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ATR2010 > Quiz 4 [CH 13, 14, 15] > Flashcards

Quiz 4 [CH 13, 14, 15] Flashcards

1
Q

acute injury

A

-caused by trauma
-we can typically refer to a single event when the injury occurred

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2
Q

chronic injury

A

-generally results from overuse
-injuries that occur with repetitive dynamics of running, throwing, or jumping

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3
Q

diaphysis

A

main shaft of the bone
-middle part of bone

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4
Q

epiphysis

A

located at the ends of long bone
-growth areas

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5
Q

what are the growth areas of a bone

A

epiphysis

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6
Q

articular cartilage

A

covers the ends of bones to provide cushion + protection during movement

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7
Q

what 2 bones have articular cartilage + what does it do

A

femur + tibia
-absorbs shock

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8
Q

periosteum

A

covers long bones exept at joint surfaces

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9
Q

osteoblasts

A

bone forming cells

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10
Q

osteoclasts

A

absorb + remove osseus tissue

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11
Q

fractures

A

occur as a result of extreme stresses + strains placed on bones

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12
Q

how can fractures be classified

A

open or closed

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13
Q

open fx

A

bone protruding out of skin

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14
Q

closed fx

A

fracture doesn’t penetrate superficial tissue

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15
Q

signs + symptoms of fx

A

-obvious deformity
-point tenderness
-swelling
-pain with active + passive ROM

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16
Q

transverse fracture

A

occurs in a straight line

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17
Q

see image of each type of fx (ch13 ppt, slide 6)

A
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18
Q

linear fracture

A

bone splits along its length
-caused by shear forces

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19
Q

what forces cause linear fracture

A

shear forces

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20
Q

oblique fracture

A

occurs when 1 end receives sudden torsion/twisting, + the other end is fixed/stabilized
-nondisplaced: stays in place
-displaced: bone broken in 2

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21
Q

spiral fractures

A

has an “s” shaped separation

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22
Q

greenstick fracture

A

complete breaks in bones that have no completely ossified

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23
Q

greenstick fx occurs in what population

A

-occurs more often in children
-because they have a lot of collagen in their bones
-collagen keeps the bone springy, making the bone harder to fully break

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24
Q

comminuted fracture

A

consists of 3 or more fragments at the fracture site
-bone breaks into a bunch of different pieces
-needs a lot of force to occur + compression

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25
Q

if you got into a car accident + knees went into dash in front of you, what fracture most likely would occur

A

comminuted

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26
Q

what can long bones be stressed by

A

-tension
-compression
-bending
-torsion
-shear

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27
Q

in most cases, what must happen to the fractured bone for an extended period

A

the fx bone must be immobilized for an extended period

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28
Q

how long will long bones be immobilized after fx

A

4-6 weeks

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29
Q

how long will small bones be immobilized after fx

A

3-4 weeks

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30
Q

what is one of the most common fx that results from physical activity

A

stress fractures

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31
Q

common sites for stress fx

A

weight bearing bones of leg or foot

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32
Q

how do stress fx occur

A

repetitive forces transmitted through the bones produce irriation of the periosteum

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33
Q

do stress fx show up on x-ray

A

can be difficult to diagnose
-might not show up on x-ray

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34
Q

treatment for stress fx

A

stop activity for at least 14 days + slowly progress back to activity

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35
Q

dislocation

A

occurs when at least 1 bone in a joint is forced completely out of its normal alignment + must be manually or surgically reduced

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36
Q

subluxation

A

occurs when bone partially comes out of its normal articulation but then goes right back into place

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37
Q

what do both dislocation + subluxation likely result in

A

rupture of stabilizing ligaments + tendons surrouding the joint

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38
Q

what should first time dislocation be wary of

A

fx

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39
Q

2 common sites for dislocations/subluxations

A

-shoulder
-knee

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40
Q

difference between dislocation + subluxation

A

-dislocation won’t reset on its own
-subluxation does reset on its own, automatically

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41
Q

what 3 joints are the hardest to put back into place + require imaging

A

-ankles
-elbows
-hips

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42
Q

sprain

A

involves damage to a ligament that provides support to a joint

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43
Q

ligament

A

tough inelastic band that connects 1 bone to another

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44
Q

grading system for ligament sprains

A

-grade 1
-grade 2
-grade 3

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45
Q

grade 1 ligament sprain

A

some stretching with minimal instability of the joint
-mild to moderate pain with localized swelling

