is pulled with humeral head causing damage to the 6 to 9 O’clock region
  • Occurs in up to 80% of first time dislocations (especially in young individuals)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hill-Sachs Lesion

A

When dislocation occurs, posto-lateral aspect of humeral head is compressed against glenoid when trying to pop back in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Structures possibly damaged with AC joint sprain

A
  • Deltoid attachment
  • Upper traps attachment
  • AC ligament
  • AC joint capsule
  • CC ligaments
  • Brachial Plexus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which motions will hurt the least with an AC joint sprain

A

Internal and external rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which motions are most likely to produce pain with an AC joint sprain

A
  • Sagittal Flexion (elevation of shoulder girdle)
  • Cross- flexion (protraction)
  • Cross- extension (Retraction)
  • Abduction (elevation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ranges of motion most likely to produce pain with anterior GH dislocation

A
  • External rotation
  • Cross-extension
  • Abduction
    Recreate MOI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Paxino’s Sign test

A

Posteriorly translate clavicle and anteriorly translate the acromion to test the AC joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical presentation of chronic shoulder condition

A
  • Pain on edge of acromion, vague pain in deltoid region, pain in posterior scapula just below acromion process
  • Aggravated by sport-specific training (often overhead sport)
  • aggravated by ADL involving shoulder movement (reaching, overhead movement, sleeping positions)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Impingement condtions

A
  • Mechanism of chronic injury in the shoulder involving the pinching of tissues
  • progressively leads to breakdown, tendinopathy and possibly bursitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Sub-acromial impingement (SAI) - What is it and where is it located

A
  • Reduction in sub acromial space associated with overhead arm positions
  • Space optimized when arm is down and decreased when arm is raised
  • margins of this space marked by superior head of humerus, coracoacromial ligament and some of acromion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What structures are most likely to be compromised within the subacromion

A
  1. Supraspinatus tendon ( anterior portion)
  2. Subacromial Bursa
  3. Tendon of the long head of the biceps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a bursa

A

Little fluid sack filled that acts similar to a synovial membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are some mechanical factors that can cause SAI?

A
  1. Scapular Mechanics
    - Not enough superior rotation of the scapula
    - insufficient posterior tilt (responsible for getting the acromion out of the way of the humerus when lifting arm)
  2. Excessive anterior translation of humerus (catches on anterior margin of subacromial sapce)
  3. Reduced acromio-humeral distance (based on individual differences)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Posterior Internal Impingement

A
  • Pinching between posterior edge of glenoid rim and posterior aspect of humeral head
  • Tissues get caught between the two i the vulnerable position
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Possible structures involved in PII

A

Posterior and superior structures:
1. Supraspinatus
2. Infraspinatus
3. Labrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Position leading to PII

A

90 degrees abduction and external rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

MOI PII

A

When placed in vulnerable position of shoulder, posterior tissues get gathered and pinched by GH joint and then lifted/sucked in as joint humerus continues to rotate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Mechanics that may increase risk of IIP

A
  1. Excessive Scapular protraction (must pull GH joint apart rather than move shoulder girdle)
  2. Excessive Cross-extension (Also leads to pulling apart GH joint, not moving shoulder girdle)
  3. Glenohumeral internal rotation deficiency (GIRD) (arch of movement shifted backwards)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the odds ratio for PII if GIRD > 10 degress

A

1.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What range of motion is most likely to be painful with supraspinatus tendonopathy?

A

Active and resisted abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which special test is used for supraspinatus tendinopathy?

A

Empty can and full can

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What ROM is most likely to be painful with infraspinatus pathology

A
  • Active and resisted external rotation
  • Passive internal rotation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Where is the pain located of SAI

A
  • Inferior and maybe anterior to acromial process
  • Into deltoid region
  • maybe posterior shoulder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What ROM would be painful for long head of biceps tendonopathy

A
  • Active and resisted flexion of GH in sagittal plane
  • Passive Extension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What special test is used to test the long head biceps tendon

A

Speed’s test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the special test for SAI

A

Hawkin’s Kennedy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the special test that will show labral tear

A

O’Brien and maybe Speed’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is involved in the MOI of a posterior dislocation of the elbow

A
  1. Axial loading (always)
  2. Extended elbow
  3. Valgus (not always but more common than varus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Simple vs complex posterior elbow dislocation

A

Complex dislocation also involves some level of dislocation in the radius or ulna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Clinical presentation of Elbow dislocation

