Ortho/Sports/MSK Flashcards
When do you need to wear eye goggles in sports?
CORRECTED vision worse than 20/40
For any sport with high risk of eye injury (basketball, baseball, hockey, lacrosse, racket sports)
Wrestling is low risk, but no eye goggles available so CANNOT participate!
Heat stroke vs Heat Exhaustion
Heat stroke: T > 40 and mental status changes
- Tx: rapid cooling ideally by immersing the affected individual in ice water until he or she becomes more responsive and core temperature is below 39°C.
Heat exhaustion: T < 40 but elevated, cramping, fatigue, tachycardia
- Tx: stop exercising and drink fluids
Syncope with myoclonic jerks VS. Seizure
Syncope with myoclonic jerks
- unresponsiveness with muscle jerking
- very rapid recovery and return to baseline
- no postictal phase
- may have some FHX leading you to think cardiac (long QT)
- needs cardiac w/u and no sports until then
Seizure
- postictal phase
- recovery less fast
- NOT an absolute contraindication to sports. Some sports swimming, diving, archery, and powerlifting, may pose a higher risk.
How should T1DM pts try to prevent hypoglycemia during exercise?
Lower their pre-exercise insulin dose or decrease their basal infusion of insulin 1 to 2 hours before exercise.
Post-exercise hypoglycemia risk typically peaks about 3 to 4 hours after exercise.
Boy who got “popped hip” with resulting pain at anterior inferior iliac spine with pain on flexion and extension of hip
anterior inferior iliac spine (AIIS) apophyseal avulsion injury
due to pediatric skeletal immaturity
In what sports are concussion rates the highest?
football
boys’ hockey
boys’ lacrosse
girls’ soccer.
Do boys or girls have a higher rate of concussion in high school sports?
GIRLS
Is rate of concussion higher during game or practice?
Game
The rate of concussion is higher during sports competition than during practice. However, because athletes typically spend more time practicing than in competition, the absolute number of concussions is often higher in the practice setting
Do helmets decrease rate of concussion?
NO.
Implementation of rules that limit player-to-player contact during practice and competition appears to be a successful strategy for reducing sports concussion.
Protective headgear, mouthguards, and helmets with increased padding have not proven effective in preventing concussions.
What is an ankle sprain?
Ligamentous injury
The anterior talofibular and calcaneofibular ligaments are the most often sprained.
The initial treatment of ankle sprain is aimed at decreasing swelling, and includes compression, ice, and elevation. Early mobilization of the joint is associated with faster recovery - so you’d recommend stir-up style brace and ROM exercises.
When should you get an XR of ankle?
unable to bear weight on the affected ankle
those with tenderness involving the tip or posterior aspect of the ankle malleoli.
How do you reduce risk of ACL tear?
Neuromuscular training program would reduce her risk
Insidious onset knee pain, tenderness over inferior pole of patella suggests what etiology
Apophysitis involving inferior pole of the patella
Patellofemoral pain syndrome
Chronic anterior knee pain without inciting injury Pain with prolonged sitting instability with running Pain with climbing/descending stairs Can be bilateral
PE: Pain over medial patella, pain with compression, mild swelling
If someone has aortic stenosis with pressure gradient < 20 and normal exercise test, what sports can they participate in?
Mild AS = all sports with annual cards re-eval
Also:
Mod AS= low dynamic and static component
Severe AS = restricted
Back pain causes in children
Most are mechanical - physical therapy
If there is anatomic cause, most likely spondylosis.
- back pain with extension and activity