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46
Q

grade 2 ligament sprain

A

some tearing + separation of ligament fibers with moderate instability
-moderate to severe pain
-also called “partial tear”

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47
Q

grade 3 ligament sprain

A

total tearing of the ligament which leads to instability
-severe pain
-joint becomes stiff

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48
Q

does pain go away faster in grade 2 or grade 3 sprains

A

goes away faster in grade 3 because in grade 2, pain receptors are still sending signals since partially holding on

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49
Q

contusion

A

aka bruise
-mechanism of injury that involves an impact from some external object that causes soft tissue to be compressed against hard bone

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50
Q

myositis ossificans

A

-if the same muscle is bruised repeatedly, small calcium deposits can accumulate in the injured area
-can significantly impair movement

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51
Q

what 2 muscles are most vulnerable for myositis ossificans

A

-quadriceps
-biceps brachii

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52
Q

muslce strain

A

if a muscle is overstretched or forced to contract against high loads, separation or tearing of the muscle fibers occur

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53
Q

grading system for muscle strains

A

-grade 1
-grade 2
-grade 3

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54
Q

grade 1 muscle strain

A

few muscle fibers have been stretched/torn
-some tenderness + pain on active motion
-full ROM usually possible

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55
Q

grade 2 muscle strain

A

several muscle fibers have been torn + active contraction is extremely painful
-possible swelling + discoloration

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56
Q

grade 3 muscle strain

A

complete rupture of a muscle
-signficant impairment
-loss of ROM
-pain initially but dies down due to nerve fiber separation

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57
Q

guarding

A

following injury, the muscles that surround the injured area contract to in effect splint the area + minimize pain by limiting movement

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58
Q

cramps

A

extremely painful involuntary contractions that most commonly occur in the calf, abdomen, or hamstrings

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59
Q

what 3 muscles do cramps most often occur in

A

-calf
-abdomen
-hamstrings

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60
Q

soreness

A

pain caused by overexertion in exercise

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61
Q

acute-onset soreness

A

occurs during + immediately after exercise

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62
Q

delayed-onset soreness (DOMS)

A

occurs 24-48 hours post exercise

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63
Q

nerve injuries usually involve ____ or ____

A

compression or tension

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64
Q

responses produced by nerve injuries

A

-diminished sense of feeling
-increased sense of feeling
-numbness, prickling, or tingling

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65
Q

neuropraxia

A

sudden nerve pinch or stretch can produce both a sharp shooting pain that radiates down a limb + muscle weakness
-called a stinger

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66
Q

what can serious injuries involving the crushing of a nerve cause

A

lifelong disability such as paraplegia

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67
Q

most common overuse/chronic injuries involve a ____

A

tendon

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68
Q

tendinitis

A

inflammation of the tendon
-general inflammatory response
-only been around 6 weeks or less

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69
Q

tendinosis

A

microtears + degeneration of the tendon
-repetitive overuse continues + the inflamed/irritated tendon fails to heal, the tendon begins to degenerate

-has been around for a longer period of time, usually minimum 6 weeks
-doesn’t necessarily have continuous inflammatory response but rather repetitive damage

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70
Q

tenosynovitis

A

inflammation of a tendon + its synovial sheath
-when inflammation occurs, tendons adhere to synovial sheath + cause pain

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71
Q

what does the synovial sheath usually do

A

reduces friction for movement

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72
Q

where does tenosynovitis most commonly occur

A

in the long flexor tendons of the fingers

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73
Q

bursae

A

pieces of synovial membrane that contain a small amount of fluid
-lubricate + cushion joints for fluid motion

-basically water baloons in your body that provide shock absorption

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74
Q

bursitis

A

due to repetitive movement or direct trauma, large amounts of synovial fluid are produced

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75
Q

is bursitis chronic or acute

A

can be both chronic + acute

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76
Q

is bursitis an inflammatory condition

A

yes

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77
Q

are there more bursae or articular cartilage in the body

A

bursae

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78
Q

osteoarthritis

A

wearing down of hyaline cartilage
-can be worn down enough, exposing, eroding, + polishing the underlying bone