A
  • Deformation
  • Loss of ability to move
  • Swelling/bruising
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the actually movement that occurs when dislocating an elbow

A

Ulna moves posterior relative to humerus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What ligaments are associated with elbow dislocation

A

Most Likely: MCL complex (limits valgus)
Potentially:
- Anular ligament
- LCL complex
- Lateral ulnar collateral ligament
- Radial Collateral ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Other than ligaments, what other structures may get damaged in an elbow dislocation

A

Capsular sprain
Tendon damage
- Biceps
- Brachioradialis
-Pronator teres
- Wrist flexors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Valgus Extension Overload syndrome (VEOS or VEO)

A
  • Common in overhead throwing athletes
  • Chronic medial or posteromedial elbow pain
  • Sensations: Locking or catching, crepitus
  • Results in reduced throwing velocity
  • pain primarily occurs at ball release
  • Natural valgus with extension of elbow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

MOI of VEOS

A

Overhead throwing with Valgus stress and tensile load

47
Q

What other structures may become damaged with VEOS

A
  • Wrist flexors or pronator teres
  • Ulnar nerve, median nerve
48
Q

At what 2 points does valgus elbow stress peak in throwing cycle

A
  1. Late cocking phase: at point of peak external roation of GH - ball in hand
  2. Acceleration phase: depends on elbow flexion angle at release - those who reach full extension in release are at higher risk
49
Q

What 3 areas of the elbow are effected by VEOS

A
  1. Stretching of the MCL complex
  2. Pinching of olecranon process and its fossa
  3. Compression of radio-humeral joint
50
Q

What is Osteophyte (bone spur) development and where does it occur with VEOS

A

Margins of the bone become bumpy as pieces break off - occurs mostly on olecranon process

51
Q

What is Chondromalacia and where does it occur with VEOS

A

Breakdown of cartilage (not breaking off, just sick) - mostly at radio-humeral head

52
Q

What is Osteochondritis Dissecans

A

Breaking off of bone and Cartilage which floats around joint - occurs mostly at radio-humeral joint

53
Q

Lateral Epicondylalgia

A
  • Common in tennis players ( aggravated by backhand stroke and pain may spread into dorsal forearm
  • Aggravated by tasks that require gripping
  • can be brought on by changes in equipment
54
Q

What muscle is associated with lateral epicondylalgia

A

Extensor Carpi Radialis brevis
- Origin: lateral epicondyle
- Insertion: base of the 3rd metacarpal

55
Q

What changes occur to the tendon with tendinopathy

A
  • Disrepair and progressive degeneration
  • Increased CSA
  • Decreased stiffness
  • less competent with ECC
56
Q

How can wrist position contribute to eccentric loading with lateral epicondylalgia

A

Extensors must fight wrist flexion when fingers are flexed and ulnar deviation

57
Q

What 2 ROM tests are most likely to be painful if you have has a posterior elbow dislocation

A

Active and passive Extension

58
Q

What 3 ROM tests are most likely to be painful if you have strained your distal biceps tendon

A
  • A and R Flexion
  • A and R Supination
  • Passive elbow extension
59
Q

If you experience neurological damage following an elbow dislocation, which nerve is most likely to be affected

A

Ulnar
- tingling and numbness on ulnar side into pinky
Median
- tingling and numbness on radial palmar side
- middle finger to thumb

60
Q

What do VEOS and posterior elbow dislocation have in common

A

Damage to MCL complex

61
Q

Which two active and resisted tests are most likely to be positive for an athlete with lateral epicondylalgia

A

wrist extension and radial deviation

62
Q

Which passive test is most likely to be positive for an athlete with lateral epicondylalgia

A

Wrist flexion and ulnar deviation

63
Q

How is a sports-related concussion classified

A

Mild traumatic brain injury

64
Q

How long does it take SRC symptoms to present

A

May present immediately or evolve over minutes or hours, commonly resolve within days but may be prolonged

65
Q

Clinical Presentation of concussion

A
  1. Symptoms
    - Physical, mental, emotional
  2. Cognitive Deficits
    - Orientation, memory and concentration
  3. Motor Deficits
    - Co-ordination and balance
66
Q

Structural overview of the brain

A
  • A tethered organ (via spinal cord)
  • Texture like nearly ripe avocado
  • In a shallow bath of about half a cup of CSF (same consistency as water)
  • High H2O content (70 to 75% giving tissue squishiness)
  • Grey soma on outside, white axons on insde
67
Q

What are the 3 MOI of a SRC

A

External forces applied to body through different mechanisms transferring mechanical energy to brain
1. Moving object strikes head
2. Head strikes a stationary object
3. Head acceleration-deceleration without direct head contact

68
Q

Cause of pathophysiology

A

Mechanical energy transferred onto brain causes angular acceleration around axis located in neck
- Causes grey matter to move with acceleration
- stretches white matter as it tries to follow grey matter

69
Q

Pathophysiology through mechanoporation

A

Stretching of axons mechanically opens ion channels allowing ions to flow through and disrupt homeostasis - K+ out and Na+/Ca++ in
- Causes depolarization - facilitating communication between neurons and leading to an acute release of glutamate
- Na-K pumps require energy to restore ion balance leading to increased energy demand

70
Q

Pathophysiology in the mitochondria

A
  • Calcium gets in the way of mitochondrial function
  • Blocks aerobic production of energy must switch to anaerobic (glycolysis) but lack of blood flow
71
Q

Pathophysiology cerebral blood flow

A

Decreases with concussion, limiting delivery of glucose which is needed for anaerobic metabolism

72
Q

What is the clinical and physiological time to recovery after concussion

A

Physiological imprint out lasts clinical symptoms
- Clinical symptoms on average 14 days
- Cerebral blood flow up to 30 days or even a year

73
Q

Emergency Head trauma situations

A
  • Includes skull fractures or intracranial hematomas
    WHAT TO WATCH OUT FOR:
  • Severe and worsening headache
  • Vomiting
  • Impaired pupil response
  • Fluid Leaks and bruising (eyes and ears)
74
Q

What is the relative risk of concussion for participants wearing interventional protective equipment compared with those that wore standard or no protective equipment

A

RR= 0.82 CI 0.56 to 1.2 with a p=0.30

75
Q

What is the relative risk of superficial head injury in participants that wore interventional protective equipment relative to their counterparts?

A

RR= 0.41 CI 0.31 to 0.56 p<0.0001
- Helmet decrease impact but doesn’t stop whipping head around

76
Q

What is the average time until a concussion patient is symptom free in daily living

A

14 days

77
Q

What is the average time until a concussion patient can return to sport

A

20 days

78
Q

What drop is understudied in recovery periods of concussions and why is this significant

A

Para sport athletes
- Different MOI

79
Q

Persistent post concussion symptoms (PPCS)

A
  • Symptoms lasting beyond 4 weeks
  • Occurs in up to 30% of children and adults (value drops with athletes - could be a result of under reporting)
80
Q

What variables are thought to influence prognosis

A
  • Severity: initial symptom burden
  • Age: Children have longer recover times compared to adults
  • Gender
  • History of concussion
81
Q

Acute testing of concussions

A

Using SCAT 6
- Useful for diagnosis, but not assessing recovery
- used by health care professionals

82
Q

Assessing recovery of concussions

A

Test physiological and clinical presentation
- Cerebral blood flow
- Balance
- Coordination
- Functional capacity in daily living and sport
- Visual and cognitive improvements

83
Q

RTS stages

A
  • 6 stages
  • Minimum 24 hours at each stage
  • If symptoms worsen, return to previous stage
84
Q

RTS Stage 1

A

Active Rest
- Occurs with symptoms present
- ADL activites like walking
- Shouldn’t make symptoms worse
- 24- 48 hours post-injury

85
Q

RTS Stage 2

A

Light Aerobic
- Up to 55% MHR, then 70% MHR
- Stationary bike (don’t need balance)
- Walking
- Light resistance

86
Q

RTS Stage 3

A

Sport-specific Exercise
- Done individually (lower risk)
- More Movement
- Running
- Drills/ running patterns/ direction changes (increase cognitive load)

87
Q

RTS Stage 4

A

Non-Contact Drills
- Risk of physical contact is introduced
- Symptom-free and monitored closely
- Done with team
- High intensity
- More coordination
- Cognitive load
- Must get medical clearance to move to next step

88
Q

RTS Stage 5

A

Full Contact Practice
- Requires medical clearance
- No symptoms and closely monitored

89
Q

RTS Stage 6

A

Return to Competition
- Requires medical clearance
- No symptoms and closely monitored

90
Q

Exercise as medicine

A
  • Psychological and social benefits
  • Physiological
  • Normalize autonomic function (CBF or PNS/SNS balance)
91
Q