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79
Q

osteoarthritis most often affects what joints

A

weight bearing joints
-knees
-hips
-lumbar spine

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80
Q

is osteoarthritis common in athletes

A

no because younger populations
-more common in professional athletes like NFL + MBA because older in professional career

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81
Q

myofascial trigger points

A

area of tenderness in a tight band of muscle
-palpation of trigger points produces pain

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82
Q

what causes development of myofascial trigger points

A

develops due to mechanical stress
-static postural position that produces constant tension in the muscle

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83
Q

what are 3 places were myofascial trigger points typically occur

A

-neck
-upper back
-lower back

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84
Q

importance of healing process following injury

A

any interference with the healing process during a rehab program is likely to slow return to full activity

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85
Q

is it possible to speed up healing process

A

-you can’t necessarily speed up the process physiologically
-however, you can create an environment conducive to the healing process

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86
Q

3 phases of the healing process

A
  1. inflammation
  2. proliferation
  3. maturation
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87
Q

healing process- inflammation

A

when it is uncomfortable + often results in swelling, the inflammatory process is crucial for removing damaged cells + beginning tissue repair
-first 48-72 hours

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88
Q

healing process- proliferation

A

in the proliferation phase, collagen is formed + granulation occurs (laying down new CT + tiny blood vessels)
-next 6 weeks

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89
Q

healing process- maturation/remodelling

A

finally the maturation/remodelling stage, which may last up to 2 years, allows new collagen to be synthesized + results in the formation of scar tissue
-next 2 years

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90
Q

timeline of healing process

A

-inflammation- first 48-72 hours
-proliferation- following 6 weeks
-maturation/remodelling- 2 years

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91
Q

how many bones in the foot

A

26 bones

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92
Q

how many tarsal bones in the foot

A

7

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93
Q

how many metatarsal bones in the foot

A

5

94
Q

how many phalangeal bones in the foot

A

14

95
Q

be able to identify tarsal bones + arches of the foot on both a skeleton + outside of foot (ch 14 powerpoint slides 2 + 3)

A
96
Q

tarsal bones (7)

A

-talus
-calcaneus
-navicular
-cuboid
-3 cuneiforms (medial, intermediate, lateral)

97
Q

arches of the foot

A

-medial longitudinal
-metatarsal
-transverse
-lateral longitudinal

98
Q

medial longitudinal arch

A

along the medial border of calcaneus, extending to the distal head of the first metatarsal
-spring ligament is the main support

99
Q

what is the main support of the medial longitudinal arch

A

spring ligament

100
Q

plantar fascia

A

thick white band of fibrous tissue extended the entire bottom of the foot

101
Q

medial movements of foot

A

-adduction
-supination

102
Q

what muscles produce medial movements of foot (adduction/supination)

A

muscles passing behind + in front of medial malleolus
-posterior tibialis

103
Q

lateral movements of foot

A

-abduction
-pronation

104
Q

what muscles produce lateral movements of foot (abduction/pronation)

A

muscles passing behind + in front of lateral malleolus
-peroneal muscles

105
Q

plantar muscles of foot cause what movement

A

toe flexion

106
Q

dorsal muscles of foot cause what movement

A

toe extension

107
Q

how can many injuries to the foot be prevented

A

by using an orthotic device to correct biomechanical problems

108
Q

what should be performed routinely by athletes in sports that place a great deal of stress + strain on the feet

A

strenthening, stretching, + mobility exercises

109
Q

majority of foot skin conditions are ____

A

preventable
-proper hygiene
-washing/drying feet following activity
-changing to clean socks

110
Q

assessment of the foot- history

A

-how did the injury occur?
-did it occur suddenly or come on slowly?
-what type of pain is there?
-on what type of surface has the athlete been training on?
-is this the first time your foot has been injured?

111
Q

what is sharp pain indicative of

A

soft tissue injury or fx

112
Q

single most important predictor of injury

A

if athlete has had injury before

113
Q

if you take a good history…

A

you should be able to narrow down to top 5 diagnoses at most

114
Q

assessment of the foot- observation

A

-athlete favoring a foot
-ability to bear weight
-swelling, discoloration
-wear patterns on inside of shoe

115
Q

know wear patterns (ch 14 ppt slide 7)

A
116
Q

assessment of the foot- palpation

A

-check bony structures first for deformities or areas of point tenderness
-the dorsal pedal pulse should be palpated to check for normal circulation

117
Q

retrocalcaneal bursitis

A

bursa between achilles tendon + calcaneus becomes irritated by constantly rubbing or pressure from the heel of a shoe

118
Q

signs of retrocalcaneal bursitis

A

-swelling
-warmth
-redness
-TTP at the calcaneus

119
Q

care for retrocalcaneal bursitis

A

donut shaped pad to disperse pressure created by heel counter

120
Q

heel bruise

A

caused by direct blow to heel (acute or chronic)
-often caused by cleats

121
Q

signs of heel bruise

A

-severe pain at the heel
-unable to tolerate stress of weight bearing

122
Q

care for heel bruise

A

-cryotherapy initially
-heel cup for protection

-athlete will be out for a while since they cannot weight bear

123
Q

plantar fasciitis

A

caused by leg legnth discrepancies, inflexibility of the medial longitudinal arch, calf tightness, or shoes without arch support

124
Q

signs of plantar fasciitis

A

-pain along plantar aspect of foot
-pain in morning after waking up
-pain intensifies when dorsiflexed

125
Q

why is there severe pain in mornings for patients with plantar fasciitis

A

because we sleep slightly plantarflexed

126
Q

care for plantar fasciitis

A

-stretching of gastroc, soleus, + achilles tendon
-night splint to gently stretch the plantar fascia

127
Q

fractures of metatarsals

A

caused by direct force (stepped on) or twisting/tortional stress

128
Q

what is the most common metatarsal fx

A

Jones fx
-neck of the 5th metatarsal

129
Q

signs of metatarsal fx

A

-swelling + pain
-point tender
-needs x-ray to diagnose

130
Q

care for metatarsal fx

A

-POLICE- protect, optimal load, ice, compress, elevate
-short leg walking cast for 3-6 weeks
-potentially surgery if displacement fx

131
Q

Jones fx

A

fracture of the neck of the 5th metatarsal caused by inversion or high-velocity rotational forces

-athlete complains of sharp pain on lateral foot + hearing a “pop”
-poor blood supply, could result in nonunion

132
Q

care for Jones fx (displaced + nondisplaced)

A

-nondisplaced- non-weight bearing case for 6-8 weeks

-displaced- surgery

133
Q

second metatarsal fx

A

also called March fx (named in 1855 due to Prussian soldiers on long marches)

-pain + point tenderness
-overuse injury
-modified rest + non-weight bearing

134
Q

longitudinal arch strain

A

caused by subjecting foot to unaccustomed stresses when coming in contact with hard playing surfaces

135
Q

signs of longitudinal arch strain

A

pain only when running below the medial malleolus + posterior tibialis tendon

136
Q

care for longitudinal arch strain

A

-POLICE
-arch taping
-reduction of weight bearing

137
Q

metatarsal (transverse) arch strain

A

caused by:
-hypermobility
-fatigue
-poor posture
-excessive weight
-improperly fitted shoes

138
Q

signs of metatarsal (transverse) arch strain

A

pain in metatarsal region

139
Q

care for metatarsal (transverse) arch strain

A

apply pad to elevate depressed metatarsal heads

140
Q

fx + dislocation of the toes- cause

A

kicking an object, stubbing toe, or direct blow to the toes

141
Q

fx + dislocation of the toes- signs

A

-swelling + discoloration
-pain weight bearing

142
Q

fx + dislocation of the toes- care

A

-involving 1 or more toes, cast for 3-4 weeks
-reduction of dislocated toe performed easily by physician without anesthesia

143
Q

bunions (hallux valgus)- cause

A

painful deformity of the head of the first metatarsal (big toe)
-occurs from wearing shoes that are pointed + too narrow

144
Q

bunions (hallux valgus)- signs

A

-tenderness
-swelling
-enlargement

145
Q

bunions (hallux valgus)- care

A

-shoe selection plays important role in treatment
-night splints to correct position of the great toe

146
Q

what sport do we see bunions the most in

A

soccer

147
Q

Morton’s neuroma

A

mass occurring in the plantar nerve, aka neuroma

148
Q

where is Morton’s neuroma most common

A

between 3rd + 4th metatarsals

149
Q

signs of Morton’s neuroma

A

-severe intermittent pain radiating from the distal MT heads to the tips of the toes
-pain relieved when not weight bearing
-burning numbness

150
Q

Morton’s neuroma- care

A

tear drop shaped pad is placed between the 2 MT heads to have the toes spread apart while weight bearing

151
Q

turf toe

A

hyperextension injury resulting in sprain of the great toe from overuse or trauma

152
Q

turf toe- care

A

-flat insoles that have thin sheets of steel under the forefoot
-taping the toe to prevent further dorsiflexion

153
Q

if an athlete has less severe turf toe, can they play

A

yes, continue to play

154
Q

if an athlete has more severe turf toe, can they continue to play

A

no- out for 3-4 weeks

155
Q

ingrown toenail

A

nail growing into soft tissue resulting in inflammation + infection

156
Q

ingrown toenail- signs

A

-swelling
-heat
-aching

157
Q

how can ingrown toenail be prevented

A

by trimming nails properly + straight across

158
Q

subungual hematoma (blood under toenail)

A

-blood can accumulate as a result of toe being stepped on or dropping an object on the toe
-area under toenail appears bluish-purple color

159
Q

our ankles provide us with ____ information

A

proprioceptive

160
Q

prevention of lower-leg + ankle injuries- stretching

A

-achilles tendon
-gastroc
-soleus

161
Q

prevention of lower-leg + ankle injuries- strengthening

A

ex: 4-way ankle

162
Q

prevention of lower-leg + ankle injuries- neuromuscular control

A

-relies on CNS to interpret proprioceptive information + then to control individual muscles + joints to move properly
-ex: balance exercises

163
Q

prevention of lower-leg + ankle injuries- footwear + tape

A

-shoes worn for activity intended
-protection

164
Q

what 3 bones make up the ankle

A

-tibia
-fibula
-talus

165
Q

be able to identify tibia, fibula, talus (ch15 ppt slide 4)

A
166
Q

talocrural joint

A

aka ankle
-tibia, fibula, talus

167
Q

movements of talocrural joint

A

-plantarflexion
-dorsiflexion

168
Q

subtalar joint

A

talus + calcaneus

169
Q

movements of subtalar joint

A

-inversion
-eversion

170
Q

be able to identify ligaments (ch15 ppt slide 5)

A
171
Q

lateral ligaments of ankle/lower leg

A

-ATFL
-CFL
-PTFL

172
Q

medial ligaments of ankle/lower leg

A

deltoid ligaments

173
Q

most ankle sprains occur due to what movement

A

inversion
-thus, lateral ligaments are injured

174
Q

majority of ankle sprains occurs to what ligaments

A

lateral ligaments
-ATFL
-CFL
-PTFL

175
Q

an eversion ankle sprain would tear what ligaments

A

deltoid ligaments (medial)

176
Q

compartments of muscle

A

-anterior
-lateral
-superficial posterior
-deep posterior

177
Q

most common place for compartment syndrome

A

anterior cmopartment

178
Q

assessment of ankle joint- history

A

-what trauma or mechanism occurred?
-did you hear a sound- snap, crackle, pop?
-prior history of injury?

179
Q

assessment of ankle joint- observation

A

-obvious deformity
-discoloration
-swelling
-obvious pain
-ROM

180
Q

assessment of ankle joint- palpation

A

start with key bony landmarks then progress to ligaments + muscles

181
Q

bump test

A

rules out fx for ankle joint

182
Q

anterior drawer test

A

tests ligament stability in plantarflexion/dorsiflexion directions

183
Q

talar tilt test

A

tests ligament stability for inversion/eversion directions

184
Q

assessment of ankle joint- functional examination

A

if the athlete has difficulty performing the following activities, they aren’t ready for RTP:
-walk on toes
-walk on heels
-hop on affected foot
-stop + start running
-change of direction

185
Q

inversion/eversion ankle sprains are more common

A

inversion

186
Q

inversion sprains- what ligament is the weakest + most commonly sprained ligament

A

ATFL

187
Q

why are eversion sprains less common than inversion

A

due to bony + ligamentous anatomy

188
Q

do inversion/eversion sprains take longer to heal

A

eversion

189
Q

high ankle sprain

A

anterior + posterior tibiofibular ligaments involved
-injury most often occurs in forced dorsiflexion + ER of the foot
-extremely hard to treat + can take months

190
Q

ankle sprains- signs

A

-swelling
-tender to palpation
-may have inability to bear weight
-pain
-joint stiffness

191
Q

ankle sprains- care

A

-POLICE
-returning to activity should be a gradual progression of functional activities

192
Q

ankle fractures

A

caused by several mechanisms:
-direct blow
-inversion/eversion

193
Q

ankle fx- signs

A

-immediate swelling
-point tenderness
-athlete apprehensive when bearing weight

194
Q

ankle fx- care

A

-refer for x-ray
-immobilization

195
Q

assessment of lower leg- history

A

-how long has it been hurting?
-where is the pain or discomfort?
-any numbness or tingling?
-feeling of warmth?

196
Q

numbness/tingling in the lower leg directly relates to ____

A

compartment syndrome

197
Q

what emergency do we worry most about in the lower leg

A

compartment syndrome

198
Q

assessment of lower leg- obesrvation

A

-postural deviations
-walking difficulty
-obvious deformities

199
Q

assessment of lower leg- palpation

A

-musculature in the 4 compartments
-tibia
-fibula

200
Q

bump test

A

test for fx of lower leg

201
Q

squeeze test

A

test for fx in lower leg

202
Q

thompson test

A

used to determine rupture of the achilles tendon

203
Q

achilles tendon ruptures are usually which grade

A

grade 3

204
Q

achilles tendon ruptures are commonly seen in what sport

A

gymnastics

205
Q

what bone of lower leg carries most of your weight

A

tibia
-big weight bearing bone

206
Q

what is the most commonly fractured long bone in body

A

tibia

207
Q

tibial + fibular fractures

A

usually the result of direct trauma to the area or of indirect trauma such as rotation + compression

208
Q

tibial + fibular fractures- signs

A

-immediate pain
-swelling
-possible deformity (open or closed)

209
Q

tibial + fibular fractures- care

A

splint to immobilize + immediate referral to hospital

210
Q

shin splints (medial tibial stress syndrome)

A

stress reaction of the distal 2/3 tibia

211
Q

shin splints (medial tibial stress syndrome)- signs

A

-initially may only hurt after an intense workout
-as it worsens, may have pain throughout normal daily activities
-can progress to stress fx

212
Q

shin splints (medial tibial stress syndrome)- care

A

-modification of activity
-correction of foot mechanics
-stretching program
-referral to physician for bone scan

213
Q

if shin splints are left untreated, what can occur

A

can become stress fx

214
Q

compartment syndrome

A

increased pressure in 1 of the 4 compartments of the lower leg which causes pressure on the muscular + neurovascular structures of the leg
-if you get too much pressure on the neurovascular strecture, acts like a tourniquet + cuts off blood supply

215
Q

can compartment syndrome cause loss of a limb

A

yes

216
Q

compartment syndrome- what compartments are commonly involved

A

-anterior
-deep posterior

217
Q

3 types of compartment syndrome

A

-acute
-acute exertional
-chronic

218
Q

acute compartment syndrome

A

-medial emergency
-direct blow

219
Q

acute exertional compartment syndrome

A

occurs without any trauma

220
Q

chronic compartment syndrome

A

usually occurs during running + jumping
-worse after activity

221
Q

compartment syndrome- signs

A

-deep aching pain due to compression
-tightness
-swelling
-reduced circulation

222
Q

compartment syndrome- care

A

-immediate first aid
-compression wrap should NOT be used due to compression already causing pain
-measurement of intercompartmental pressure by physician confirms diagnosis
-surgery to release pressure (fasciotomy)

223
Q

describe swelling in compartment syndrome

A

one calf would be bigger than the other

224
Q

describe reduced circulation in compartment syndrome

A

dorsal pedal pulse would be different on one of the sides

225
Q

tendinitis

A

inflammatory condition occurring from repetitive stress placed on the tendon such as running or jumping

-general pain + stiffness
-tendon may be warm + painful
-can take increased amounts of time to resolve
-NSAIDs may help

225
Q

what basic emergency care is counter-productive for compartment syndrome

A

compression wrap

226
Q
A
227
Q

achilles tendinitis or rupture- which sounds like a gun shot

A

rupture

228
Q

achilles tendinitis or rupture- which requires surgical repair

A

rupture

229
Q

what population is achilles rupture most common in

A

males above age 30

230
Q

time difference for tendinitis vs tendinosis

A

-tendinitis is first 6 weeks
-tendinosis is fter first 6 weeks

ATR2010 (11 decks)

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