Buffalo Concussion Treadmill Test

A
  • Use VAS for baseline Symptoms
  • Walk at 5 km/h with increasing incline (1 degree per min)
  • Measure HR, RPE, VAS
  • Determine when patient reaches threshold based on 90% of age predicted max HR, 17/20 RPE, 3 increase from baseline VAS
  • HR at threshold is used to prescribe exercise regime
  • 80% of threshold for 20 min 5 days a week for 2 weeks and then re-assess
92
Q

What is HR variability

A
  • Beat to beat variability in time and frequency
93
Q

How does HRV change following concussion

A
  • Decreases in HRV for 1 to 2 weeks
  • Increase in SNS and decrease in PNS
  • Causes symptoms of anxiety and difficulty sleeping
94
Q

Spinal Cord Injury

A
  • MOI: Compression, contusion, or distraction of spinal cord
  • Can be complete or incomplete loss of motor and/or sensory function
  • Level of injury determines where the deficits will lie - distal function impaired
95
Q

What are common ways to sustain a spinal cord injury

A
  • Axial load
  • High velocity fall on pelvis
  • ZA joint dislocation
  • Spinal fracture
96
Q

In what sports are cervical spinal cord injures most prominent

A

Hockey, Skiing, diving, football
- also prominent in horse-riding and snowboarding

97
Q

What half of the spinal cord holds most motor information and which half holds most sensory information

A
  • Ventral = motor
  • Dorsal = Sensory
98
Q

Cervical Cord Neuropraxia

A
  • MOI: Cervical hyperflexion or hyperextension
  • Mimics the signs and symptoms of cervical SCI, but transient in nature
  • Reverses within minutes to 24-48 hours (could be up to 2 weeks tho)
  • Sometimes called Spinal cord concussion cause it mimics the physiology and metabolic disfunction
99
Q

Neurapraxia

A
  • axon still fully intact
  • Epineural protective layer been stressed but still connected
  • Function able to return within max 2 weeks
100
Q

Axonotmesis

A
  • Axon broken - interrupts signal
  • Epineural layer stressed but still intact
  • Up to 3 months recover
101
Q

Neurotmesis

A

Both axon and epineural layer broken
- 1 year + recover

102
Q

Congenital Spinal Stenosis

A
  • Narrowing of the vertebral foramen
  • Determined by comparing the diameter of the spinal canal to vertebral body - normally 1:1 ratio
  • Canal 80% of vertebral diameter with stenosis
  • more likely stressed
103
Q

What conditions are associated with congenital spinal stenosis?

A
  • Cervical Cord Neuropraxia
  • Brachial Plexus Neuropraxia
104
Q

Brachial Plexus Neuropraxia

A
  • MOI
    1. Traction mechanism (pull apart)
    2. Compression Mechanism (Nerve roots get compressed) - often associated with extension mechanism
    3. Direct blow (to exposed plexus between Clavicle, sternocleidomastoid and upper trapezius)
  • Burner/stinger sensation
  • Most commonly effects C5 and C6
  • Unilateral pain, paresthesia, numbness, weakness
  • Decreased cervical ROM, with pain
  • Most RTP under 24 hours
105
Q

What is the range of spinal nerves involved in the brachial plexus

A

C5-T1

106
Q

How to test Neurological Injuries

A
  • Check sensory using dermatomes with sharp and dull objects
  • Check motor using myotomes with resistance tests graded out of 5
107
Q

Def: Dermatome

A

An area of skin that a specific spinal nerve collects sensory information from

108
Q

Dermatomes C5 to T1

A
  • C5: lateral side of elbow and upper arm
  • C6: Finger 1 and 2, radial side of forearm
  • C7: Finger 3
  • C8: Fingers 4 and 5
  • T1: Ulnar side of elbow and forearm
109
Q

Def: Myotome

A

A joint action produced by a group of muscles that rely heavily on the motor messages traveling along that spinal nerve

110
Q

Myotome Patterns C5 to T1

A
  • C5: Elbow flexion
  • C6: Wrist extension
  • C7: Elbow extension
  • C8: finger flexion
  • T1: Finger abduction
111
Q

Expected AC sprain recover timeline

A

4 weeks for every Rockwood type

112
Q

Reoccurrence rates for Shoulder injury operative vs non-operative

A

6% for operative
47% for non-operative

113
Q

Sling Support

A
  • Up to 10 days or until comfortable without
  • Recurrent instability, higher odds for some groups
  • Sling duration may have little impact on recurrence
114
Q

ER vs IR immobilization

A

RR risk ratio 0.56
In those aged 20 to 40 but not younger than 20 years
- 10 degrees?

Sports Injuries (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions